LANGUAGE ABILITIES OF CHILDREN WHO STUTTER: A PRELIMINARY STUDY

The purpose of this study was to examine differences between children who do (CWS) and children who do not stutter (CWNS) on standardized tests of receptive/expressive language and receptive vocabulary. Subjects were 16 boys and 4 girls who stutter (mean age = 46.80 months) and 16 boys and 4 girls who do not stutter (mean age = 47.55 months). Each child was audio recorded during a loosely structured, 30-minute conversation with an adult. This conversational interaction was subsequently assessed to provide information pertinent to the child's frequency and type of speech disfluency. After completion of the adult-child conversational interaction, each child was administered and responded to standardized tests of syntactic, semantic, and phonological abilities and development. Results indicated that the difference between measures of receptive/expressive language and receptive vocabulary is significantly greater for CWS than CWNS; however, this difference between receptive/expressive language and receptive vocabulary scores was not significantly correlated with the overall stuttering frequency of CWS. Findings were taken to suggest that the semantic development of CWS may lag behind their syntactic development, a possible imbalance among components of the speech-language systems of CWS that may contribute to the difficulties they have establishing normal speech fluency. Research supported by an NIH grant (DC00523) to Vanderbilt University.     

Phonological neighborhood density in the picture naming of young children who stutter: preliminary study

The purpose of this study was to assess the effect of phonological neighborhood density on the speech reaction time (SRT) and errors of children who do and do not stutter during a picture-naming task. Participants were nine 3-5-year-old children who stutter (CWS) matched in age and gender to nine children who do not stutter (CWNS). Initial analyses indicated that both CWNS and CWS were significantly faster (i.e., exhibited shorter SRTs) and more accurate on phonologically sparse than phonologically dense words, findings consistent with those found with older children (Newman & German, 2002). Further analyses indicated that talker group differences in receptive language scores weakened these findings. These preliminary findings were taken to suggest that phonological neighborhood density appears to influence the picture-naming speed and accuracy of preschool-aged children. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) recognize the relevance of examining phonological variables in relation to childhood stuttering; and (2) describe the method of measuring speech reaction times and errors during a picture-naming task as a means of assessing linguistic skills.     

Past tense marking in the spontaneous speech of preschool children who do and do not stutter

PurposeThe aim of this study was to identify whether different patterns of errors exist in irregular past-tense verbs in children who stutter (CWS) and children who do not stutter (CWNS).MethodSpontaneous language samples of thirty-one age- and gender-matched pairs of children (total N = 62) between the ages of 24 months and 59 months were analyzed.ResultsResults indicated that children who do and do not stutter over-regularize irregular past-tense verbs (i.e., saying runned for ran) with comparable frequency. However, two nonsignificant trends which suggest possible intra-group differences were noted. First, irregular past tense verbs represented a greater portion of total verbs for CWS than for CWNS. Second, CWS appeared to double-mark (i.e., say ranned for ran) more often than CWNS. Results are discussed in light of theories about the acquisition of the irregular past-tense and about differences in language skills between CWS and CWNS.Educational objectives: After reading this article, the reader will be able to: (a) summarize previous findings about connections between stuttering and language in CWS and CWNS; (b) describe similarities and differences between irregular past-tense verb use and errors in CWS and CWNS; (c) discuss possible connections between the declarative–procedural model and stuttering.     

Age of acquisition and repetition priming effects on picture naming of children who do and do not stutter

The effects of age of acquisition and repetition priming on picture naming latencies and errors were studied in 22 children who stutter (CWS) and 22 children who do not stutter (CWNS) between the ages of 3;1 and 5;7. Children participated in a computerized picture naming task where they named pictures of both early and late acquired (AoA) words in two consecutive stages. Findings revealed that all children's picture naming latencies and errors were reduced following repetition priming and in response to early AoA words relative to late AoA words. AoA and repetition priming effects were similar for children in both talker groups, with one exception. Namely, CWS benefitted significantly more, in terms of error reduction, than CWNS from repetition priming for late AoA words. In addition, CWNS exhibited a significant, positive association between linguistic speed and measures of vocabulary, but CWS did not. These findings were taken to suggest that the (a) semantic-phonological connections of CWS may not be as strong as those of CWNS, and (b) existing lexical measures may not be sensitive enough to differentiate CWS from CWNS in lexically related aspects of language production. Educational objectives: After reading this article, the learner will be able to: (a) describe the effects of repetition priming and age of word acquisition in speech production; (b) summarize the performance similarities and differences of children who stutter and children who do not stutter on a computerized picture naming task; and (c) compare the results of the present study with previous work in this area.     

