A component model for diagnosing and treating children who stutter

Nine components of stuttering and their distribution among 54 children who stutter are described. The components are arranged into a model that includes four neurologic components (attending disorder, auditory-processing disorder, sentence-formulation disorder, and oral-motor disorder) and five traditional components (high self-expectations, manipulative stuttering, disruptive communication environment, unrealistic parental expectations, and abnormal parental need for the child to stutter). Diagnostic and treatment usefulness of the model are discussed. Thirty-two of the children have been followed through component-based treatment and 12 mo post termination. Results indicate that treatment was successful with 27 (84%) of the 32 children. Only one child regressed during the 12 mo after treatment ended. These results suggest that treating the neurologic and traditional factors which disrupt fluency improves maintenance and carry-over.     

Maintenance of fluency: A review

Three purposes for writing this paper are: to review specific work done on the maintenance of fluency in the post-treatment environment, to abstract and discuss pertinent issues in maintenance, and to present several speculative positions which might account for the relapse phenomenon and stimulate further research.     

Listener preferences for stuttered and syllable-timed speech production

The purpose of this study was to determine how “naive” listeners react to syllable-timed speech production. Three stutterers were videotape recorded while speaking in their usual manner and pacing their speech at 100 words per minute (wpm) and 70 wpm. Twenty-three listeners rated the speech samples as to which they preferred to hear. The results indicated generally that listeners preferred paced speech to stuttering.     

Suggestibility and type of interpersonal relationship: Special implications for the patient-practitioner relationship

Suggestibility was assessed in five conditions by the subject's response to suggestions falsely labeled as matters of fact. These misrepresentations of fact, or virtual suggestions, denoted a variety of hallucinations, an anesthesia, and an amnesia. They were administered as incidental intrusions while the subject was involved in the primary experimental task. In three of these conditions, the subject either observed his own spontaneous visual imagery, observed visual scenes provided by the experimenter, or simply waited with closed eyes for the presentation of the virtual stimuli. These conditions were characterized by a passive-receptive, interpersonal relationship in which the subject remained silent. Suggestibility was expected to be high. In a fourth condition the subjects described spontaneous visual imagery. This was characterized as an active-receptive relationship in which speech was maintained throughout. The suggestibility of the three passive-receptive conditions was comparable, and none of them differed from a baseline condition involving the formal induction of hypnosis. However, the fourth, active-receptive condition was significantly lower, and this difference survived a replication. Of special interest was the induction of an anesthesia in the majority of subjects in the three passive-receptive conditions.     

Androgyny and traditional versus nontraditional major choice among college freshmen

The present study investigated the relationship of psychological androgyny to career choice among college freshmen. Women in home economics and engineering and men in engineering (N = 231) completed the Bem Sex-Role Inventory and rating scales of satisfaction with and certainty of college major and intended occupation. As a group, women in engineering scored in a more androgynous direction than did either men in engineering or women in home economics. Among sex-typed subjects, more women in engineering scored in a masculine sex-typed category than did women in home economics. Men and women in engineering did not differ on satisfaction and certainty ratings of major or career; however, feminine-typed women were significantly less satisfied with and tended to be less certain of their choice of major than other women in engineering.     

THE TIMEOUT RIBBON: A NONEXCLUSIONARY TIMEOUT PROCEDURE1

Recently, the use of timeout rooms has been questioned by various agencies, and some have adopted policies that prohibit or greatly restrict exclusionary timeout. The present study developed a timeout procedure that did not require removal of the misbehaver from the learning environment. The procedure was applied to the disruptive behaviors of five severely retarded children in an institutional special-education classroom. An observer prompted all teacher behaviors related to the procedures to assure their precise implementation. After baseline, a reinforcement-only condition was implemented. Each child was given a different colored ribbon to wear as a tie and received edibles and praise every few minutes for good behavior and for wearing the ribbon. When timeout was added, a child's ribbon was removed for any instance of misbehavior and teacher attention and participation in activities ceased for three minutes or until the misbehavior stopped. Reinforcement continued at other times for appropriate behavior. An ABCBC reversal design was used to demonstrate control of the behavior by the conditions applied. On average, the children misbehaved 42% and 32% of the time during the baseline and reinforcement conditions respectively but only 6% of the time during the timeout conditions. A followup probe during the new school year revealed that the teacher was able to conduct the procedure independently and that the children's disruptive behaviors were maintained at low levels. The practicality and acceptability of the procedure were supported further by the successful implementation of the procedure by a teacher in another state and by responses to a questionnaire given to 40 mental health professionals. The ribbon procedure appears to be a viable form of timeout, provided that disruptive behaviors during timeout can be tolerated within the setting, or a backup procedure such as exclusionary timeout is available when needed.     

