Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

The Japanese version of the overall assessment of the speaker’s experience of stuttering for adults (OASES-A-J): Translation and psychometric evaluation

PurposeThis study evaluates the psychometric performance of the Japanese version of the Overall Assessment of the Speaker’s Experience of Stuttering for Adults (OASES-A), a comprehensive assessment tool of individuals who stutter.MethodsThe OASES-A-J was administered to 200 adults who stutter in Japan. All respondents also evaluated their own speech (SA scale), satisfaction of their own speech (SS scale) and the Japanese translation version of the Modified Erickson Communication Attitude scale (S-24). The test-retest reliability and internal consistency of the OASES-A-J were assessed. To examine the concurrent validity of the questionnaire, Pearson correlation was conducted between the OASES-A-J Impact score and the S-24 scale, SA scale and SS scale. In addition, Pearson correlation among the impact scores of each section and total were calculated to examine the construct validity.ResultsThe OASES-A-J showed a good test-retest reliability (r = 0.81–0.95) and high internal consistency (α > 0.80). Concurrent validity was moderate to high (0.55–0.75). Construct validity was confirmed by the relation between internal consistency in each section and correlation among sections’ impact scores. Japanese adults showed higher negative impact for ‘General Information’, ‘Reactions to Stuttering’ and ‘Quality of Life’ sections.ConclusionThese results suggest that the OASES-A-J is a reliable and valid instrument to measure the impact of stuttering on Japanese adults who stutter. The OASES-A-J could be used as a clinical tool in Japanese stuttering field.     

Formant transitions in the fluent speech of Farsi-speaking people who stutter

PurposeSecond formant (F2) transitions can be used to infer attributes of articulatory transitions. This study compared formant transitions during fluent speech segments of Farsi (Persian) speaking people who stutter and normally fluent Farsi speakers.MethodsTen Iranian males who stutter and 10 normally fluent Iranian males participated. Sixteen different “CVt” tokens were embedded within the phrase “Begu CVt an”. Measures included overall F2 transition frequency extents, durations, and derived overall slopes, initial F2 transition slopes at 30 ms and 60 ms, and speaking rate.Results(1) Mean overall formant frequency extent was significantly greater in 14 of the 16 CVt tokens for the group of stuttering speakers. (2) Stuttering speakers exhibited significantly longer overall F2 transitions for all 16 tokens compared to the nonstuttering speakers. (3) The overall F2 slopes were similar between the two groups. (4) The stuttering speakers exhibited significantly greater initial F2 transition slopes (positive or negative) for five of the 16 tokens at 30 ms and six of the 16 tokens at 60 ms. (5) The stuttering group produced a slower syllable rate than the non-stuttering group.ConclusionsDuring perceptually fluent utterances, the stuttering speakers had greater F2 frequency extents during transitions, took longer to reach vowel steady state, exhibited some evidence of steeper slopes at the beginning of transitions, had overall similar F2 formant slopes, and had slower speaking rates compared to nonstuttering speakers. Findings support the notion of different speech motor timing strategies in stuttering speakers. Findings are likely to be independent of the language spoken.Educational objectives This study compares aspects of F2 formant transitions between 10 stuttering and 10 nonstuttering speakers. Readers will be able to describe: (a) characteristics of formant frequency as a specific acoustic feature used to infer speech movements in stuttering and nonstuttering speakers, (b) two methods of measuring second formant (F2) transitions: the visual criteria method and fixed time criteria method, (c) characteristics of F2 transitions in the fluent speech of stuttering speakers and how those characteristics appear to differ from normally fluent speakers, and (d) possible cross-linguistic effects on acoustic analyses of stuttering.     

Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter.Educational objectives: The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.     

Preliminary study of self-perceived communication competence amongst adults who do and do not stutter

PurposeAdults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter.MethodsTwenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker’s Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency.ResultsAdults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores.DiscussionThis is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.     

Origin and Pawn scaling for adults who do and do not stutter: A preliminary comparison

PurposeIn order to determine whether adults who stutter (AWS) would show changes in locus of causality during stuttering treatment and approximate those of adults who do not stutter (AWNS) this preliminary study compared the locus of causality as indicated by Origin and Pawn scaling procedures from two groups of young adults who do and do not stutter.MethodA total of 20 age- and gender-matched undergraduate and graduate students who did (n = 10) and did not (n = 10) stutter participated. The AWS took part in a three week intensive stuttering treatment provided by the American Institute for Stuttering (AIS). Along with measures of treatment outcome, writing samples were analyzed for Origin and Pawn statements that indicated the participant's locus of causality.ResultsAt the outset of treatment the AWS showed significantly greater Pawn scores than the control group of AWNS and similar occurrences of Origin statements. The AWS showed a statistically significant increase in pre- to post-treatment Origin scores and a statistically significant decrease in Pawn scores. Following treatment the AWS showed the Origin and Pawn score ratios similar to those of AWNS.ConclusionA pattern of increasing Origin and decreasing Pawn scores may indicate a pattern of increasing agency during successful stuttering treatment. Moreover the post-treatment Origin and Pawn score ratios of AWS, which were not significantly different from those of AWNS, may indicate a change trend toward normalization. Further research will determine whether such change patterns are predictive of long-term maintenance.Educational Objectives: By reading this article the reader will be able to: (a) describe advantages of content analysis measure such as the Origin and Pawn Scales; (b) discuss the purposes and procedures of the Origin and Pawn Scales; (c) describe typical change pattern of Origin and Pawn scores of adults who stutter while receiving treatment; (d) discuss how successful treatment for stuttering can result in the normalization of one's locus of causality.     

