The differential effect of three auditory stimuli on the frequency of stuttering behaviors

In view of the frequent clinical use of external auditory stimuli in fluency building programs, the purpose of the present experiment was to compare the effects of rhythmic pacing, delayed auditory feedback, and high intensity masking noise on the frequency of stuttering by dysfluency type. Twelve normal hearing young adult stutterers completed an oral reading (approximately 250 syllables) and conversational speech task (3 min) while listening to the three auditory stimuli and during a control condition presented in random order. The results demonstrated that during oral reading all three auditory stimuli were associated with significant reductions in stuttering frequency. However, during conversational speech, only the metronome produced a significant reduction in total stuttering frequency. Individual dysfluency types were not differentially affected by the three auditory stimuli.     

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.     

Behavioral engineering: stuttering as a function of stimulus duration during speech synchronization

Past studies have shown that stuttering is eliminated when speech is synchronized with a metronomic beat, but the speech sounds artificial. The present study investigated the effect of increasing the duration of these individual stimulus beats with the stimulus-off period constant at 1 sec. When subjects were instructed to speak during the stimulus-on period, stuttering was an inverse function of stimulus duration, indicating that the known metronome effect on stuttering is one point on a continuum of effective rhythm procedures. The "naturalness" of speech increased as the stimulus duration increased up to durations of about 2 sec, and then decreased. At optimal values, stuttering was greatly reduced and naturalness and rapidity of speech were retained. These optimal values effectively controlled stuttering in a field test that used two types of specially designed portable instruments, one of which produced a tactual stimulus and the other an auditory stimulus.     

Vocal changes in stutterers and nonstutterers when speaking to children

Within the last few years, considerable attention has been devoted to the possibility that the amelioration of stuttering in many novel speaking conditions is a function of vocal changes with or without accompanying modifications in prosodic expression. These formulations have made reference primarily to conditions in which stutterers were induced into one or another novel speech pattern by an external stimulus such as masking noise, a rhythmic cue, or by instructions to sing, or read in unison with another speaker. In contrast, far less attention has been paid to other ameliorative conditions that lack a novel external stimulus or special instructions that direct the stutterer to speak in some unique manner. Speaking or reading to a child is an example of this latter type of condition. The present study was conducted to see if nine adult stutterers and a matched group of nonstutterers would evince vocal changes as they read aloud to another adult, a child, and a child and adult together. There was also a fourth control condition wherein the subjects read to one of the experimenters. Dependent measures of disfluency and stuttering, fundamental frequency, fundamental frequency deviation, fluent reading rate, and peak vocal sound pressure level were made and treated statistically. The major findings of this study indicated that, relative to the control condition, both subject groups exhibited several vocal changes when reading to a child alone and to a child and adult together. In addition, the stutterers experienced a reduction in disfluency, but only when reading to the child alone. The normal speakers exhibited too few disfluencies in the control condition for any meaningful change to occur in that dependent variable. The fact that the stutterers evinced vocal changes in both experimental conditions but a significant drop in disfluency in just one bears importantly on hypotheses that emphasize vocal changes in conditions that ameliorate stuttering.     

The effects of pacing and masking on stutterers' and nonstutterers' speech initiation times

The present study was undertaken to determine whether pacing and masking would facilitate improved speech initiation times (SITs) both for stutterers and for nonstutterers. All subjects were tested in control, pacing, and masking conditions. The results showed that both stutterers and nonstutterers (1) improved their SITs during the pacing condition as compared with the control condition (p = 0.01), (2) had slower SITs in the masking condition as compared with the control condition (p = 0.05), and (3) had faster SITs during the pacing as compared with the masking condition (p = 0.01). The SIT between-group findings demonstrated that stutterers were slower than nonstutterers across all SIT conditions (p = 0.08). The discussion of these results centers on the facilatory nature of novel stimulation in modifying speech-system functioning.     

Rate changes in the speech of stutterers after therapy

The fluent speaking rate of nine adult male stutterers was compared before and after stuttering intervention. The subjects, ranging in age from 18 to 37 yr (mean, 25 yr, 3 mo), exhibited mild to severe stuttering prior to treatment. The only rate reduction strategy taught to subjects during intervention was to slow the first phoneme or syllable of sentences spoken. In addition, however, subjects significantly reduced their overall rate as determined by measurements made of their fluent speech at the middle of sentences, as well as overall sentence durations (excepting the first word of utterances). The data from this investigation are interpreted relative to the facilitation/simplification hypothesis.     

