Abstracts for Research Papers
Perfectionistic individuals set unrealistic personal standards and are self-critical. Preliminary research revealed that people who stutter (PWS) are more perfectionistic than people who do not. This study investigated a treatment model combining Cognitive Behavior Therapy and Stuttering Modification (CBT-SM) to determine its effects on perfectionistic tendencies in PWS. Levels of perfectionism and stuttering severity were measured in eight PWS before CBT-SM, after CBT-SM, and at 15 weeks follow-up. After treatment, participants’ perfectionism scores decreased and communication attitudes improved. At follow-up, participants’ perfectionism scores continued to reduce. Participants displayed a statistically significant reduction in stuttering severity at follow-up.
The primary purpose of this
investigation was to examine the relations between temperament and parenting
behaviors in preschool children who do (CWS; n = 19) and do not stutter (CWNS; n = 24). Parents completed the short form of the Children’s Behavior Questionnaire and an
adaptation of the Child Rearing Practices
Report. Findings revealed both similarities and differences between CWS and
CWNS in temperament-parenting relations, suggesting that the potential
association between temperament and developmental stuttering may be moderated
by parental behaviors.
This study examined effects of holistic/incremental phonological priming on picture naming (Byrd, Conture & Ohde, 2005) in children who do (CWS) and do not stutter (CWNS) using behavioral and psychophysiological (event-related potential, ERP) measures. Participants were 3- to 6-year-old CWS and age- and gender-matched CWNS. Preliminary results indicate that prime type differences affect speech-reaction time (SRT) and picture-naming accuracy in CWS and CWNS. ERP analyses identified early (100-200ms) and late (approx. 450 ms) components reflecting prime-specific differences associated with phonological processing of picture naming.
The Wright and Ayre Stuttering Self-Rating Profile (WASSP, 2000) has been
used internationally for assessment, planning therapy and outcome measurement.
A review of WASSP was carried out to consider revision and recommendations.
Staff from the Stuttering Information Center of Denmark obtained permission to
translate WASSP for use in
Out
of a clinical population of 2000 Dutch speaking stammering children and adults
two groups are constructed to study the long term effects of a social cognitive
behaviour therapy for stuttering: an experimental group (“with
therapy”) and a matched control group (“without therapy”). A stratified research design is set up to
measure the post therapy results on stuttering, speech attitude, personality
traits, quality of life (outcome). The
effect is observed in relation to the pre therapy results and principal
variables such as gender, subtype of stuttering, age category (1-6, 7-12, 13-18
and > 18 years) and initial severity of stuttering.
To stimulate discussion and debate, I’ll explain for 10-15 minutes:
Discussion will follow in the remaining time.
This presentation will outline the background to the development of a
national teaching programme for generalist and specialist therapists in the management of children
who stutter. It will discuss the
delivery of two three-day teaching packages for working with under
sevens and seven to fourteen year olds who stutter. We will evaluate participants’
feedback forms both quantitatively and qualitatively. In conclusion we will
present the results of a questionnaire designed to identify changes in practice
over the medium to long term. We will reflect on the impact this training has
had on local service delivery.
The two models for the diagnosis and treatment of
stuttering, used by the department of Otorhinolaryngology-Phoniatrics
of the Erasmus MC, University Medical Center Rotterdam, the
Information about the onset and
development of dysfluency in Down syndrome is
severely limited. We know that a high
percentage of adults with the syndrome are dysfluent
(45%), but we have no knowledge of the links between childhood dysfluency and its persistence into adulthood. In-depth case studies of two young children
who have been recently identified as stuttering by their parents will be
presented. Linguistic and phonetic analysis
of the children’s speech and language from samples collected over a 9 month
period, as well as the family histories and coping styles will be
discussed. The findings will be linked
to current linguistic and neurobiological ideas about stuttering.
