Measuring lexical diversity in children who stutter: application of vocd

There is growing but equivocal evidence that the language abilities of young children who stutter (CWS) may be depressed when compared to those of their fluent peers. In particular, the lexical skills of CWS have variously been reported to be weaker or stronger than comparison children in a number of recent studies. One source for such disagreement may be the measures used to compute lexical characteristics of these children's spoken conversations. In this study, we examined the concurrent validity of two measures of lexical diversity in spontaneous language samples, Type-Token Ratio (TTR) and the newly developed utility vocd (Malvern & Richards, 1997), using a standard test of expressive vocabulary as the comparison measure. Findings indicated that vocd values ("D") correlated well with standardized measures of expressive vocabulary, while TTR values did not. In addition, both the standardized measure and vocd revealed significantly poorer expressive lexical skills of CWS, whereas TTR analyses did not evidence this difference. Results are discussed in relation to the relative strength of vocd over TTR as a method for describing lexical characteristics of the spontaneous language samples of this population. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) identify several common measures of conversational vocabulary and the strengths and weaknesses of each, and (2) compare the performance of the young CWS in this study to their normally fluent peers in terms of vocabulary performance on both formal and conversational measures of vocabulary.     

A parent-report scale of behavioral inhibition: Validation and application to preschool-age children who do and do not stutter

PurposeThis two-part (i.e., Study 1, Study 2) study investigated behavioral inhibition (BI) in preschool-age children who do (CWS) and do not (CWNS) stutter. The purpose of Study 1 was to develop the Short Behavioral Inhibition Scale (SBIS), a parent-report scale of BI. The purpose of Study 2 was to determine, based on the SBIS, differences in BI between CWS and CWNS, and associations between BI and CWS’s stuttering frequency, stuttering severity, speech-associated attitudes, and stuttering-related consequences/reactions.MethodParticipants in Study 1 were 225 CWS and 243 CWNS with the majority of them being included in Study 2. In Study 2, a speech sample was obtained for the calculation of stuttering frequency and severity, and the parents of a subset of CWS completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (Vanryckeghem & Brutten, 2007), and the Test of Childhood Stuttering Disfluency-Related Consequences Rating Scale (Gillam, Logan, & Pearson, 2009).ResultsStudy 1 analyses indicated that SBIS is a valid and reliable tool whose items assess a single, relatively homogeneous construct. In Study 2, CWS exhibited greater mean and extreme BI tendencies than CWNS. Also CWS with higher, compared to CWS with lower, BI presented with greater stuttering frequency, more severe stuttering, greater stuttering-related consequences, and more negative communication attitudes (for CWS older than 4 years of age).ConclusionFindings were taken to suggest that BI is associated with early childhood stuttering and that the SBIS could be included as part of a comprehensive evaluation of stuttering.     

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.     

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.     

Loci of stuttering of English- and Korean-speaking children who stutter: Preliminary findings

PurposeThe purpose of the study was to determine whether differences exist between young English- and Korean-speaking children who stutter (CWS) in the loci of stuttering.MethodParticipants were 10 Korean-speaking and 11 English-speaking CWS between the ages of 3 and 7 years. Participants produced narratives while viewing various picture scenes and a wordless picture book.ResultsFindings indicated that Korean-speaking CWS stuttered more on content than function words whereas English-speaking CWS stuttered more on function than content words. Furthermore, both Korean- and English-speaking CWS tended to stutter more on utterance-initial words. These findings appear to be related to the differences in linguistic/syntactic structures between Korean and English. Specifically, in the Korean-speaking CWS’s narratives, most utterance-initial words (73.60 %) were content words whereas in the English-speaking CWS’s narratives, most utterance-initial words (83.57 %) were function words.ConclusionThese preliminary findings, although in need of replication with a larger sample size, seem to suggest that the word class (i.e., content/function words) contributions to stuttering loci are more language-specific whereas the word position (i.e., utterance-initial position) contributions to stuttering loci are more language-nonspecific. Given that the true characteristics of stuttering may be rather language-nonspecific than language-specific, further research may need to focus more on stuttering loci related to word position than word class.     

