Linguistic stress, within-word position, and grammatical class in relation to early childhood stuttering

The purpose of the present study was to investigate whether the link that has been established between stuttering and linguistic stress in adolescents and adults (the so-called stress effect) can also be observed in childhood stuttering. To account for confounding variables, both within-word position and grammatical class were measured, because these factors covary with linguistic stress. Speech samples of 22 preschool children (mean time of 9 months since onset of stuttering) were analyzed. The relative stress of each syllable was rated and syllables were categorized into long and short stressed, unstressed, and intermediately stressed syllables. Results showed that 97.8% of stuttering events occurred on first syllables of words and 76.5% on the first sound of syllables, that means a clear word-initial effect. Stuttering frequency on first syllables of function words was 16.9% and significantly higher than the frequency of stuttered first syllables of content words (11.5%). In function words short stressed syllables and intermediately stressed syllables were stuttered more often than unstressed syllables. The analysis for individual disfluency types revealed that, for function words, stuttering on short stressed syllables was associated with prolongations and syllable repetitions. However, in intermediately stressed syllables stuttering coincided most often with one-syllable word repetitions. This differentiation of the stress effect may suggest different causal mechanisms underlying these disfluency types. Educational objectives: The reader will learn about and be able to: (1) describe how within-word position, grammatical class, and linguistic stress effect stuttering frequency in preschool children who stutter; (2) explain how the occurrence of individual disfluency types depends on linguistic stress; (3) discuss how patterns of adults and preschool children who stutter differ in regard to these aspects.     

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.     

The association between stuttering, Brown''s factors, and phonological categories in child stutterers ranging in age between 2 and 12 years

Though the phonological difficulty of a word might reasonably be supposed to influence whether a word is stuttered, it has recently been reported that the incidence of stuttering does not depend on this factor in child stutterers. This conclusion is reexamined in the current report. Data are employed that were obtained from groups of child stutterers (and their controls) who vary in age and severity of their disorder. First, it is shown that the measure of phonological difficulty reveals differences in phonological ability for children of different ages (stutterers and fluent controls). The properties of words with regard to whether they are function words or content words, their position in the sentence, their length, and the phoneme that they start with vary between phonological categories (referred to as “Brown's factors”). Since these factors could influence whether words are stuttered in their own right, they may led to apparent differences in stuttering between words in different phonological categories that are spurious. Alternatively, these factors may disguise influences that phonological categories have on stuttering. It is shown in the next analysis that the words in the various phonological categories differ with regard to Brown's factors. In the final analysis, the proportion of words stuttered for words in each phonological category are analyzed so that any influence Brown's factors might have are removed by treating the factors as covariates. No dependence of stuttering on phonological category is observed for age group, stutterer's severity, or word types (stuttered word or word following the stuttered word). Thus, phonological difficulty as measured here and elsewhere does not appear to be a major factor governing the incidence of stuttering in children.     

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.     

Long-term effects of intensive treatment for a client with both a cluttering and stuttering disorder

This study presents data on the effects of an intensive smooth speech treatment program for stuttering on the speech and psychological status of a man, aged 21 years who stuttered and who was also diagnosed as a clutterer (S 29). Stuttering was mild to moderate (7% syllables stuttered) (%SS) and consisted mostly of rapid repetitions with an occasional block. The client had stuttered since the age of 5 years. Initial rate could not be determined with accuracy due to its irregularity and speed, but was estimated to be between 260 to 300 syllables per minute (SPM). Speech was also characterized by irregular quick bursts that were often unintelligible. There was no evidence of abnormal psychological traits. However, a higher than normal level of negative communication attitudes was evidenced. An intensive 3-week smooth speech program designed to reduce and control stuttering was initiated. It was believed the training, which involved rate control, would control the cluttering symptoms as well. After successful completion of the program, stuttering was greatly reduced, and the gains were maintained after 10 months. Speech rate was reduced to normal levels and was also maintained at the 10-month follow-up. Negative attitudes to communication, furthermore, were greatly reduced both in the short- and long-term. Consequently the cluttering symptoms after treatment were minimal. This case study suggests that an intensive treatment for stuttering, which contains rate control, can also be a successful treatment for cluttering, at least for those who also stutter.     

INTERNAL STRUCTURE OF CONTENT WORDS LEADING TO LIFESPAN DIFFERENCES IN PHONOLOGICAL DIFFICULTY IN STUTTERING

This study investigated whether frequency of stuttering was affected by factors that specify the phonological difficulty of a sound and whether and how any influences vary across age groups. Analyses were performed separately on content words and function words. The phonological factors examined were: a) Whether the word contained a late emerging consonant (LEC); and b) Whether the word contained a consonant string (CS). Analyses showed that these factors occurred at different rates across the age groups used (children under 12, teenagers between 12 and 18, and adults). A more detailed breakdown was also reported of frequency of usage of LEC and CS over age groups depending on whether and where these factors occurred in the content words; all nine combinations of no LEC, word-initial LEC, non-initial LEC with no CS, word-initial CS, and non-initial CS were examined. Usage of certain of these nine categories varied over age groups. Friedman statistic on the ratio of stuttering (proportion of stuttered words in a particular word class divided by the proportion of words in that particular word class) showed that the frequency of stuttering remained high for adult speakers when CS and LEC both occurred in a word and when they appeared in word-initial position. These findings support a recently proposed theory that accounts for life-span changes in stuttering.     

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents’ native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany.

Educational objectives: Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.     