Nonword repetition and identification skills in Kannada speaking school-aged children who do and do not stutter

PurposeThe present study employed nonword repetition and nonword identification tasks to explore the phonological working memory (PWM) abilities and its interaction with speech motor control in school-aged children who do and do not stutter.MethodParticipants were 17 children who stutter (CWS) (Age range = 7–12) and 17 age and gender-matched children who do not stutter (CWNS). For the nonword repetition task, the participants repeated sets of 2-, 3-, and 4-syllable nonwords (n = 12 per set). The participants silently identified a target nonword from a subsequent set of three nonwords (n = 12 per 2-, 3- and 4-syllable length) for the nonword identification task. The performance of CWS on the nonword repetition task was compared with the CWNS for the mean number of accurate repetitions, number of trials taken, number of accurate repetitions on initial trial, and number of fluent repetitions across the three-syllable conditions for the tasks. For the nonword identification task, the number of nonwords identified accurately by the two groups were subjected to analysis.ResultsCWS were significantly less accurate on the initial production of nonwords and required significantly more number of attempts to repeat the nonword accurately. Further for the nonword identification task, CWS were significantly less accurate than CWNS in correctly identifying the target nonword.ConclusionsThe present findings suggest that, in addition to limitations in PWM capacity, an unstable speech motor control system in CWS may lead to dysfluent speech.     

Nonword repetition skills in young children who do and do not stutter

The purpose of this study was to assess the nonword repetition skills of 24 children who do (CWS; n = 12) and do not stutter (CWNS; n = 12) between the ages of 3;0 and 5;2. Findings revealed that CWS produced significantly fewer correct two- and three-syllable nonword repetitions and made significantly more phoneme errors on three-syllable nonwords relative to CWNS. In addition, there was a significant relationship between performance on a test of expressive phonology and nonword repetition for CWS, but not CWNS. Findings further revealed no significant fluctuation in fluency as nonwords increased in length. Taken together, findings lend support to previous work, suggesting that nonword repetition skills differ for CWS compared with CWNS, and that these findings cannot be attributed to (a) weak language performance on the part of CWS, or (b) the occurrence of stuttering in the course of nonword production. EDUCATIONAL OBJECTIVES: After reading this article, the learner will be able to: (a) describe one common means of assessing phonological working memory in children; (b) summarize the performance differences of children who stutter compared to peers on a nonword repetition task; (c) compare the results of the present study with previous work in this area.     

Frequency of verb use in young children who stutter

Several recent studies have suggested that young children who stutter (CWS) tend to show depressed lexical performance relative to peers. Given the developmental literature as well as several studies of verb processing in individuals who stutter, verbs may pose a particular challenge for this group. The purpose of the present study was to examine verb use in CWS. In theory, if young CWS differ in their production of verbs, this finding would partially explain the findings of studies that probed conversational vocabulary skills more generally. Fifteen CWS and 15 children who do not stutter (CWNS) participated in a play-based conversational sample with a parent. Samples were analyzed for the total number of verbs, the number of different verbs, and the proportion of general all-purpose (GAP) verbs within the samples. CWS produced significantly fewer different verbs and total verbs than the CWNS. However, previously reported near-significant differences in utterance length between groups would appear to temper the robustness of this finding. The groups did not differ in the proportion of GAP verbs used, suggesting that the CWS did not over-rely on GAP verbs in conversational language production but rather used these verbs to the same extent as their peers. Educational objectives: As a result of this activity, the participant will be able to: (1) relate the purpose and rationale for examining verb use in children who stutter (CWS); (2) summarize the procedures used to assess verb use and GAP verb use in the present study; (3) explain the findings of the present study; (4) relate findings to the extant literature on lexical diversity in CWS.     

Childhood stuttering and speech disfluencies in relation to children's mean length of utterance: a preliminary study

The purpose of this study was to examine the influence of utterance length and complexity relative to the children's mean length of utterance (MLU) on stuttering-like disfluencies (SLDs) for children who stutter (CWS) and nonstuttering-like disfluencies (nonSLDs) for children who do not stutter (CWNS). Participants were 12 (3;1-5;11, years;months) children: 6 CWS and 6 age-matched (+/-5 months) CWNS, with equal numbers in each talker group (CWS and CWNS) exhibiting MLU from the lower to the upper end of normal limits. Data were based on audio-video recordings of each child in two separate settings (i.e., home and laboratory) during loosely structured, 30-min parent-child conversational interactions and analyzed in terms of each participant's utterance length, MLU, frequency and type of speech disfluency. Results indicate that utterances above children's MLU are more apt to be stuttered or disfluent and that both stuttering-like as well as nonstuttering-like disfluencies are most apt to occur on utterances that are both long and complex. Findings were taken to support the hypothesis that the relative "match" or "mismatch" between linguistic components of an utterance (i.e., utterance length and complexity) and a child's language proficiency (i.e., MLU) influences the frequency of the child's stuttering/speech disfluency. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) compare different procedures for assessing the relationship among stuttering, length and complexity of utterance, (2) describe the difference between relative and absolute measures of utterance length, (3) discuss the measurement and value of mean length of utterance and its possible contributions to childhood stuttering, and (4) describe how length and complexity influence nonstuttering-like disfluencies of children who stutter as well as the stuttering-like disfluencies of children who do not stutter.     