This paper will describe the process of change
underlying the introduction of an integrated approach to adult stammering
therapy into a programme which had hitherto been exclusively ‘stammer more
fluently’ based. The rationale for the change will be given and some preliminary
findings presented. We shall refer back to the history of adult stammering
therapy in the
Sixty fluency experts rated how accurately fifty statements from the literature described characteristics of cluttering. Fifteen items were rated characteristic of cluttering 66% or more of the time. "Repetition of multi-syllabic words" and "Rapid rate with intact articulation" were not included among the top 15 items. Experts also rank-ordered the characteristics' importance for clinical diagnosis. Interestingly, not all items rated within the 15 items appeared in the top ten rankings. Implications of the experts' top and bottom rankings and ratings will be discussed. The feasibility of using these data to develop a meaningful diagnostic inventory will be presented.
The results will be reported of an ongoing
study that investigates stuttering severity as a possible variable to take into
account when considering the use of Delayed Auditory Feedback (DAF) in an
individual client. Analyses completed thus far in five male participants (age
13 to 48 years) with developmental stuttering of different degrees of severity
suggest that the amount of reduction of stuttered disfluencies
is not necessarily larger when stuttering is more severe and that just like normals also stuttering individuals may demonstrate an
increase of disfluencies
as the result of DAF.
Most of the children with Down’s syndrome have
speech and language disorders and show a higher frequency of speech dysfluencies. Depending on the study, prevalences
as high as 77% for stuttering and/or cluttering are
reported. The literature is somewhat ambiguous in labelling these dysfluencies: stuttering, cluttering, or as some authors
suggest, an increased amount of normal dysfluencies. In
this study the speech of 150 people with Down’s syndrome, within 3 different
age categories (<12;11, 13y.-21;11, >22)
will be assessed. A qualitative and quantitative analysis of the dysfluencies will be performed. We will report on our
preliminary findings of a possible link between language level, motor aspects
and speech dysfluencies.
Asynchronies in developmental linguistic domains may be linked to speech
disfluencies. So far, relatively little attention has been given to the
pragmatical skills of young stuttering children. To investigate whether young
stuttering children show deviant or slow developing pragmatical skills (communicative functions,
conversation skills and narrative skills) 20 stuttering children (4-7 years
old) were tested with the Nijmeegse Pragmatiek Test (Embrechts, Mugge
& Van Bon, 2005), and compared to the results for 20 matched controls.
Additional data on the pragmatical skills of the child were obtained by means
of questionaires for the teacher and parents of the child.
This study examined the influence of stuttering frequency on middle school students’ perceptions of a peer who stutters. Participants viewed a video of a peer telling a joke at one of four stuttering frequencies and responded to Likert statements. Preliminary findings indicate that regardless of stuttering frequency, peers felt comfortable communicating with a peer who stutters and having a peer who stutters as a friend. Participants who viewed 5% and greater stuttering perceived the peer would endure teasing and would be less communicatively competent. Results are discussed relative to affective, behavioral, and cognitive-social perceptions of the peer who stutters.
The Fluency Committee of the
International Association of Logopedics and Phoniatrics recently carried out a survey in
Viewing stuttering as a communicational disorder, led us to investigate gesture production by People Who Stutter (PWS). Adult PWS (8) and fluent speakers (7) were video-recorded during a storytelling task and filled out questionnaires regarding social and communicational attitudes. Contrary to previous research, no differences were found between groups as to gesture production. PWS produced one kind of gesture proportionally more during fluency than during stuttering. Correlations were found between some kinds of gestures and the speaker’s emotional status. Findings support cognitive approaches, relating gestures to speech production, and demonstrate a link between emotions and gestures, supporting communicative approaches.
A 130 item belief checklist about stuttering, fluent speech, stutterers, and fluent speakers has been developed and used to investigate:
1) Stutterers’ belief systems.
2) Cognitive change during successful therapy.
3) The relationship of beliefs to speech-related anxiety.
These studies were used to identify the most useful items and
trim the size of the checklist to 81 items. It has been renamed the Stuttering/Fluency
Belief Inventory (SBI). The SBI will be presented and distributed and it’s
clinical and research potential will be discussed.
The present study examines the interactions of language and
fluency in the spontaneous language of 30 typical children in Brown’s MLU
stages Late I to Post V. The presence of speech disruptions is analyzed
relative to a variety of linguistic variables, including syntactic, lexical,
and phonologic. Results are discussed in terms of children’s mastery of fluency
in the context of developing language.
