Stuttering and anxiety: The difference between stutterers and nonstutterers in verbal apprehension and physiologic arousal during the anticipation of speech and non-speech tasks

To test if stressful anticipation of speech situations is a factor in eliciting stuttering behavior, the difference between 24 stutterers and 24 nonstutterers in verbal apprehension and physiologic activity was studied before and during speech tasks (reading and conversation), and nonspeech tasks (motor and intelligence task).Results indicate that the difference between stutterers and nonstutterers mainly were restricted to anxiety ratings assessed after each task. Heart rate, vasomotor responses, and electrodermal activity recorded before and during speech tasks were higher compared with the physiologic activity before and during nonspeech tasks but, unexpectedly, this was also the case for nonstutterers. It is concluded that stuttering is not elicited by anxiety.     

Multiple component agraphia in a patient with atypical cerebral dominance: an error analysis

A 52-year-old man with atypical cerebral dominance (left-handed for writing but mixed handedness for other tasks) suffered an extensive right hemisphere stroke, resulting in a combination of deficits that has not been previously reported. There were profound visual constructive and visual perceptual disturbances and a spatial agraphia, which were consistent with a nondominant hemisphere lesion. There was also a severe apraxic agraphia, which is typically associated with a dominant hemisphere lesion, but no other signs of dominant hemisphere dysfunction such as linguistic disturbance or limb-motor apraxia were present. This case serves to highlight the functional and anatomical relationship between handwriting and other forms of praxis; the various sources of error in letter formation; the need to be specific in labeling and describing agraphias ; and the role of a detailed analysis of writing errors in delineating the neuropsychological processes involved in handwriting.     

On the Ethics of Constructing Realities

The author describes the successful use of Solution-Focused Brief Therapy intervention with an 11-year-old female who had been hospitalized for two weeks because she could not walk. He raises some ethical questions about the use of diagnosis “if, or when, we know different and maybe faster and simpler ways to find out what can be helpful?”     

FREE SPEECH

Recognition of the harms done by free speech is a function of the social ontology presupposed. An atomist ontology implies that the harms suffered are restricted to individual people. This paper suggests an alternate ontology—one that describes systems established by the causal reciprocities of their proper parts. It proposes a consequentialist moral theory, and considers the harms suffered by these systems (a) when speech exposes their internal, otherwise private, behaviors or features, (b) when speech is malicious and false, and (c) when speech is monopolistic. Does the proposed ontology have objectionable implications for public policy? Alternative answers are considered briefly.     

A path analysis model of psychosexuality in young women

Path analysis is employed to delineate the relationships among sexual behavior variables, including orgasm consistency, masturbation frequency, cognitive sexual arousal, and satisfaction with sexual responsivity. The analysis provides insights into the processes by which the variables are related to one another and generates specific hypotheses for future questionnaire and experimental research. The results are used to develop a psychosexual model for women, which holds that a masturbation/orgasm sequence may be a prerequisite for an understanding of cognitive elements leading to arousal and their physiological concomitants. Once this platform has been established, a single-partner-oriented sexual adjustment is possible, but a frequent exchange of partners at this time may prove detrimental to sexual satisfaction. Later on in life, intercourse frequency may diminish, and moderate sexual dissatisfaction may develop. The implications of this model for further research are explored. Replication and extension of this study with additional measures and older populations of women is recommended.     

The use of self-efficacy scaling in training student clinicians: Implications for working with stutterers

A scaling technique developed by Bandura for determining an individual's personal performance expectations (self efficacy) was applied to student clinicians working with stutterers. The self-efficacy scores of clinicians conducting treatment increased significantly while the scores of clinicians without treatment experience showed no significant change. As the student clinicians gained clinical experience there appeared to be a corresponding reduction in fear and avoidance of the treatment situation. Clinician fear concerning stuttering treatment appeared to have little relation to performance in treatment as rated by supervisors. The results indicate that self-efficacy scaling may be used to indicate clinician avoidance of working with stuttering clients.     

Group play therapy for Japanese children who stutter

Twenty-one sessions of group play therapy were conducted with children who stutter in order to improve their stuttering and to promote their development in social adaptation. Follow-up surveys were made 6 mo and 5 yr after therapy.As therapy progressed, a definite process of change was observed in each child, from periods of anxiety, appearance of aggressive behavior, frequent occurence of aggressive behavior, to a decrease in aggressive behavior. After the appearance of aggressive behavior, a fluctuation in stuttering occured as cooperative play with other children was established. This was followed by a decrease in stuttering. The appearance of aggressive behavior during therapy is thought to be of major significance for the disappearance of stuttering and for interpersonal relationships.A follow-up survey showed that both stuttering and social adjustment had improved, indicating the effectiveness of therapy.     

Learning from negative outcomes in stuttering therapy: II. An epiphany of failures

Proceeding on the premise that learning advances on the feet of failure, a litany of therapeutic failures with stutterers across 3 decades is recounted. The basis for these failures included the assumptions that stuttering is a neurotic symptom; that “lucky fluency” can be maintained permanently; that a fluent drone is preferable to stuttering; that controlled fluency, once established, can be maintained permanently; that a proper task for clinicians is to motivate clients to achieve and preserve fluency; that the clinician has the responsibility for marching clients through their therapeutic paces; and that stuttering is punishing to the stutterer, so it is not preserved by reinforcement. Unfortunately, more has probably been learned about what does not work than what does.     

Nature of spelling errors in transcortical sensory aphasia: A case study

The nature and extent of spelling errors in a patient with transcortical sensory aphasia were investigated. The two experimental conditions required the patient to spell monosyllabic and polysyllabic words both verbally and in written form. Analysis of the spelling errors revealed partially preserved knowledge of the visual image of a word as a whole, as well as preserved knowledge of temporal order. Our patient's error patterns in both conditions were more similar than dissimilar. These findings in conjunction with results reported in the literature indicate that patients exhibiting different aphasia syndromes use separate spelling strategies.     

The effect of an intensive behavioral program on the distribution of EEG alpha power in stutterers during the processing of verbal and visuospatial information

Prior to an intensive behavioral treatment program, stutterers showed greater than normal activation of the posterior frontal region of the right hemisphere during the performance of speech tasks. After treatment they showed increases in proportional alpha for most regions of the two cerebral hemispheres, but most markedly for the posterior frontal region of the right hemisphere for both verbal and nonverbal tasks. This increase resulted in a reversal of the previous R/L interhemispheric alpha relationships with the left posterior frontal region showing greater activation during speech after treatment. The relationship of this finding to previous findings is briefly discussed and an hypothesis of decreased inhibitory control of the right hemisphere at the posterior frontal region by the left hemisphere during speech in stutterers is proposed and briefly expounded.