Toward an integrated approach to early childhood stuttering

This article proposes a model that integrates various factors influencing early childhood stuttering. The factors interact in a synergistic manner and can be subsumed under three macrofactors: physiological, psycholinguistic, and psychosocial. Such a model can be clinically applied toward an integrated approach to the assessment and treatment of the young stutterer.     

The problem of relapse in stuttering: Some thoughts on what might cause it and how to deal with it

Bloodstein recently wrote that “the most vital part of science is not accurate measurement or the insistence on empiricism. It is an attitude of inquiry into the how and why of things” [Bloodstein, O. Foreword. In: Maintenance of Fluency (E. Boberg ed.). New York: Elsevier, 1981, p. vii]. In the paper below, I present some unsubstantiated and no doubt controversial thoughts on the how and why of relapse in stuttering. The overall thrust of these thoughts is that stutterers have different propensities to stutter because of the inherent variability in their speech production systems. For this reason, for therapy to have long-range success, stutterers must learn to accept and deal with the inherent variability in their speech production mechanisms.     

Parental defense style and child competence: A match-mismatch hypothesis

This study sought to explore the possible relationship between parental style of psychological defense and children's social competence in 50 families in which one parent had been hospitalized for a psychiatric disorder. Based upon a formal analysis of the logical transformations inherent in various defense mechanisms, three levels of complexity of defenses were identified, along with a counterpart set of cognitive operations necessary for decoding these defense levels. It was hypothesized that children lacking the requisite cognitive skills to grasp the logical complexities of their disturbed parent's primary mode of psychological defense would be less socially adjusted and judged less competent than children who could understand the defensive transformations of their parent. The results suggested that children who, due to their cognitive immaturity, are potentially     

Student counseling groups in senior high school settings: An evaluation of outcome

This paper reviewed the studies which evaluated counseling groups in senior high school settings. A methodological evaluation was conducted within four areas: subjects, counselors, treatment, and outcome criteria. The studies were reviewed according to the type of outcome measure: achievement, attitude and personality, behavioral, and vocational. Three levels of voluntariness (voluntary, semivoluntary, and nonvoluntary) were examined in relation to outcome. Subjects who were free to volunteer for the group experience achieved greater gains than subjects who were coerced into participation. Overall, behavioral and directive groups achieved greater success than nondirective or client-centered groups. The time spent on topics relating to treatment goals appeared to be an important factor for success. Future researchers should assess the effects of treatment on each participant instead of relying upon group mean changes.     

Factors affecting judgments of fluency: I. interjections

Six speech samples containing varying amounts of schwa interjections were tape-recorded and presented to 36 male and 36 female listeners. For each sample, listeners were asked to make judgments of fluent, disfluent, and stuttered speech, and to answer the question “Would you recommend speech therapy?” Results indicated that speech samples containing 5% or more interjections evoked a judgment of disfluent speech by a majority of listeners. The sample containing 20% interjections, however, was found to evoke judgments of disfluent and stuttered speech about equally. Varying numbers of listeners recommended clinical services for disfluent speech. In general, the results indicated that (1) the presence of interjections in connected speech is not normal regardless of frequency, (2) fluent speech may not contain interjections in excess of 5%, and (3) with 20% interjections in speech, the distinction between disfluency and stuttering may be blurred.     

Stability of performances of individual stutterers on oral reading adaptation tasks

This study aimed to determine whether individual oral reading adaptation task performances are sufficiently reliable to be used as predictive indicators of improvement in stuttering behavior by testing the stability of individual stutterers' adaptation scores. Results demonstrated that all stutterers are not stable in their individual adaptation scores and therefore individual adaptation scores may be insufficiently reliable for predicting and classifying. Theoretical and clinical implications are discussed.     

Outcome predictors in the behavioral treatment of stuttering

The MMPI and subscales of the Stuttering Severity scale were utilized to predict motivation and success in the behavioral treatment of 32 stutterers. Subjects spent a mean of 10 individual sessions in criterion-oriented learning of fluent speech based on speech-muscle relaxation aided by EMG visual biofeedback. Judged motivation and judged success were strongly related to each other and significantly related to MMPI K and Es scores and negatively to F and Sc. Actual success was negatively related to Sc and Pd, completely unrelated to Es, and (if anything) negatively related to K. Results are consistent with previous studies, and show that global judgements of progress were only minimally related to a measure of actual progress.     

Bibliography of literature pertaining to the onset,development, and treatment of stuttering during the preschool years

This bibliography consists of clinical, experimental, and theoretical papers pertaining to the onset, development, and treatment of stuttering in children five- years old and younger. It is a downward extension of Silverman, F.H., Bibliography of literature pertaining to stuttering in elementary-school children, Journal of Fluency Disorders, 1978, 3, 87–102.