The purpose of this study was to assess mean length of utterance (MLU) and (non)stuttered disfluencies associated with changes in listener (parent-clinician), communicative (conversation-narrative), and situational (home-clinic) variables with preschool children who do (CWS; n=8) and do not stutter (CWNS; n=7). Findings indicated an influence of listener, situation and communicative variables on MLU; however, the ratio of Stuttering-Like Disfluencies/Total Disfluencies (SLD/TD) consistently differentiated both talker groups, regardless of changes in variables. Findings suggest that although stuttering varies across different contexts, the SLD/TD ratio can be used to differentiate between CWS/CWNS regardless of the context where stuttering is measured.
The purpose of this study was
to assess semantic processing of 13 preschool children who do (CWS) and 13 who
do not stutter (CWNS). Participants’ speech reaction times (SRTs)
and errors associated with picture naming were assessed during four semantic
priming conditions: (1) Neutral, (2) Physical, (3) Functional and (4)
Categorical. Findings indicated that CWS
exhibited significantly slower SRTs and greater semantic
priming effects than CWNS. Results suggest that the semantic processing of CWS
operates at less than their maximal potential thus they benefit more from
semantic priming than CWNS who operate closer to their maximum abilities.
A systematic review and meta-analysis was conducted for studies using randomized experimental designs to study the effects of treatment for people who stutter. A total of 375 citations were identified for potential inclusion using hand and electronic search strategies. Of the 12 included studies, six studies reported outcomes for treated vs. non-treated participants yielding a significant Hedges g effect size of 0.91. Seven studies compared two different treatments and yielded a non-significant Hedges g effect size of 0.21. Additional data will be presented for participant, treatment, and design characteristics.
An
English/Spanish bilingual client enrolled for treatment by a monolingual
English-speaking clinician was trained to identify her own disfluencies
in English; she successfully transferred that training to self-identification
of disfluencies in Spanish, offering the possibility
of using client judgments to monitor the client’s fluency in Spanish. As a
potential treatment procedure, further investigation of transfer of fluency
identification training across languages is warranted.
The purpose of this study was to investigate the influence of rhythmic ability of people who stutter (PWS) on their successful results in speech fluency in stuttering therapy. It turned out that the higher the initial level of rhythmic ability of the participants was, the better they mastered the fluent speech technique they were taught. Having determined this correlation we developed a special communicative method for both non-speech and speech rate and rhythm improvement. The systematic use of the method as a part of the stuttering therapy encouraged more efficacious fluent speech technique mastering of PWS.
Properties of choral speech underlying its stuttering reduction effect can be examined by manipulating features of the accompanist. In this seminar, results of two studies are discussed. In one, choral speech conditions were designed to approximate altered auditory feedback (AAF). Stuttering was significantly less in the manipulated choral speech conditions than in the AAF condition. A second experiment compared stuttering reduction for presentation of the accompanist’s auditory speech signal with visual images of the accompanist’s mouth/jaw movements. Findings from both studies are interpreted as indicating that pacing may be important to the stuttering reduction effect of choral speech.
The current study provides
needed information related to adolescents’ perceptions of their peers who
stutter. Eighth and eleventh grade students (n = 251) were randomly assigned to view a videotaped interview of
either a peer who stuttered or a peer who demonstrated normal speech patterns,
but not both. After viewing the videotape, the participants were asked to rate
the speaker on seven personality traits using 5-point semantic differential
scales. Results of the study indicate that the individual who stuttered was
rated less positively than the individual who demonstrated fluent speech on six
of the seven personality traits.
Self-help groups for PWS are a rich and insightful resource for understanding how PWS experience life. Discourse data from these groups suggest that "expert" PWS and "novice" PWS experience "life with stuttering" in different ways. In this study, intergenerational discourse among PWS was analyzed drawing on the sociolinguistic research of discourse analysis and conflict talk. Results show that each group struggles to manage conversational order while negotiating their stuttering identities through demonstrating their beliefs about "life with stuttering" and their experiences. Multiple ways of understanding stuttering identity are offered for effective PWS self-help group discussions.
