Annotated Bibliography
An annotated bibliography of the articles about stuttering from ASHA publications, including :
- JOURNAL OF SPEECH AND HEARING RESEARCH (JOURNAL OF SPEECH-LANGUAGE AND HEARING RESEARCH) (1986 through issue 5, 2007)
- LANGUAGE SPEECH AND HEARING IN THE SCHOOLS (1987 through issue 1, 2007)
- AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY - through issue 2, 2007
- ASHA MAGAZINE (1989 through issue 3, 2000)
as well as
- JOURNAL OF FLUENCY DISORDERS - 1986 through volume 4, 2007
- JOURNAL OF COMMUNICATION DISORDERS - 1987 through volume 6, 2007
- TOPICS IN LANGUAGE DISORDERS - May 1995
- JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS - Fall-Winter 1982 issue
- SEMINARS IN SPEECH AND LANGUAGE - Vol 23, 2002 and Vol. 24, 2003
- CICSD - fall 2002, spring 2004, fall 2004, spring 2005, spring 2006
- STAMMERING RESEARCH (A Journal Published by the British Stammering Association), Vol. 1, Issue 1, 2004 through issue 4, 2005 (http://www.stamres.psychol.ucl.ac.uk)
- JOURNAL OF STUTTERING, ADVOCACY & RESEARCH (http://www.journalofstuttering.com) - Volume 1, issue 1, 2006 - Volume 2 issue 1, 2007
- BULGARIAN JOURNAL OF COMMUNICATION DISORDERS - Vol. 1, issue 1, 2006
This was the project of:
- the following ten students in a Seminar on Stuttering at Mankato State University, winter quarter 1994-95. Laura Borneke, Robin Hopperstad, Stephanie Market, Carrie Northway, Ann Plienis, Jessica Saucier, Jenny Schultz, Risa Smith, Tom Woodside and Heidi Wright
- the following nine students, spring quarter 1995-96. Sara Bachmann, Sheila DeRose, Lisa Erickson, Karin Gavin, Sheilagh Haeny, Becky Nowacki, Gretchen Olson, Cynndi Regehr, and Kris Warmka
- the following nine students, spring quarter 1996-97. Kris Erickson, Jason Fornwald, Nikki Hegland, Ana Lammers, Kristi Loos, Jennifer McDonald, Steve Pittelko, Patty Powell, and Sharon Weist
- the following ten students, spring quarter 1997-98. Nicole Amann, Lisa Arras, Theresa Berg, Kristin Genser, Kara Harder, Dan Marreel, Shawna Hill, Cheryl Olson, Lindsay Strickland, and Katie Widestrom
- the following nine students, fall semester 1999-2000. Peter Amberg, Meghan Culey, Heather Herrman, Rebecca Hubbling, Laurie Ling, Salena Nikolaisen, Lavonne Reed, Jessica Schneider, and Kelly Birken
- the following nine students, fall semester 2000-2001. Renee Beardsley, Angela Chouinard, Caryn Englund, Brooke John, Tamara Knapton, Nancy Ritland, Chandra Rothstein, Angela Shafer, Tina Swenson
- the following seven students, fall semester 2001-2002: Ruth Becraft, Tara Blair, Maureen Boyle, Amanda Honstad, Lisa Kindred, Katie Lash, and Jodie McGough
- the following thirteen students, fall semester 2002-2003: Erica Anderson, Vickie Benda, Elizabeth Gormley, Sarah Helm, Dawnyale Johnes, Tracy Magill, Sue Muelebroek, Nicole Murphy, Angie Olson, Brynn Rhodes, Molly Rourke, Lindsay Temple, Heidi Wolak-Faber
- the following thirteen students, fall semester 2003-2004: Katharine Armendariz, Sarah Bos, Christina Carson, Renae Christenson, Mary Harkema, Julie Holub, Shannon Leppi, Joyce Mace, Mary Margaret Mathers, Maggi Mitchell, Hilary Penner, Leah Schultz, Samantha Shindle
- the following eight students, fall semester 2004-2005: Jodi Frestedt, Aunie Gieseke, Lindsay Gordon, Michelle Graber, Jenny Kortuem, Ann Schimmel, Amanda Seefeld, Amanda Sigler
- the following five students, fall semester 2005-2006: Amy Kruse, Brianne Linaman, Paul Matejcek, Hanifa Sait and Sarah Van Roekel
- the following twelve students, fall semester 2006-2007: Laina Bockenstedt, Larry Gieseke, Becky Haas, Kerry Hill, Laura Lindeman, Elizabeth Miller, Tabitha Reuter, Julie Rue, Cristen Schnabel, Amanda Simon, Martha Speckel, and Heidi Thompson
- the following eighteen students, fall semester 2007-2008: Elizabeth Briggs, Chad Clower, Bridget DeSaer, Kathryn Hainrich, Maria Jensen, Laura Johnson, Jada Jokumsen, Lindsey Keil, Amy Kietzer, Kirsten Markiewicz, Evan Panitzke, Emily Resch, Kelly Ritter, Ashley Schulzetenberg, Kim Scranton, Amy Ulwelling, Kristi Thomas, and Deann Wenner
- the following twenty-three students, fall semester 2008-2009: Natasha Agha, Kim Allen, Stephanie Anderson, Katelyn Astedt, Tara Bauman, Jessica Beck, Bonnie Berglund, Miranda Davis, Kristine Hoppe, Jennifer Ireland, Malorie Johnson, Beth Knoll-Fleming, Alicia Krone, Holly Linder, Jennifer Reinartz, Brandi Roeker, Jackie Schueller, Rebecca Simmons, Ann Strommer, Lisa Vadnie, Jessica Weiler, Molly Weinandt, and Elizabeth Zika
Index
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Adams, M. (1988). Five-year retrospective on stuttering theory, research, and therapy: 1982-1987. JOURNAL OF FLUENCY DISORDERS, 13, 399-405.
The purpose of this retrospective was to review the theories, research and treatment for stuttering between the years of 1982- 1987. The following theories were reviewed: Starkweather's demands and capacities model, Kent's reduced capacity for temporal regulation, Andrews and associates' internal model of the relationship between motor acts and the various sensory stimuli they produce, Yeudall's three-dimensional, hierarchical concept of the brain and its functioning, and Perkins' involuntary disruption in the flow of speech. Research trends have involved direct physiological, and indirect acoustic, studies of stutterers' speech production abilities and their stuttering. Therapy has involved increased attention to the language abilities of young stutterers during both their evaluation and treatment.
Adams, MR. (1987). Voice Onsets and Segment Durations of Normal Speakers and Beginning Stutterers. JOURNAL OF FLUENCY DISORDERS, 2, 133-139.
To better explore the possibility of discrepancies between the speech production abilities of stuttering and normal speakers, voice onset times (VOT) and segmental durations were assessed in 5 stuttering and 5 nonstuttering preschoolers. VOTs, initial consonants, and vowel durations were measured. Results demonstrated that the preschoolers who stuttered had slower VOTs and their mean initial consonant and vowel durations were longer.
Acton, C. (2004). A conversation analytic perspective on stammering: Some reflections and observations. STAMMERING RESEARCH, 1, 249-270. http://www.stamres.psychol.ucl.ac.uk
Qualitative research can aid in studying aspects of stuttering that have been given less attention or that have been ignored altogether. Conversation analysis is one type of qualitative research that could increase our knowledge of stuttering. This paper explores literature on interactional, or conversational, aspects of stuttering such as turn-taking, adjacency pairs, and response tokens. More information is needed about natural conversations in order to fully understand communication interactions of and with those who stutter. The conversation analytic perspective is a promising tool to help uncover and understand various behaviors of people who stutter.
Adams, M.R. (1992). Childhood stuttering under "positive" conditions. AMERICAN JOURNAL OF SPEECH - LANGUAGE PATHOLOGY 1, 5-6.
Adams gives reasons why children stutter during "positive" conditions. Adams gives his subjective impressions that any number of four patterns may be present in a given case. Parents and clinicians need to look for possible negative factors that might be undermining their young child's fluency. Parents identify positive and negative factors by participating in parental counseling.
Adams, M. & Webster, L.M. (1989). Case selection strategies with children "at risk" for stuttering. JOURNAL OF FLUENCY DISORDERS, 14, 11-16.
This examines strengths and weaknesses of strategies used to determine if services should be provided to fluency clients. The first to be discussed is the "differential diagnostic approach" in which a clinician uses behavior criteria to differentiate children that may be at risk, normally disfluent, or are already labeled as a "stutterer". The next case selection strategy is the "individualized treatment for all approach" where the issue of the validity of clinical labels or groupings is avoided and some type of intervention is offered to every child. These approaches are compared to view their similarities and differences and the need for studies addressing surrounding issues is discussed.
Alexander, T. (2006). Our time provides kids their time. JOURNAL OF STUTTERING, ADVOCACY & RESEARCH, 1, 33-35. http://www.journalofstuttering.com/ListofArticles.html.
Founded in 2001, Our Time Theatre Company became an opportunity for young people who stutter to express themselves in their own voices and in their own time. Our Time is a non-profit organization working with children and young adults who stutter (ages 8-19). Rehearsal meeting are weekly and run for a 34-week period and concludes with a professional production of a play written and performed by the young people of Our Time. Many people who stutter allow the fear and shame associated to control their lives. The staff at Our Time wants young people to believe in their power, imagination, and self-worth, and to understand that they can be whatever they want to be, and that stuttering will not hold them back from their dreams!
Alm, PA. (2004). Stuttering, emotions, and heart rate during anticipatory anxiety: a critical review. JOURNAL OF FLUENCY DISORDERS, 29, 123-133.
The study in this article focuses on any effects or changes that occur in emotions and heart rate during anticipatory anxiety. Within the study is an overview of the autonomic nervous system and the freezing/fighting response in relation to their effects in a person who stutters. It was noted that a person who stutters would often react in a "freezing moment" during a stressful speech situation in correlation with the feeling of helplessness or loss of control. This study found a reduction in the heart rate of those persons who stuttered when tested. Although heart rate was decreased skin conductance and pulse volume showed similar results for both stutterers and fluent speakers. No conclusive evidence was given to explain the reduction in heart rate when obvious anxiety occurs in speakers who stutter during speech related situations.
Alm, P.A., & Risberg, J. (2007). Stuttering in adults: the acoustic startle response, tempermental traits, and biological factors. JOURNAL OF COMMUNICATION DISORDERS, 40, 1-41.
This article analyzes the relationship of stuttering and a number of factors including acoustic startle, biochemical variables (calcium, magnesium, and prolactin), anxiety, temperament, and neurological lesions (concussion and head injuries). A heightened level of neuromuscular reactivity has been hypothesized in adults. The current study researches this hypothesis and involves 32 adults who developmentally stutter compared to 28 persons without speech problems. Many questionnaires, temperament scales and large test batteries were used as measures in the study. No statistical group difference was shown between the group who stuttered and the controls regarding the startle. However, startle was positively correlated with trait anxiety. There were no significant group differences found regarding the biochemical variables. The group who stuttered had a result of lower calcium levels. Pre-onset events resulting in neurological lesions were also supported by the current study. Overall, the anxiety was found to be primarily caused from the stuttering experiences.
Ambrose, N. G. (2004). Theoretical perspectives on the cause of stuttering. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCES AND DISORDERS, 31, 80-91.
This article focused on the different etiologies of stuttering. The main etiologies that it discussed were psychology, learning theory, and biology. In the section about psychological causes the article discussed many different individuals and their views about stuttering being psychological. One of these views were Freud's, where he said, "Stuttering is an overt symptom of something else - unconscious, deep-seated neurotic disorder." This article also talked about the idea that stuttering is learned, and once again discussed many people's views dealing with this belief, like Wendell Johnson's diagnosogenic theory. Finally, the article discussed the theory that stuttering is biological, and discussed different views from people and EEGs and MRIs. The article concludes by saying that there is probably something in the brain, but maybe other genetic factors or environmental factors may "trigger" stuttering.
Ambrose, N., Cox, N., & Yairi, E. (1997). the Genetic Basis of Persistence and Recovery in Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 40, 567-580.
The purpose of this study was to examine the relationship between the susceptibility to stuttering and genetics. Two questions were investigated: "Is there a sex effect in recovery from stuttering?" and "Is persistence/recovery in stuttering transmitted in families?". Subjects were recruited from the University of Illinois area through referrals and 66 subjects participated. Results of the study confirm that stuttering is familial. Four primary conclusions were derived. There is a greater proportion of females than males that recover from stuttering, persistence and recovery are both familial, there is statistical evidence for both a major locus and polygenic components contributing to both persistent and recovered stuttering, and persistent and recovered stuttering are unlikely to be genetically independent disorders. Overall, data from this study support the hypothesis that persistent and recovered stuttering possess a common genetic etiology.
Ambrose, N., Paden, E., Watkins, R., & Yairi, E. (2001). What is stuttering? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 3, 585-597.
This article was written in response to a letter that was written by Professor Wingate (2001). It was recently published in the Journal of Speech, Language, and Hearing Research. The authors have made several opposing statements in regards to Wingate's argument. The authors feel that Wingate has harshly violated the fundamental measures of accuracy, validity, and internal consistency, as well as reliance on published data. The authors focus on these principles and respond with their own arguments against Wingate's attacks on their report on persistency and natural recovery in children who stutter.
Ambrose, N.G. & Yairi. E. (1994). The Development of Awareness of Stuttering in Preschool Children. JOURNAL OF FLUENCY DISORDERS, v19. n4, Dec.
This was a three year study with twenty preschool children who stuttered and twenty age and gender matched, normally fluent children in the Champaign Illinois area. The children were shown a videotape of two puppets: one fluent and one nonfluent. Each child was asked separately to point to the puppet that talks the way you do . The study found that there is some awareness for some children at an early age. They also found that as age increases, awareness also increases.
Ambrose, N.G., & Yairi, E. (1999). Early childhood stuttering I: Persistence and recovery rates. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 24, 1097-1112.
The purpose of this study was to study the characteristics of stuttering during the early childhood. The focus was placed on the likelihood of persistent stuttering and spontaneous recovery from stuttering. The study included 147 preschool children who stuttered. They were periodically assessed for several years since their onset of stuttering. The study indicated a continual decrease in the frequency and severity of stuttering as children aged and as many children progressed to recovery. This study also discussed if a pattern was present in those who recovered and why others didn't recover. The study suggests more research needs to focus on the patterns of recovery.
Ambrose, N.G., Yairi, E., & Cox, N. (1993). Genetic aspects of early childhood stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 701-706.
This report looks at genetic perspectives of stuttering with emphasis on preschool children, close to stuttering onset, including those children who recover and those who continue to stutter into adulthood. Sixty nine children participated in the study, ages 2.1- 6.3 years. Data was collected on family history and stuttering through interviews, followed by a segregation analysis. Results indicate that more than 2/3 of children who stutter, report that others in their family stutter also. The male to female ratio is higher among subjects with other family members who stutter, and 1:1 for subjects that reported no family members stutter. There were more males who stutter than females, but male and female stutters often have equal numbers of reported family stutterers. The frequency of stuttering was also higher among first degree relatives than among second and third degree relatives.
Ambrose, N.G., & Yairi, E. (2001). Longitudinal studies of childhood stuttering: Evaluation of critiques. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 4, 867-872.
Ambrose and Yairi wrote this article in response to the attacks made on them by Ingham and Bothe (2001). They state that despite the progress that's been achieved in research methodology and strong consistent evidence for natural recovery, they regret that several professionals have maintained ignorant perspectives on the issue. Ambrose and Yairi provide statements in this article in defense of their previous research in the Illinois Studies. They feel that their willingness to modify their position as evidence develops reflects scientific integrity, and also the belief that a single, brief counseling session was a probable cause of the high rate of recovery, is unreasonable. The authors continue to defend other arguments, such as parental source information, home speech samples, and SLD versus stuttering. They also discuss the use of proximal versus distal variables and genetic factors that affect recovery. The authors firmly believe that there is more than one method and/or measure that is useful for the study of stuttering and that a narrow approach would delay progress.
Ambrose, N.G., & Yairi, E. (2001). Perspectives on stuttering: Response to Onslow & Packman (2001). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 3, 595-597.
This article was written by Ambrose and Yairi in response to Onslow and Packman's (2001) article: Ambiguity and algorithms in diagnosing early stuttering: Comments on Ambrose & Yairi (1999). Ambrose and Yairi state that although Onslow and Packman raised valid issues about their data, they may have taken the data and conclusions out of context. Ambrose and Yairi claim the following items in response to the three issues raised by Onslow and Packman: 1) they selected children perceived as stuttering or normally fluent, 2) they did use the weighted SLD measure (along with several others) to examine disfluencies, and 3) they reported, given that people were identified as stuttering, what disfluency behaviors were exhibited.
Ambrose, N., & Yairi, E. (2002). The Tudor study: data and ethics. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 2, 190-203.
Recent exposure of the Tudor Study that was conducted in 1939 at the University of Iowa with the aim of studying the effects of verbal labeling on the frequency of disfluent children who stutter has raised strong reactions in the general and medical communities. Allegedly, the investigator and her mentor, a past leader in the field, were successful in their attempts to induce stuttering in normally speaking children. The potential clinical implications of such conclusions for the treatment of early childhood stuttering has had effects on the recent developments that suggest direct intervention with preschool children who show signs of stuttering. The purpose of this article is to re-examine the results of the Tudor Study, and to discuss its related broad range of ethical issues.
Amir, O., & Yairi, E. (2002). The effect of temporal manipulation on the perception of disfluencies as normal or stuttering. JOURNAL OF COMMUNICATION DISORDERS, 35, 63-82.
This study compared the temporal features of speech repetitions of normally fluent speakers with people who stutter. The vowel length and the interval between repeated speech units (part-word and whole-word repetitions) are typically shorter in persons who stutter than in fluent speakers. After the vowel length and time interval between speech units were lengthened using computer software, listeners were more likely to perceive the repetitions as normal disfluency. Longer intervals between repetitions (slowing the overall rate of repetitions) may make them sound more like normal disfluency.
Anderson, J.D. (2007). Phonological neighborhood and word frequency effects in the stuttered disfluencies of children who stutter. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 50. 229-247.
This fluency study focuses on the stuttering-like disfluencies of preschool children who stutter in relation to neighborhood density/frequency and the affect it may or may not have on the production of stuttering-like disfluencies. A speech sample was taken from each of the 15 subjects and values were gathered from an online source. Results proved that fluency is indeed affected by neighborhood and frequency variables and those variables also influence the children's production of stuttering-like disfluencies
Anderson J. D., (2008) Age of acquisition and repetition priming effects on picture naming of children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS, Vol. 33, Issue 2, 135-155.