Self-efficacy beliefs: Experiences of adults who stutter

PurposeChildhood-onset stuttering is a complex and multifaceted disorder. Intervention for adults who stutter has historically addressed speech fluency more so than psychosocial aspects of the disorder, including the nature of the individual’s self-efficacy beliefs concerning their confidence in their capacity to enact change. Self-efficacy is an important construct related to quality of life, resilience, and maintenance of treatment gains for adults who stutter. The purpose of this qualitative study is to explore the nature of the self-efficacy beliefs expressed by adults who stutter in order to inform efficacious and holistic intervention for these individuals.MethodSemi-structured interviews were conducted with 29 adults who stutter to describe their experiences as a person who stutters and elucidate the nature of their self-efficacy beliefs.ResultsThematic analysis identified several major themes that provided novel insight into the complex nature of the self-efficacy beliefs experienced by adults who stutter: speaker experiences shaped communicative confidence, there was a conflict between communication and fluency, stuttering was viewed as more than fluency, and individual perspectives shaped communicative confidence, as did the pervading influence of self. The notion that fluency and confidence are inextricably linked was evident within and across each major theme.ConclusionThese preliminary findings provide further support for a multidimensional approach to the treatment of adults who stutter. Findings will be used to inform a novel integrated fluency and psychosocial intervention for adults who stutter that addresses fluency and self-efficacy concurrently, with a view of engendering durable improvements in speech fluency and communicative confidence.     

The experiences of migrants to Australia who stutter

PurposeMigration is a contemporary, global matter. With the number of international migrants doubling over the past four decades, speech-language pathologists will likely work with migrants who have childhood-onset stuttering. However, combined migration and stuttering experiences have never been investigated specifically. This study is the first to investigate the experiences of migrants to Australia who stutter.MethodsThree women and six men, aged 23 to 66 years old, participated. Data from individual interviews were analysed using Interpretative Phenomenological Analysis to examine the ‘lived experience’ of participants, as well as with NVivo 12 software for the management of coding. Participants also completed The Overall Assessment of the Speaker’s Experience of Stuttering (OASES™).ResultsThe stress experienced from migration interacted and compounded the existing stress of stuttering. Central themes emerged pertaining to the impact of increased stress on self-identity, the interactions of the stresses, as well as the coping strategies/facilitators. Stuttering and other personal factors, such as language(s) spoken and accent, had a negative impact on communication skills.ConclusionMigration cannot be experienced independently of a stutter, as both are intrinsically linked to self-identity. The combined stress of migration with stuttering amplified the perception of feeling abnormal and resulted in difficulties with establishing a stable self-identity and a sense of belonging in the new context. Participants found strength in the company of others and considered Australia to be accepting of stuttering.     

Dynamic self-organization and early lexical development in children

In this study we present a self-organizing connectionist model of early lexical development. We call this model DevLex-II, based on the earlier DevLex model. DevLex-II can simulate a variety of empirical patterns in children's acquisition of words. These include a clear vocabulary spurt, effects of word frequency and length on age of acquisition, and individual differences as a function of phonological short-term memory and associative capacity. Further results from lesioned models indicate developmental plasticity in the network's recovery from damage, in a non-monotonic fashion. We attribute the network's abilities in accounting for lexical development to interactive dynamics in the learning process. In particular, variations displayed by the model in the rate and size of early vocabulary development are modulated by (a) input characteristics, such as word frequency and word length, (b) consolidation of lexical-semantic representation, meaning-form association, and phonological short-term memory, and (c) delayed processes due to interactions among timing, severity, and recoverability of lesion. Together, DevLex and DevLex-II provide an accurate computational account of early lexical development.     

Resilience in people who stutter: Association with covert and overt characteristics of stuttering

PurposeRecent literature stresses the importance of resilience, as a trait, for successful coping with life’s difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.MethodThirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker’s Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.ResultsA strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants’ gender and age and their resilience levels (p > 0.05).ConclusionThis study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.     