The purpose of the present study was to evaluate the influence of creative theater on the stuttering severity and communication attitudes of children who stutter. The program introduced creative theater as a supplement to Synergistic Fluency Therapy (Bloom & Cooperman, 1999) and examined changes in: frequency of dysfluencies; secondary behaviors; and measures of self-esteem, locus of control, assertiveness, communication apprehension/attitude, and perception of communicative competence. Results indicated that implementation of the program corresponded to a decrease in stuttering severity in three of four subjects. Each subject also evidenced improvement in at least one measure of communication attitudes and feelings.
Longitudinal surveys of Canadian speech-language pathologists regarding their academic and clinical preparation for working with individuals who stutter show consistently low ratings of academic and clinical experience with stuttering over a fifteen year period. A survey of university educators of speech-language pathology programs revealed a shortage of clinical placement sites and a low percentage of classroom time allocated to fluency disorders, as well as considerable variation in student preparation across programs. The findings have implications for the effectiveness of both academic and clinical preparation, as well as practice.
Clinicians may find it useful to use drawings
during diagnosis and treatment of stuttering, I use pictures in both group and
individual therapy. In individual therapy, I ask the children to draw their
family, a fantasy family or their stutter. I also use the picture to discuss
what happens during stuttering, including the possibility that fear actually
sometimes causes the stutter. Artwork can help children to share their feelings
about stuttering. I will present a case
study of a 11 years old boy. He was a talented artist
who stuttered severely. He resisted speech therapy, but was willing to share
his emotions about stuttering when he painted.
Negative perceptions of stuttering exist in many groups of people, e.g., teachers and school-age children, but no study has yet considered young children’s perceptions of dysfluent speakers. This study involved 3-5 year old children using a non-experimental survey method, explanatory in nature. 18 children viewed two video-clips of a puppet telling a story, one a fluent speaker, the other dysfluent. Children’s perceptions and possible influencing factors (age, gender and prior exposure to stuttering) on perceptions were examined. Qualitative analysis of responses suggested that negative evaluation of the dysfluent speaker increases with age and is more pronounced in males than females.
This study investigates the perceptions of Irish children (6-13 years) of a person who stutters (PWS). Having listened to a recording of a PWS and a fluent speaker reading a passage, 80 children completed a questionnaire assigning attributes to the speakers. They also completed an open-ended question with comments about the speakers. There was a significant difference between how the children rated the speakers, with PWS perceived more negatively than the fluent speaker, and increasing negativity found in the older children. There was no gender influence in the findings, and no significant difference found between numbers of children choosing to be friends with any one speaker.
Narrative therapy focuses on
increasing the meaningfulness of changes made in therapy, and ultimately, on
the deconstruction of the undesirable elements of a person’s dominant
narrative. For people who stutter, the role of stuttering can take precedence
over most other activities in life, demanding time and attention on a daily
basis. In this paper jointly presented by a client and a therapist, the stages
of narrative therapy, their implementation and effects will be discussed.
Narrative therapy complements the traditional focus on the impairment,
concentrating on individuals’ sense of identity, their personal experiences of
‘disorder’, and their unique abilities to counter ‘the speech problem’
storyline.
Dublin Adult Stuttering (DAS)
was established to provide an appropriate and accessible service for adults who
stutter in the Eastern region of
This is a presentation of the Integrative-Existential Method, designed to be used in stuttering therapy. It engages the principles of human science, which incorporates the emerging scientific post-modern paradigm. This is a qualitative method which encompasses objectivity and subjectivity, emphasizing the dialectic view by integrating the polarities of world/human being, body/mind, physical/psychic, and stuttering/stutterer. This therapy employs two focal points: one directed to the stuttering itself which occurs through the systematic use of atypical muscular actions, either hypo- or hyper-tonus; the other is directed to the stutterer, dealing with his/her feelings and emotions related to stuttering.
Parent-child interaction therapy aims to help parents develop strategies to facilitate a child’s fluency, including modifying parent interaction variables. The aim of this paper is to explore whether there is evidence that this therapy has an impact on children’s use of language. Data from twelve children who have participated in two single subject replication studies will be presented. During both studies, the children were video recorded playing with their parents at home before, during and after therapy. The videos were transcribed using Codes for the Human Analysis of Transcripts and the data analysed using Child Language Analysis programme (MacWhinney 2000).