Children who stutter, and children who do not stutter, between the ages of 3; 1 and 5; 7 participated in computerized picture naming tasks of words acquired early and late in the English language. The purpose of the study was to examine the phonological and semantic development differences of children who stutter and children who do not stutter when presented with words that are considered early age of acquisition, acquired early in language, and later developing words. Both stuttering and non-stuttering groups took more time to respond to words acquired later in language development and no significant differences were noted between the group's errors. Findings concluded that the use of priming and repetition of words that are acquired later in life helps children to process them faster in both groups.
Anderson, J. D., & Byrd, C. T. (2008). Phonotactic probability effects in children who stutter. JOURNAL OF SPEECH, LANGUAGE and HEARING RESEARCH, 51, 851-866.
The purpose of this study was to determine the effects of phonotactic probability on the susceptibility of words to stuttering in naturalistic speech production. (Phonotactic probability refers to the frequency of sound segments and segment sequences such as blends within a language.) A secondary purpose was to determine if the types of disfluencies produced were affected by phonotactic probability. Nineteen children who stuttered, age 3;0-5;8, participated in the study. Language samples were collected in naturalistic settings. Results indicated phonotactic probability did not significantly influence susceptibility to stuttering, however it did appear to have an effect on the type of stuttering-like disfluencies produced.
Anderson, J.D., & Conture, E.G. (2000). Language abilities of children who stutter a preliminary study. JOURNAL OF FLUENCY DISORDERS, 25, 283-304.
The purpose of this study was to determine 1) whether children who stutter (CWS) and children who do not stutter (CWNS) score differently on standardized receptive/expressive language and receptive vocabulary tests and 2) whether there is a relationship between differences in receptive/expressive and receptive vocabulary scores and total disfluency frequency for CWS and CWNS. Forty subjects were tested in their homes, participating in informal clinician-child conversation and standardized speech-language tests. Results indicate a significant difference in measures of receptive/expressive language and receptive vocabularies for CWS compared to CWNS. This difference was not correlated with the stuttering frequency of CWS. Findings suggest the imbalance of semantic and syntactic development may contribute to difficulty in establishing normal speech fluency.
Anderson, J.D., Conture, E.G. (2004). Sentence-structure priming in young children who do and do not stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 552-571.
The purpose of this study was to determine if there is a difference between children who stutter and children who do not stutter in speech reaction time and correctness of picture explanation during no-prime and syntactic-prime conditions. The study consisted of 32 children; 16 who stutter, and 16 who do not. The participants were matched on the basis of age (3;3- 5;5) and gender (12 male, 4 female) and had no history of neurological, psychological, speech- language, or intellectual problems. The participants were tested on two occasions, at their homes and at the clinic to obtain conversational speech samples. The subjects were assigned to a stuttering group if he or she exhibited more than three disfluencies per 100 words of conversational speech and if he or she were rated mild or worse on the Stuttering Severity Instrument for Children and Adults, Third Edition (SSI). The procedures included a sentence- structure priming task where children responded to pictures. The study found that both the children who stutter and the children who do not stutter were influenced by the syntactic priming; that the children who stutter showed greater improvement in scores during a syntactic-prime condition; that children who stutter provided less correct responses than children who do not stutter; and that children who exhibit more stuttering-like disfluencies in their conversational speech have slower reaction times during no-prime conditions.
Anderson, J., Pellowski, M., & Conture, E. (2005). Childhood stuttering and dissociations across linguistic domains. JOURNAL OF FLUENCY DISORDERS, 30, 219-253.
100 preschool children were assessed to examine ' the presence of dissociations in the speech and language skills of nonfluent vs. fluent speakers. Four standardized speech-language measures were administered on two occasions to assess the children's receptive and expressive language, vocabulary, and articulation. An informal parent-child conversational interaction took place to gather a 300-word speech sample for the analysis of stuttering and speech dysfluency. Results of this investigation indicated that some speech-language abilities of children who stutter may not be as well developed as children who do not stutter. A subgroup of children who stutter may exist who exhibit dissociations across speech-language domains. It is likely that these children are more susceptible to breakdowns in speech fluency.
Anderson, J. D., Wagovich, S. A., & Hall, N. E. (2006). Nonword repetition skills in young children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS, 31, 177-199.
The purpose of this study was to describe the phonological working memory skills of young children who stutter (CWS) and compare them to young children who do not stutter (CWNS). The participants (12 CWS and 12 CWNS ages 3-5 years) completed the children's test of nonword repetition (CNRep) and a battery of standardized language tests. Results demonstrated that CWS produced significantly fewer two- and three-syllable nonwords correctly than their CWNS matches. Also, these children produced significantly more phoneme errors than the CWNS at the three-syllable word level. No significant relationships were evident between CNRep and language scores for CWNS. Results of the present study are in concordance with previous studies examining nonword repetition skills in CWS and CWNS.
Anderson, J.M., Hood, S.B., & Sellers, D.E. (1988). Central auditory processing abilities of adolescent and preadolescent stuttering and nonstuttering children. JOURNAL OF FLUENCY DISORDERS, 13, 199- 214.
Previous research suggests a relationship between auditory processing disorders and stuttering. Central auditory processing abilities of stutterers and nonstutterers were studied. The results indicate no significant differences between the two subject groups on the central auditory processing tasks. However, an exception to one condition was present, left competing on the Staggered Spondaic Word Test. This suggests that the auditory processing abilities of stutterers develop later than their nonstuttering peers.
Anderson, J.D., Pellowski, M.W., Conture, E.G., & Kelly, E.M. (2003). Temperamental characteristics of young children who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 1221-1233.
The purpose of this study was to determine whether temperamental characteristics of children who stutter are different from those of children who do not stutter. The authors also looked at the relationship between the onset of stuttering and the temperamental characteristics of the children who stutter. Subjects included 62 children between the ages of 3:0 and 5:4. The children were matched by age, gender, and race in a group of children who stutter and a group of children who do not stutter. Standardized speech and language tests were administered to the subjects and the parents completed a Behavioral Style Questionnaire (BSQ) during an in home visit. Later, during a clinic visit, the children and parents participated in an informal conversational interaction, and the children completed a hearing screening. Results of this study indicated that children who stutter scored above the mean in terms of adaptability and rhythmicity but below the mean in terms of distractibility compared to children who do not stutter. Overall, parents judged 3 to 5- year-old children who stutter to be slower in adapting their behavior to change, more persistent during tasks, and more irregular in daily biological functions such as sleep or hunger compared to children who do not stutter. The authors concluded that such temperamental characteristics might influence or contribute to childhood stuttering.
Andy, O.J., and Bhatnagar, S.C. (1991). Thalamic-induced stuttering (surgical observations). JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 796-800.
This article discusses the relationship of thalamic discharge and disfluencies. It is a single case study of a surgical procedure on a 29 year old man. The electrode was inserted in 2mm increments. Abnormal thalamic discharges were identified at 1.8 cm. However, when advancing the electrode another 2mm, a discharge was activated along with an 8 second interval of repetition disfluencies. The patient was aware of his disfluencies, but he could not control them. The disfluencies were thought to be a result of discharges of the mesothalamus.
Archibald, L.; DeNil, LF. (1999). The Relationship Between Stuttering Severity and Kinesthetic Acuity for Jaw Movements in Adults Who Stutter. JOURNAL OF FLUENCY DISORDERS, 24: 1, 25-42.
Based on previous research, this study looked into a deficiency in the processing of oral kinesthetic sensations in adults who stutter. Twelve subjects, ranging from normally fluent speakers to moderately/severe stutterers, were asked to repeatedly make the smallest possible upward movement with their jaw with visual feedback, and then again without the visual feedback. Results showed that all of the subjects made larger movements when there was no visual feedback, but the persons with very mild stuttering had the most significant increase in movement. When looking at the amount of time it took to make the movements, all subjects took longer when there was no visual feedback, but the persons with moderately/severe stuttering took the longest.
Arends, N., Povel, DJ., Kolk, H. (1988). Stuttering as an intentional phenomenon. JOURNAL OF FLUENCY DISORDERS, 13, 141-151.
This study examined the relation between stuttering and attention by means of a dual-task paradigm. Eleven stutters and eleven nonstutterers ages 19-34 were chosen as subjects for this study. The study tested two hypotheses. The "overload" hypothesis assumes that the stutterer has some problem in the motor control of speech and the "regression" hypothesis assumes that a stutterer can speak in an automatic mode, but that for some reason and under particular circumstances regressed to the earlier developmentally controlled mode. All of the subjects performed three speech tasks both alone and in combination with a tracking task. The results showed that the number of disfluencies increased with the complexity of the speech task and that the rate of speech depends highly on the nature of the speech task (decreases with complexity). From this study, it was concluded that at least part of the results supported the regression hypothesis indicating that stuttering may arise from the attempts of the stutterer to produce controlled speech. There were other aspects of the study, however, that still need to be accounted for.
Ardila, A., Bateman, J.R., Nino, C.R., Pulido, E., Rivera, D.B., & Vanegas, C.J. (1994). An epidemiologic study of stuttering. JOURNAL OF COMMUNICATION DISORDERS, 27, 37-48.
The general purpose of this study was to obtain epidemiologic data regarding stuttering from a Spanish-speaking population in South America. The specific goals were to determine the frequency of: a) self-reported stuttering, b) possible risk factors of minor central nervous system dysfunction correlated with self-reported stuttering, c) associated disorders, and d) depression symptoms in those who reported self-stuttering. Results indicated that the presence of self- reported stuttering may be associated with minor brain injury or dysfunction, developmental dyslexia, word-finding problems, language disorders, and/or depressive symptoms.
Arjunan, K., Rousey, C.G., Rousey, C.L. (1986). Successful treatment of stuttering following closed head injury. JOURNAL OF FLUENCY DISORDERS, 11, 257-261.
The purpose of this case study was to examine the effects of months of treatment after a head injury. The 41 year old man was in a motor vehicle accident and suffered a cerebral concussion and developed a severe stuttering disorder. After 16 weeks of speech therapy consisting of: a slower speaking rate, use of sign language, reading and writing while speaking. The speech therapy encouraged the use of intact functional systems to develop a more fluent speaking ability. It is thought that underdetermined neurological factors contributed to the stuttering. After the 16 weeks of therapy the patient did! achieve a more fluent speaking ability.
Armson, Joy; Kiefte, Michael; Mason, Jessica; & De Croos, Dayani. (2006) The effect of SpeechEasy on stuttering frequency in laboratory conditions. JOURNAL OF FLUENCY DISORDERS, Volume 31, issue 2, 137-152.
The authors of this article investigated the benefits of the SpeechEasy device in monologue, conversation speech as well as oral reading. Research used thus far has been done on other devices such as the DAF and AAF. The study was done in a laboratory setting to examine the role of the SpeechEasy in reducing stuttering in monologue and conversation as there primary interest. The device was presented in two ways: Device only (participants wore devise and the results were documented) and Device Plus (the participants wore the device with instruction to begin with prolongation of vowels). The results were more dramatic if they prolonged their vowels. All participants had a reduction in at least one of the speaking tasks. It is unknown how much impact the behavioral change of vowel prolongation impacted the devices credibility. More research is needed with a larger population to determine its performance. It continues to be a tool available for therapy techniques.
Armson, J. & Kiefte, M. (2008). The effect of SpeechEasy on stuttering frequency, speech rate, and speech naturalness. JOURNAL OF FLUENCY DISORDERS, 33, 120-134.
This article analyzed the effect of an Altered Auditory Feedback (AAF) device, the SpeechEasy, on the frequency, rate, and naturalness of speech in 31 adults who stutter by comparing both oral reading and monologue speech samples with and without the SpeechEasy. The results of the study showed a 79% reduction in the frequency of stuttering during oral reading and a 61% reduction during monologue speech when the SpeechEasy device was used. Speech rate was increased by 15% during the oral reading task and 8% during the monologue task when using the device. However, although the speech rate increased, the rate of speech was still lower than that of normally fluent speakers. Speech naturalness increased from 5.3 without the use of the SpeechEasy to 3.3 with the SpeechEasy during the oral reading task and from 5.5 to 3.2 during the monologue task, which is only slightly outside of the normal range of 1-3. The overall results show an increase of fluent speech during a clinical setting; however, the use of the SpeechEasy device during daily living situations should be investigated before determining the long-term treatment potential this may have for people who stutter.
Arndt, J. & Healey, E.C. (2001). Concomitant disorders in school-age children who stutter. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 32, 2, 68-78.
This article focused on determining the number of children who stutter with verified and suspected concomitant phonological and language disorders. Also, the study assessed the type of treatment clinicians tend to use with these children. Survey Responses were obtained from 241 ASHA-certified, school-based SLPs from ten states that were considered to have similar state verification criteria for fluency, articulation/phonology, and language disorders. Results found that of the 467 children who stuttered who were reported on, 205 (44%) had verified concomitant phonological and/or language disorders. This is an important finding for SLPs in the schools because they need to be aware of the strong possibility that school- aged children who stutter might have a phonological and/or language disorder. Based on the findings, most clinicians use a blended approach (treating both disorders simultaneously), when treating these types of children.
Arnold, H. S., Conture, E. G., & Ohde, R. N. (2005). Phonological neighborhood density in the picture naming of young children who stutter: Preliminary study. JOURNAL OF FLUENCY DISORDERS, 30, 125-148.
The purpose of this article was to evaluate what effect naming phonologically dense and sparse words had on speed reaction time and errors of preschool children who stutter (CWS) and preschool children who did not stutter (CWNS). The examiners used two groups of words that differed in phonological density. Phonological density is determined by how many phonological neighbors a word has. Phonological neighbors are words that differ by one phoneme substitution, deletion or addition. The more neighbors a word has the more dense it is considered. Data revealed both groups speech reaction time was slower and less accurate when naming phonologically dense words. Data also revealed no significant difference between CWS and CWNS speed reaction times or number of errors in relation to phonologically density of words.
Armson, J., Jenson, S., Gallant, D., Kalinowski, J., & Fee., E. (1997). The relationship between degree of audible struggle and judgments of childhood disfluencies as stuttered or not stuttered. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 1, 42- 50.
This study investigated whether degree of audible struggle can be used to categorically distinguish childhood stuttered disfluencies from normal disfluencies. Thirty-one first year graduate students in communication disorders participated. Speech samples were collected from 12 children aged 33-59 months. Results indicated that as the perception of degree of struggle increased, so did the likelihood that the disfluent production would be judged as stuttered. It is suggested that a rating scale for degree of struggle may be a useful clinical tool for diagnosing childhood stuttering.
Armson, J., & Kalinowski, J. (1994). Interpreting results of the fluent speech paradigm in stuttering research: Difficulties in separating cause from effect. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 69-82.
This paper is a review of past research studies and problems encountered in a search for the cause of stuttering. Specifically reviewed are studies that compare fluent speech of stutterers and nonstutterers. The authors provide evidence which suggests that measures of fluent speech of PWS may be influenced by the context of speech samples, treatment history of subjects, stuttering severity of subjects, and developmental history of stuttering. Alternative methods of research are recommended. These methods include comparison of the nonspeech motor function of stutterers and nonstutterers, examination of conditions associated with increase and decrease in stuttering, and study of the stuttering moment.
Armson, J., & Stuart, A., (1998) Effect of Extended Exposure to Frequency- Altered Feedback on Stuttering During Reading and Monologue. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 479-490.
The fluency program outlined uses frequency altered auditory feedback to decrease stuttering during both monologues and reading tasks. Twelve adults who stutter spoke into a microphone that increased or decreased their speech by one quarter octave before returning it to the individual's headsets. Half of the participants were chosen to receive an upward shift of _ octave and the other half received downward shift. Reading tasks included reading from a set of 22 passages while the monologue tasks allowed the individual to chose a topic that would facilitate continuous monologue from a set of 20 topics. Results indicated that the number of syllables increased and percentage of stuttering decreased while performing the reading tasks, whereas the monologue tasks recorded no notable changes in these same areas.
Atkins, C. P. (1988). Perceptions of speakers with minimal eye contact: implications for stutterers. JOURNAL OF FLUENCY DISORDERS, 13, 429-436.
The first objective of this study was to determine percentage definitions of "good," "minimal," and "no" eye contact and the second objective was to determine how others perceive speakers with little or no eye contact. One hundred thirty-three college students responded to a 60-item semantic differential seven-point scale, which contained polarized adjective pairs regarding personality traits. Prior to completing the semantic differential scale, students circle percentages that they felt best described the degrees of eye contact. The majority of the respondents judged a speaker with "good" eye contact to look at his/her listener 90-100% of the time. The speaker with no eye contact was perceived by the majority to look 10% or less of the time. Minimal eye contact was judged to look between 10-50% of the time. Speakers with little or no eye contact were judged negatively on 70% of the personality traits presented. The development of effective eye contact needs to be incorporated as a major goal in stuttering therapy because it is important to the manner in which the stutterer is perceived.
Attanasio, J. S. (1987). A case of late-onset or acquired stuttering in adult life. JOURNAL OF FLUENCY DISORDERS, 12, 287-290.
A case report is presented of a 36 year old male who reports stuttering onset at age 29 years. The subject reports the stuttering began when he began experiencing marital difficulties. The symptoms progressed gradually and consist of typical stuttering symptoms. There is tension, anxiety, and concern over not being able to talk "normal." There is a possible link between the stuttering and epilepsy which emerged when the subject was 11 years old.
Attanasio, JS. (1987). The Dodo was Lewis Carroll, You See: Reflections and Speculations. JOURNAL OF FLUENCY DISORDERS, 2, 107-118.
Lewis Carroll, the pen name of Charles Ludwidge Dodgson, known as the author of Alice's Adventures in Wonderland and Through the Looking Glass, suffered from 2 cases of communication disorders: hearing loss in his right ear and stuttering. Carroll's own comments on his own speech indicated that he found it to be a problem that interfered with his personal life. The author of this article speculates that much of the nonsense, humor, and whimsy in Carroll's writing reflect what happens when communication breaks down. He also speculates that much of what Carroll wrote was based at least somewhat on his own conscious or unconscious experiences.
Attanasio, J.S. (1997). Was Moses a person who stuttered? Perhaps not. JOURNAL OF FLUENCY DISORDERS, 22, 65-68.
This essay argues that Moses was not a person who stuttered, but rather he had an organic or structural communication disorder which affected the intelligibility of his speech and his articulation.