Phonological complexity in school-aged children who stutter and exhibit a language disorder

PurposeThe Index of Phonological Complexity and the Word Complexity Measure are two measures of the phonological complexity of a word. Other phonological measures such as phonological neighborhood density have been used to compare stuttered versus fluent words. It appears that in preschoolers who stutter, the length and complexity of the utterance is more influential than the phonetic features of the stuttered word. The present hypothesis was that in school-age children who stutter, stuttered words would be more phonologically complex than fluent words, when the length and complexity of the utterance containing them is comparable. School-age speakers who stutter were hypothesized to differ from those with a concomitant language disorder.MethodsSixteen speakers, six females and ten males (M age = 12;3; Range = 7;7 to 19;5) available from an online database, were divided into eight who had a concomitant language disorder (S + LD) and eight age- and sex-matched speakers who did not (S-Only).ResultsWhen all stuttered content words were identified, S + LD speakers produced more repetitions, and S-Only speakers produced more inaudible sound prolongations. When stuttered content words were matched to fluent content words and when talker groups were combined, stuttered words were significantly (p ≤ 0.01) higher in both the Index of Phonological Complexity and the Word Complexity Measure and lower in density (“sparser”) than fluent words.ConclusionsResults corroborate those of previous researchers. Future research directions are suggested, such as cross-sectional designs to evaluate developmental patterns of phonological complexity and stuttering plus language disordered connections.Educational objectives: The reader will be able to: (a) Define and describe phonological complexity; (b) Define phonological neighborhood density and summarize the literature on the topic; (c) Describe the Index of Phonological Complexity (IPC) for a given word; (d) Describe the Word Complexity Measure (WCM) for a given word; (e) Summarize two findings from the current study and describe how each relates to studies of phonological complexity and fluency disorders.     

Effects of perceptual and conceptual similarity in lexical priming of young children who stutter: preliminary findings

The purpose of this study was to investigate the influence of conceptual and perceptual properties of words on the speed and accuracy of lexical retrieval of children who do (CWS) and do not stutter (CWNS) during a picture-naming task. Participants consisted of 13 3–5-year-old CWS and the same number of CWNS. All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a picture-naming task where they named, one at a time, computer-presented, black-on-white drawings of common age-appropriate objects. These pictures were named during four auditory priming conditions: (a) a neutral prime consisting of a tone, (b) a word prime physically related to the target word, (c) a word prime functionally related to the target word, and (d) a word prime categorically related to the target word. Speech reaction time (SRT) was measured from the offset of presentation of the picture target to the onset of participant's verbal speech response. Results indicated that CWS were slower than CWNS across priming conditions (i.e., neutral, physical, function, category) and that the speed of lexical retrieval of CWS was more influenced by functional than perceptual aspects of target pictures named. Findings were taken to suggest that CWS tend to organize lexical information functionally more so than physically and that this tendency may relate to difficulties establishing normally fluent speech and language.

Educational objectives: The reader will learn about and be able to (1) communicate the relevance of examining lexical retrieval in relation to childhood stuttering and (2) describe the method of measuring speech reaction times of accurate and fluent responses during a picture-naming task as a means of assessing lexical retrieval skills.     

Evidence-based guidelines for being supportive of people who stutter in North America

PurposeWhile many resources, particularly those available on the Internet, provide suggestions for fluent speakers as they interact with people who stutter (PWS), little evidence exists to support these suggestions. Thus, the purpose of this study was to document the supportiveness of common public reactions, behaviors, or interventions to stuttering by PWS.Methods 148 PWS completed the Personal Appraisal of Support for Stuttering-Adults. Additionally, a comparison of the opinions of adults who stutter based on gender and their involvement in self-help/support groups was undertaken. Results Many of the Internet-based suggestions for interacting with PWS are aligned with the opinions of the participants of this study. Significant differences were found amongst people who stutter on the basis of gender and involvement in self-help groups.Conclusions Lists of “DOs and DON’Ts” that are readily available on the Internet are largely supported by the data in this study; however, the findings highlight the need for changing the emphasis from strict rules for interacting with people who stutter to more flexible principles that keep the needs of individual PWS in mind.     

