Effects of right hemisphere damage in an adult stutterer

One thesis on stuttering states that stuttering results from hemispheric imbalance of language. Some authors have reported stutterers who ceased stuttering following unilateral neurosurgical procedures, thereby correcting this imbalance. The first case of a stutterer in whom a right hemisphere stroke subsequently developed is reported here. The effects of the stroke on his speech production are discussed.     

Stuttering onset after laryngectomy

Two cases of onset of stuttering subsequent to laryngectomy are reported. These patients demonstrate that the existence of a larynx is not necessary for the generation of stuttering. The findings support the hypothesis that neuromotor control of sound source (laryngeal or alaryngeal) plays a critical role in the generation of stuttering-type dysfluencies and, perhaps, even in the onset of stuttering. They also suggest that dramatic alteration in sound source has the potential for dramatically altering fluency.     

Dichotic testing of cerebral dominance in stutterers

Matched groups of right-handed male stutterers and controls received dichotic presentations of CVs and melodies on two occasions. Right ear advantages were obtained for CVs and left ear advantages for melodies, without significant differences between groups. However, a significantly greater number of stutterers than controls consistently failed to show the expected ear laterality for either type of material.     

Effects of stuttering on fundamental frequency

The purpose of this study was to systematically investigate quantitative fundamental frequency measures prior to moments of stuttering, and relate these measures to the severity and type of stuttering. A repeated readings adaptation procedure was employed to acquire samples of the stuttered and identical fluent speech of stutterers. Thirty-six utterance pairs were classified by type of stuttering (absence of phonation, prolongation, or repetition). A fundamental frequency meter was sampled by a microprocessor computer system at a rate of 256 samples/1.024 sec. Four temporal periods (each 256 msec) preceding the stuttering block were compared with the same periods in a fluently produced sample of similar speech. The analyses revealed differences relative to mean fundamental frequency, variation around the mean fundamental frequency, and the number of voiced data points contained within each temporal segment. The results of this study confirm the existence of acoustic changes in the vocal production of stutterers prior to overt blocks. These changes relate to the type of block that follows. Individual variations that emphasize the need for analyses of within subject differences were found.     

Dementia in Parkinson disease: A neuropsychological analysis

An extensive set of neuropsychological measures was administered to 60 Parkinson's disease patients and age-, sex-, and education-matched controls in order to investigate the nature and prevalence of the cognitive deficit in the disease. Parkinsonian patients performed significantly poorer on all measures with the exception of tests for apraxia and object recognition, and on a test of vocabulary knowledge. Discriminant analysis of the test data revealed that over 93% of patients are impaired relative to matched controls, but that assigning a prevalence rate for dementia in the disease may be difficult due to the continuous distribution of cognitive deficits.     

Effects of simulated stuttering on listener recall

In an investigation of the effects of simulated stuttering on listener recall, a presentation was varied on two factors: degree of stuttering (mild or severe) and information value of stuttered words (low or high). A control presentation featuring non-stuttered speech also was prepared. Five groups of 16 subjects were randomly assigned to, and participated in, one of the five listening conditions. Then they completed a 20-item recall test. A one-way analysis of variance revealed sognificant differences among the five conditions. Two-way analysis of variance disclosed no main effects. However, a significant interaction showed that recall was lowest in the severe stuttering-high information condition. The results are discussed in terms of attention to critical information.     

A case report on the use of flooding in stuttering therapy

The last several years have seen the development and use of anxiety-reduction procedures in stuttering therapy. Among these types of methods, systematic desensitization and reciprocal inhibition have been employed almost exclusively. Emotional de-conditioning by means of flooding or implosive techniques has been attempted far less often. This article presents a case report on the utilization of the flooding tactic. Results are offered and discussed relative to the question of whether the elimination of anxiety is a realistic goal in therapy. The suggestion is offered that what many stutterers may really need to develop is the ability to generate fluency-enhancing behaviors in spite of the presence of heightened emotionality.     

Tokens for stuttering

Four young stutterers were observed during 10 weekly sessions. Each session was divided into pretreatment, treatment, and posttreatment segments. Redeemable tokens were administered contingent upon stuttering behaviors in the treatment segment of the Experimental condition. In a Parallel Control condition, no tokens were administered during the entire session. The differences between the pretreatment and treatment segments were compared for the two conditions. Three subjects had dramatically fewer stuttering behaviors when tokens were being administered, while the fourth had more stuttering under the same condition. The subject whose stuttering increased had a history of therapy in which voluntary, “faked” stuttering had been called for, and the behaviors that increased were judged to be of this type. The decreases were interpreted as suggesting that the contingent tokens acted to countercondition the aversiveness of the stuttering experience, which reduced the anticipation of stuttering and hence the stuttering itself. The increase was felt to be simple reinforcement. The counterconditioning interpretation was borne out in two clinical applications in which money was presented contingent on stuttering behaviors judged to be aversive to the stutterer, and in which dramatically sudden, but long-lasting, improvement was seen.     

Learning from negative outcomes in stuttering therapy: I. Getting off on the wrong foot

Considering the long history of research into stuttering, it is surprising that so little time has been devoted to the study of factors that contribute to the success of therapy. Even less attention has been devoted to uncovering forces that promote poor treatment outcomes. In this article and the companion piece that follows it, an attempt has been made to delineate what may prove to be predictors of unsuccessful therapy. In this first of the two articles, the focus in on the identification of patient, extraclinical, and clinician variables that could act to negate progress during the establishment phase of treatment.     