Attanasio, J.S., Onslow, M., & Packman, A. (1998). Representativeness Reasoning and the Search for the Origins of Stuttering: A Return to Basic Observations. JOURNAL OF FLUENCY DISORDERS, 23, 4, 265-277.
This article describes the different theories on the distal and proximal causes of stuttering. Distal is defined as the reason for the existence of stuttering (the underlying causes for the problem) whereas proximal causes try to explain why stuttering can occur for an individual on a daily basis. A pattern of representativeness heuristic is defined as a way to help organize the search for the cause of stuttering by suggesting that the cause is seen in it's effects (the effects resemble the causes that produce them). Anxiety as a cause is emphasized as a key factor in representativeness reasoning. Also, models are given as examples to explain that stuttering can be dynamic and have multi- factorial implications on fluency. But, if stuttering appears complex and multi- factorial it does not necessarily mean that its cause is complex and multi- factorial. This heuristic and early stuttering is discussed by explanation of Ortin- Travis' cerebral dominance theory, Johnson's diagnosogenic theory, and Bloodstein's anticipatory struggle theory. Early repetitions are shown to be beneficial in yielding information to formulate theories on stuttering. There is no data available to prove that stuttering is an anticipatory struggle disorder. It is suggested that recall Froeschel's and Bluemel's thoughts on the cause of stuttering and incorporate representativeness heuristic to find the proximal etiologies of the repetitions of early stuttering.
Au-Yeung, J., Gomez, I. V., Howell, P. (2003). Exchange of disfluency with age from function words to content words in Spanish speakers who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 754-765.
The purpose of this study was to find if the progression of function word disfluency to content word disfluency observed in English speakers who stutter as they age could also be observed in Spanish speakers who stutter. The study involved 46 monolingual speakers divided into five age groups from ages 3 to 68. Findings of this study support that Spanish speakers who stutter also follow a similar course of disfluency change as they develop. Covert repair hypothesis and EXPLAN theories as well as comparative phonological complexity of English are discussed as possible causes for this trend.
Au-Yeung, J., Howell, P., & Pilgrim, L. (1998). Phonological words and stuttering on function words. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 1019-1030.
The main purpose of this study was to examine the stuttering rate of function words in people who stutter while considering the phonological word as well as the utterance position. Fifty-one subjects participated and were subdivided into three different child groups (young- two to six years; middle- six to nine years; and older- nine to twelve years), teenagers (thirteen to eighteen years), and adults (twenty to forty years). Four separate, yet related, analysis were performed. Analysis 1 examined the effect of word type (content vs. function) on stuttering rate, Analysis 2 examined the effect of utterance position on stuttering rate in content and function words, Analysis 3 examined the specific position within phonological words on the stuttering rate in both content and function words, and Analysis 4 examined the effect of the position of the function word within a phonological word relative to the content word. Results of Analysis 1 showed that younger speakers were more dysfluent on function words than content words, and older speakers were more dysfluent on content words than function words. Results of Analysis 2 showed that the stuttering rate was higher in function words that were at the beginning of the utterance than at other positions. However, the position of content words did not seem to affect the rate of stuttering. Results of Analysis 3 showed that the stuttering rate was higher for phonological word-initial function words than function words in other positions. However, the stuttering rate did not vary with changing position of content words within phonological words. Results of Analysis 4 showed that the percentage of function words that are stuttered is higher in the pre-content word position than in post-content word positions. These authors concluded that stuttering on function words is dependent on word-external factors, whereas stuttering on content words is dependent on word-inherent factors.
Au-Yeung, J., Howell, P., & Sackin, S. (2000). Internal Structure of content words leading to lifespan differences in phonological difficulty in stuttering. JOURNAL OF FLUENCY DISORDERS, 25, 1- 20.
This article discusses a study that investigated whether stuttering frequency was affected by factors that determine phonological difficulty and the variances across different age groups. The age groups included children, teenagers, and adults. The study evaluated content and function words and took into consideration phonological factors such as late emerging consonants and consonant strings. The results of the study showed that the frequency of stuttering remained high for adults when late emerging consonants and consonant strings were both present and when they occurred in the initial position.
Bailey W.R., (1982). Managing the environment of the stutter. JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS, 6, 26-39.
Bailey and Bailey explain that many factors have been linked to the disruption of fluency in children. Lack of language facility or oral-motor coordination may contribute, also the structure and harmony in the child's environment can play a significant role in acquiring fluency. This article presents suggestions for parents and teachers of young children who are having difficulties managing fluency. The authors list two general guidelines for helping with childhood fluency. 1. Direct intervention and modeling procedures will promote fluent speech, 2. The child's environment will promote fluent speech The authors give guidelines for parents and teachers to remember when working with a child who is showing some fluency breakdowns. Create and environment which is rich in encouragement and respect, be a good listener, get down to eye level when talking with the child, insure the child has had enough rest, and eliminate time pressures as frequently as possible.
Bajaj, A. (2007). Working memory involvement in stuttering: Exploring the evidence and research implications. JOURNAL OF FLUENCY DISORDERS, 32, (3), 218-238.
Empirical evidence that supports the correlation between working memory and stuttering, along with the link between the two, are the main topics of discussion within this article. The intention of this articles content is to look into the research dealing with verbal working memory, where phonological storage, phonological retrieval and the execution of speech have been examined more intensely than in stuttering research. An outline of Bradley's (2003) model, with research and support on short-term memory along with the similarities that link verbal working memory to stuttering are proposed. Overall, working memory is crucial to the process of phonological encoding within our speech and language and imperative to higher level cognition.
Bajaj, A., Hodson, B., & Schommer-Aikins, M. (2004). Performance on phonological and grammatical awareness metalinguistic tasks by children who stutter and their fluent peers. JOURNAL OF FLUENCY DISORDERS, 29, 63-77.
The purpose of this study is to look at metalinguistic skills, including phonological awareness and grammatical awareness, of children who stutter (CWS) and children who do not stutter (CWNS). Twenty-three CWS and 23 CWNS participated in the study. The results indicated that CWS do not have deviant phonological awareness skills when compared to their peers who do not stutter. On the grammar judgment task the CWS had scores that were significantly lower that CWNS. However, this could be due to the co-morbid disorders present in 8 of the CWS. This study indicates that CWS do not have metalinguistic skills below that of their peers.
Bajaj, A., Hodson, B., & Westby, C. (2005). Communication ability conceptions among children who stutter and their fluent peers: A qualitative exploration. JOURNAL OF FLUENCY DISORDERS 30(1), 41-64
The current study employed qualitative methods to study the criteria used by 23 male children with stuttering (CWS) and their fluently speaking peers in describing meatalinguistic behaviors which were positive and negative and the participants' self- appraisals as communicators. Verbally-descriptive data form participants was collected by conducting interviews which were then analyzed and transcribed. On transcription thematic categories were identified which formed the bases for group comparisons. The outcome of the study provides evidence that for CWS, good and bad talkers endowed or were lacking principally in fluent, articulate, grammatical, or otherwise vocally proficient behaviors. In contrast CWNS made use of diverse criteria to attend adequately to speaker's speech-language forms and pragmatic behaviors in positive descriptions and gave slight precedence to pragmatic behaviors in negative descriptions. In conclusion it is evident form this study that early conception of communicative abilities among CWS depend upon their stuttering experiences and differ form those communicative abilities of their age matched peers.
Baker, K, Brutten, G. J. & McQuain, J. (1995). A preliminary assessment of the validity of three instrument-based measures for speech rate determination. JOURNAL OF FLUENCY DISORDERS, 20(1), 63-76.
The validity of three instrument-based measures with regard to a potential for implementation in automated procedures for speech rate determination is assessed. Correctional analysis reveals that automated counts of stressed syllables are strongly predictive of live and transcription-based syllable counts. Subsequent studies demonstrate that the number of pauses represent a separate unique dimension. Finally, automated stressed-syllable counts are most promising for clinical applications targeting speech rate modification.
Bakker, K. (1995). Two supplemental scoring procedures for diagnostic evaluations with the Speech Situations Checklist. JOURNAL OF FLUENCY DISORDERS, 20 (2), 117-126.
The purpose of this article was to expand the traditional use of the Speech Situations Checklist with two new scoring procedures. Analyzing a client's response may help in assessing the nature of stutterer's speech concerns. Therefore, implementing the analysis can provide the client with a systematic hierarchy of speech situations. The article contains several tables which show the results of stutterer's responses to the Speech Situation Checklist.
Bakker, K. (1996) Cluttering: Current scientific status and emerging research and clinical needs. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 359-365.
This article attempts to give the best possible answers to questions on how the identifying characteristics and associated symptomatologies of cluttering need to be measured. It discusses the issue of whether or not cluttering exists in its own right, whether or not it is a result exclusively of coexisting perceptuomotor and cognitive anomalies, or a result of both factors.
Barasch, CT., Guitar, B., McCauley, RJ., Absher, RG. (2000). Disfluency and time perception. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 1429-1439.
This study compared the ability of stuttering and nonstuttering adults to estimate protensity and to distinguish the relative lengths of short tones. They also examined whether there is a correlation between a person's degree of disfluency and the ability to measure protensity or judge the relative length of short tones. Twenty stuttering adult subjects and twenty nonstuttering adult subjects were given the Duration Pattern Sequence Test. A negative correlation was found between degree of disfluency and ability to determine the relative lengths of short tones. A positive correlation was found between degree of disfluency and length of protensity estimates.
Belknap, H., Finn, P., Ingham, R.J., & Sato, W. (2001). The modification of speech naturalness during rhythmic stimulation treatment of stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 4, 841-852.
The research article focused on a study in which the authors investigated the modification of speech naturalness during stuttering treatment. This particular study is a replication of a study done by Ingham and Onslow (1985). The only difference between the two being that the latter addressed the effect of using speech- naturalness-rating feedback to increase as well as decrease the speech-naturalness ratings of specific listeners. The study used three people who stutter: two female adolescents and one adult male. The data was collected by having the participants sit in sound-treated rooms, wear headphones, and speak on topics of their choice. Each participant completed ten 5-minute trials while using a metronome stimulus. Two listeners sat outside the rooms and rated speech- naturalness. Results for two of the participants showed that when stuttering is reduced to near-zero levels during rhythmic stimulation, it's possible to shape the person's speech into relatively natural sounding speech. However, these results were not found in the adult male.
Bergmann, G. (1986). Studies in stuttering as a prosodic disturbance. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 29, 290-300.
The study described in this article includes two elements regarding the ability of people who stutter (PWS) to produce prosodic features in their speech. The first component studied the ability of the subjects to place appropriate accent and stress patterns when answering questions. Based on the tasks administered, PWS were able to produce appropriate intonation patterns when compared to fluent speakers. The second component of the study examined the relation between stuttered words and stressed or unstressed syllables. Because stuttered words were found significantly more often on stressed syllables, results imply stuttering to be a disturbance in prosody due to motor difficulty.
Berkowitz, M., Cook, H., & Haughey, M.J. (1994). A non-traditional fluency program developed for the public school setting. LANGUAGE, SPEECH AND HEARING SERVICES IN SCHOOLS, 25, 94-99.
This fluency program focuses on changing student and parental attitudes about stuttering and helping the students gain control over their speech. Student groups met once a week for 1.5 hours and parent groups met one evening a month. The program evolved through many phases with attitudinal issues being addressed before trying to change behaviors. Results indicated improvements in situational avoidance, attitude indicators of significance of stuttering, and indicators of perception of severity. Improvements were also made in frequency, duration, and physical concomitants of stuttering.
Berstein Ratner, N. (1992). Measurable outcomes of instructions to modify normal parent-child verbal interactions: Implications for indirect stuttering therapy. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 14-20.
This study looked at the differential effects of instructions to slow maternal speech rate, or to slow and simplify maternal speech when conversing with normally fluent children. Twenty normally fluent children and their mothers participated in the study. The instructions to simply slow parental speech rate resulted not only in decreased speech rate, but also in significantly shorter and simpler utterances. No significant differences were found between the effects of the two sets of instructions. Also, the children's speech rate and language complexity did not parallel the maternal adjustments. These findings do not support the use of indirect therapy in parental counseling.
Bernstein Ratner, N. (1995). Language complexity and stuttering in children. TOPICS IN LANGUAGE DISORDERS, 15 (3), 32-47.
The purpose of this article is to explore the connection between stuttering moments and language formulation. Both clinical and experimental research is reviewed. This research investigates the impact of syntax, lexicon, and conversational demands as they relate to stuttering moments. The frequency and location of the stuttering moments within an utterance is also explored in these studies. Although the relationship between language and stuttering is not yet clearly understood, there are implications for assessment and therapy planning which the author discusses in the article.
Bernstein Ratner, N., & Silverman, S. (2000). Parental conceptions of children's communication development at stuttering onset. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 1252-1263.
This study focuses on the concept that there has been clinical speculation that parents of young children who stutter have expectations of their children's communication abilities that are not well matched to the children's actual skills. They took 15 subjects who were close to the onset of stuttering symptoms and analyzed their language ability and 15 age, sex, and SES-matched fluent children. Parents completed two parent-report measures of the children's communication development. Results indicated generally depressed performance on all child speech and language measures by the children who stutter. Parent report was closely attuned to child performance for the stuttering children; parents of nonstuttering children were accurate in their predictions of children's communicative performance. Implications for clinical advisement to parents of stuttering children are discussed.
Betz, I.R., Blood, G.W., & Blood, I.M. (2008). University students' perceptions of pre-school and kindergarten children who stutter. JOURNAL OF COMMUNICATION DISORDERS, 41, 259-273.
This study assessed university students' perceptions of a hypothetical child aged three through six to determine if stuttering decreased the students' perceptions of the child. Participants read short paragraphs of hypothetical demographic information for a child. Some of the paragraphs contained demographic information that the child stuttered and some did not. Participants rated how various adjectives applied to the child on a semantic differential scale containing the anchor points _ very much,' _ quite a bit,' _ slightly,' and _ neutral.' The results indicated that the participants rated the hypothetical children who stuttered more negatively.
Beverung, J., Jensen, P., Markel, N. (1986). Evidence of conversational disrhythmia in stutterers. JOURNAL OF FLUENCY DISORDERS, 11, 183-200.
The study was conducted to investigate if people who stutter have different non-verbal communication styles, frequency of eye contact, difference in body movement, and turn taking, in comparison to people who do not stutter. The examiners hypothesized that more than dysfluencies are involved in the stuttering disorder. The subjects were nine people who stutter and a control group that consisted personal friends to the person who stutters. The subjects completed a word association task, in which, the subjects were to repeat words from a list during video recordings. The video recordings were analyzed and provided that people who stutter maintain less eye contact, experience more body movement, and are one second quicker to respond in reference to latency.
Black, J. A. (1987). A comparative study of the perception of freedom-in-leisure between stuttering and nonstuttering individuals. JOURNAL OF FLUENCY DISORDERS, 12, 239-248.
This study tested the hypothesis that stutterers have less freedom in leisure than non- stutterers. The subjects of the study were stuttering and non-stuttering members of the National Stuttering Project. Results indicated no significant difference in level of perceived freedom in leisure, but that stuttering members perceived barriers to freedom in leisure.
Blair, C., & Smith, A. (1986). EMG recording in human lip muscles: Can single muscles be isolated? JOURNAL OF SPEECH AND HEARING RESEARCH. 29, 256-266.
Electromyography (EMG) is a way to record the electrical activity of muscles. This article looks at the possibility of individual perioral lip muscles being isolated through the use of EMG and if the ability to do so is important. Overall, the possibility of isolation is low. Also, this article implies that EMG studies are not appropriate because the structural makeup of the lip is too complicated and the muscle fibers do not have homogeneous mechanical action.
Blanchet, P. (2006). Using delayed auditory feedback to treat fluency and speech rate in individuals with Parkinson's disease: Specific clinical considerations. JOURNAL OF STUTTERING, ADVOCACY, AND RESEARCH, 1(3), 94-101.
This article follows-up a previous article, also done by Blanchet and Hoffman (2006). The use of delayed auditory feedback (DAF) devices allows the client to prolong each syllable or word. Research pertaining to the use of DAF for speakers with Parkinson's disease (PD) is limited. However, the limited research implies that DAF may be used to improve effective rate control, along with improvements on speech intensity, pitch, and sometimes intelligibility (if the appropriate delay interval is found). To facilitate optimal improvements/effectiveness, clinicians should provide instruction, model correct DAF usage, and provide feedback. The author discusses strengths and weaknesses when a client with PD decides to use a DAF. For a client with PD, his/her speech rate may increase due to the limited neuromuscular capabilities; intelligibility maybe compromised. The "first word dilemma" or the inability to initiate phonation for the PD client may also be compromised. The clinician should be thoroughly involved with the client with PD when introducing DAF.
Blanchet, P. (2006) Treating fluency and speech rate disorders in individuals with Parkinson's Disease: The use of delayed auditory feedback. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, Vol. 1, Issue 2. http://www.journalofstuttering.com/ListofArticles.html
This article reviews literature examining the effect of using delayed auditory feedback (DAF) to treat speech rate and fluency disorders related to Parkinson's Disease. This effect was most dramatic in those who experienced hypokinetic dysarthria, where slowing speech rate alone produced significant improvements in intelligibility. With proper education, modeling and feedback from the clinician, results indicate that DAF could useful for slowing speech rate in people with Parkinson's Disease, which resulted in fewer disfluencies in their speech production and increased intelligibility.
Blomgren, M. & Goberman, A.M. (2008) Revisiting speech rate and utterance length manipulations in stuttering speakers. JOURNAL OF COMMUNICATION DISORDERS. 41(2), 159-178.
22 stuttering speakers and 22 non-stuttering speakers were included in this study to measure the stuttering frequency over different speech tasks. Measured were spontaneous speech tasks and four controlled speaking tasks. Length of utterances and speech rate stability were measured during the controlled speaking tasks. Non-stuttering speakers showed no dysfluencies throughout the study and stuttering speaker¼_s results were similar for the spontaneous and controlled speaking tasks.
Blomgren, M., Nagarajan, SS., Lee, JN., Li, T., & Alvord, L. (2003). Preliminary results of a functional MRI study of brain activation patterns in stuttering and nonstuttering speakers during a lexical access task. JOURNAL OF FLUENCY DISORDERS, 28, 337-356.