Preliminary outcome measures at the six month mark of a clinical trial with the SpeechEasy altered auditory feedback (AAF) device are reported. Data are presented for a variety of speech fluency measures in three communication situations (monologue, oral reading, and telephone), speech naturalness ratings, and satisfaction ratings for 20 adult and adolescent stutterers. Results for pre-device baseline measures are contrasted with those obtained at one month, three month, and six month post-device delivery evaluations.
This study examines the relationship between an individual's performance on auditory event-related potential (AERP) measures and the individual's response to an altered auditory feedback device (AAF). Auditory ERP measures were obtained in a oddball P300 paradigm using simple linguistic stimuli for 20 stutterers, 10 who demonstrated a positive response to AAF, and 10 who did not appear to benefit from AAF. Results are discussed in terms of the relationship between auditory AERP latency and amplitude distribution patterns and AAF response.
This study examines the influence of the use of an altered auditory feedback device (AAF) on the perceived impact of stuttering for 15 adult stutterers. The Overall Assessment of the Speaker's Experience with Stuttering (OASES) was administered during initial qualifying testing for AAF usage, and again at 1 month, 3 months, 6 months, and 12 months after participants received the AAF device. Results are discussed in terms of changes in reactions to stuttering, functional communication, and quality of life measures. Relationships between AAF device usage patterns, speech fluency, and OASES scores are examined.
The author presents via a multimedia analysis (nasovideo, fibroscopic,
endoscopies, acoustic recordings, spectrographic analysis etc…) recordings made
along the two past years on severe stutterers and the
same subjects using speech modifications techniques as well as normally fluent
speakers. Each patient had been recorded (synchronized numeric video and
acoustic recordings) for at least two to four minutes. The data will be
described and compared. Further comments will be made about implications and
new perspectives for diagnosis, the role of the larynx during stuttering, and
the effectiveness of speech modification techniques.
Stuttering is commonly conceptualized as a disorder of speech motor control, thus analyses and descriptions are required to reflect the mechanisms governing the characteristics of the speech signal. Methods of characterizing stuttering are also required to be more objective and reliable. This preliminary study aimed to characterise the speech of adults who stutter (AWS) using detailed acoustic analysis procedures. Categories of acoustic events were devised to classify speech behaviours for all participants. Acoustic events were associated with overt stuttering behaviours but could also occur in the midst of a fluent speech segment. Implications for this methodology for characterizing the speech of AWS will be discussed.
The literature lacks information about why adults who stutter (AWS) and controls differ, e.g., at different stages of speech production. Thus, the cause of stuttering is still unknown due to lack of theoretically driven investigations. Word retrieval processes (semantic activation, phonological encoding, motor programming and execution) (Levelt, 1989) were examined using reaction time (RT) behavioural tasks in 18 AWS and 18 controls. Clinical information about stuttering severities and use of compensatory mechanisms were also gathered. Word retrieval functioning was examined in AWS compared to controls, and also relationships with clinical measures. Implications of results will be discussed.
Recent fMRI studies indicated in male subjects with persistent developmental stuttering a spontaneous but not very effective compensation mechanism for stuttering in the right-hemispheric homolog of the Broca´s area. A successful fluency shaping therapy revealed more left-sided overactivations adjacent to regions where other authors have described structural abnormalities, indicating a more effective compensation by left-hemispheric networks. Because subjects who had recovered from stuttering might exploit even more effective compensation mechanisms, this study investigates the cerebral activation of such subjects with fMRI. First results indicate increased left-hemispheric activations adjacent to the Broca´s region in subjects who had recovered from stuttering.
We
investigated whether lexical access in adults and children who stutter differs
from that seen in people who do not stutter. Specifically, we examined the role
of three lexical factors on naming speed, accuracy and fluency: word frequency,
neighborhood density and neighborhood frequency. If stuttering results from an impairment in lexical access, these factors were
hypothesized to differentially affect naming performance in fluent and
stuttering speakers. We report data from approximately 70 participants
suggesting group differences in naming accuracy, but no differences in effects
of lexical factors on performance. Ramifications for future research and models
of stuttering will be provided.