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.     

The relationship between treatment exposure times and changes in stuttering frequency during contingent stimulation

Four adult stutterers were exposed to 60 consecutive minutes of verbal contigent stimulation. In each session subjects spoke until a stuttering frequency stability criterion was met (baserate) followed by 60 min of exposure to the word wrong presented contingently upon each instance of stuttering. The data were analyzed according to changes in stuttering which occured following 20, 40, and 60 min of treatment exposure. The results revealed that stuttering frequency was reduced for all subjects during all three 20-min segments of the treatment condition. The only significant reductions in stuttering frequency, however, occured within the first 20 min of treatment.     

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.     

The effects of punishment of repetitions and the acquisition of “stutter-like” behaviors in normal speakers

The purpose of this study was to determine if a punishing stimulus, presented contingent upon repetitions, would cause normal speakers to develop behaviors that are “stutter-like,” resembling the secondary reactions often observed in stutterers. Ten normal-speaking adult males spoke spontaneously during a 15 minute A-B-A (base rate-punishment-withdrawl) single subject experiment. Repetitions decreased when the stimulus “you repeated” was made contingent upon their occurrence, but several other behaviors, “stutter-like” in nature, surfaced. As a less spontaneous speaking style was adopted, speech rate decreased significantly. Within a few minutes, the subjects developed some avoidant behaviors that may be characteristic of stuttering. The results were interpreted as having at least one therapeutic implication that could be particularly troublesome. The data seem to indicate that when clinicians focus solely on the reduction of repetitions in stuttering therapy, they may be generating avoidance behaviors that facilitate the development of stuttering.     

Differential levels of speech and manual dysfluency in adults who stutter during simultaneous drawing and speaking tasks

We examined the disruptive effects of stuttering on manual performance during simultaneous speaking and drawing tasks. Fifteen stuttering and fifteen non-stuttering participants drew continuous circles with a pen on a digitizer tablet under three conditions: silent (i.e., neither reading nor speaking), reading aloud, and choral reading (i.e., reading aloud in unison with another reader). We counted the frequency of stuttering events in the speaking tasks and measured pen stroke duration and pen stroke dysfluency (normalized jerk) in all three tasks. The control group was stutter-free and did not increase manual dysfluency in any condition. In the silent condition, the stuttering group performed pen movements without evidence of dysfluency, similar to the control group. However, in the reading aloud condition, the stuttering group stuttered on 12% of the syllables and showed increased manual dysfluency. In the choral reading condition stuttering was virtually eliminated (reduced by 97%), but manual dysfluency was reduced by only 47% relative to the reading aloud condition. Trials where more stuttered events were generally positively correlated with higher manual dysfluency. The results are consistent with a model in which episodes of stuttering and motor dysfluency are related to neural interconnectivity between manual and speech processes.     

The effect of SpeechEasy on stuttering frequency in laboratory conditions

The effect of SpeechEasy on stuttering frequency during speech produced in a laboratory setting was examined. Thirteen adults who stutter participated. Stuttering frequencies in two baseline conditions were compared to stuttering frequencies with the device fitted according to the manufacturer's protocol. The fitting protocol includes instructions for deliberate use of vowel prolongation. Relative to the initial baseline condition, stuttering was reduced by 74%, 36%, and 49% for reading, monologue, and conversation, respectively. In comparison, stuttering was reduced by 42%, 30%, and 36%, respectively with the device in place, but before participants were instructed to deliberately prolong vowels. Examination of individual response profiles revealed that although stuttering reduced in the device compared to the baseline conditions during at least one of three speech tasks for most participants, degree and pattern of benefit varied greatly across participants. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) discuss recent research in altered auditory feedback that led to the development of SpeechEasy, (2) analyze and describe issues related to evaluating the treatment benefits of fluency aids, and (3) summarize the range of outcomes that were observed with SpeechEasy in this study.     