'The purpose of this study was to use functional MRI (fMRI) measures to compare brain activation patterns of normally fluent speakers and those of PWS, with regard to lexical access tasks. A total of sixteen adults, aging from 19 to 38, participated in this study. Of the sixteen, seven were people who stuttered. All participants took part in a lexical access task during the fMRI. The task consisted of word descriptions (nouns and verbs), presented through headphones. The participants were instructed to "think" of the word being described. The fMRI measures were done to compare the activation patterns while the participants were "thinking" of the word. Results indicated large activation variances within the two groups. The participants in the stuttering group displayed increased right hemisphere activation in right Broca's and Wernicke's areas, as compared to the nonstuttering group. 'However, between-group comparisons yielded no significant differences.
Blomgren, M., Smith, A.B., & Wolk, L. (2000). The frequency of simultaneous disfluency and phonological errors in children: a preliminary investigation. JOURNAL OF FLUENCY DISORDERS, 25, 269-281.
The co-occurrence of stuttering and phonological disorders in seven English specking children was studied. Speech samples were collected and analyzed. All occurrences of stuttering were identified and coded as to whether a phonological error was present. Results indicate the frequency of disfluency on syllables with phonological errors was similar to those utterances produced without errors. However, the frequency of dysfluency on initial consonant clusters with phonological errors was higher than on initial consonant clusters without phonological errors.
Blomgren, M., Roy, N., Callister, T., & Merrill, R.M. (2005). Intensive stuttering modification therapy: A multidimensional assessment of treatment outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 48, 509-522.
This article focuses on adults who participated in the Successful Stuttering Management Program (SSMP) during a 3-week intensive period to assess stuttering before, immediately after, and 6 months after treatment. Nineteen individuals who stutter (15 males and 4 females) and were enrolled in two sessions of the SSMP volunteered for this study. Data on the individuals was collected through audio and video using speech samples during an oral reading task and through spontaneous speech as well as inventories and questionnaires resulting in very high reliability coefficients (p<.0001) in both tasks. However, results show that the SSMP was ineffective in reducing core behaviors, such as stuttering frequency and severity.
Blood, G.W. (1993) Treatment efficacy in adults who stutter: Review and recommendations. JOURNAL OF FLUENCY DISORDERS, 18, 303- 318.
The author of this article discusses the question, "Does stuttering therapy work?" He looks at three predictive factors for therapy success; client variables, clinician variables, and treatment variables. Some client variables include; motivation, expectations, locus of control, gender, intelligence, anxiety, education, social class, and previous therapy experiences. Clinician variables include; age, experience, empathy, expectations, knowledge, and locus of control among others. The length of therapy, degree of cognitive restructuring, and the issue of process versus outcome are all treatment variables which are discussed. Finally the author discusses the need for a standardized set of outcome measures.
Blood, G. W., et al. (1994). Subjective anxiety measurements and cortisol responses in adults with stutter, JOURNAL OF SPEECH AND HEARING RESEARCH, 37 (4), 761-768.
This study measures anxiety by self-report and salivary cortisol levels. The authors attempt to use cortisol, a hormone, to measure autonomic anxiety levels. The results of the study of 11 males who stutter and 11 males who do not stutter show an increase of a different proportion in cortisol levels in the stuttering group than in the non-stuttering group. The authors conclude that the anticipation of stress triggers this physiological hormonal response in PWS. The relationship between the self-report and cortisol levels reveals that there was no correlation between cortisol response and the subjects behavior in either group. The authors conclude that subjective anxiety and communicative apprehension do not relate to hormonal response.
Blood, G. W. (1995). A behavioral-cognitive therapy program for adults who stutter: Computers and counseling. JOURNAL OF COMMUNICATION DISORDERS, 28, 165-180.
The treatment program presented addresses three components of stuttering: the speech behavior, the feelings and the thoughts. The speech is monitored using a computer-assisted biofeedback program called CAFET, which measures airflow noninvasively. Feelings and thoughts are addressed and reshaped using Blood's POWER2 relapse management program. An outline of this treatment program and the results (based on single subject multiple baseline across subjects design on four adult males) are provided and discussed. Establishment and maintenance of improved fluency is documented up to 12 months post treatment.
Blood, G. (1995). POWER2: Relapse management with adolescents who stutter. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 26, 169-179.
This article presents a study which assessed the effectiveness of the POWER2 relapse management program. Designed for adolescents, the POWER is a board game that facilitates discussion about coping with interpersonal conflict, social pressure, and coping with negative emotional states in a fun, nonthreatening way. The study included three phases; intensive speech therapy, supportive counseling and relapse management, and a 6 and 12 month follow-up. The results showed a reduction in stuttering to within normal levels, a reduction in negative feelings, and an inward shift of locus of control. The follow-up indicated that the positive changes persisted one year past treatment. The authors suggest that counseling adolescents who stutter about changing speech behavior, negative emotions, and maladaptive attitudes can result in lasting fluency beyond therapy.
Blood, G. & Blood, I. (1989). Laterality preferences in adult female and male stutterers. JOURNAL OF FLUENCY DISORDERS, 14, 1-10.
This study was to determine the ear preferences for groups of stuttering and non-stuttering males and females on a dichotic word task. Subjects responded to a 36-item word test. The study found stutterers' ear advantages were not as strong as the non-stutterers, non-stutterers had a higher right ear preference, severe female stutterers showed more left ear responses than mild stutterers, and there was no significant difference found between male and female stutterers.
Blood, GW., & Blood, IM. (1989). Multiple data analyses of dichotic listening advantages of stutterers. JOURNAL OF FLUENCY DISORDERS, 14, 97-107.
This study focuses on the data analysis of dichotic listening tasks in relation to cerebral dominance and stuttering disorders. Previous research has been conflicting as to whether or not differences exist between stutterers and nonstutterers. These conflicts may have occurred from a number of different variables including severity of stuttering, age and sex of the subjects and type of stimuli. This study is concerned with the variable of data analysis. The authors used five data analysis methods to analyze the results obtained from twenty subjects who were given the Dichotic Listening Test. The subjects were asked to listen to the syllables being presented and point to the correct one on the card in front of them. Results showed that only one of the five analyses showed a statistically significant difference between the two groups. This suggests that depending on the type of analysis used, the number and percentage of left and right dominant people may vary. The results of this study can serve as a caution to experimenters if they use only group data and rely heavily on statistical information.
Blood, GW & Blood, M. (2004). Bullying in adolescents who stutter: Communicative competence and self-esteem. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 69- 79.
Bullying can result in serious and negative long-term outcomes. This study looks at (a) the relationship between social and communication skills in adolescents, (b) the negative effects of bullying and (c) the possible relationship between bullying and stuttering. First, Blood and Blood look at past studies which have shown that adolescents who either perceive themselves as "different " or are thought of as "being different " by others because of a lack or absence of using social and communication skills with peers may be more likely to be bullied. These past studies have also shown that children who are bullied may develop long-term psychosocial and physical health problems. They also have trouble sleeping, low self-esteem, show signs of depressions, a loss of confidence and greater social isolation among other things. It has also been noted adolescents who stutter are three times as likely to be bullied. This study done by Blood and Blood shows similar results. The current study shows that adolescents who stutter are at a greater risk for being bullied. Another important finding is that bullying does have negative effects on an adolescent's self-esteem. In the current study, the numbers are higher for this than in past studies. One other important finding from this study is that there is a relationship between an adolescent's communicative competence and their risk of being bullied.
Blood, G., W., Blood, I., M., Maloney, K., Meyer, C., Qualls, C., D. (2007). Anxiety levels in adolescents who stutter. JOURNAL OF COMMUNICATION DISORDERS, 40, 452-469.
Living with a disability can have a negative influence on individuals. This study was conducted in order to examine physiological and emotional anxiety in people who stutter in order to assist clinicians and researchers in treatment planning and techniques used in schools and clinics. Thirty-six students who stutter were included in the study. Upon data collection and analysis it was found that significant levels of anxiety between those who do stutter and those who do not were evident, however, both within normal limits. No significant differences were noted on the self- esteem scale and no significant differences were found between ethnic groups, socioeconomic class, gender and anxiety levels. Significantly higher levels of anxiety were noted in adolescents who stutter with co-occurring disorders compared to adolescents who stutter with no co-occurring disorders.
Blood, GW., Blood, IM., & Hood SB. (1987). The Development of Ear Preferences in Stuttering and Nonstuttering Children: A Longitudinal Study. JOURNAL OF FLUENCY DISORDERS, 2, 119-131.
This study examined changes in young male stuttering and nonstuttering children ages 7-9 over a 3-year period. The purpose of this study was to determine if differences existed between stutterers and nonstutterers over a small period of time and to determine if a relationship existed between the child's fluency and changes in ear preference over time. Results suggested that stuttering and nonstuttering children present a significant right ear advantage in the initial, second, and third time of testing. This study supports the notion that stuttering and nonstuttering children present similar developmental trends for dichotic ear preferences.
Blood, G.W., Blood, I.M., McCarthy, J., Tellis, G. & Gabel, R. (2001). An analysis of Verbal Response Patterns of Charles Van Riper During Stuttering Modification Therapy. JOURNAL OF FLUENCY DISORDERS, 26:2, 129-147.
The introduction to this article focuses on the counseling aspect of fluency disorders. This article explains many authors beliefs, but the one belief that is shared by them is that the one factor of influencing the effectiveness of counseling in fluency therapy is the clinician and client relationship. The present study discussed is one by Charles Van Riper. The purpose of the study was to examine the quantity and type of verbal responses during demonstration therapy sessions videotaped from beginning to end. The method used was 7 commercially available Charles Van Riper: Therapy in Action videotapes were used. These videos included Van Ripers therapy program, and was conducted on an 18 year old male university student. These videos were evaluated by 10 trained raters. The verbal response patterns were analyzed in accordance to the Hill Counselor Verbal Response Category System (1993), which involves 9 categories of counsel or verbal response behavior (Approval, Providing Information, Direct Guidance, Closed Question, Open Question, Paraphrase, Interpretation, Confrontation, and Disclosure). The findings were: (1) When the client, compared Van Riper, produced a greater percentage of verbal responses during all therapy sessions. (2) Van Riper consistently spoke more often than the client during interaction in therapy. (3) The highest response patterns while conducting therapy were those of Van Riper (Direct Guidance, Providing Information. and Close Question). (4) Close Question, Paraphrasing, and Providing Information were what Van Riper primarily used for verbal response patterns. (5) Paraphrasing was mainly used during the diagnostic session. The discussion discusses how the observations of verbal response skills used by Van Riper during his therapy stages support his therapy approach. Examples of the categories from the Manual for Hill Counselor Verbal Response Category System-taken from Van Riper's transcripts are provided at the end of the study.
Blood, G., Blood, I., Newton, K. (1986). Simultaneous and staggered dichotic word and digit tests with stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 201-216.
The purpose of the study was to focus on dichotic digit stimuli in comparison to people who stutter and people who do not stutter. The article was an ongoing study which investigates the relationship between auditory functioning and stuttering. Nine people who stutter from Ohio and Indiana were matched with a person, of the same age, who does not stutter. The subjects were assessed using four dichotic listening tests: Staggered Spondaic Word (SSW) Test, Staggered Digit Simultaneous (SDS) Test, Staggered Digit Offset (SDO) Test, and Staggered Paired Digit (SPD! ) Test. The results indicated that there were differences between the control group and experimental groups within these tests: SDS, SDO, and SPD. The results for the Staggered Spondaic Word Test were the same for both groups.
Blood, G. W., Blood, I. M., Tellis, G., & Gabel, R. (2001). Communication apprehension and self-perceived communication competence in adolescents who stutter. JOURNAL OF FLUENCY DISORDERS, 26, 161-178.
This study examined the communication apprehension and self-perceived competence of thirty-nine adolescents who stuttered and thirty-nine adolescents who did not stutter. The study utilized two standard communication measures: the Personal Report of Communication Apprehension (PRCA-24) and the Self-Perceived Communication Competence (SPCC). Results of the study suggested that adolescents who stutter have greater apprehension of communication than those who do not stutter, especially during group discussions and interpersonal conversations. Adolescents who stutter also exhibit poorer self-perceived communication competence than their normally fluent peers, particularly during group discussions, interpersonal conversations, and when talking with strangers. The article also discussed the need to specifically address communication apprehension in stuttering therapy sessions.
Blood, G. W., Blood, I. M., Tellis, G. M., & Gabel, R. M. (2003). A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter. JOURNAL OF FLUENCY DISORDERS, 2, 143-159.
This study examined the self-esteem, perceived stigma, and disclosure practices of 48 adolescents who stutter divided into two age groups: younger (13, 14, and 15 years) and older (16, 17, and 18 years) adolescents. Results revealed that 41 of the participants scored within one standard deviation from the mean on a standardized measure of self-esteem, indicative of positive self-esteem. Results also showed that stuttering did not present a stigmatizing condition for the majority of adolescents who stutter. The younger adolescents perceived stuttering as a more negative and stigmatizing condition than older adolescents.
Blodgett, EG., & Cooper, EB. (1988). Talking about it and doing it: metalinguistic capacity and prosodic control in three to seven year olds. JOURNAL OF FLUENCY DISORDERS, 13, 283-290.
This study was conducted to assess the ability of 3 to 7 year old children in using adjectives metaphorically. The area of metalinguistic ability is important because speech-language pathologists often make therapeutic use of metaphoric adjective with children. The results of the study indicate that children may be able to talk about prosodic aspects of speech patterns and yet unable to change them. When therapy is used with very young disfluent children, there might be a need to teach the language of fluency.
Bloodstein, O. (1988). Verification of stuttering in a suspected malingerer. JOURNAL OF FLUENCY DISORDERS, 13, 83-88.
This article reviews a legal case regarding robbery. The suspect claimed to be innocent because he is a person who stutters. He said he would not be able to fluently speak the words that the robber spoke at the crime scene. The Brooklyn College Speech and Hearing Center was contacted and asked to complete various tasks to determine if the suspect was a malingering stutterer. The suspect underwent repeated oral reading tasks, interview questions, and binaural masking. Analysis of the suspects words stuttered in oral reading revealed the adaptation, consistency and adjacency effects. The suspects stuttering almost completely disappeared under white noise and decreased with clinician feedback. Ultimately, the suspect was found to be a true adult stutterer.
Bloodstein, O. (1992). Response to Hamre: Part I. JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 29-32.
The purpose of the article is to provide a background of support for the continuity and diagnosogenic hypotheses. Descriptive parallels are given to show, how in many ways, stuttering is not always clearly distinct from normally disfluent characteristics. As a result, Bloodstein argues that there is need for preventive counseling with parent's whose children are on the fringe of stuttering.
Bloodstein, O. (1992). Response to Hamre: Part II. JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 85-86.
This is a commentary by Oliver Bloodstein in response to Curt Hamre's article Stuttering Prevention II: Progression which is contained in this same issue. Bloodstein explains why he thinks that Hamre's portrayal of the continuity hypothesis as on extension of Johnson's diagnosogenic theory is invalid. Bloodstein also clarifies a quote of his that Hamre used in his article.
Bloodstein, O. (1993). Communication attitudes of school-age stutterers. JOURNAL OF FLUENCY DISORDERS, 18 (4), 403-406.
A letter to the editor concerning the report by Vanryckeghem and Brutten (1992) whose findings did not support Bloodstein's (1987) contention that malattitudes toward speech generally are not formed before high school age. Bloodstein clarified his results in the 1987 article. More specifically, he meant that because their attitudes and reactions contrast so sharply with those of other stutterers, what he terms as Phase II Stutterers will usually show little concern about their speech difficulty.
Bloodstein, O. (2001). Incipient and Developed Stuttering as Two Distinct Disorders: Resolving a Dilemma. JOURNAL OF FLUENCY DISORDERS, 26:1, 67-73.
Bloodstein discusses various characteristics and beliefs of stuttering. Some of his terms and definitions are: Transient stuttering, which is the difficulty a child may have in producing a word or phrase. Persistent stuttering, which is a child or an adult reaction to continual difficulty in producing words. Bloodstein also gave examples of ephemeral interest in stuttering, such as: talking until it dawns on the stutterer that he is fluently speaking, which results in consistent stuttering; hypnotized to believe they no longer stutter; visited with a SLP, until the stutterer realized the profession of the listener, then stuttered continuously thereafter; some people stutter on "p" words, and even have trouble with words such as "photo" "Philip". Genetic factors addressed were: those most susceptible to stuttering are identical twins and those children who has a first degree relative that stutters. Incipient stuttering and persistent form of stuttering were also discussed. Evidence of genetic contributions to stuttering doesn't conflict with the knowledge of the conditions under which stuttering varies. It is believed it may lye more motorically, or motor controlled speech.
Bloodstein, O. (2006). Some empirical observations about early stuttering: A possible link to language development. JOURNAL OF COMMUNICATION DISORDERS, 39, (3), 185-191.
Early stuttering, also known as incipient stuttering, is detected very early on in a child, as early as preschool age. There is a collection of observations within this article that clinicians should take into consideration when identifying stuttering in young children. They include: early stuttering occurs regularly on the first word of a syntactic structure; incipient stuttering frequently involves function words; incipient stuttering does not emerge from the influence of word-related factors; early stuttering consists of whole- word repetitions; incipient stutterers seldom stutter on one-word utterances; stuttering is reported at 18 months old or later; syntax is acquired at 2-5 years old, around the same time as stuttering is reported; spontaneous recovery occurs with early detection of stuttering early on; boys who stutter outnumber girls among incipient stutterers. Each observation within the article is described in detail relating to incipient stuttering how it affects children at such a young age.
Blomgren, M., Robb, M., & Chen, Y. (1998). A note on vowel centralization in stuttering and nonstuttering individuals. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 1042-1051.
The purpose of this study was to obtain more information concerning the steady state formant frequency characteristics of people who stutter. In particular, formant centralization in the fluent vowel productions of individuals who stutter was examined. Fifteen adult men participated and were divided into three groups: the first group consisted of five untreated stuttering individuals, the second group consisted of five treated stuttering individuals, and the third group consisted of five nonstuttering individuals who made up the experimental control group. A series of consonant + vowel + /t/ syllables were used as the speech sample and acoustic analysis was performed. Calculation of vocal tract vowel space was obtained through three measures: the relative spacing between formants one and two, the area within the F1/F2 triangle, and the average Euclidean distance of each vowel from a predetermined central location. Acoustic differences were noticed between the groups. The untreated stuttering individuals tended to use a neutral vocal tract posture during fluent CV/t/ productions, creating significantly greater vowel centralization.
Boehmler, RM & Boehmler, SI. (1989) The cause of stuttering: What's the question? JOURNAL OF FLUENCY DISORDERS, 14, 447-450.