Electromyographic indications of laryngeal-area activity during stuttering expectancy

Using surface electrodes, mean microvolt values of laryngeal-area muscle activity were determined for 13 male and 6 female stutterers during 10-sec periods in which single words were silently read and stuttering expectancy was indicated. No significant differences in levels of laryngeal-area muscle activity were found between periods of fluency expectancy and stuttering expectancy preceding both fluent and stuttered speech. The results were interpreted as being nonsupportive of the hypothesis that a breakdown in stutterers' laryngeal-area muscle activity occurs during moments of stuttering expectancy. In addition, the results suggest that the most common rationale for the utilization of laryngeal biofeedback procedures to enhance fluency should be questioned.     

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.     

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%).     

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.     

Predicting stuttering from phonetic complexity in German

This study investigated how phonetic complexity affects stuttering rate in German and how this changes developmentally. Phonetic difficulty was assessed using Jakielski's index [Motor Organization in the Acquisition of Consonant Clusters, Dissertation/Ph.D. Thesis, University of Texas Austin, 1998] of phonetic complexity (IPC) in which words are scored on eight different characteristics. Stuttering rate was not related to IPC score for German function words, as previously shown for Spanish and English. Significant correlations between stuttering rate and IPC score were found for content words for children over the age of six and adults. It was also found that German content words have a higher mean IPC sum compared to their English counterparts. There was a bigger difference in IPC score between fluent and stuttered words in German than in English. Factor 5 (word shape) influenced stuttering rates in both German age groups. This has also been found for Spanish but does not apply to English. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe a method to measure phonetic complexity and how this affects stuttering rates for words of different grammatical classes; (2) explain why this method is suitable for different languages and age groups; (3) detect which phonetic characteristics have most impact on different age groups in English and German; (4) assess possible theoretical reasons for these findings.     

Unassisted recovery from stuttering: self-perceptions of current speech behavior, attitudes, and feelings

The purpose of this study was to investigate the nature of recovery from stuttering based on the experiences of adults who recovered without treatment. Using a semi-structured, open-ended interview format, 15 speakers verified as persons who recovered without treatment were asked to describe their status as everyday speakers. Seven speakers reported that they no longer stuttered and eight reported that they still stuttered on occasion. Interview material was coded and analyzed by the investigators and checked by independent judges. Results suggested that complete recovery was possible for speakers who reported that they no longer stuttered; whereas, those who still stuttered occasionally appeared to no longer be handicapped by stuttering, but required some vigilance to maintain their relatively fluent speech.

Educational objectives: After completing this activity, the learner will be able to: (1) describe the relevance of self-report data for evaluating the nature of recovery from stuttering without treatment; (2) describe the differences in self-perception concerning the nature of recovery for those who no longer have any tendency to stutter compared to those who still have an occasional tendency to stutter; and (3) suggest the possible implications for understanding the nature of recovery from persistent stuttering based on investigations of late recovery without treatment.     

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.     

LONG-TERM FOLLOW-UP OF A BEHAVIORAL TREATMENT FOR STUTTERING IN CHILDREN

We report 3.5-year follow-up data from children who participated in a study that evaluated a behavioral treatment for stuttering. Six of 7 subjects continued to be at or below the criterion of 3% stuttered words. Stuttering increased for 1 subject, but remained far below his baseline level. Social validity data are also reported.     

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.     

ANALYSIS OF A SIMPLIFIED TREATMENT FOR STUTTERING IN CHILDREN

We investigated the effectiveness of a simplified program for the treatment of stuttering in children. The simplified treatment included awareness training, in which the subjects learned to detect every occurrence of stuttering; training a response incompatible with stuttering, which involved relaxation and regulation of air flow over the larynx when speaking; and social support, which involved parent-delivered prompts and praise of children's use of the techniques in everyday environments. Eight children were treated in their homes with the simplified treatment, in a multiple baseline across subjects design, and all reached the criterion level of less than 3% words stuttered. In addition, the reduction in stuttering generalized to the school setting and was maintained at posttreatment (10 to 13 months). The subjects' rates of speech remained stable throughout baseline and treatment. Pretreatment and posttreatment ratings by the parents showed that they found treatment to be both acceptable and credible. Finally, social validity measures revealed a noticeable improvement in the subjects' speech to parents and speech pathologists.     

A palmar sweat measure of the effect of drugs on stuttering behavior

The question is asked why drugs designed to affect physiological responses associated with anxiety do not affect stuttering if the antecedent of stuttering is anxiety? Sixteen stutterers and sixteen matched controls each participated in four conditions which were twenty-four hours apart. There were two experimental conditions where the subject received medication prior to participation. One drug was nembutal and the other benzedrine. There were also two control conditions; one in which the subject received a sugar pill and the other where he received nothing. Three simultaneous measures were made of Palmar Sweat Index (PSI), number of non-fluencies, and reading rate. The order of participation among the conditions was counterbalanced.

As a main effect the study indicated that drugs do not affect stuttering. However the interaction of drugs with the order in which drugs were administered was significant. Subjects who received nembutal as the first condition stuttered more on all four conditions than those subjects who received nembutal last. Benzedrine had little effect on stuttering. It was concluded that nembutal causes a release of stuttering and stuttering, once released, gets conditioned to the situation and continues at a high level. Theoretical explanation for such findings is presented.     

Communicative stress and stuttering frequency during normal,whispered, and articulation-without-phonation speech modes

The effect of communicative stress on the frequency of stuttered syllables in 12 adult stutterers reading six different but equivalent passages using normal voicing, whispering, and articulation-without-phonation speech under a stress and a non-stress condition was studied. Although the frequency of stuttering was significantly greater in the normal voicing mode than in the whispering mode and greater in the whispering mode than in the articulation-without-phonation mode, no differences were found between the stress and the nonstress conditions with respect to stuttering.