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.     

Case study of a Thai conduction aphasic

A case study of a 55-year-old nonfamilial left-handed monolingual Thai patient with clinical and pathoanatomic evidence of major infarction in the left temporoparietal region is presented. He was studied at 9 years poststroke with a Thai adaptation of the Boston Diagnostic Aphasia Exam and supplementary tests. His language characteristics included fluent spontaneous speech, near-normal auditory language comprehension, and poor repetition, leading to a diagnosis of conduction aphasia. In regard to this aphasic syndrome, issues concerning classification, neuroanatomic correlates, and underlying neuropsychological mechanisms are addressed. The nature of his grammatical disturbance is examined critically in light of the notion of “information load.”     

Factor-derived categories of chronic aphasia

A large sample of patients with aphasia (N = 118), unselected for etiology, were administered the Porch Index of Communicative Ability more than 6 months after the onset of aphasia. Factor analysis of PICA subtest scores identified five factors which accounted for 83.9% of the total variance. The factors were labeled speaking, writing, comprehension, gesturing, and copying. Cluster analyses of the factor scores yielded five patient categories which differed in the pattern of impairment on the language factors as well as in overall severity of aphasia. A subgroup of the parent sample consisting of 52 patients with localized left-hemisphere CVA had cluster analyses repeated after having first been studied as part of the larger sample. The factor-derived categories for the subgroup were similar to those of the entire group. Discriminant functions of the PICA raw scores of the 52-patient subsample correctly classified all of the patients. When discriminant functions were based upon the factor scores of the 118-patient parent sample, 80.7% of the 52 patients were correctly classified into the five categories.     

The precision fluency shaping program: Replication and evaluation

The purpose of this article is to present the results of a two-year project to evaluate the Precision Fluency Shaping Program (Webster, 1980) in a community speech and hearing center. Fifty stutterers participated in therapy. Results indicated that Precision Fluency Shaping was an effective therapy for the treatment of stuttering. In addition, stutterer's perception of their speech changed from pre to post therapy. Follow-up data are presented on 28 clients. Advantages of conducting Precision Fluency Shaping, meeting accountability standards, and procedures for collecting follow-up data are discussed.     

Disfluent speech associated with brain damage

The frequency and type of disfluencies in the spontaneous speech of 15 people with Broca's aphasia and right hemiplegia was studied. Two aged-matched control groups (15 nonaphasic stroke patients with left hemiplegia and 15 normals) were also studied. The frequency of disfluencies in the speech of aphasics was three times greater than that in the speech of either control group. However, most of the disfluencies uttered by aphasics were of the types commonly found in speech of normals.     

Rate reduction strategies used by normally fluent and stuttering children and adults

Speech rate can be reduced by prolonging the duration of phonetic units, by pausing between words, or through a combination of these approaches. Child and adult normally fluent speakers and stutterers were tested in basal and modified speaking rate conditions. Subjects' utterances in both conditions were converted to spectrographic displays so that measures of phonetic and pause durations could be made. Comparisons of these measures across conditions revealed that all four groups of subjects spontaneously extended pause and phonetic durations, the former more than the latter, when instructed to voluntarily reduce speech rate.     

A survey of communicative disorders students' attitudes toward stuttering

Cooper's (1975) Clinician Attitudes Toward Stuttering (CATS) inventories were conpleted by 1,902 speech-language pathology and audiology students from 33 universities, each in a different state. The majority of respondents perceived stutterers as having psychosocial problems and believed that client and parental counseling were essential aspects of treatment. These views were relatively unaffected by student training and clinical exposure. In addition, most of the assumptions of Johnson's diagnosogenic theory of stuttering were held by the majority of the students surveyed. Most of the respondents believed that stuttering was difficult to modify and that speech clinicians were neither adept nor comfortable treating stutterers. These latter attitudes were significantly affected by training, i.e., the more advanced the students' training, the more pessimistic their views on clinician competence. Other professional attitudes and the effect of training on them are also discussed.     

Issues to consider in the differential diagnosis of normal childhood nonfluencies and stuttering

Historically more attention has been focused on the adult stutterer than on the young stutterer. This article discusses three key issues in the differential diagnosis of normal childhood nonfluencies and childhood stuttering. The three issues are (1) whether early childhood disfluencies are heterogeneous or homogeneous phenomena, (2) whether the relationship between normal childhood nonfluencies and early stuttering is continuous or dichotomous, and (3) whether normal nonfluencies and stuttering differ quantitatively or qualitatively. Theoretical research as well as clinical implications of these issues are discussed.     

Speech timing skills of normally fluent and stuttering children and adults

This study was designed to explore the speech timing skills of normally fluent and stuttering children and adults producing two sentences, ten consecutive times at basal and modified speaking rates. Spectrographic displays of subjects' utterances in both conditions were made in order to obtain consonant, vowel, pause, and utterance duration measures. Results showed that (1) the two groups of children produced speech durational values similar to those of the two adult groups and (3) there were no consistent between- and within-group differences in the basal and modified rate conditions. Findings are discussed in terms of methodological and sampling differences that exist between the present study and past research on stutterers' speech production abilities.     

Influence of stuttering therapy on clinicians'' disfluencies: Effects of client modeling

This study investigated whether student clinicians working with stutterers subsequently produce more disfluencies than student clinicians providing therapy to clients with other speech and language disorders. Seventeen graduate students working in a 6-wk summer camp setting were divided into two groups: eight who provided treatment for stutterers (group 1) and nine who provided therapy for clients with other communication disorders (group 2). All student clinicians were recorded during spontaneous speaking and oral reading tasks prior to camper arrival and following camper departure. An eight-category classification system was used to determine disfluency types. Findings revealed that Group 1 clinicians significantly decreased their total disfluencies between pre- and post-camp recordings on the spontaneous speaking task. Unexpectedly, this same group also substantially increased part-word repetitions and sound prolongations. The possibilities of incidental learning, reverse modeling, and overidentification with stuttering clients are discussed.