The many studies to determine the cause of stuttering have shown only inconclusive results. The stuttering category may be to broad to result in finding one cause. In therapy for stuttering, many differentiations are made between different stuttering behaviors. Separation of lingual and motor execution, and separation within categories (such as three types of elemental repetitions,) are common when diagnosing and treating an individual. The authors believe the key to determining the cause of stuttering lies in appropriately asking the correct research questions. Seeking the cause for individual behavioral elements of stuttering, rather than finding a single cause for a broad range of stuttering behaviors, may lead to an answer.
Borden, G., Kim, D., & Spiegler, K. (1987). Acoustics of stop consonant-vowel relationships during fluent and stuttered utterances. JOURNAL OF FLUENCY DISORDERS, 12, 175-184.
Acoustic duration measures were made on the stop-gap, voice onset time (VOT), and vowel portions of the utterance [tu] in the context '425' as spoken ten times or more by five normal speakers, four mild stutterers, and four severe stutterers. The present study was undertaken in order to analyze these absolute and relative acoustic properties in the speech of adult stutterers. Tape recordings provided a sample of 187 instances of the CV /tu/ framed between the words 'four' and 'five', as in '3425' and '4253'. The evaluations were made by two speech-language pathologists and by the use of the Stuttering Severity Index and the reading and conversational parts of the Stuttering Interview. The fluent utterances of the severe stutterers were significantly longer than those of normal speakers on stop-gap and vowel durations but not on voice onset times. Normal speakers and mild stutterers showed an inverse relationship between stop-gap and VOT measures across speakers, but severe stutterers did not maintain this relationship for either fluent or stuttered tokens, nor did a mild stutterer suspected of covert stuttering. Abnormal gap to VOT ratios may serve to detect covert stuttering. The subject's consonant/vowel ratios were not significantly different from normal even though two of them were at least twice a slow as the normal speakers.
Bosshardt, H. (1990). Subvocalization and reading rate differences between stuttering and nonstuttering children and adults. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 776-785.
The author of this study examined the oral reading and silent reading rates of children and adults to determine whether stutterers' subvocalize more slowly than nonstutterers and therefore require more time for production of fluent speech. The subjects included 59 children (27 stutterers and 32 nonstutterers) and 39 adults (18 stutterers and 21 nonstutterers). The task included reading, either silently or orally, an article and noun from a computer screen and then pressing a button to make the words disappear. The results indicate that the stutterers presentation times for both and silent productions were significantly longer than the nonstutterers' presentation times.
Bosshart, H.G. (1993). Differences between stutterers' and nonstutterers' short-term recall and recognition performance. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 286-293.
The present study was done in a attempt to determine the relationship between overt and subvocal speech rates of stutterers and nonstutterers and their effects on short term memory. It has already been shown that for nonstuttering speakers, the duration of speech is the same vocally and subvocally. It was hypothesized that PWS have slower subvocalic rates and consequently, their short term memory (STM) would be impaired in tasks that require silent rehearsal. The results indicated that PWS did show a short-term reproduction performance inferior to that of nonstuttering speakers. The results were interpreted to mean that nonstuttering speakers encode syllables more distinctly and form more associations, images and language mediators. No differences were interpreted to mean that stutterers and nonstutterers use differing coding strategies.
Bosshardt, Hans-Georg (2002) Effects of concurrent cognitive processing on the fluency of word repetition: comparison between persons who do and do not stutter. Journal of Fluency Disorders, 27, 93-114
This study examined how silent reading and word memorization effects the fluency of concurrently repeated words. Fourteen adults who stutter and 16 adults with normal fluency were matched for age, education, sex, forward and backward memory span, and vocabulary. Results indicate that a person who stutters has greater disfluencies on the presented task. The fluent speakers showed little significant changes in fluency on the same tasks.
Bosshardt, H., Ballmer, W., & Nil, L. F. de. (2002). Effects of category and rhyme decisions on sentence production. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 5, 844-857.
The aim of this experiment was to investigate differences between people who stutter and people who do not stutter during the production of sentences in a single task versus two dual-task conditions. Participants were required to form a sentence containing 2 unrelated nouns. In dual-task conditions, rhyme and category decisions were used as secondary tasks. The results for 14 adults who stutter and 16 adults who do not stutter indicated that both groups reduced the average number of correct rhyme and category decisions when this task was performed concurrently with sentence generation and production. Overall, the results support the view that the organization of the speech- production system of people who stutter makes it more vulnerable to interference from concurrent attention-demanding semantic tasks.
Bosshardt, H., & Fransen, H. 1996. Online Sentence Processing in Adults Who Stutter and Adults Who do not Stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 4 785-797
This purpose of this study was to , 1) determine if people who stutter encode phonological and semantic information more slowly than people who do not stutter during a silent reading task, and 2) observe how syntactic complexity of a sentence effects the speed of encoding. Subjects were 14 adult stutterers and 14 adult non- stutterers. Silent reading tasks were self paced and included target words the subjects were to monitor. Analysis of the results indicates that although the two groups did not differ in speed of word identification, people who stutter access semantic meaning more slowly.
Bosshardt, H., and Nandyal, I. (1988). Reading rates of stutterers and nonstutterers during silent and oral Reading. JOURNAL OF FLUENCY DISORDERS, 13, 407-420.
This study investigated the differences between the reading rates of stutterers and nonstutterers during both silent and oral reading of fluently spoken words. The stutterer group consisted of 10 adults that reported onset of stutter during childhood and rated as being mild to severe during reading by a speech pathologist. The nonstutterer group consisted of 14 adults. Half the stutterer group had completed their high-school education, and the other half had completed a primary school education. All the nonstutterers completed high school. All subjects were told that they had to silently and orally read two lists of words as quickly as possible. The test words appeared on a monitor one at a time and after the subjects read a word, they had to press a key for the next word to appear on the screen. Oral readings were audiotaped and response time between word read and striking the key for the next presentation was also registered. Results of this study show that in oral reading trials, the stutterers required more time for both silent and oral reading. Oral reading times decreased over trials in both groups as a practice effect.
Bothe, A. (2002). Speech modification approaches to stuttering treatment in schools. SEMINARS IN SPEECH AND LANGUAGE, 23, 181-185.
Speech modification approaches to treatment are based on a known fluency condition and have a main purpose to teach the client to speak in a manner that will not include stuttering. The focus of this paper is on four approaches to speech modification. The most common of these is variations on prolonged speech in which the client uses variations of prolonged speech, smooth speech, easy speech or similar approaches. The controlled length approach has the child practice fluent speaking at a linguistically simplified level with gradual increases in length and complexity. Also included is the response-contingent program which is based on the clinician pointing out incorrect and correct responses. The final approach is a mixed one combining elements from various approaches. The article also provides information to aid the clinician in identifying and dealing with challenges he/she may face.
Bothe, A. K. (2003). Evidence-based treatment of stuttering: V. The art of clinical Practice and the future of clinical research. JOURNAL OF FLUENCY DISORDERS, 28, 247-258.
The author of this article states that clinical practice and evidence-based treatment can coincide with each other and provide structure for future research in stuttering. Evidence- based treatment and the art of clinical setting are similar in that they both combine clinical research, clinician expertise, and client goals and desires to provide clients with the most effective and efficient treatment. These three components lead to future clinical research in stuttering. Evidence-based research will help clinicians choose the most effective treatment for their client. For clinician expertise, future research could examine clinicians' decision-making process and the relationship among client variables, desired outcomes, and treatment approaches. For client preference, future research could focus on carefully designed surveys to find clients' goal for therapy (attitude, speech).
Bothe, A. K. (2003). Evidence-based treatment of stuttering: V. the art of clinical practice and the future of clinical research. JOURNAL OF FLUENCY DISORDERS, 28, 247-258.
This article describes the similarities between evidence-based practice and the art of clinical practice. It also explains how evidence-base practice provides structure for future research in stuttering and finally, it discusses the importance of evidence-based research to stuttering intervention. Evidence-based practice combines several elements including asking a client specific clinical question that will best achieve a desired outcome, focusing on identifying and evaluating published research as a basis for clinical decisions, combining information from research with clinical experience, and finally collecting information about whether these treatments are helping clients meet their goals. Bothe (2003) describes the art of clinical practice as, "the clinicians ability to balance, multiple, constantly changing sources of information in a dynamic, client centered attempt to help individuals and their loved ones." There is very little difference between the art of clinical practice and evidence-based practice they both include elements that provide the client with effective treatment. Evidence-based practice can be useful for treatment in stuttering by examining research that has already been done in this area. Some research has more support than others and these are the treatments that should be used more frequently. Evidence-based practice means basing clinical decisions on research evidence along with the clinician's experiences and the client! 's preferences.
Bothe, A.K. (2008). Identification of children's stuttered and nonstuttered speech by highly experienced judges: Binary judgments and comparisons with disfluency-types definitions. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 51, 867-878.
Research was conducted to determine the interjudge and intrajudge agreement of children's specific stuttering behaviors between eleven (interjudgment) and eight (intarjudgment) highly experienced clinicians. These clinicians were asked to judge 20 similar children, who were described as stutters by their parents, between the ages of 3 and 8 years old. The clinicians were provided necessary materials (i.e. written response forms, and 2 ½ minute speech samples for each child). The clinicians were asked to listen to the audiotapes in 5 second intervals and simply determine if stuttering or no stuttering occurred. Two months after the clinicians returned the materials, they were asked judge the same samples for a second time (eight clinicians agreed to the second trial). Results indicated an average of 88.3% interjudge agreement between all judges and an average between 81.7% and 96.3% intrajudge agreement. Research results will be able to determine and direct future clinician training for research.
Bothe, A., K., Davidow, J., H., Bramlett, R., E., Ingham, R., J. (2006). Stuttering treatment research 1970-2005: I. Systematic review incorporating trail quality assessment of behavioral, cognitive, and related approaches. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 15, 321-341.
This journal article involves the findings of a systematic review. Specifically, the purpose of the systematic review was to find a much needed bank of published literature on treatment for developmental stuttering of preschoolers, school-age children, adolescents and adults. Criteria for the review consisted of 162 English articles published between 1970 and 2005. Data bases included Medline, Web of Science, PsychINFO and ComDisDome. Searches included the terms 1) stuttering, 2) fluency, 3) therapy, 4) treatment and 5) management. All analyses were descriptive and of trial quality focusing on the number of criteria met in the methodological and outcome criterion. Results of the systematic review showed that specific evidence acquired clearly found that many treatment types currently being used are ineffective and do not meet specific goals and therefore should not be recognized as viable options for stuttering therapy.
Bothe, A. K., Davidow, J. H., Bramlett, R. E., Franic, D. M., & Ingham, R. J. (2006). Stuttering treatment research 1970-2005: II. Systematic review incorporating trial quality assessment of pharmacological approaches. AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY, 15, 342-352.
This article provides an updated review of the research on pharmacological treatments for stuttering. Thirty-one articles were analyzed based on 5 methodological criteria and 4 outcomes criteria which were described in part I of this series review. Out of the 31 articles reviewed, there were not any with results that didn't have any complicating factors. Only one article showed evidence of a less than 5% reduction of stuttering frequency and another 4 articles that were reviewed noted stuttering characteristics that decreased in half. Overall, this review determined that there were not any pharmacological approaches that significantly decreased frequency of stuttering, reduced the amount of person's stuttering in half, or improved any personal aspects such as social, emotional or cognitive.
Bothe, A. K., Finn, P., & Bramlett, R. E. (2007). Pseudoscience and the SpeechEasy: Reply to Kalinowski, Saltuklaroglu, Stuart, and Gruntupalli (2007). AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 16, 77-83.
This article is a letter to the editor, written in response to a letter written in 2007 by Kalinowski, Saltuklaroglu, Stuart, and Gruntupalli. The 2007 letter suggested that Finn et al.'s discussion of the Speech Easy in their 2005 article was biased. In this current letter Finn et al. address the comments made in the 2007 letter by Kalinowski et al. The current letter presents information regarding the effectiveness of the SpeechEasy device in alleviating stuttering behavior. The authors of this letter do not believe that the information presented by the makers of the SpeechEasy device is sufficient to support the effectiveness of the device.
Bothe, A. K., Franic, D. M., Ingham, R. J., and Davidow, D. H. (2008). Pharmacological approaches to stuttering treatment: Reply to Meline and Harn. AMERICAN JOURNAL OF SPEECH, LANGUAGE PATHOLOGY, 17, 98-101.
The purpose of this article was to address several issues that Meline and Harn (2008) raised in regards to Bothe et. al's 2006 article about pharmacological drug usage in the treatment of stuttering from the years 1970-2005. Bothe et al. systematically address each one of Meline and Harn's (2008) critiques and either agrees or disagrees with each comment.
Bothe, A.K., & Ingham, R.J. (2001). Recovery from early stuttering: Additional issues within the Onslow and Packman-Yairi and Ambrose (1999) exchange. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 4, 862-867.
This article was written in response to the 1999 exchange between Onslow and Packman-Yairi and Ambrose. The purpose of this letter was to discuss three remaining interrelated issues that Bothe and Ingham felt deserved more attention if the points of disagreement are to be resolved. The three issues are determining the presence and effects of treatment, identification of proximal variables within the Illinois Studies, and using SLDs instead of measures of stuttering. Bothe's and Ingham's response to each of these is as follows: 1) repeated sampling in the children's natural environments might have made it possible to determine whether introduction of treatment, passage of time, both, or neither could be associated with changes in children's stuttering, 2) the overlooked role of potentially important proximal variables is also relevant to claims that recovery or persistent stuttering may be inherited, and 3) SLDs are not necessarily stutterings, and no thresholds can be established, in either direction. The problem facing researchers is how the interaction among these factors influences the disorder's variability, including its persistence and recovery.
Boutsen, F. (1995). A comparative study of stress timing of stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 20 (2), 145- 155.
This author contends that the varying results of earlier studies comparing fluent speech of stutterers and nonstutterers are the result of methodological differences. This study assessed the affects of two such differences by comparing the consonant duration and voice onset time (VOT) in stressed and unstressed utterances of these two groups while varying the levels of rhythm and phonetic context. It also described the relationship between consonant duration (through stopgap measures) and VOT. Twelve adult stutterers and 12 nonstutterers were presented 20 separate syllable sequences and were instructed to stress specific words with the guidance of metronomic beeps. Results found that the VOT of the stutters was protracted during both stressed and unstressed conditions. This supports earlier findings that there are physio-acoustic differences in the fluent speech of the two groups. A systematic relationship between stopgap and VOT was found only in the nonstutterers. This suggests that persons who stutter have "subtle difficulties in controlling and stabilizing the temporal coordinations between supraglottal and laryngeal structures"(p. 151).
Boutsen, F., Brutten, G., Watts, C. (2000). Timing and Intensity Variability in the Metronomic Speech of Stuttering and Nonstuttering Speakers. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 43, 513-520.
This fluency program focuses on the model that speech is rhythmically structured in time. A study including 8 adults who stutter and 8 fluent speakers was conducted to measure timing and intensity under metronomic conditions. The participants were asked to read 20 sentences in which certain syllables were repeated 9 times. Participants were given a practice session as well as auditory and visual cues before reading the sentences. The intensity variation between the beginning consonant and successive vowels was computed, and the variation of successive syllable onsets. The results indicate little variation between timing in PWS and fluent speakers, but there was discrepancy between the timing of syllables. In PWS the timing was more variable than in fluent speakers.
Bramlett, R.E., Bothe, A.K., & Franic, D.M. (2006). Using preference based measures to assess quality of life in stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 49, 381-394.
This study investigated the use of preference-based measures in the assessment of the quality of life in stuttering. The participants, 75 adults with no history of stuttering, completed a structured, scripted interview. In the interview, the researchers gathered background information, familiarized the participants with the anchor health states (perfect health and death), and played videotapes of people who stutter. The participants were then presented with cards representing four health states (your health, mild stuttering, moderate stuttering, and severe stuttering) from best to worst. Participants also rated the four health states using a rating scale, standard gamble, and time trade-off preference. The researchers compared the rating methods and calculated the utility values for each health state. It was concluded that standard utility measurements used to assess the quality of life in fluency disorders are consistent with published measurements used with other disorders (e.g. vision impairments). In addition, the researchers conclude that standard utility measurement techniques may be beneficial in stuttering treatment and research.
Bray, M. , Kehle, T. J. , Lawless, K. A. & Theodore, L. A. (2003). The relationship of self-efficacy and depression to stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 12(4), 425-431.
This article discussed a study which looked at the relationship between self- efficacy in verbal fluency and academics and depression. Twenty-one adolescents were involved in the study and were given the Self-Efficacy Scaling for Adolescents Who Stutter (SEA), the Self-Efficacy for Academic Tasks (SEAT), and the Reynolds Adolescent Depression Scale (RADS). Their scores on these assessments were compared to matched fluent speakers. The results found that self-efficacy for speaking was the only factor that had a significant difference between the adolescents who stutter and the fluent speakers.
Brisk, D.J., Healey, E.C., & Hux, K.A. (1997). Clinicians' training and confidence associated with treating school-age children who stutter: A national survey. LANGUAGE, SPEECH AND HEARING SERVICES IN SCHOOLS, 28(2), 164-176.
A national survey was conducted to update information pertaining to the treatment of school age children who stutter. Speech- Language Pathologists' training, confidence, attitudes, and perceptions of stuttering were examined. The results indicate that SLP's have a more positive outlook in treating school age stutterers. However, it was indicated that university programs need to continue offering courses and experience with stuttering to instill greater confidence in SLP's.
Brocklehurst, P.N. (2008 Spring). A review of evidence for the covert repair hypothesis of stuttering. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCES & DISORDERS, 35: 25-43.
This article focuses on CRH-covert repair hypothesis which is based on monitoring and self-repair of linguistic errors in normal speech. This review examines evidence to support or disagree with the ideas of CRH. The review is broken down into sections dealing with specifics: Is the phonological encoding in adults who stutter abnormally slow? Do symptoms of stuttering result from covertly repairing errors of phonological encoding? And does language monitoring function normally in a person who stutters? Concluding this review, the evidence does not strongly support CRH, though it does suggest that error repair plays a role in symptoms of stuttering.
Broscolo, B & Rescorla, L (2002) Fluency of School-Aged Children With a History of Specific Expressive Language Impairment: An Exploratory Study. American Journal of Speech-Language Pathology, 11, 41-49
This study elicits narratives from 22 pairs of 9-year-old children and analyzes for fluency characteristics. Eleven of the children had a history of specific expressive language impairment (HSLI-E) and the other half had histories of normal language development. The results indicate that the children with HSLI-E as a group produce more disfluencies then their typically developing peers.