Language and motor abilities of preschool children who stutter: Evidence from behavioral and kinematic indices of nonword repetition performance

Stuttering is a disorder of speech production that typically arises in the preschool years, and many accounts of its onset and development implicate language and motor processes as critical underlying factors. There have, however, been very few studies of speech motor control processes in preschool children who stutter. Hearing novel nonwords and reproducing them engages multiple neural networks, including those involved in phonological analysis and storage and speech motor programming and execution. We used this task to explore speech motor and language abilities of 31 children aged 4–5 years who were diagnosed as stuttering. We also used sensitive and specific standardized tests of speech and language abilities to determine which of the children who stutter had concomitant language and/or phonological disorders. Approximately half of our sample of stuttering children had language and/or phonological disorders. As previous investigations would suggest, the stuttering children with concomitant language or speech sound disorders produced significantly more errors on the nonword repetition task compared to typically developing children. In contrast, the children who were diagnosed as stuttering, but who had normal speech sound and language abilities, performed the nonword repetition task with equal accuracy compared to their normally fluent peers. Analyses of interarticulator motions during accurate and fluent productions of the nonwords revealed that the children who stutter (without concomitant disorders) showed higher variability in oral motor coordination indices. These results provide new evidence that preschool children diagnosed as stuttering lag their typically developing peers in maturation of speech motor control processes.Educational objectives: The reader will be able to: (a) discuss why performance on nonword repetition tasks has been investigated in children who stutter; (b) discuss why children who stutter in the current study had a higher incidence of concomitant language deficits compared to several other studies; (c) describe how performance differed on a nonword repetition test between children who stutter who do and do not have concomitant speech or language deficits; (d) make a general statement about speech motor control for nonword production in children who stutter compared to controls.     

Long-term Consequences of Childhood Bullying in Adults who Stutter: Social Anxiety,Fear of Negative Evaluation,Self-esteem,and Satisfaction with Life

Purpose: Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter.Method: Participants were 36 adults who stutter and 36 adults who do not stutter (mean age = 21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales.Results: The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales.Conclusion: Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted.     

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.     

Real and virtual classrooms can trigger the same levels of stuttering severity ratings and anxiety in school-age children and adolescents who stutter

PurposeMany school-age children and adolescents who stutter experience the fear of public speaking. Treatment implications include the need to address this problem. However, it is not always possible to train repeatedly in front of a real audience. The present study aimed to assess the relevance of using a virtual classroom in clinical practice with school-age children and adolescents who stutter.MethodsTen children and adolescents who stutter (aged 9–17 years old) had to speak in three different situations: in front of a real audience, in front of a virtual class and in an empty virtual apartment using a head-mounted display. We aimed to assess whether the self-rated levels of anxiety while speaking in front of a virtual audience reflect the levels of anxiety reported while speaking in front of a live audience, and if the stuttering level while speaking to a virtual class reflects the stuttering level while speaking in real conditions.ResultsResults show that the real audience creates higher anticipatory anxiety than the virtual class. However, both the self-reported anxiety levels and the stuttering severity ratings when talking in front of a virtual class did not differ from those observed when talking to a real audience, and were significantly higher than when talking in an empty virtual apartment.ConclusionOur results support the feasibility and relevance of using a virtual classroom to expose school-age children and adolescents who stutter to a feared situation during cognitive behavioral therapy targeting the fear of public speaking.     