This paper will present preliminary findings from a study investigating the nature of temperament in school-aged children who stutter (CWS) compared to fluent peers (CWNS). Participants will be CWS and CWNS between the ages of 9 and 15 years. The CWS will be matched by age, gender and social background to the CWNS. Children’s temperament will be determined using the Early Adolescent Temperament Questionnaire – Revised (EATQ-R) (Ellis & Rothbart, 2001) which includes both parent-and self-report of children’s temperament. Comparisons will be made between the temperamental profiles of CWS and their fluent peers and between parent and child ratings of temperament.
It is clear, even to the casual observer, that stuttering is associated with aberrant speech breathing. Moments of stuttering may involve explosive release of air, complete cessation of airflow, and even speaking on inspiration. However, while many therapies and intervention programs require participants to alter their breathing patterns, it is not known whether aberrant breathing is a cause or a result of stuttering. A third possibility is that certain features of speech breathing, such as high lung volume, may trigger stuttering. This presentation will report preliminary findings of a large collaborative program of research that is investigating these hypotheses.
This study reports the results of a survey of Australian parents who had recently participated in the Lidcombe Program of early stuttering intervention. The study was initiated by the second and third authors, who wanted to find out if parents thought the Lidcombe Program was an acceptable treatment for preschoolers and, thus, whether it would be an acceptable alternative to the more traditional indirect treatment used in Norway Thirty-five parents responded to closed and open ended questions about their experiences with the program. The data were analysed qualitatively and quantitatively.
The purpose of this study was to examine the influence of text type, topic familiarity, and stuttering severity on listener recall, comprehension, and perceived listening effort. A total of 60 participants were assigned to one of four stuttering severity levels. Each participant listened to two narrative and two expository texts. Results indicated that increasing stuttering severity and unfamiliar expository text speech samples decreased listener recall and comprehension. Perceived listener effort also increased as stuttering severity increased. Clinical implications suggest not only focusing on the management of the stuttering but on the linguistic complexity of the spoken information as well.
Parent child interaction incorporates play situations as an intrinsic part of the therapy process, whereas Lidcombe Therapy uses highly structured activities to facilitate fluency. This study aimed to investigate the impact of different types of play situations on children’s fluency. The fluency of fifteen children under five was measured in both structured and unstructured play situations with a parent. The results indicated that children were significantly more fluent in structured play situations. A measure of the child’s mean length of utterance revealed that this was significantly longer during unstructured play. The implications of this study will be discussed in relation to therapeutic input.
Wingate's 2002 Fluency Analysis was used by experienced and inexperienced clinicians to analyze speech samples of normal young adults. Results showed that this analysis has utility to clinicians. Results of analyses and fluency profiles will be presented along with implications for clinical training and treatment.
A Dutch translation of the Overall Assessment of the Speaker’s
Experience of Stuttering (OASES; Yaruss & Quesal, in press) and Assessment of the Child’s Experience
of Stuttering (ACES; Yaruss, Coleman & Quesal, in preparation) questionnaires have been used in
the
A curriculum, integrated into a
graduate fluency disorders course with students from various cultural
backgrounds, focused on negative stereotypes toward stuttering in multicultural
and multinational contexts. Its purpose was to improve students’ attitudes
toward people who stutter and to enhance students’ interest in treating
stuttering. A qualitative questionnaire and an experimental edition of the
Public Opinion Survey of Human Attributes (POSHA-E) (
Increased EEG abnormalities have been reported in individuals who stutter, but these are not well described. We aimed to determine whether a group of children who stutter who have an epileptic tendency as demonstrated by an abnormal EEG. Using community-ascertained cases of children who stutter and matched fluent speaking controls, we undertook a battery of speech, language and fluency assessments and collected sleep and awake EEG data. Preliminary data suggests a higher rate of EEG abnormalities in the 16 cases compared to the 8 controls. We report a single case report of a trial of anticonvulsant medication with one participant who had an epileptiform EEG.