Brown, C.J., Zimmerman, G.N., Linville, R.N., and Hegmann, J.P. (1990). Variations in self-paced behaviors in stutterers and nonstutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 317-323.
The subjects who participated in this study, 10 stutterers and 10 nonstutterers, were asked to perform three different self-paced rhythmic tasks: finger tapping, jaw opening and closing, and repetition of "ah". Each task was performed at three different rates. Results indicated that the subjects who stuttered performed the tasks at a slower rate than the nonstutterers and with less variability.
Brown, S.L. & Colcord, R.D. (1987). Perceptual comparisons of adolescent stutterers' and nonstutterers' fluent speech. JOURNAL OF FLUENCY DISORDERS, 12, 419-427.
This study examined the differences between the fluent speech of stutterers and of nonstutterers. It was determined that perceptual differences can be identified in the areas of segmental and suprasegmental aspects of speech. Those areas identified as perceptual cues were voice quality, imprecise articulation, choppy speech, tension, rapid rate, inappropriate/reduced intonation, monotone, and hard glottal attacks/hard articulatory contact. It was suggested in the conclusion of this study that the characteristics of an adult stutterer's fluent speech are present in adolescence. The conclusion further stated that emphasis should be placed on the production of speech which is acoustically and physiologically similar to a nonstutterer's speech pattern as well as the reduction or elimination of stuttering behaviors.
Brundage, S.B. (2007). Virtual reality augmentation for functional assessment and treatment of stuttering. TOPICS IN LANGUAGE DISORDERS, 27, 254-271.
This article focuses on the application of virtual reality techniques in the assessment and treatment of individuals who stutter. Within this article, the uses of virtual reality are described as well as recent research findings. Results of the studies reveal that virtual reality programs and naturalistic speaking situations appear to have similar effects on individuals who stutter. Thus, resulting in similar attitudes and behaviors. One advantage to virtual reality programs is that the clinician is able to modify the various aspects of the program to meet the needs of specific clients.
Brundage, S.B., Bothe, A.K., Lengeling, A.N., & Evans, J.J. (2006). Comparing judgments of stuttering made by students, clinicians, and highly experienced judges. JOURNAL OF FLUENCY DISORDERS, 31, 271-283.
The reliability of stuttering judgments made by students, practicing clinicians, and experienced judges was examined in this study. The participants, including 41 students and 31 practicing clinicians, watched a videotape containing 216 speech samples of adults who stutter. Each 5 second long sample was judged as stuttered or not stuttered. The researchers calculated intrajudge and interjudge reliability for the clinicians and student participant groups. The results were then compared to the data from an experienced judge group, collected in a previous study using the same procedures. Mean intrajudge and interjudge reliability was found to be similar across groups (approximately 84%-89%). However, when compared to the experienced judges, the students and clinicians under-identified more than half of the speech samples as stuttered. The researchers propose that under-identification may be because the clinicians and students are fearful of labeling normal disfluencies as stuttered speech. These findings evidence the need for more intensive training in the identification of fluency disorders for students and practicing clinicians.
Brundage, S., Graap, K., Gibbons, K., Ferrer, M., & Brooks, J. (2006). Frequency of stuttering during challenging and supportive virtual reality job interviews. JOURNAL OF FLUENCY DISORDERS, 31, 325-339.
One of the biggest challenges a speech language pathologist must address in the treatment of stuttering is generalization of the client's fluency from the clinical setting to the real world. A virtual reality environment (VRE) is a computer simulation which represents the environment and speaking situations that people who stutter may encounter. This article describes the experiences of 20 people who stutter participating in a VRE trial, specifically a challenging interview environment and a supportive interview environment. The findings suggest that the VRE is perceived similarly to the real world. For this reason the VRE could possibly serve as a valid tool for speech language pathologists to measure the generalization achieved by the person who stutters.
Brundage, S. & Ratner, N. (1989). Measurement of stuttering frequency in children's speech. JOURNAL OF FLUENCY DISORDERS, 14, 5, 351-358.
The purpose of this study was to examine the relationship between three different indicators of utterance length and the frequency of stuttering in children's speech. The measurements were mean length of utterance in morphemes, syllables and words. Eight children who were disfluent were analyzed from a spontaneous speech sample. Mean length-of-utterances and disfluencies were compared. The study found increases in utterance length is correlated with stuttering. They also found increasing the length of short utterances in word increments is more likely to impair fluency of output than is increasing utterance length by adding syllables or morphemes. The study did not find a correlation between the amount of disfluent words and the amount of disfluent syllables or morphemes. The authors state a better indicator of disfluency prediction is the utterance length and not the morpheme or syllable length.
Brutten, G. J., & Dunham, S. L. (1989). The communication attitude test. JOURNAL OF FLUENCY DISORDERS, 14, 5, 371-377.
The purpose of this study was to develop and assess an instrument that would assess the communication attitudes of grade school children. The study was designed to evaluate the communication beliefs of children whose speech is considered "normal". Those scores will be used to compare attitudes with children who stutter and those with other speech disorders. The test developed was the Communication Attitude Test (C.A.T.). It was administered to 518 children grades 2-8 whose speech was considered to be normal. The student's average C.A.T. score indicated that most children have few if any negative attitudes toward their speech. There was also a correlation between the decrease in scores and the increase in age among the students. The study suggests that addition evaluation of the C.A.T. should be completed, but that the information presented in this study is of significance to the reliability of the C.A.T.
Brutten, GJ., & Miller, R. (1988). The disfluencies of normally fluent black first graders. JOURNAL OF FLUENCY DISORDERS, 13, 291-299.
Rarely has race of the subjects sampled been addressed in research studies. This study was designed to investigate if nonstuttering black children differ in the amount of disfluency that they exhibit, if black children differ in the frequency with which they emit different types of fluency failures, and if there is an interaction between the sex of black children and the types of disfluency that they are likely to display. The results indicate that the disfluency types of black children are similar to past research.
Brutten, G.J., Trotter, A.C. (1986). A dual-task investigation of young stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11 (4), 275-284.
The purpose of this study was to compare the capacity of children who do and who do not stutter under dual-task circumstances that differed in demand level. Subjects included 40 students: 20 right handed children who stuttered and 20 right handed children who did not stutter. The subjects were asked to tap a button as quickly as possible with either their right or left hand in a single-task control condition where they remained silent, in three increasingly demanding dual-task conditions where they tapped and spoke concurrently, and in a dual-task condition where they tapped and vocalized a sound concurrently. Results indicated that there was no significant difference between the group by hand, group by condition or group by hand or condition. The children who stuttered did perform slower than the children who did not stutter.
Brutten, G.J. and Vanryckeghem, M. (1993). The development of stuttering: A reply to Bloodstein. JOURNAL OF FLUENCY DISORDERS, 18 (4), 407-410.
A letter to the editor concerning Bloodstein's (1993) letter to the editor. The authors felt that Bloodstein's developmental phases are based on data that show relatively low co-relationship between age and features and, thus, a notable amount of unaccounted variance. They felt that they would be better off if they used a behavioral model in which the observed variations in age and features among stuttering children was seen as a function of difference in their experience history rather than as a somewhat atypical aspect of an underlying developmental process.
Byrd, C. T., Conture, E. G., & Ohde, R. N. (2007). Phonological priming in young children who stutter: Holistic versus incremental processing. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 16, 43-53.
Holistic processing is the act of processing speech at the syllable level. Incremental processing is processing the individual sounds in words, from the beginning to the end of the word. A picture-naming priming model was used to compare these two methods of processing phonology of children who stutter and children who do not stutter. Speech recognition time was measured while the children named pictures during holistic, incremental, and neutral priming conditions. The results indicated that children who stutter are delayed in the ability to shift from holistic to incremental processing. It is thought that this delay may play a factor in their inability to consistently produce fluent speech.
Burger R. & Wijnen, F. (1999). Phonological encoding and word stress in stuttering and nonstuttering subjects. JOUNAL OF FLUENCY DISORDRS, 24, 91-106.
The main focus of this study was to collect more data to support a previous study done by Wijen and Boers (1994) hypothesizing that stuttering is related to difficulty in phonological encoding and word stress. A problem with the previous study was small subject size, so this study tested a larger selection of stutterers and nonstutterers. Researchers looked at the priming effect, the difference in reaction time, between heterogeneous and homogeneous conditions. That is, response words that are phonologically related and words that are not phonologically related. Subjects uttered one response words from a set of five as fast as they could upon visual presentation of a related cue word. The previous study indicated that the stress-bearing part of a syllable is delayed due to difficulty encoding. However, the results of the recent study indicated that although nonstutterers responded faster than stutterers, the expected interaction of group, primetype, and condition was not apparent.
Burley, P., & Morley, R. (1987). Self-monitoring processes in stutterers. JOURNAL OF FLUENCY DISORDERS, 1, 71-78.
This study uses the Self-Monitoring Scale created by Snyder. The scale was administered to 26 adult stutterers and 26 adult non-stutterers. The study tried to determine if stutterers differed significantly in their level of self-monitoring compared to normally fluent speakers. The authors indicated that stutterers are usually thought of as low self-monitoring speakers. The outcomes of this study support this idea. Analysis of the self-monitoring scale indicated that the stutterers received a low score on the scale for self-monitoring in speech as opposed to the high self-monitoring score achieved by the normally fluent speakers.
Burley, P.M. & Rinaldi, W. (1986) Effects of sex of listener and of stutterer on ratings of stuttering speakers. JOURNAL OF FLUENCY DISORDERS, 11, 329-333.
This study addresses how the sex of the person who stutters may affect the listener's attitude toward them. A rating scale was used to assess the fluent speaker's attitudes toward people who stutter in such areas as intelligibility and decisiveness. The fluent speakers listened to two recordings of a person who stuttered. One was a man and one was a woman. The people who stuttered read the same weather forecast and their stuttering was in the same severity rating. Although there was no significant interaction between the sex of the person who stuttered and the sex of the subject, men rated the people who stuttered lower than the females rated the people who stuttered.
Bushey, T & Martin, R (1988) Stuttering in Children's Literature. Language, Speech, and Hearing Services in Schools, 19, 235-250
The Authors review 20 works of children's fiction in which a character stutters. All books used were published before 1960 with all but three published after 1969. The books were assessed on the following topics (a) Symptomalogy of stuttering, (b) conditions under which stuttering increases or decreases, (c) personality characteristics of the stuttering, (d) cause of stuttering, (e) and clinical treatment of stuttering. Some of the included books are Don't worry, dear, The Legend of the Veery Bird, Creole, Why Are People Different? A Book About Prejudice, Seal Secret, The Puma, Mirror of Her Own, and The Immediate Gift.
Byrd, K. & Cooper, E. (1989). Apraxic speech characteristics in stuttering, developmentally apraxic, and normal speaking children. JOURNAL OF FLUENCY DISORDERS, 14(3), 215-229.
The focus of this study is looking at the similarities and differences of scores between three groups of children on an apraxia screening measurement. This research analyzes the scores obtained by three groups of children, ages 4-9, on the screening test for Developmental Apraxia of Speech (STDAS). The three groups were comprised of children who speak normally, children who stutter, and children who have developmental apraxia of speech. The results of this study indicate that the groups had some significant performance differences. The apraxic group and the disfluent group significantly differed on only one subtest, articulation. These results indicate that there may be more similarities between apraxia and stuttering. These results may provide insight into both a cause and the recovery pattern of some stutterers.
Byrd, K., & Cooper, EB. (1989). Expressive and receptive language skills in stuttering children. JOURNAL OF FLUENCY DISORDERS, 14, 121-126.
It has been noted that one of the characteristics of children who stutter is delayed language. It is unknown whether or not this delay is the result of the etiology of the stuttering, the adaptation to the stuttering or both. The purpose of this study was to identify any language delay in the child subjects that stuttered. The subjects were given the TACL-R to test receptive language, the TOLD-P to test expressive language, and the FAD-C to test fluency. The results showed significant differences in the chronological ages and age equivalent scores on the expressive language test. These results could be used to support the hypothesis that the expressive language delays observed in children who stutter could be the result of the child using simple verbalizations as a way of coping with the stuttering.
Caizuso, A.J., et al. (1994). Adults who stutter: Responses to cognitive stress. JOURNAL OF SPEECH AND HEARING RESEARCH, 37(4), 746-754.
This study investigates the effects of speech and cognitive stress on the articulatory coordination abilities of adults who stutter. Two groups were assessed, 9 people who stuttered, and 9 people who did not stutter. Measurements of heart rate, blood pressures, dysfluencies, errors, speech rate, and response latency as well as word duration, vowel duration, and formant center frequency. The results of the study indicated that cognitive stress results in greater temporal disruptions and more dysfluencies for stutterers. Cardiovascular evidence indicates PWS experience increases in blood pressure at the same rate as those who do not stutter. The authors believe their findings support the theory of stuttering as a disorder of timing.
Carlo, E.J. & Watson, J.B. (2003). Disfluencies of 3-and 5-year old Spanish-speaking children. JOURNAL OF FLUENCY DISORDERS, 28, 37-53.
This study investigated the effects of gender and age on speech disfluencies in normally fluent speaking Spanish-speaking children. The study also focused on the differences in the frequency of disfluencies in boys compared to girls, younger compared to older age, and in terms of gender/age interaction. The study included 32 monolingual, Spanish- speaking children between the ages of 3 and 5 years old. All students attended the Head Start program in Puerto Rico. Data was gathered through a spontaneous speech sample from a 30-minute interaction with each child. The 500 ' 800 syllable sample was analyzed for disfluencies. Results revealed that the total number of speech disfluencies per 100 syllables was 3-8.99 for 87.5% of the boys and for 75% of the girls. The same mean number of disfluencies was found for 80% of the younger children and for 82.4% of the older children. High variability was found for different types of disfluencies. Discussion followed about the insignificant decrease of the frequency of speech disfluencies with an increase in age.
Cannito, M. P., Vogel, D., Deal, J. L., & Watson, B. C. (1995). Response to Ham (1995): Dysfluency and disordered speech motor control. JOURNAL OF FLUENCY DISORDERS, 20(1). 80-85.
The authors are appreciative of Ham's positive review of Treating Disordered Speech Motor Control: For Clinicians by Clinicians. They continue by defending the areas of which Ham makes specific criticisms. In addition, the authors hope that this book will stimulate continued research, as well as scholarly activity in the areas of dysfluency and motor disturbances of speech.
Carpenter, M., & Sommers, R. K. (1987). Unisensory and bisnesory perceptual and memory processing in stuttering adults and normal speakers. JOURNAL OF FLUENCY DISORDERS, 12, 291-304.
This study compared the performance of adult stutterers to the performance of normal speakers in unisensory and bisensory perceptual and memory tasks. The senses tested were manual, oral, and auditory. Unisensory results indicated that there was no significant difference between the group of stutterers and the group of non-stutterers. The stutterers performed more poorly on the bisensory tasks in which the examiners requested words than did the non-stutterers.
Caruso, AJ, Conture, EG., & Colton, RH. (1988). Selected temporal parameters of coordination associated with stuttering children. JOURNAL OF FLUENCY DISORDERS, 13, 57-82.
The purpose of the study was to objectively investigate selected temporal aspects of coordination within and among the three major components of the speech production system during instances of young stutters' stuttering and to compare these events to those exhibited during normally fluent children's' instances of speech fluency. The study focused on five children who stutter and five normally fluent children's speech productions. Measurements of onsets, offsets, and durations of respiratory and laryngeal movements and supralaryngeal muscle activity permitted objective assessments of coordination within a particular component of the speech production system and between different components of the speech production system. Results indicated that during stuttering events, the relative sequence of movement and muscle activity onsets is generally similar to that of normally fluent children's fluent utterances and in some cases even to those of normally fluent adult speakers.
Caruso, A., Ritt, C., & Sommers, R. (2002). Interactions between fluency and phonological disorders: Case study. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 29, 146-153.
The study investigated the possible interaction between disordered phonology and stuttering in a case study of a preschool boy's speech production. Results of the study indicated that words containing speech sounds that the child consistently misarticulated had a greater probability of being produced disfluently as compared to words that contained sounds that the child inconsistently misarticulated. When controlling for the number of fluent and stuttered words, feature deviation scores were highest for words that were adjacent to stuttered words. This finding suggests that the occurrence of a disfluency contaminates or exacerbated phonological production in adjacent, fluent words.
Choudhury, N., & Benasich, A. (2003). A family aggregation study: The influence of family history and other risk factors on language development. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 261-272.
One hundred thirty-six infants from one hundred twelve families were studied to determine if specific language impairment (SLI) were related to the family's history of SLI. The study also focused on the gender ratios within the families. This study involved two groups. The FH+ group (SLI) consisted of forty-two infants from thirty- seven families. At least one member of their family had been diagnosed with SLI. The FH- group (comparison) consisted of ninety-four infants from seventy-five families. No members of this group had any reported history of SLI, dyslexia, attention deficit disorder, or autism. Results indicated that yes, SLI is found to aggregate in families and that children from the FH+ group performed lower on language comprehension and expression tests at age three compared to the FH- group. They study also found that males are often more affected by SLI. These findings are in agreement with previous studies on this topic.
Christensen, J. & Sacco, P. (1989). Association of hair and eye color with handedness and stuttering. JOURNAL OF FLUENCY DISORDERS, 14, 37-45.
This article examines the relationship among handedness, hair and eye color, and stuttering to test the possible relation of pigmentation to stuttering. 199 questionnaires were given to stutterers in order to determine hair and eye color and handedness. The stutterers were found to be more non-right-handed, disfluency severity was greater in those with blond hair and blue eyes, and females were more severe stutterers than males. The role of hypopigmentation in maldevelopment in neural cell assemblies is also discussed.
Coakley, J. (2006). My journey with stuttering. JOURNAL OF STUTTERING, ADVOCACY & RESEARCH, 1, 90-93.URL: http://www.journalofstuttering.com/1- 2/Coakley.2006.JSTAR.1.90-93.pdf
John Coakley has been a PWS for 32 years. As an infant he suffered a grand mal seizure and battled with dyslexia throughout his adolescence. Mr. Coakley began speech therapy when he was five or six, usually participating in group sessions. He noticed that therapy never focused on the emotional side of stuttering. In fifth grade, he enrolled in the Geneseo program, which focused on intensive daily therapy for 8 hours a day. Therapy focused speaking at different speeds or 'gears', which proved to be effective when used diligently. Mr. Coakley entered the program for a second time during college. The program was more rigorous, but helped him to realize this was no the avenue he wanted to take toward stuttering. It helped him put his old thoughts about stuttering behind him and rely instead on skills he had been using on his own for years, which proved to be effective for him. These skills came easier to him; he no longer felt embarrassed about stuttering and worried less about other's reactions to his speech.
