Case report of stuttering acquired in association with phenytoin use for post-head-injury seizures

Previous research indicates that stuttering and deficits in motor performance may be associated with the use of phenytoin (Dilantin). The present report concerns a case of stuttering acquired in association with phenytoin use for post-head-injury seizures. The extent and nature of dysfluencies and the motor performance of speech and nonspeech muscle systems were evaluated over an extended period during which changes in anticonvulsant medication were made. Reductions in dysfluency levels and improved motor performance were observed following a medication change from phenytoin to carbamazepine. Performance on tests assessing nonmotor functions, such as memory and attention, was equivalent before and after the medication change. The apparent association between dysfluency levels, motor performance deficits, and phenytoin suggest that in the present case stuttering resulted in part from a general impairment in motor control.     

Are mothers of stutterers different? An investigation of social-communicative integration

Many speech-language pathologists assume that parent-child communicative interactions are critical precipitating or maintaining factors in the onset and development of stuttering. Although parents are frequently counseled to alter their attitudes or behaviors, no studies have pinpointed specific parental behaviors as increasing children's disfluency. The purpose of this study was to analyze differences between 12 mothers of stutterers and 12 mothers of nonstutterers in their social-communicative interactions with their own child, an unfamiliar stutterer, and an unfamiliar nonstutterer. Ten minutes of free-play interaction between each mother and child were video recorded from behind a one-way mirror. Results indicate that the two groups of mothers differed significantly only in their use of routine statements. Other findings indicate that stuttering children used significantly more positive and imperative statements than nonstuttering children. All children asked significantly more questions of their own mothers than of unfamiliar mothers.     

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.     

Patterns of vocal fold movement during stuttering

By means of an electroglottography, 114 tokens of stuttering produced by 12 adult stutterers were analyzed for patterns of vocal fold vibration as observed in eight types of stuttering episodes. Results suggest that stuttering events share certain phonational attributes. Issues concerning the nature of the disorder and approach to treatment are discussed.     

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.     

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.     

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.