Primary-school stutterers: Have attitudes changed?

How concerned are primary-school-aged stuttering children about their communication problem? What are the clinical implications of this concern?Fifteen years ago, Silverman (1970) suggested that primary-school-aged children who stuttered were not concerned about their disfluencies. A clinical implication of that report was that the interpreted lack of concern might negatively affect the children's motivation and desire for change in therapy. Scant research exists to support or refute this implication. While research is available on reactions to stuttering, pretherapeutic attitudes—especially those of children—have not been systematically reported. Guitar (1976) measured the pre-treatment attitudes of 38 adult stutterers and reported that, “those stutterers with more negative attitudes measured just prior to treatment, were most likely to have high levels of stuttering a year later, even though all subjects left therapy entirely fluent.” In related areas, research by Kolb, Winter, and Berlen (1968), McFall (1970), and McFall and Hammen (1971) has indicated that clients who are more motivated do better in behavior modification programs.Whether or not these findings may be generalized to children, in the midst of a developmental process, is purely speculative.     

Deep dyslexia in childhood?

Deep dyslexia is an acquired reading disorder in which semantic substitutions (e.g., city read as town) are made in reading single isolated words. In this paper, evidence for deep dyslexic-type errors is presented from the word-recognition responses of six children, aged 7 years and 0 month to 8 years and 9 months, with severe reading disorders. These semantic substitutions occur in the absence of phonological skills. Therefore, it appears that there exists a small subset of developmental dyslexics who at the beginning of acquisition of reading skills are able to engage in semantic processing, but who show severe impairment of phonological processing. The existence of these reading errors indicate that the use of a phonological code is not necessary to extract meaning from the printed word.     

Treatment of chronic global aphasia with a nonverbal communication system

Four chronic global aphasics were treated with Blissymbols (C. K. Bliss, 1965, Semantography-Blissymbolics, Sydney: Semantography Pub.). As soon as possible the therapeutic communication was based solely on the use of the symbols. Three patients seemed to benefit from therapy. In one case therapy had to be discontinued because of massive perseveration. In one patient expression of needs relied solely on the use of the symbols. In another, expressive speech could be restored to such an extent that communication by the use of symbols was discontinued.     

The word-superiority effect under conditions that approximate reading

Observers detected a briefly flashed target letter embedded in word, pronounceable nonword, and unpronounceable nonword contexts. The word context facilitated perception under both holistic and analytical processing strategies; the facilitative effect was enhanced when processing was analytical.     

Different methods of lexical access for words presented in the left and right visual hemifields

Right-handed adults were asked to identify by name bilaterally presented words and pronounceable nonwords. For words in the normal horizontal format, word length (number of letters) affected left visual hemifield (LVF) but not right visual hemifield (RVF) performance in Experiments 1, 2, 3, 5, and 6. This finding was made for words of high and low frequency (Experiment 6) and imageability (Experiment 5). It also held across markedly different levels of overall performance (Experiments 1 and 2), and across different relative positionings of short and long words in the LVF and RVF (Experiment 3). Experiment 4 demonstrated that the variable affecting LVF performance is the number of letters in a word, not its phonological length. For pronounceable nonwords (Experiment 7) and words in unusual formats (Experiment 8), however, length affected both LVF and RVF performance. The characteristics identified for RVF performance in these experiments also hold for the normal reading system. In this (normal) system the absence of length effects for horizontally formatted words is generally taken to reflect the processes involved in lexical access. Length effects in the normal reading system are thought to arise when lexical access for unusually formatted words and for the pronunciation of nonwords requires the short-term storage of information at a graphemic level of analysis. The characteristics of LVF performance indicate that horizontally formatted words presented to the right cerebral hemisphere can only achieve lexical access by a method that requires the short-term storage of graphemic information. This qualitative difference in methods of lexical access applies regardless of whether the right hemisphere is seen as accessing words in the left hemisphere's lexicon or words in a lexicon of its own.     

USE OF ESCAPE AND REWARD IN THE MANAGEMENT OF YOUNG CHILDREN DURING DENTAL TREATMENT

A reinforced practice procedure was used to facilitate cooperative behavior in five children, aged 3 to 6 years, during dental treatment. In a multiple baseline design across subjects, the children were rewarded with escape, inexpensive stickers, and praise for cooperative behavior in the presence of the sights, sounds, and some sensations of the dental instruments prior to actual dental treatment. Direct observations of disruptive behavior via a 15-s interval recording system indicated baseline levels as high as 90% were reduced to less than 15% by the final treatment visit. In addition, the procedure was effective in reducing overall heart rate and blood pressure reactivity to dental treatment. All children were rated by the involved dental professionals as more cooperative and relaxed following exposure to reinforced practice.     

SOCIAL INFLUENCES ON “SELF-STIMULATORY” BEHAVIOR: ANALYSIS AND TREATMENT APPLICATION

We tested the hypothesis that the “self-stimulatory” behaviors exhibited by some individuals may be socially mediated. Four developmentally disabled children who exhibited hand flapping and body rocking participated in a series of three experiments conducted to assess the influence of social variables on stereotyped behavior and to develop a treatment based on the assessment. Experiment 1 used an assessment procedure to determine the relative influences of social attention and task demands on stereotyped behavior. For all four children, hand flapping and body rocking increased when difficult academic tasks were introduced. Experiment 2 involved the use of a procedural time-out and demonstrated that removing task demands contingent on stereotyped behavior resulted in increased rates of hand flapping and body rocking. In Experiment 3, these results were used to develop a communication treatment that consisted of teaching the children to request assistance on the difficult tasks. This treatment resulted in significant reductions in self-stimulatory behavior. These results are consistent with the hypothesis that some forms of repetitive stereotyped behavior may come to serve social functions (e.g., escape from aversive situations). Teaching a functionally equivalent communicative alternative to escape-motivated stereotyped behavior can be an effective form of intervention for this problem.     

MAINTAINING PERFORMANCE OF AUTISTIC CLIENTS IN COMMUNITY SETTINGS WITH DELAYED CONTINGENCIES

To facilitate the classroom and workshop integration of three autistic clients, we examined the feasibility of teaching them to respond appropriately without the continual presence of specially trained treatment providers. Within a multiple baseline design, a 4-step treatment process was implemented to promote durable responsive performance. Results indicated that the therapist could be removed from the treatment environment and that appropriate behavior could be successfully maintained in community settings with only infrequent and delayed contingencies.