Colcord, R., & Gregory, H. (1987). Perceptual analysis of stuttering and nonstuttering children's fluent speech productions. JOURNAL OF FLUENCY DISORDERS, 12, 185-195.
The purpose of this study was to evaluate listeners' abilities to perceptually discriminate stuttering and nonstuttering children's fluent speech productions in both a paired- and single-stimulus paradigm. Identical fluent sentences from nine stuttering children and nine nonstuttering children matched individually for sex and age were analyzed perceptually in both a paired- and single-stimulus paradigm by 12 sophisticated listeners. Individual subject analysis revealed that only one-half or fewer of the stutterers could be discerned in either paradigm. In the remaining cases, either no discrimination could be made or a nonstutterer was incorrectly! identified as a stutterer. When averaged for subject group comparison, these findings indicate that listeners could not discriminate between the two groups. Explanations for why stuttering is harder to distinguish in children's speech that for adults are the difference due to learning that interrupts children's speech as well as various artifacts introduced into adult stutterers' fluent speech as a result of tong- term exposure to therapy.
Coleman, C. E., Yaruss, S. J., & Hammer, D. (2007, July). Clinical research involving preschoolers who stutter: Real-world applications of evidence-based practice. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 38, 283-289.
The authors further explain the main points from a previous study and treatment program in a response to a Letter to the Editor from Dr. Ingham. The main points include a clear definition of Evidence-Based Practice (EBP) from the American Speech-Language Hearing Association (ASHA), reasons behind the replicable procedure, natural recovery, reasons for not withholding therapy, why the study was referred to as a preliminary study, and the difference between efficacy studies and effectiveness studies.
Columbus, PJ. (1992). Don't call me Billy Budd. JOURNAL OF FLUENCY DISORDERS,17, 205-209.
This article discusses a psychoanalytically view of stuttering. The author of this article suggests that the portrayal of people who stutter from the Lacanian psychoanalytical viewpoint perpetuates a negative stereotype that stigmatize people who stutter.
Conture, E., Colton, R., & Gleason, J. (1988). Selected temporal aspects of coordination during fluent speech of young stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 640-653.
The study selected aspects of the temporal parameter of stutterers' perceptually fluent speech productions. They were assessed to minimize the possibility that any temporal abnormalities were merely a reaction to or a part of the stuttering act. A comparison of the onsets, offsets, and durations of respiratory, articulatory, and laryngeal behavior during the perceptually fluent speech production of preschool and early elementary school-age children who stutter and peers who were normally fluent were conducted. The findings conclude that there were no apparent differences during perceptually fluent speech between young stutterers and their normally fluent peers in terms of the selected temporal measures of speech production.
Conture, E.G., Colton, R.H., & Gleason, J.R. (1990). Letters to the editor. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 404-406.
This is a reply to DiSimoni's comments by Conture and his colleagues. Conture, et al. felt that DiSimoni had concerns regarding their study which include: overlooking the possibility that "incoordination" does not cause stuttering, inappropriate speculations that young stutterers'' disruptions in speech production may be "subtle" and/or "brief", and the distinction between "scientific truth" and "theory" may be blurred. Comments regarding these points are made.
Conture, E.G., and Guitar, B.E. (1993) Evaluating efficacy of treatment of stuttering: School-age children. JOURNAL OF FLUENCY DISORDERS, 18, 253-287.
The focus of this article is on the progress and problems in evaluating efficacy in the treatment of young school-age children. The unique characteristics and nature of the elementary school-aged stutterer, current treatment approaches, measurement, reliability, and validity are discussed with an emphasis on the need for future research. Also discussed is the need for further knowledge in the evaluation of long-term treatment outcomes in terms of speech naturalness, attitude changes, and the child's own perceptions of their speech.
Conture, E.G., & Kelly, E.M. (1991). Young stutterers' nonspeech behaviors during stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 1041-1056.
The purpose of this study was to compare nonspeech behaviors of stutterers' to nonstutterers'. There were 10 subjects for the study, 30 people who stuttered and 30 nonstutterers. Each of the children interacted for about 30 minutes with his/her mother in spontaneous conversation. Both the mother and the child were viewed on a video camera. The movements were categorized as follows: (a) actions of the upper face (b) actions with up/down actions of the lower face (c) actions associated with the lower face horizontal action (d) action of the lower face oblique action (e) actions of the lower face orbital action (f) miscellaneous (g) head and eyeball movements (h) actions with upper body, hands, and arms. The results indicated that there is no absolute difference between children who stutter and nonstutterers in terms of the number and types of disfluencies. Children who stutter exhibit more nonspeech behaviors during stuttering than nonstutterers. However, there is a large overlap between the two groups in regard to the type of behavior exhibited.
Conture, E., & Melnick, K. (2000). Relationship of length and grammatical complexity to the systematic and nonsystematic speech errors and stuttering of children who stutter. JOURNAL OF FLUENCY DISORDERS, 25, 21-45.
This article describes the results of a study that evaluated the relationship between the length and grammatical complexity of utterances and the systematic and nonsystematic speech errors and stuttering of children who stutter. The subjects of the study included 10 boys with a mean age of 50.6 months who stuttered and exhibited disordered phonology. The subjects were audiotaped and video taped during a 30-minute conversation period with their mothers. Their utterances were analyzed and the results indicated that stuttered utterances were more complex and longer than nonstuttered utterances. No differences were found in the systematic and nonsystematic errors for stuttered and nonstuttered utterances in relation to utterance length and complexity.
Conture, E. G., Rothenberg, M., & Molitor, R. D. (1986). Electroglottographic observations of young stutterers' fluency. JOURNAL OF SPEECH AND HEARING RESEARCH. 29, 384-393.
This study consisted of 16 children, 8 stuttering children and 8 age and sex matched nonstuttering peers. Each child produced a sample of 32 CVC test words. Each response from the child was recorded by means of an EGG recording unit. The results of the study illustrate that there is a significant difference of abduction measure patterns in between-group and in group when looking at CV-VC transitions. Therefore, the findings show that normally fluent children exhibit significantly more typical laryngeal adjustments during CV and VC transitions than stuttering youngsters.
Conture, EG. & Zebrowski, PM. (1992). Can childhood speech disfluencies be mutable to the influences of speech-language pathologists, but immutable to the influences of parents? JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 121-130.
This is a commentary by Edward Conture and Patricia Zebrowski in response to Curt Hamre's articles Stuttering Prevention I: Primacy of identification and Stuttering Prevention II: Progression which are contained in this same issue. The authors of this article criticize Hamre for citing only studies that support his theories and go on to cite several studies that do not support his theories. The authors also express concern that Hamre wants to disprove current theories such as the diagnosogenic theory but is unable to come up with viable and testable alternatives. A final concern was that Hamre regarded parents as experts on stuttering and discredits the knowledge of speech language pathologists.
Cooper, C.S. (1991). Using collaborative/consultative service delivery models for fluency intervention and carryover. LANGUAGE SPEECH AND HEARING SERVICES IN SCHOOLS, 22, 152-153.
This article describes a classroom collaborative service model for therapy of stuttering. The speech language pathologist went into a variety of settings (library, playground, lunchroom, classrooms) for therapy. This enables the clinician to serve as a consultant to others in the school system. In addition, it gave awareness and placed new importance on the role of the speech language pathologist in the school system.
Cooper, E. (1986). Joseph G. Sheehan's contributions: An eagle soars. JOURNAL OF FLUENCY DISORDERS, 11, 175-182.
This was a paper that had been presented at the 1984 ASHA convention in San Francisco. The paper focuses on what type of person and clinician Dr. Sheehan was. The author stresses that Dr. Sheehan's "approach-avoidance theory" was not his only contribution to fluency disorders. The author also agrees with many of Dr. Sheehan's views, such as, the importance of client-clinician relationship, the insignificance of the amount of stuttering, the thought that parents do not cause stuttering but instead they are the primary factor of the child's spontaneous recovery, the importance of early intervention, the need for realistic stuttering goals, the knowledge that there is no "quick fix," and how needed continued support for adults who stutter is. Dr. Sheehan has inspired the author to become very involved in support groups for people who stutter and to continue research on the spontaneous recovery of stuttering. The author relates the phrase "eagles don't flock" to Dr. Sheehan because he was such an independent, strong man who made many contributions to the area of fluency disorders.
Cooper, E.B. (1986). Treatment of disfluency: Future trends. JOURNAL OF FLUENCY DISORDERS, 11, 317- 327.
The future holds many exciting changes for the treatment of stuttering. It is encouraging to know that in the future there may be more assessments for children and commercially available treatment materials. Therapy goals in the future may focus on developing the client's feeling of fluency control. Treatments may become more long-term and less intensive rather that short and intensive in order to reduce the possibility of relapse that people often experience. In the future, it is also important to be able to differentiate between people who will be able to conquer their stutter and those who will have to live with it for the rest of their lives.
Cooper, E.B. (1987). The chronic perseverative stuttering syndrome; incurable stuttering. JOURNAL OF FLUENCY DISORDERS, 12, 381-387.
This paper defines chronic perseverative stuttering, identifies chronic perseverative stuttering syndrome, discusses the goal of treatment in adults and teenagers with chronic perseverative stuttering, and discusses the role of self-help groups which have been established world wide.
Cooper, E.B. (1993). Red herrings, dead horses, straw men, and blind alleys: escaping the stuttering conundrum. JOURNAL OF FLUENCY DISORDERS, 18 (4), 375-388.
Response to Curt Hamre's (1992) statements pertaining to Cooper and Cooper (1991) fluency disorders prevention program and to other issues raised as a result of the Forum. The past 30 years of cooper's thinking regarding fluency disorders is reviewed. Also included is the author's definition of stuttering and the etiology of stuttering syndromes - divided into developmental stuttering, remedial stuttering, and chronic preservation stuttering.
Cooper, EB. (1999). Review of Stuttering: A Short History of a Curious Disorder, by ME. Wingate. JOURNAL OF FLUENCY DISORDERS, 24: 1, 73-76.
Cooper states his opinions about the book Stuttering: A Short History of a Curious Disorder, by Marcel Wingate. According to him the first few chapters about the history of the disorder were written well. The last few chapters though, are not written as well. Cooper felt that Wingate picked apart present day theories on stuttering, but did not give suggestions on how he would make these theories more acceptable.
Cooper, E. B., & Cooper, C. S. (1995). Treating fluency disordered adolescents. JOURNAL OF COMMUNICATION DISORDERS, 28, 125-142.
This article discusses three stuttering syndromes: developmental, remedial, and chronic perseverative stuttering. The treatment procedure suggested is based on Cooper's Personalized Fluency Control Therapy- Revised. Therefore, the main goal of treatment is a feeling of fluency control rather than actual fluency. The article concludes by using this therapy approach in a case history.
Cooper, E. B., & Coopers, C. S. (1996). Clinician attitudes towards stuttering: Two decades of change. JOURNAL OF FLUENCY DISORDERS, 21(2), 119-136.
This is a repeat study on the attitudes of SLP's (speech language pathologists) regarding stuttering etiology, early intervention, treatment efficacy, stutter's personality, various therapy techniques, teachers, and parents among others. The study covers an 18 year span which questioned 674 SLP's in the first survey (1973-1983) and 1,198 SLP's (1983-1991) in the second. The CATS (Clinician Attitude Toward Stuttering) questionnaire consisting of 50 statements was used. Four universal attitudes were noted over two decades: 1) Parent counseling is critical, 2) teachers are not to handle stuttering, 3) do not avoid counseling parents, and 4) clinicians are more comfortable with articulation than stuttering disorders.
Cooper, E. & De Nil, L. (1999). Is stuttering a speech disorder? ASHA, 2, 10-11.
Professor Eugene B. Cooper, of the University of Alabama's Department of Communication Disorders, feels stuttering is far too complex, baring intricate aspects that do not allow it to be simply labeled as a speech disorder. Cooper feels focusing on only the "speech" aspects of the disorder will not allow us to gain progress in understanding all facets of stuttering itself. Professor Luc De Nil, of the Department of Speech-Language Pathology at the University of Toronto, provides the reader with a different angle of interpretation. De Nil agrees that stuttering is indeed a speech disorder, although he feels that many various underlying aspects affect the level of stuttering such as the stutterer's own reactions emotionally and socially. This can also hold true for almost any disorder affecting humans. De Nil believes we need to focus of the science of stuttering, the study of the motor disruption which is the one true common characteristic of stuttering. This will allow us to better understand the core of the disorder.
Corcoran, J. & Stewart, M. (1998). Stories of Stuttering: A Qualitative Analysis of Interview Narratives. JOURNAL OF FLUENCY DISORDERS, 23, 4, 247-264.
The article explains the experiences that adults who stutter endure. Eight adults who stutter ( 5 men, 3 women, ages 25-50) were interviewed up to 90 minutes initially, then returned for a 60 minute interview to confirm the findings from the initial interview. Questions for the interviews were created from the interviewer's personal, academic, and clinical experiences as well as writings from related research on the topic. Results showed that adults who stutter experience a sense of suffering when they are dysfluent. Participants explained the reason for this was due to blocking and obstruction of speech. These entailed 4 key elements: 1) helplessness, 2) shame, 3) fear, and 4) avoidance.
Cordes, A. K. (1995). Stuttering includes both within-word and between-word disfluencies. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(2). 382-386.
The author argues against the philosophy which says that all within-word disfluencies are stuttering and disfluencies occurring between-words are not stuttering. She proposes a definition of stuttering be logically consistent with empirical information and clinical experience.
Cordes, A. K. (1996). Letters to the editor: Disfluency types and stuttering measurement: a necessary connection. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 404-405.
Cordes responds to Yairi's Letter to the Editor regarding disfluency measurements by noting their agreement in the main premise that describing all within-word disfluencies as nonstuttering is an indefensible practice. The point of disagreement noted by Cordes is in Yairi's statement that judgments of disfluency types, especially monosyllabic word repetitions, may still enhance the validity of stuttering measurement. Because no studies have demonstrated a link between the occurrence of a disfluency and the occurrence of stuttering, Cordes does not condone Yairi's suggestion of considering whole word repetitions as an occurrence of stuttering but suggests that the speaker's and observer's perceptions of a production be more closely considered. Cordes closes by addressing Yairi's concern regarding the semantics by saying that "These people will not be helped by further layers of terminology. . . they might be helped, on the other hand, by the development of a system that can reliably and validly describe, measure, and reduce their stuttering."
Cordes, A. K. (2000). Individual and consensus judgments of disfluency types in the speech of persons who stutter. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 43(4), 951- 964.
Research indicates that there is very poor reliability when individuals attempt to identify different disfluency types. The judging, involves significant differences among the stuttered speech in various disfluency based characterizations. This study required 30 judges to identify all of the types of disfluencies present in a 5-s recorded speech stimuli, each individually (Individual condition) and then in a partnership (Consensus condition). Intrajudge and interjudge agreement of occurrences, from Individual conditions, were significantly lower than those agreements measured in Consensus conditions. However, both of the intrapair and interpair agreement of occurrences were less than 50%. This research also indicated that the types of disfluency, based on three stuttering definitions, were not heavily related to whether speech included or did not include stuttering. In accordance with previous data, The findings of this study, and previous data, recommend one use caution when using types of disfluency to depict or illustrate "stuttered speech".
Cordes, A.K., & Ingham, R.J. (1994). The reliability of observational data: II. Issues in the identification and measurement of stuttering events. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 279-294.
The authors of this paper review studies of inter-rater reliability in the measurement of stuttering. They conclude that there is virtually no evidence that observers show adequate agreement on counts of stuttering events. One problem identified is that current definitions of stuttering are inadequate for differentiating between stuttered and nonstuttered speech behaviors, or between stuttered and normally disfluency speech. Also, there are no standardized procedures for measuring stuttering events or for training judges to count or measure stuttering behaviors. More promising methods of judgment were discussed and included interval-based methods, categorization-based methods, and physiological or neurophysiological measures.
Cordes, A.K., & Ingham, R.J. (1994). Time interval measurement of stuttering: Effects of interval duration. JOURNAL OF SPEECH AND HEARING RESEARCH, 37(4), 779-788.
This study looked at observer judgments of stuttering based on interval duration. Two groups of judges were used with varying degrees of experience working with PWS. Longer intervals tended to be judged as stuttered while more confusion arose on the shorter intervals. There was no important, clear evidence of important differences between experienced and inexperienced judges, except that experienced showed better agreement for shorter intervals.
Cordes, A.K., & Ingham, R.J., (1990). Judgments of stuttered and nonstuttered intervals by recognized authorities in stuttering research. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(1), 33-41.
This study focuses on the reliability and validity of observer counts of occasions, or "moments" of stuttering. Most stuttering measurements rely almost exclusively on observer judgments of individual stuttering events. The study shows that the judges clearly disagreed widely about the absolute amount of stuttering in speech samples they viewed. It was also noted that a high degree of disagreement occurred between clinics. This study shows there is a need for amore standardized assessment of stuttering behavior.
Cordes, A., & Ingham, R. 1996. Time-Interval Measurement of Stuttering: Establishment and Modifying Judgment Accuracy. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 2 298-310
This study investigated student's accuracy and interjudge agreement for time interval judgments of stuttering. The study also hoped to determine if student's might generalize improved accuracy after training. Subjects were 10 undergrad students with no previous experience with stuttering. Results indicate that training does increase judgment accuracy of familiar as well as non-familiar speakers, and that a slight increase in interjudge and intrajudge agreement exists post-training.
Cordes, A. & Ingham, R. (1999). Effects of Time-Interval Judgement Training on Real-Time Measurement of Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 42, 4, 862-879
This article addresses issues regarding treatment decisions for young children who stutter, which were presented in a paper by Curlee and Yairi (1997). Issues consisted of distin- guishing between disfluency and stuttering, general approaches to treatment, desirable outcomes for children who stutter, and the effects of delaying treatment. The authors of this article offer differing insight to the Curlee and Yairi paper, suggesting the Curlee and Yairi paper questionable, but still a thought-provoking "reality check."
Cordes, A.K., Ingham, R.J., Frank, P., & Costello Ingham, J. (1992). Time-interval analysis of interjudge and intrajudge agreement for stuttering event judgments. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 483-494.