A systematic review of interventions for adults who stutter

PurposeTo examine the effectiveness of (i) face to face interventions (ii) models of service delivery and (iii) psychological treatments combined with speech-focused interventions for adults who stutter.MethodsFive electronic databases and three clinical trial registries were searched. Systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with adults who stutter were included. Pharmaceutical interventions were excluded. Primary outcomes included a measure of stuttering severity. Risk of bias assessment was conducted on included studies and overall quality of the evidence was graded.ResultsFive RCTS, four registered trials and three systematic reviews met inclusion criteria. Intervention approaches included speech restructuring programs (e.g. Camperdown Program) and transcranial direct current stimulation (tDCS). One study investigated cognitive behaviour therapy (CBT) alongside speech restructuring. Overall, studies were classified low risk of bias and good quality. Speech restructuring was included in all but one study (tDCS study) and had the most evidence i.e. supported by the greatest number of RCTs. On average, stuttering frequency was reduced by 50–57 % using speech restructuring approaches. No study reduced stuttering to the same level as community controls who don’t stutter. The study on tDCS reduced stuttering frequency by 22–27 %. Speech restructuring delivered via telehealth was non-inferior to face-to-face intervention. One study reported CBT was an effective adjunct to speech restructuring interventions.ConclusionSpeech restructuring interventions were found to reduce stuttering in adults, however degree and maintenance of fluency varied. The body of evidence surrounding tDCS and psychological interventions is limited. Replication studies should be considered.     

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.     

Birth weight and stuttering: Evidence from three birth cohorts

PurposePrevious studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples.MethodsLogistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500 g; normal range; high birth weight, ≥4000 g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent.ResultsNone of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6–3.6 times more likely than females to stutter.ConclusionOur results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering.     

Validation and evaluation of the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering for School-age children (OASES-S-D)

BackgroundStuttering can have a negative impact on many aspects of a speaker's life. Comprehensive assessment must therefore examine a range of experiences in order to reflect the overall impact of the disorder.PurposeThis study evaluated the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering – School-age (OASES-S; Yaruss & Quesal, 2010), which examines the impact of stuttering on the lives of children ages 7–12.MethodThe OASES-S was translated to Dutch (OASES-S-D) using a forward/backward translation process. Participants were 101 Dutch-speaking children who stutter (ages 7–12) who were recruited by speech-language therapists throughout the Netherlands. All participants completed the OASES-S-D, the Children's Attitudes about Talking-Dutch, a self-assessment of severity, a clinical assessment of severity, and a speech satisfaction rating. A control group of 51 children who do not stutter also completed the OASES-S-D to determine whether the tool could differentiate between children who stutter and children who do not stutter.ResultsAll sections of the OASES-S-D except section I surpassed a Cronbach's alpha of 0.70, indicating good internal consistency and reliability. Comparisons between the OASES-S-D and other tools revealed moderate to high associations. The OASES-S-D was able to discriminate between children who stutter and children who do not stutter and between participants with different levels of stuttering severity.DiscussionThe OASES-S-D appears to be a reliable and valid measure that can be used to assess the impact of stuttering on 7- to 12-year old Dutch-speaking children who stutter.Educational Objectives: The reader will be able to: (a) describe the purpose of the OASES-S-D measurement tool; (b) summarize the translation process used in creating the OASES-S-D; (c) summarize the aspects of stuttering measured in the different sections of the OASES-S-D; (d) describe with what measurement tools the validity of the OASES-S-D was investigated; and (e) describe the differences between the American-English version and Dutch translation of the OASES-S.     

Which body features are associated with female adolescents’ body dissatisfaction? A cross-cultural study in Australia,China and Malaysia

This study investigated how dissatisfaction with various aspects of the body is associated with overall body dissatisfaction among female adolescents in Western and Asian cultures. Data used in the study were obtained from 58 Malaysian Malays, 95 Malaysian Chinese, 242 Chinese from China, and 81 non-Asian Australians aged 12–19 years (M = 15.72, SD = 1.72) who were recruited from high schools. Participants completed a questionnaire assessing dissatisfaction with their body overall, and dissatisfaction with varying aspects of their body. Malaysian Chinese were the most dissatisfied with their bodies. After controlling for body mass index (BMI), age and dissatisfaction with weight/shape, upper, middle and lower body, and muscles, dissatisfaction with the face was positively correlated with overall body dissatisfaction among Malaysian Malays and Australians. These findings demonstrate the importance of using assessment measures that address all possible areas of body focus as well as being tailored to the relevant culture.     

Traits of attention deficit/hyperactivity disorder in school-age children who stutter

PurposeThe purpose of this study was to explore whether parents of CWS reported the presence of ADHD symptoms that would warrant a referral to a psychologist to rule out the disorder. This study also aimed to describe the characteristics of the sample in terms of gender, family history of stuttering, presence of neurological impairment, concomitant diagnoses, and stuttering severity. Finally, this study sought to explore the possible statistical relations among these same variables.MethodsParticipants were 36 school-age CWS (32 males and 4 females) between the ages of 3.9 and 17.2 years (M = 10.4, SD = 4.0). Parent responses on the ADHD Rating Scale (Power et al., 2001) were collected via a retrospective chart review.ResultsFor this sample 58% (n = 21), of the participants met criteria for needing referral for additional evaluation for symptoms related to ADHD. A strong positive relation (r = .720, p < .001) was found between a reported family history of recovered stuttering and the presence of a concomitant diagnosis.ConclusionThe results of the present study demonstrate the need for further training and education for SLPs working with CWS regarding ADHD.Educational objectives: The reader will be able to (1) describe the main characteristics of ADHD, (2) discuss the evidence suggesting a possible relationship between ADHD and stuttering and (3) discuss how ADHD characteristics could impact clinical outcomes for CWS.     