GENERALIZATION EFFECTS FROM INTRATHERAPY ARTICULATION TRAINING: A CASE STUDY1

This study analyzed generalization effects found associated with a language-training intervention to modify the articulation (/f/ phoneme) of a 3.5-year-old boy. The McLean and Raymore Stimulus Shift Articulation Program was implemented by the subject's mother. This language training program is designed to produce setting generalization effects based on an intratherapy training model (i.e., systematic training is applied in a single setting to promote transfer effects to nontraining environments). The intervention resulted in a significant improvement in the subject's production of the /f/ phoneme within the clinical setting in response to untrained stimuli (stimulus generalization). Additionally, the subject's correct phoneme production was observed to generalize to his home and school settings (setting generalization) under “opportunity loaded” (picture prompts) and “spontaneous” (no prompts) conditions. The results provide case-study evidence that stimulus generalization, both within and across settings, may occur with exclusively intratherapy articulation training.     

Perceptual study of the speech of “successfully therapeutized” stutterers

The purpose of this investigation was to determine if the fluent speech of “successfully therapeutized” stutterers and a group of partially treated stutterers was perceptually different from the fluent speech of normal speaking subjects. Tape recorded speech samples of treated stutterers were obtained from leading exponents of (1) Van Riperian, (2) metronome-conditioned speech retraining, (3) delayed auditory feedback, (4) operant conditioning, (5) precision fluency shaping, and (6) “holistic” therapy programs. All forms of disfluency were edited out of these tapes. The remaining samples were then paired with matched fluent samples of normal talkers and presented to a group of 20 sophisticated judges. The judges were instructed to select from each paired speech sample presented to them the one produced by the stuttering subject. The results of the analyses of variance for correct identification of the stutterers showed that the partially treated stutterers, as well as each group of therapeutized stutterers, were identified at levels significantly above chance. This meant that the fluent speech of the partially and successfully treated stutterers was perceptibly different from the utterances of the normal speakers sampled. In addition, the analyses of variance also revealed that all stuttering groups had a significant severity factor. This finding indicated there was a significant difference between the severity subgroup in all the samples investigated. These results were discussed in terms of their clinical implications.     

Dimensions of stuttering and relationship to psychopathology

This article reports two studies. The first attempted to define stable dimensions within the Stuttering Severity (SS) scale. A factor analysis of correlations among its 64 items defined four factor-based subscales, and three additional subscales were developed rationally. Relationships among these seven subscales suggested the existence of two major dimensions. The second study investigated the relationship of the seven subscales to psychopathology. Correlations were obtained among the subscales and MMPI scales for 69 subjects, and were subjected to a second factor analysis. The MMPI scales and the SS subscales clearly loaded on separate factors, indicating little relationship between dimensions of stuttering and psychopathology as defined by MMPI scores. The second analysis also supported the previous identification of two general dimensions for stuttering. Items were selected for two final scales to represent these dimensions, labeled behavior (22 items) and sensitivity (20 items). Norms were developed for them and also for the full 64-item SS scale.     

Brightness contrast: a reinterpretation of compound cue and combined cue experiments with pigeons.

A group of three pigeons was trained on a 4-ply multiple schedule: a green color and a vertical line superimposed upon an achromatic background as positive stimuli, and a red color and a horizontal line on an achromatic background as negative stimuli. The pigeons were tested with the vertical line superimposed upon different achromatic background intensities, then with the vertical line superimposed upon different green background intensities, and finally with the vertical line and its training achromatic backgfound attenuated (and unattenuated) by a neutral density filter. The gradients peaked at the luminance of the achromatic background used during training and at the equivalent luminance for the green background when it was substituted for the achromatic background. The brightness contrast, not the background luminance, was the critical variable as the neutral density filter attenuated both the line and the background equally, leaving brightness contrast unchanged; there was no response decrement to this attenuated stimulus. Two other groups of three pigeons showed that they attended to line orientation as well as to brightness contrast. The brightness contrast hypothesis was extended to explain results of attention experiments and combined cue experiments which have used line stimuli in combinations with different backgrounds.