Several studies in recent years
(Klein & Hood, 2004; Rice and Kroll, 1994) have shown that North Americans who
stutter perceive that their speech disorder has a negative impact on their
employability, job performance evaluations and career advancement. The present
study attempts to extend our understanding of the impact of stuttering in the
work place by surveying and comparing the perceptions of a larger, more international
sample of people who stutter. This includes a statistically relevant sample of
people who stutter in the
Traditionally reduction in stuttering following treatment has been expressed in terms of percent syllables stuttered (%SS) or scores on a severity scale. Even though it is necessary to limit the end measure to describe statistical significance, additional measures are needed to describe clinical significance. We propose using self-report measures such as the Subjective Screening of Stuttering Severity, Avoidance, and Locus of Control; the Perception of Stuttering Inventory, etc. to capture changes that may not be reflected in the %SS.
Studies on the Lidcombe Program (LP) present uniformly impressive results. Almost all children reach less than 1% syllables stuttered. However, we do not know whether children maintain these gains. This study compares the spontaneous speech of 20 children 2 to 7 years post- LP to the speech of age- and gender-matched, non-stuttering children. Dependent variables, measured in English and French, include: %SS, disfluencies per 100 syllables, MLU, and rate of speech. Most of the children have maintained the levels of fluency attained in the maintenance phase of the LP. Implications for therapy with preschool children and for bilingual stuttering children will be discussed.
In previous work computational analysis showed that changes in ego-states occur during stuttering therapy, and that these changes are related to treatment outcome. This study extends that investigation by examining the relationship of changes in ego-states, as defined by transactional analysis theory, to changes in fluency rate, types of dysfluencies, concomitant behaviors, and ratings of the success achieved by participants. Regression analysis shows that treatment outcome is significantly related (R=.79) to both ego-state change and change in objective speech measures. A complete understanding of the treatment process cannot be derived solely from objective measures, but must also include psychodynamic constructs.
The Lidcombe Program is a behavioural treatment for preschool children who stutter which is supported by Phases I, II and III clinical trial evidence. In this treatment, parents deliver verbal contingencies for stuttering and stutter-free speech during conversational exchanges with their children. The mechanism underlying the effectiveness of the program is currently unknown, although it has been suggested that children achieve fluency by curtailing their language use. This hypothesis is investigated in this project by measuring utterance length and complexity in a group of preschool children before and after treatment.
Speech therapy courses for adult stutterers have been held in
This paper will describe events
in a speech and language therapy student’s clinical training. The student’s
initial construing of stammering was explored using elicitation of a metaphor
for stammering and this process was repeated at the end of the placement. This
process will be outlined and full details of both (pre and post) metaphors will
be given. A qualitative analysis involving both the therapist and the student
was carried out and specific themes emerged. The significance of these themes
for both the therapist and the student will be discussed. Finally, the authors
will consider what bearing their results have on clinical training for speech
and language therapists.
This paper is a further
consideration of art in relation to stammering, rather than the application of
science. In this presentation the particular artistic technique involved in
creating perspective will be described; the vanishing point. Parallels will be
drawn with human experience. There appear to be important experiences in
people’s lives, defining moments which influence and shape construing. Meanings
that individuals give to events can continue to resonate into the future and
back into their recall of the past. New constructions of self generated within
a therapeutic situation can allow individuals to view their stories from
alternative standpoints. Thus individuals’ perspectives on themselves can be
redefined. The metaphor of the vanishing point in relation to therapy for
people who stammer will be the main focus of the paper.
This paper will contrast two studies of listeners’ perceptual ratings of eight speech and 14 speaker variables in fluent and disfluent videotaped presentations of a short passage. Fluent forms included normal, fast, single word productions, and continuous phonation. Disfluent forms included excessive pauses, stretched initial syllables, explosive tense starts, easy stuttering forms, and “um” interjections. Multivariate analysis revealed continuums of fluency and disfluency in each study, statistically significant differences within continuums across speech and speaker variables in each study, and a reversal of speech versus speaker rating patterns across the two studies.