The accuracy with which adults who do not stutter predict stuttering-related communication attitudes

The purpose of this study was to examine the extent to which adults who do not stutter can predict communication-related attitudes of adults who do stutter. 40 participants (mean age of 22.5 years) evaluated speech samples from an adult with mild stuttering and an adult with severe stuttering via audio-only (n = 20) or audio-visual (n = 20) modes to predict how the adults had responded on the S24 scale of communication attitudes. Participants correctly predicted which speaker had the more favorable S24 score, and the predicted scores were significantly different between the severity conditions. Across the four subgroups, predicted S24 scores differed from actual scores by 4–9 points. Predicted values were greater than the actual values for 3 of 4 subgroups, but still relatively positive in relation to the S24 norm sample. Stimulus presentation mode interacted with stuttering severity to affect prediction accuracy. The participants predicted the speakers’ negative self-attributions more accurately than their positive self-attributions. Findings suggest that adults who do not stutter estimate the communication-related attitudes of specific adults who stutter in a manner that is generally accurate, though, in some conditions, somewhat less favorable than the speaker's actual ratings. At a group level, adults who do not stutter demonstrate the ability to discern minimal versus average levels of attitudinal impact for speakers who stutter. The participants’ complex prediction patterns are discussed in relation to stereotype accuracy and classic views of negative stereotyping.Educational objectives: The reader will be able to (a) summarize main findings on research related to listeners’ attitudes toward people who stutter, (b) describe the extent to which people who do not stutter can predict the communication attitudes of people who do stutter; and (c) discuss how findings from the present study relate to previous findings on stereotypes about people who stutter.     

Long-term effectiveness of the SpeechEasy fluency-enhancement device

The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the SpeechEasy were maintained for longer periods, from 13 to 59 months. Results indicated no significant change for seven device users from post-fitting to the time of the study (t = ?.074, p = .943); however, findings varied greatly on a case-by-case basis. Most notably, when stuttering frequency for eleven users and former users, prior to device fitting, was compared to current stuttering frequency while not wearing the device, the change over time was found to be statistically significant (t = 2.851, p = .017), suggesting a carry-over effect of the device. There was no significant difference in stuttering frequency when users were wearing versus not wearing the device currently (t = 1.949, p = 0.92). Examinations of these results, as well as direction for future research, are described herein.Educational objectives: The reader will be able to: (a) identify and briefly describe two types of altered auditory feedback which the SpeechEasy incorporates in order to help reduce stuttering; (b) describe the carry-over effect found in this study, suggest effectiveness associated with the device over a longer period of time than previously reported, as well as its implications, and (c) list factors that might be assessed in future research involving this device in order to more narrowly determine which prospective users are most likely to benefit from employing the SpeechEasy.     

Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences

PurposeThe purpose of the present study was to enhance our understanding of phonological working memory in adults who stutter through the comparison of nonvocal versus vocal nonword repetition and phoneme elision task performance differences.MethodFor the vocal nonword repetition condition, participants repeated sets of 4- and 7-syllable nonwords (n = 12 per set). For the nonvocal nonword repetition condition, participants silently identified each target nonword from a subsequent set of three nonwords. For the vocal phoneme elision condition, participants repeated nonwords with a target phoneme eliminated. For the nonvocal phoneme elision condition, participants silently identified the nonword with the designated target phoneme eliminated from a subsequent set of three nonwords.ResultsAdults who stutter produced significantly fewer accurate initial productions of 7-syllable nonwords compared to adults who do not stutter. There were no talker group differences for the silent identification of nonwords, but both talker groups required significantly more mean number of attempts to accurately silently identify 7-syllable as compared to 4-syllable nonwords. For the vocal phoneme elision condition, adults who stutter were significantly less accurate than adults who do not stutter in their initial production and required a significantly higher mean number of attempts to accurately produce 7-syllable nonwords with a phoneme eliminated. This talker group difference was also significant for the nonvocal phoneme elision condition for both 4- and 7-syllable nonwords.ConclusionPresent findings suggest phonological working memory may contribute to the difficulties persons who stutter have establishing and/or maintaining fluent speech.Educational Objectives: (a) Readers can describe the role of phonological working memory in planning for and execution of speech; (b) readers can describe two experimental tasks for exploring the phonological working memory: nonword repetition and phoneme elision; (c) readers can describe how the nonword repetition and phoneme elision skills of adults who stutter differ from their typically fluent peers.