Adult recasts as fluency-facilitators in preschoolers who stutter: Evidence from FluencyBank

Adult conversational recasts are based on child platform utterances that contain errors (e.g., Child: “Me going.” Adult: “Yes, you are going”), and recasts are effective in the child language literature. For many years, adult recasts of preschoolers’ stuttered utterances were surmised as fluency-facilitating, but to date, no evidence has been reported to support their efficacy. The purpose was to investigate the natural occurrence of, and the fluency-facilitating potential of, recasts produced by caregivers and clinicians/examiners in free-play interactions transcribed from audio or video recordings on FluencyBank. Forty-three participants with a median age of 38 mo (3;2) (Range=28–73 mo), including 32 boys and 11 girls were selected from five databases, and recasts which were near-imitations and simple recasts as per Weiss (2002) were identified. One database chosen was the Illinois project, to include a subgroup of persistent (n = 9) and recovered children (n = 9). In the 43 participants, significantly (p < 0.0001) fewer stutters and lower percent syllables stuttered (%SS) were observed in post-recast utterances (4%SS) as compared to post-nonrecast utterances (12.5%SS). The CWS-persistent subgroup (n = 9) did not fit the group trend of the 34 others who significantly differed in stuttering frequency post-nonrecast versus postrecast. Findings are taken to mean that adult conversational recasts of preschoolers’ stuttered utterances are fluency-facilitating, and interpretations are addressed.     

Multilingual children who stutter: clinical issues

Stuttering occurs across all languages and cultures. However, the impact of speaking more than one language on assessment and treatment of young children who stutter is not well documented. This paper discusses some of the challenges related to clinical issues pertaining to this population including (a) identifying stuttering in an unfamiliar language, (b) the influence of language proficiency, and (c) treatment of multilingual young children who stutter. The paper is written from the perspective of the author's experience treating multilingual children who stutter within the context of the linguistic and cultural diversity of Canada, notably in the French speaking Province of Quebec where many children grow up speaking two or more languages in everyday life. Clinical examples will be taken from the evidence-based literature as well as the author's clinical experience.Educational objectives: After reading this paper, the learner will be able to (1) summarize the literature regarding assessment and treatment of stuttering in young children speaking more than one language, (2) summarize some of the challenges related to this issue and (3) describe some of the findings associated with treatment of bilingual children who stutter and (4) be prepared to apply some of these suggestions in the treatment of bilingual children who stutter.     

T-PALS framework to assess children who stutter with coexisting disorders: A tutorial

The purpose of this paper is to present a tutorial on a diagnostic framework developed to assess children who stutter and exhibit co-existing disorders. While we have guidelines for treating these children, there are no specific guidelines for assessing them. We provide a rationale for the development of T-PALS with support from the literature. The T-PALS framework assesses 5 foundational key elements for the child: Temperament (T), Pragmatics (P), Articulation/phonology (A), Language (L), and Stuttering (S). Both qualitative and quantitative measures are used within each dimension. This framework is discussed with reference to using two clinical case examples. T-PALS observation data are presented as well as treatment suggestions for each case. We conclude that T-PALS may be a useful framework for both clinicians and researchers, working with children who present with stuttering and comorbid conditions. Clinicians are encouraged to reach beyond the traditional focus on solely assessing the stuttering behavior, even when that is the main concern for referral, and to consider a broader view of the child. It is hoped that this more integrative approach to assessment may yield a more holistic diagnostic picture of a dual diagnosis child from which treatment goals can be derived.     