There are many conditions that produce disfluent speech. Although stuttering is the most common, other types of fluency disruptions and breakdowns occur that are associated with various conditions. This report describes the different types of nonfluencies that occur with three different participants. Each of the participants has been noted to have a “fluency disorder” by family members and a speech-language pathologist. In addition, each of the clients carries a diagnosis of Asperger Syndrome and/or ADD. Results reveal three distinctly different disfluency profiles. Two of these profiles show behaviors that are not typically present in “typical” stuttering clients.
We propose a novel use of movie and spot dubbing in the rehabilitation
path of the stuttering patient. In particular, in dubbing the patient faces
relevant technical difficulties such as the control of the verbal fluency and
the time pressure caused by the sharp timing in pronouncing the lines.
This provides a fundamental training instrument. Here we identify, describe and analyse an
effective methodology to use this tool, consisting of different levels of
gradually increasing difficulty for the patients. Moreover, we present the
results of an empirical study of the use and the efficacy of this methodology.
In this paper we discuss factors that reflect the author's experience in everyday work and investigation over the past few years in a specific form of attitudinal therapy – to accept stuttering positively not with abstract words or phrases but as a real face. We seek to change the negative feelings and attitudes of teens and adults who stutter and parents of CWS about the real nature of stuttering. We encourage them to live and communicate with Stuttering as their Friend during our therapy as well as after.
This paper traces the history of psychological approaches to stammering treatment. It examines the current place of counselling in speech and language therapy with people who stammer. The question of whether boundaries do and /or should exist between the two disciplines is addressed and consideration is given to where any such boundaries should be drawn. Case material is used to illustrate and reflect on specific issues which may arise and how dilemmas can be managed. Stroebe & Schut’s dual process model of loss (1995) is adapted to describe how counselling can be integrated in speech and language therapy.
Genetic syndromes are often associated with
mental retardation and the prevalence of stuttering in the mentally retarded is
generally assumed to be high. Yet, detailed accounts on the occurrence and
nature of fluency disorders in individuals with genetic syndromes are scarce.
This presentation reviews the available literature on fluency disorders in a
number of syndromes. Included are Down Syndrome, Fragile X Syndrome, Prader-Willi Syndrome, Tourette Syndrome, neurofibromatosis type I, and Turner Syndrome.
Starting from a literature review, the present seminar discusses and illustrates factors to take into account when considering the use of delayed audtiory feedback (DAF) in an individual client. Three types of factors are distinguished: factors inherent to the client, factors outside the client, and possible side-effects. The review shows that most likely multiple factors play a role, but with the currently available data it is very hard to predict whether an individual will or will not benefit from the use of DAF. Overall, the evidence for the influence of the different factors is still meager.
Random control trials (RCTs) are succesfully applied in many areas. Recently, they have been used to evaluate treatment sucess: see Lidcombe and Pagoclone study. I explain why a standard RCT in stuttering faces several conceptual difficulties, and might lead to an overly positive outcome. Specifically, I look at the statistical analysis of the outcome data of early childhood intervention. The natural recovery rate of dysfluent children significantly complicates the statistical study of the outcome data. I argue that the standard random control trial setup needs to be modified, because children are randomly assigned to the treatment or control group and by chance one group will have a higher natural recovery rate. I also point out other methodological difficulties like the possibility of a false positive due to a faster recovery of children that would have recovered anyway.
This presentation will
investigate regularities and differences in the personal experiences of persons
who stutter (PWS) as they relate their recollections of first
self-identification of themselves as PWS, or stories of origin, and their
moments of decision to make changes in their speech, or stories of transition.
Analysis of how these two important passages in the lives of PWS unfold may
yield useful information for therapists designing comprehensive programs for
carryover of stuttering management strategies into their clients’ activities of
daily living.
This presentation will outline
a program of research investigating the need for telehealth
adaptations of speech pathology interventions. In addition, the outcomes of two
low-tech telehealth trials of the Lidcombe
Program will be presented and compared to benchmarks established by the Lidcombe team (Jones, Onslow, Harrison, & Packman,
2000) and others (Kingston, Huber, Onslow, Jones, & Packman, 2003) for
standard delivery of the program. The presentation will also outline research, either completed, underway or planned, addressing the
availability of telehealth technologies in rural