Auditory processing and perceptual abilities of “organic” and “functional” stutterers

The present investigation was undertaken to determine whether significant differences in auditory processing and perceptual abilities exist between (1) stutterers as a supposedly homogeneous group when compared with controls, (2) two differentiated subgroups of stutterers, and (3) either of the stuttering subgroups when separately compared with controls. Dichotic listening and masking level difference (MLD) tasks were administered to the two groups of school-age stutterers and an age-matched nonstuttering control group. Stuttering subjects were differentiated into “organic” and “functional” subgroups on the basis of neuropsychological test performances. Organic stutterers performed significantly poorer than did controls on one MLD experimental condition. Functional stutterers performed more like control subjects than like organic stutterers.     

Electroencephalographic and dichotic indices of cerebral laterality in stutterers

To test the hypothesis that stuttering is the product of faulty cerebral laterality four experiments were performed on each of five adult stutterers and five fluent speakers. These tests were: (1) dichotic listening with consonant-vowel pairs, (2) alpha recording over both hemispheres during the performance of cognitive tasks intended to engage preferentially the left or right hemispheres, (3) contingent negative variation with either an articulatory or bilaterally symmetrical response, and (4) readiness potential with the same responses. The results fail to disconfirm the null hypothesis regarding stutterers and their fluent peers. All subjects showed consistent patterns of cerebral laterality indicative of localization of speech function in the left hemisphere. Suggestions are made regarding a possible contribution of deficient sensorimotor integration in stuttering.     

A comparison of syntax in young stutterers and nonstutterers

This study compares the syntactic structure of the spontaneous speech of a small group of stutterers and nonstutterers, using a method of constituent analysis. Speech samples were taped during play sessions with subjects, and the tapes were then transcribed and analyzed according to preselected constituent criteria. The stutterers were in the early stages of stuttering and had been diagnosed as stutterers by experienced clinicians. The method of analysis proved to be highly reliable. Differences were found in the number of complete clauses, the number of complex sentences, and in clause types between the two groups.     

Syntactic influences on stuttering in young child stutterers

This study examined the location and rate of stuttering in the spontaneous speech of nine young stutterers (4.0–6.6 yr) in relation to certain aspects of syntax. It was designed to answer the following questions: Is there more stuttering at clause onset (boundary) than at other points in the clause? Does the type of clause influence rate of stuttering? Is there more stuttering on complex than on simple sentences? The syntactic analysis defined 10 clause types (seven pertaining to complex sentences and three pertaining to simple sentences); clause boundaries (taking into account “filler” words occuring in such positions); and hierarchical constituent structure within sentences. Stuttering was found with significantly greater frequency at clause boundaries than at internal (nonboundary) positions of clauses. This was apparent for nine of the 10 clause types, the exception being complement clauses. The word “and” at the beginning of simple and complex sentences provoked a high rate of stuttering. The hierarchical structure within the clause did not influence the location of stuttering, and sentence complexity was not a factor in the rate of stuttering.     

Vocal changes in stutterers and nonstutterers during monotoned speech

For years, reports have circulated that stutterers experience marked decrements in their stuttering when they speak or read in monotone. Wingate has suggested that the ameliorative effects of various novel speaking conditions on stuttering can be attributed to modifications in vocalization induced by such conditions. The present study was conducted to see whether this explanation would extend to monotoned speech as well. Ten teenage and adult stutterers and 10 normal speakers were tested in control and monotone reading conditions. Dependent measures were the frequencies of disfluency and stuttering, fundamental frequency, fundamental frequency standard deviation, vocal SPL, vocal SPL standard deviation, and fluent reading rate. Only within-group statistical comparisons were made, because members of the two groups could not be matched pairwise along critical vocal parameters. The major findings of this study indicated that across the two conditions, both groups significantly reduced their fundamental frequency, fundamental frequency standard deviation, vocal SPL and vocal SPL standard deviation. Only the stutterers exhibited a significant decrement in disfluency and stuttering. The normals did not evince enough disfluency in the control condition for a reduction to occur during monotoning. Neither group effected a reduction in fluent reading rates. These and other findings and interpretations are discussed relative to Wingate's modified vocalization hypothesis.     

Word-by-word analysis of observer agreement utilizing audio and audiovisual techniques

The purpose of this study was to compare audio and audiovisual techniques of analyzing stuttering behavior using a recently developed index of agreement (Young, 1975). Twenty speech pathologists identified moments of stuttering for ten adult stutterers using both audio and audiovisual methods. Although no statistically significant differences existed between the two conditions, the listeners had more difficulty identifying moments of stuttering during the audio condition when mild stutterers were used.