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.     

Disfluency data of German preschool children who stutter and comparison children

This study compared the disfluencies of German-speaking preschool children who stutter (CWS, N = 24) with those produced by age- and sex-matched comparison children who do not stutter (CWNS, N = 24). In accordance with Yairi and Ambrose's [Yairi, E., & Ambrose, N. (1992). A longitudinal study of stuttering in children: A preliminary report. Journal of Speech and Hearing Research, 35, 755-760] guidelines the CWS group had a narrow age range (2-5 years) and were seen close to the reported time of their stuttering onset (average of 8 months). Furthermore, over 95% of the CWS group had not received any type of speech therapy intervention. Consistent with previous findings for English-speaking preschool children, 'stuttering-like' disfluencies (prolongations, blocks, part- and one-syllable word repetitions) were significantly more frequent in CWS (mean = 9.2%) than in CWNS (mean = 1.2%), whereas no significant group differences occurred with respect to 'normal' disfluencies. The number of iterations in stuttering-like disfluencies was also significantly higher in CWS (mean = 1.28 iterations) than in CWNS (mean = 1.09 iterations). In contrast to previous findings, a sub-group of children who have been stuttering for a shorter time (1-5 months) did not differ from a sub-group who had stuttered for a longer period (8-22 months). EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe how German-speaking preschool children who stutter and who do not stutter display stuttering-like and normal disfluencies including number of iterations; (2) explain how powerful classification measures for the diagnosis of stuttering are for German-speaking preschool children; (3) discuss how disfluency patterns of native English- and German-speaking children close to onset of stuttering differ.     

Phonetically governed voicing onset and offset in preschool children who stutter

Phonetically governed changes in the fundamental frequency (F₀) of vowels that immediately precede and follow voiceless stop plosives have been found to follow consistent patterns in adults and children as young as four years of age. In the present study, F₀ onset and offset patterns in 14 children who stutter (CWS) and 14 children who do not stutter (CWNS) were investigated to evaluate differences in speech production. Participants produced utterances containing two VCV sequences. F₀ patterns in the last ten vocal cycles in the preceding vowel (voicing offset) and the first ten vocal cycles in the subsequent vowel (voicing onset) were analyzed. A repeated measures ANOVA revealed no group differences between the CWS and CWNS in either voicing onset or offset gestures. Both groups showed patterns of F₀ onset and offset that were consistent with the mature patterns seen in children and adults in previous studies. These findings suggest that in both CWS and CWNS, a mature pattern of voicing onset and offset is present by age 3;6. This study suggests that there is no difference between CWS and CWNS in the coordination of respiratory and laryngeal systems during voicing onset or offset.Educational objectives: The reader will be able to: (a) discuss the importance of investigating children who stutter close to the onset of stuttering; (b) describe the typical change in F₀ during voicing onset; (c) discuss the potential implications of these results with regard to future research.     

A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks

PurposeThe purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children.MethodThirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS.ResultsThe findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly.ConclusionFindings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.     

Identification of stuttering in bilingual Lebanese children across two presentation modes

The goals of this study were to investigate whether Lebanese speech-language pathologists (SLPs) are accurate at identifying stuttering in bilingual children, to examine whether the use of video-recordings instead of audio-recordings allows for better analyses, and to explore factors that may affect the SLPs’ judgments. In phase 1, 32 SLPs listened to narrative samples in Lebanese Arabic of 6 children who do not stutter (CWNS) and 2 who stutter (CWS). They were instructed to label each child as stuttering or not, and to explain what motivated their decisions. Afterwards, they were asked to provide background information by means of a questionnaire. In phase 2, they were asked to judge the same speech samples on the basis of video-recordings, and to explain for each child which speech characteristics they relied on to make their decisions. The results showed that misidentification happens frequently, is significantly more likely to happen with CWNS than with CWS, but also varies within these categories. Moreover, the use of video-recordings does not provide more reliable analyses of speech disfluencies, and speech samples’ characteristics and bilingual profile rather than SLPs’ characteristics seem to influence the judgments. Qualitative analyses indicate that, in the current study, misidentification may be driven by neglecting or misinterpreting physical concomitants. In general, the findings indicate that identifying and analyzing speech fluency behaviors remain a challenging perceptual task, which underlies the need for developing consistent methods for training students and clinicians in identifying stuttering, especially in a bilingual context.     

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.     