Age of acquisition predicts rate of lexical evolution

The processes taking place during language acquisition are proposed to influence language evolution. However, evidence demonstrating the link between language learning and language evolution is, at best, indirect, constituting studies of laboratory-based artificial language learning studies or computational simulations of diachronic change. In the current study, a direct link between acquisition and evolution is established, showing that for two hundred fundamental vocabulary items, the age at which words are acquired is a predictor of the rate at which they have changed in studies of language evolution. Early-acquired words are more salient and easier to process than late-acquired words, and these early-acquired words are also more stably represented within the community’s language. Analysing the properties of these early-acquired words potentially provides insight into the origins of communication, highlighting features of words that have been ultra-conserved in language.     

Effects of different attention tasks on concurrent speech in adults who stutter and fluent controls

Purpose: Motor theories indicate that focusing attention on well-practiced movements interferes with skilled performance; however, specific forms of attention (alerting vs. orienting vs. executive control) associated with this effect are not well understood. The present study explored this question in relation to stuttering, and examined whether dual task conditions that engaged sustained attention or working memory (WM) affected speech fluency in different ways. We also considered whether fluency changes were associated with changes in speech rate and language.Methods: Nineteen adults who stutter (AWS) and 20 controls produced spontaneous speech under a baseline condition and two dual task conditions: one involving a sustained attention task, the other involving WM demands.Results: Both groups produced fewer stutter-like disfluencies under dual task relative to baseline conditions and this reduction did not differ between the two dual tasks (attention vs. WM). Speech rate and language variables, which were potentially influenced by attention conditions, were not affected by dual tasks in the same way as disfluencies, and appeared to be unassociated with fluency results.Conclusions: Findings indicate that atypical disfluencies decrease when attention is divided, even when secondary task demands are minimal, as they were in the sustained attention task. For simple secondary tasks, fluency changes do not appear to be a byproduct of slowed rate and are not accompanied by observable changes in language. These results demonstrate that simple manipulations of attention can induce measurable effects on aspects of speech production, and may be a useful tool for facilitating fluency in clinical intervention.     

On leveraged learning in lexical acquisition and its relationship to acceleration

Children at about age 18 months experience acceleration in word learning. This vocabulary explosion is a robust phenomenon, although the exact shape and timing vary from child to child. One class of explanations, which we term collectively as leveraged learning , posits that knowledge of some words helps with the learning of others. In this framework, the child initially knows no words and so learning is slow. As more words are acquired, new words become easier and thus it is the acquisition of early words that fuels the explosion in learning. In this paper we examine the role of leveraged learning in the vocabulary spurt by proposing a simple model of leveraged learning. Our results show that leverage can change both the shape and timing of the acceleration, but that it cannot create acceleration if it did not exist in the corresponding model without leveraging. This model is then applied to the Zipfian distribution of word frequencies, which confirm that leveraging does not create acceleration, but that the relationship between frequency and the difficulty of learning a word may be complex.     

Communication attitudes in children who stutter: A meta-analytic review

BackgroundThis article presents a meta-analytic review of differences in communication attitudes between children who stutter (CWS) and children who do not stutter (CWNS).MethodTo be included in this review, the studies had to include a group of CWS and CWNS between the ages of 3–18 years and a measurement of communication attitudes. The journal articles were identified by using the key words stutter*, speech disfluenc*, fluency disorder*, and stammer* cross-referenced to awareness*, reaction*, attitude*, KiddyCAT, CAT, A-19 Scale, PASS and OASES.ResultsA total of 18 studies met the inclusion criteria for this meta-analysis. The results showed that CWS exhibit more negative communication attitudes than CWNS from the preschool years. The differences between the groups increased with age, but were not influenced by gender.ConclusionThe results indicate that negative communication attitudes can be an effect of stuttering. Key issues requiring further investigation are whether communication attitudes differ as a function of age at stuttering onset and whether communication attitudes influence the development of stuttering.Educational Objectives: After reading this article, the reader will be able to: (a) summarise empirical findings with regard to the relationship between communication attitudes and childhood stuttering; (b) describe the different instruments used to measure communication attitudes; (c) discuss the relationship between communication attitudes, age and gender.