Teacher attitudes toward stuttering

Attitudes of 100 elementary school teachers toward stuttering were studied using the Teacher Attitudes Toward Stuttering (TATS) Inventory. Teacher attitudes, as indicated by TATS Inventory scores, were compared with teacher knowledge of stuttering, age of teacher, number of years teaching experience, educational level, and whether the teacher had personal experience with a stutterer. Results indicated that significant positive correlations existed between teacher attitudes toward and knowledge of stuttering. Significant negative correlations were demonstrated between teacher attitudes/knowledge of stuttering and the presence of a stuttering child in the classroom. The applicability of the TATS Inventory as a clinical instrument in its current form and the research needed to enhance its flexibility are discussed.     

The identification of stuttering: Can you look and tell

This investigation focussed on how observers identify stutterers. It was found that stutterers are identified most correctly under visual circumstances as compared to auditory and combined auditory-visual conditions. Therefore, the reduction of stuttering should include removal of noticeable, interfering, and unnecessary nonverbal behaviors, particularly mouth and nostril movements.     

Complex decision making: A longitudinal study of process and performance

Two studies using a computer-simulated, strategy-formulation game and business students were conducted using simultaneous verbal protocols. It was found that a number of information-processing and information-evaluation thought processes were significantly related to game performance. Consistent with what is known about individual decision making, the present results suggest that, for the task used in this study, individuals who engage in causal analysis perform better than those who do not. But those who focus on negative emotions, blindly repeat previously successful decisions, and engage in illogical through processes perform more poorly than those who do not. Causal replication using real managers within organizational settings, however, is needed before firm conclusions can be drawn from this research.     

Case report of stuttering acquired in association with phenytoin use for post-head-injury seizures

Previous research indicates that stuttering and deficits in motor performance may be associated with the use of phenytoin (Dilantin). The present report concerns a case of stuttering acquired in association with phenytoin use for post-head-injury seizures. The extent and nature of dysfluencies and the motor performance of speech and nonspeech muscle systems were evaluated over an extended period during which changes in anticonvulsant medication were made. Reductions in dysfluency levels and improved motor performance were observed following a medication change from phenytoin to carbamazepine. Performance on tests assessing nonmotor functions, such as memory and attention, was equivalent before and after the medication change. The apparent association between dysfluency levels, motor performance deficits, and phenytoin suggest that in the present case stuttering resulted in part from a general impairment in motor control.     

Bibliography of literature pertaining to the onset,development, and treatment of stuttering during the preschool years

This bibliography consists of clinical, experimental, and theoretical papers pertaining to the onset, development, and treatment of stuttering in children five- years old and younger. It is a downward extension of Silverman, F.H., Bibliography of literature pertaining to stuttering in elementary-school children, Journal of Fluency Disorders, 1978, 3, 87–102.     

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.     

The effect of punishment on a factor I stuttering behavior

On each of five days the subject of this experiment read aloud different material during an 18-min A₁ (base rate), B (experimental), and A₂ (extinction) period. No stimulation was delivered during the first three days. On the fourth day, the nonsense word “norg” was presented noncontingently during the experimental period. There was no statistically significant difference between the A₁ and B periods on any of these four days. On day five, “wrong” was made contingent on Factor I prolongations during the experimental period. As a result, there was a statistically significant increase in their frequency. When the response consequence was removed in the A₂ priod, there was a reliable reduction in prolongations and the frequency closely approximated that found in the A₁ period. These data suggest that response-contingent negative stimulation is contraindicated as a clinical tactic for use with Factor I prolongations. It not only failed to suppress them, it increased their frequency.     

The relevance of DAF-induced speech disruption to the understanding of stuttering

The literature on delayed auditory feedback (DAF) repeatedly makes reference to the occurence of disfluencies under DAF in nonstutterers. However, no attempt has been made to determine the relative frequency of occurence of various types of disfluencies in nonstutterers under DAF. The present study investigated the frequency of occurence of various types of disfluencies in normal-speaking subjects in five successive oral readings under DAF. Twenty-four young adults read aloud a prose passage five times successively under 200 msec of bilateral DAF. Measures of the frequency of different types of disfluencies, locus of occurence of disfluencies in the speech sample, adaptation and consistency indicate that DAF-induced disfluencies are remarkably similar to those found in stuttering. It is suggested that DAF and stuttering disrupt speech at approximately the same “level” along the speech production process, possibly at the prosodic level.     

The effects of situational performance constraints on intrinsic motivation and satisfaction: The role of perceived competence and self-determination

Situational performance constraints, task interest, and pay contingencies were manipulated in a laboratory study in order to investigate the cognitive mechanisms associated with the previously observed detrimental effects of constraints on affective task reactions. It was hypothesized that feelings of task competence and self-determination would account for both the direct and the interactive effects of constraints on motivation and satisfaction. The results of the study indicated that despite the fact that participants' performance was being constrained and they were aware of these constraints, the mere presence of the constraints alone failed to result in lower levels of satisfaction or motivation on a proofreading task. Post hoc analyses suggested that the constraints, in fact, led to negative affective task reactions when they also reduced participants' feelings of competence and self-determination. Interestingly, participants' generalized locus of control was associated with such effects. Internals tended to maintain stronger feelings of competence and self-determination than externals in the presence of constraints, thereby also maintaining greater motivation and satisfaction.