Rhyming abilities in a dual-task in school-age children who stutter

PurposeWe compared school-age children who stutter (CWS) and age and gender matched control participants (CWNS) in a dual-task involving a word-level rhyming task and a tone task involving pitch decisions.MethodsParticipants were 30 children (CWS, n = 15) between 7 and 16 years. Auditory word – picture stimuli pairs from the rhyme task were categorized into nonrhyme (e.g., bear-cart), rhyme (e.g., bear-pear), and replica (e.g., bear-bear) categories. The effort associated with managing resources in the dual-task was varied through the manipulation of stimulus onset asynchrony (SOA) between the stimuli of the two tasks. Mixed methods analyses of the response time (RT, ms) and error (%) data were conducted with Group, Category, and SOA as the fixed effects and participants as the random effect. Age and phoneme awareness skills were included in the analyses.ResultsMore rhyming errors and a significant positive correlation between rhyming errors and age was observed in the CWS compared to the CWNS. Compared to the CWNS, a higher percentage of rhyming errors was observed in the rhyme than the nonrhyme and replica categories in the CWS in both the SOA conditions, and this effect was influenced by age and phoneme awareness skills. Analysis of the tone task data indicated that a subgroup of CWNS with higher phoneme awareness skills showed reduced RT difference between the long and the short SOA conditions thereby suggesting higher efficiency with resource allocation for dual tasking. Task-specific differences between the CWS and CWNS are interpreted to suggest limitations in the encoding of the phonological aspects of covert speech in a dual-task.     

Performance on phonological and grammatical awareness metalinguistic tasks by children who stutter and their fluent peers

This study was undertaken to examine the performance of 23 children who stutter (CWS) and 23 children who do not stutter (CWNS) on three metalinguistic tasks. These included two phonological awareness assessment procedures (The Lindamood Auditory Conceptualization Test (LAC) and a Phoneme Reversal Task) and one modified Grammar Judgments Task where syntactic and semantic appropriateness of sentences was evaluated. Differences between groups were significant for the grammar judgment task, where CWNS outperformed CWS in judging syntactically and semantically anomalous sentences. Group differences were not significant for the phonological awareness tasks. The results underscore the importance of examining metalinguistic abilities of CWS through a variety of tasks. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) recognize the relevance of examining metalinguistic abilities within the context of research on language-stuttering dynamics; and (2) identify measures of metalinguistic abilities that can be used to compare the performances of CWS and CWNS.     

Visual exogenous and endogenous attention and visual memory in preschool children who stutter

PurposeAttention develops gradually from infancy to the preschool years and beyond. Exogenous attention, consisting of automatic responses to salient stimuli, develops in infancy, whereas endogenous attention, or voluntary attention, begins to develop later, in the preschool years. The purpose of this study was to examine (a) exogenous and endogenous attention in young children who stutter (CWS) and children who do not stutter (CWNS) through two conditions of a visual sustained selective attention task, and (b) visual short-term memory (STM) between groups within the context of this task.Method42 CWS and 42 CWNS, ages 3;0–5;5 (years;months), were pair-matched in age, gender (31 males, 11 females per group), and socioeconomic status. Children completed a visual tracking task (Track-It Task; Fisher et al., 2013) requiring sustained selective attention and engaging exogenous and endogenous processes. Following each item, children were asked to recall the item they had tracked, as a memory check.ResultsThe CWS group demonstrated significantly less accuracy in overall tracking and visual memory for the tracked stimuli, compared to the CWNS group. Across groups, the children performed better in sustained selective attention when the target stimuli were more salient (the condition tapping both exogenous and endogenous attention) than when stimuli were less so (the condition tapping primarily endogenous processes).ConclusionsRelative to peers, preschool-age CWS, as a group, display weaknesses in visual sustained selective attention and visual STM.     

Complex nonverbal response inhibition and stopping impulsivity in childhood stuttering

PurposeThe primary purpose of this study was to examine complex nonverbal response inhibition and stopping impulsivity in children who do (CWS) and do not stutter (CWNS).MethodA total of 30 CWS and 30 CWNS between the ages of 3;1 and 6;0 (years; months) performed the Peg-Tapping Task (PTT; Diamond & Taylor, 1996; Luria, 1966), in which children were required to tap a dowel once when an examiner taps twice and vice versa. The main dependent variables were the number of practice trials, response accuracy, response latency for accurate responses, and the number of extra taps (i.e., tapping more than two times).ResultsThe CWS were less accurate and slower on the PTT than the CWNS, with no differences in the number of practice trials. Furthermore, the CWS, especially boys, produced more extra taps than the CWNS.ConclusionsFindings revealed that preschool CWS have weaknesses in complex response inhibition and stopping impulsivity in the nonverbal domain compared to CWNS. Taken together, these findings along with those of previous studies indicate that CWS may have weaknesses in inhibition and impulsivity in the nonverbal domain as well as the verbal domain, suggesting a domain-general weakness.     

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.