The study investigated a measurement methodology based on time-interval analysis of stuttering event judgments. Inter and intrajudge interval-by-interval agreement, and agreement for total numbers of intervals containing stuttering event judgments, were calculated for each judge group. The results revealed that agreement was superior for the experienced judges and in the linger interval lengths.
Craig, A. (1996). Long-term effects of intensive treatment for a client with both a cluttering and stuttering disorder. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 329-335.
This study presents results of a single-subject case study. The results indicate that a person who clutters and stutters can be successfully treated by an intensive behavioral strategy that stresses airflow techniques, slowed speech rate, and cognitive changes during carry-over activities. After successful completion of an intensive program, stuttering was greatly reduced, and gains were maintained after 10 months. Consequently the cluttering symptoms after treatment were minimal.
Craig, A. (1998). Relapse following treatment for stuttering: A critical review and correlative data. JOURNAL OF FLUENCY DISORDERS, 23, 1-30.
This article first includes a literature review, summarizing previous research which investigated relapse following treatment in children and adults. The article also includes data concerning long-term predictors of relapse in adult groups. The author discusses various definitions of relapse and long-term fluency. The author includes three important lessons regarding treatment and relapse: treatment should include self monitoring strategies, issues of attitude and feelings should be addressed in therapy, and relapse should not be looked upon as disastrous or final. A single factor causing relapse has not been found and the author stresses that long-term fluency depends upon a combination of variables.
Craig, A. (2006). The role of anxiety in stuttering. BULGARIAN JOURNAL OF COMMUNICATION DISORDERS, 1, 10-18.
This article reviews the relationship between anxiety and stuttering. From the early 20th century, research has found anxiety to play an important etiological part in the development of stuttering. Current research also suggests anxiety plays a large role in stuttering. Prior to the physical and mental act of stuttering, a stutterers anxiety level with rise. Also PWS, who live with this disorder through childhood to adolescence and into adulthood, risk developing social anxiety as they learn to cope with their stuttering
Craig, A.R., & Calver, R. (1991). Following up on treated stutterers: Studies of perceptions of fluency and job status. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 279-284.
The current study consisted of four separate studies. They included: a self-report on speech progress, job promotion and career change, employers' perceptions of stutterers' speech before and after treatment, and perceptions of relapse. Results of study I showed that 96% were satisfied with their speech immediately following therapy, and 42% were satisfied 12-18 months following the completion of therapy. At the time of the study, 90% considered their fluency to be either good or adequate, while 10% considered their fluency to be marginal or dysflueny. Study II indicated that 40% had changed jobs following therapy, and the majority considered the change an upgrade in job status. Study III showed that employers had few negative comments and many positive comments regarding their employees' speech after therapy was completed. Results of the final study, study IV, showed that although 73% believed they had relapsed, most could regain fluency by using strategies they had learned while in therapy.
Craig, A., Hancock, K., Chang, E., Mcready, C., Shepley, A., McCaul, A., Costello, D., Harding, S., Kehren, R., Masel, C., & Reilly, K. 1996. A Controlled Clinical Trial for Stuttering in Persons Aged 9 to 14 Years. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 4 808- 826
This study investigated comparisons between three treatment programs, intensive smooth speech, intensive electomyography feedback, and home based smooth speech, to a no-treatment control comprised of children who stuttered on program waiting lists. This study included 97 children who stuttered aged 9-14, split evenly across the three treatment programs with the no-treatment control group of approximately the same number of subjects as any one of the treatment programs. Results found that the control groups stuttering did not change as expected. The results also indicate that all three treatment programs were effective and that none were significantly more so than any others.
Craig, A., Hancock, K., Tran, Y., Craig, M., & Peters, K. (2002). Epidemiology of stuttering in the community across the entire life span. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 45, 1097-1105
This journal article describes a randomized and stratified study on the prevalence of stuttering in New South Wales, Australia. A total of 4,689 families were interviewed including 12,131 individuals in the study. The families were contacted via telephone and asked to participate in the survey. They were called on a later date and asked a series of questions on the topic of stuttering to find out if anyone in the family stuttered or ever had stuttered. Questions pertaining to the characteristics of their stuttering and whether or not they had ever sought treatment were also asked. Results from the study revealed prevalence, gender ratios, and estimated risk of stuttering. It attempts to estimate the prevalence of stuttering across an entire lifespan. The information derived from this study can be beneficial for treatment facilities designed for people who stutter.
Craig, A., Hancock, K., Tran, Y., & Craig, M. (2003). Anxiety levels in people who stutter: A randomized population study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 1197- 1207.
The purpose of this study was to examine levels of trait anxiety in people who stutter, using a randomly selected sample of subjects from a heterogeneous group of people. Subjects came from 4,689 households (12,131 people) and were all at least 15 years old. The results were compared to norms for trait anxiety of people who do not stutter. Information was collected through phone interviews. Participants who were people who stutter were assessed for anxiety levels and a 5-minute speech sample was tape recorded during the conversation. Results revealed that people who stutter and were in a therapy program exhibited significantly more trait anxiety than did people who did not stutter. These results suggest that clinicians should be aware that such clients may be at risk for having higher levels of trait anxiety and such issues should be addressed early in therapy.
Cray, A., Enderby, P., & Hayhow, R. (2002). Stammering and therapy views of people who stammer. JOURNAL OF FLUENCY DISORDERS, 1, 1-17.
Interviewing has become generally accepted as a satisfactory way of exploring people's beliefs, and expectations. It has been used in health services to determine the effectiveness of treatment. Those who stammer face this communication problem daily which often leads them to seek intervention. One long standing problem in serving those who stammer is the debate among professionals on the desired outcome of stammering therapy. Due to the incidence of stammering, obtaining an adequate sample is difficult. Thus a postal questionnaire was done. The questionnaire sought the views of adults who stammer on four subjects; the effects of stammering on their lives, the therapy approaches that they have found helpful and unhelpful, the value of other remedies that people have tried, and their ideas of speech and language therapy and the future. The questionnaire indicated that stammering had the greatest effects on people's lives in the areas of school life and occupation. Speech therapy had been helpful for many, but no specifics were given. Unhelpful therapy was defined as experiencing dissatisfaction due to needs not being met. In the future people hope to see therapy include three things; help in controlling stammering and in developing coping strategies, they hope to see timely and effective intervention for children and ongoing help and group work for adults, and that therapy goals be decided together, clearly defined, appropriate to individual needs, reasonable, and measurable.
Crichton-Smith, I. (2002). Communicating in the real world: Accounts from people who stammer. JOURNAL OF FLUENCY DISORDERS, 27, 333-352.
The researchers in this article investigated the communicative experiences and coping strategies of 14 adults who stammer. Subjects ranged in age from 26 to 86. They were divided into two groups; those who had received some type of speech and language therapy and some had not. The subjects were made aware of the study and participated in a semi-structured personal interview. Each subject was encouraged to discuss childhood, adolescence, employment, relationships, and speech and ! language therapy. These topics were categorized to fit three situations to which the data was figured. The categories were the lived experience of stammering, communication management, and situational management of stammering. The results showed a variety of individuals' experiences of stammering, and that both groups experience similar feelings at different points in their lives. The information derived from this study could be useful to speech- language therapists to help understand the feelings of people who stutter in various situations.
Cross, D. E., (1987). Comparison of reaction time and accuracy measures of laterality for stutterers and normal speakers. JOURNAL OF FLUENCY DISORDERS, 12, 271-286.
This study compared ear advantage through reaction time and accuracy in a dichotic listening task between stutterers and non-stutterers. A mean right ear advantage was observed for both groups. There was no group difference in ear difference score for accuracy, but there was a group difference for reaction time. The data do not support the theory that a majority of adult stutterers are different from non-stutterers in hemispheric processing.
Cross, D.E. & Olson, P.L. (1987). Articulatory-laryngeal interaction in stutterers and normal speakers: effects of a bite-block on rapid voice initiation. JOURNAL OF FLUENCY DISORDERS, 12, 407-418.
This study investigated the effect a bite-block would have on the vocal reaction time (VRT) of stutterers and normal speakers. All vocal initiations were from the jaw closed position. The use of the bite-block decreased the VRT in all normal speakers. The use of a bite-block had varying effects on the stutterers' VRT. The mean of the group of stutterers was an increased VRT. However, four of the stutterers had a decreased VRT while six had an increased VRT. This outcome points to the individuality involved with stuttering. Proposed reasons for the disparity among those in the stuttering group were individual sensitivity to the sensory disruption a bite- block introduces to the reflexes, the bite-block may fit differently in each individual's mouth depending on specific oral structures, and the degree of biting force used by the individual.
Cross, D. E. & Olson, P. (1987). Interaction between jaw kinematics and voice onset for stutterers and nonstutterers in a VRT task. JOURNAL FLUENCY DISORDERS, 12(5), 367-380.
This study examined the relationship between jaw movement and vocal onset for stuttering and nonstuttering subjects during a VRT task. Ten male subjects identified as stutterers and ten males subjects identified as non-stutterers participated in the study. The subjects were required to sustain the vowel /^/ in response to the presentation of a tone. Results indicated that non-stutterers and stutterers did not exhibit a significant difference in relation to jaw reaction time, voice reaction time or jaw kinematics. When results were analyzed within the group, the data found that four of the ten stuttering individuals exhibited longer voice and jaw reaction times in relation to the remaining individuals in the stuttering group and the non-stuttering group. These results indicate that slow reaction times may be a result of timing issues between the respiratory system and articulatory behaviors.
Crowe, T.A., & Robinson, T.L. (1993). In stuttering: Do we have an ounce to give? AMERICAN SPEECH AND HEARING ASSOCIATION, p. 53-54.
This article discusses how stuttering is actually a syndrome and would best be treated through ego-counseling. As SLP's know, a PWS develops defense mechanisms in response to their disfluencies. The process of ego-counseling addresses the possibility of those defense mechanisms being linked to repressed needs. In order to provide better primary prevention for stuttering, SLP's need to do two things. First, SLP's need to become better counselors, possibly through more coursework at the graduate level. Secondly, SLP's need to continue aggressive and comprehensive epidemiological studies of the disorder as a syndrome, discovering at risk populations, etc.
Cuadrado, EM., & Weber-Fox, CM. (2003). Atypical syntactic processing in individuals who stutter: evidence from event-related brain potentials and behavioral measures. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 960-976.
This study supports the hypothesis that the neural mechanisms in individuals who stutter (IWS) operate differently in comparison to nonstutterers (NS) on various language tasks. Nine IWS were matched to nine NS by factors such as, age, gender, and level of education. Each individual was fitted with an electrode cap and was presented with sentences of varying complexity, one word at a time through a computer program, as well as an offline task. They were then asked to answer yes or no to whether the sentence was a "good English sentence." The results indicated that both the IWS and the NS displayed normal levels of language and visual working memory on the task. However, behavioral and neurophysical distinctions were noted on the offline task. The study suggests that the neural mechanism in IWS processes syntactic information differently than NS.
Cullinan, S. A. (2006). A preliminary examination of SSMP participants' retrospective self-ratings of changes in attitude, communicative abilities, and self-acceptance. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1, 42-63. from http://www.journalofstuttering.com/ListofArticles.html.
This study examined PWS responses to a survey of those who took part in the Successful Stuttering Management Program. The survey asked questions related to the participants' feelings towards stuttering, the use of stuttering techniques, and whether or not they felt as though a relapse had occurred. Responses to the survey indicated that changes related to attitude had affected the participants' lives the most and the techniques that were taught during the program such as prolongations were still being utilized by the participants. The participants also acknowledged that they were utilizing maintenance habits once the program ended. The amount of relapse that occurred was only considered to be minimal and no downward trend in speech was indicated. Overall, surveys can be a useful method for assessing the effectiveness of a treatment program.
Cullinan, Walter L. (1988). Consistency measures revisited. JOURNAL OF FLUENCY DISORDERS, 13, 1-9.
The study focuses on the stuttering consistency measures suggested 25 years ago. The measures are reexamined and new data are provided. The results indicated that the use of the weighted percentage measure while testing significance of individual subject consistency performance in the manner suggested for the maximum difference or normal deviated measures may be the most acceptable procedure.
Curlee, R. F. (1992). Comments on stuttering prevention I. JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 57-61.
The article provides an overview of Hamre's position on stuttering prevention and identification. The article points to the lack of empirical data to either support-or-refute Hamre's premises in a definitive way. The author states that the arguments will continue about Hamre's position until conclusive longitudinal studies can be conducted on a large number of children who stutter.
Curlee, RF. (1992). To treat or to prevent: Are those the issues? JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 107-112.
This is a commentary by Richard Curlee in response to Curt Hamre's article Stuttering Prevention II: Progression which is contained in this same issue. Curlee informs the reader that Hamre interrogated and rejected several long-standing beliefs about stuttering on the grounds that there is insufficient empirical evidence to support them and in turn offered alternatives of the same caliber. Curlee suggests that at this point that until there are better studies done on the treatment and prevention of stuttering in children, the clinician must continue to rely on personal experience and intuition to decide whether or not a child has a good chance for remission of his/her stuttering or if it is likely to persist or worsen.
Curlee, R. F. (1993) Evaluating treatment efficacy for adults: Assessment of stuttering disability. JOURNAL OF FLUENCY DISORDERS, 18, 319-331.
This article proposes a strategy for evaluating treatment efficacy of the adult stutterer through assessment of the client's stuttering disability. This author describes stuttering as a behavioral event which can be modified or eliminated through therapy. Guidelines for evaluating the adult stutterer are suggested, including some optional measures of stuttering severity and speech naturalness to determine the degree to which the disabling effects decrease during the course of therapy. The author also discusses the need for systematic studies to identify the specific therapy procedures that contribute to successful outcomes and those variables which are responsible for failures.
Curlee, R. F. (1993). The early history of the behavior modification of stuttering: From laboratory to clinic. JOURNAL OF FLUENCY DISORDERS, 18, 13-25.
Curlee focuses on the advancement of behavioral modification therapies during the 1960's and 1970's. The therapies discussed include the differential response contingent stimulation, successive approximation procedures, and conditioning of replacement behavior. Curlee states that all of these therapies have been modified through time and only a few have remained in the true form of operant theory.
Curlee, R.F. (1996). Cluttering: Data in search of understanding. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 367-371.
The need for continued research in the area of cluttering is stressed in this article. It suggests the need for more information on the etiology of cluttering, its epidemiology, and how it emerges and develops during childhood. Research limitations must be corrected if the methods of science are to be used successfully to advance the understanding of this complex communication disability.
Curlee, R.F. & Yairi, E. (1997). Early intervention with early childhood stuttering: A critical examination of the data. AMERICAN SPEECH-LANGUAGE PATHOLOGY, 6, 8-18.
Data pertaining to the incidence and prevalence as well as the efficacy of early identification and treatment of childhood stuttering were examined. There seems to be a general acceptance of the incidence and prevalence estimates despite the weaknesses in data collection. The data discussing early identification and treatment indicates there is a controversy over whether or not every stuttering child should be treated between the ages of 2 and 5 and within 1 to 2 years after onset. It was also noted that parents may choose to delay treatment if the data discussing the percentages of children who do and do not stop stuttering within the first year or two of onset were discussed to them.
Curlee, Richard & Ehud Yairi. (1998). Treatment of early childhood stuttering : advances and research needs. AMERICAN JOURNAL OF SPEECH PATHOLOGY, 7, 20-26.
This article is a response to critiques written by other professionals on a previous study done by the Curlee and Yairi. They reexamine the areas of disagreement and clarify some of their previous statements. The first area Curlee and Yairi discuss is the subject of incidence and prevalence. The next focus of their article is on epidemiology and clinical practice. In their previous article, Yairi and Curlee state, "clinical intervention decisions should be based on scientifically coined research--research that describes the nature and evolution of childhood stuttering and evaluates the efficacy of early treatment intervention" (Curlee&Yairi, 21). They further explain their reasoning for this position and also include opinions from other professionals. The authors defend their position regarding recommending treatment for stuttering. They claim that they never advocated withholding treatment from any patient, however state they do agree with the principle of waiting to initiate treatment for a short period of time. That is an area that has received much criticism from other professionals. The article also has information about distinguishing between disfluency and stuttering, and distinguishing among general approaches to treatment, desirable outcomes for children who stutter, effects of delaying treatment, and treatment research and methodology.
Daly, DA. (1987). Use of the Home VCR to Facilitate Transfer of Fluency. JOURNAL OF FLUENCY DISORDERS, 2, 103-106.
It is not uncommon for a stuttering client, who has demonstrated progress establishing fluency in therapy, to encounter considerable difficulty when attempting to transfer the fluency skills back into the home environment. In this article, two clinical examples, a 13 year-old male and a 30 year-old male, demonstrate how VCR technology can be employed to facilitate the transfer of fluency in stuttering clients. Parents, siblings, spouses, or friends can view the progress of the client, and the client can "see" or "hear" him/herself correctly producing the speech targets being taught.
Daly, D.A., and Burnett, M.L. (1996). Cluttering: Assessment, treatment planning, and case study illustration. JOURNAL OF FLUENCY DISORDERS 21, 239-248.
This article discusses the procedures used in the assessment of cluttering including Daly's Checklist For Possible Cluttering. A case study is then given and describes initial evaluation finding, recommendations, treatment and finally reevaluation. A form for planning treatment was developed (Profile Analysis For Planning Treatment With Cluttering Clients) and is used with the case study.
Daly, D.A., Simon, C.A., & Burnett-Stolnack, M. (1995). Helping adolescents who stutter focus on fluency. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 26 162-168.
The diverse roles that a speech-language pathologist must employ when working with adolescents who stutter are addressed. Analogies are offered as a means of increasing the student's interest and understanding of his/her stuttering characteristics. Two phases of therapy are suggested. Phase one focuses on behavioral speech treatment strategies such as fluency target skills or stuttering modification strategies. Phase two focuses on cognitive and self- instructional procedures such as relaxation, mental imagery and positive self-talk. Five basic tenets of treatment for adolescent students are offered
Daniels, D., Hagstrom, F., & Gabel, R. (2006). A qualitative study of how African American men who stutter attribute meaning to identity and life choices. JOURNAL OF FLUENCY DISORDERS, 31, 200-215.
Six African American men who stutter (ages 24 to 58) were interviewed about their lives and their responses videotaped. Major and minor themes were taken from the participants' responses on a) being a person who stutters, b) being an African American, c) life choices, and d) identity. Results from the interviews found that five of the participants felt that stuttering affected their personal identity, and three participants thought their experiences were unique being both African American and a person who stutters. No participants reported their racial or communicative identities affected family life, but all identified stuttering as affecting their educational lives.
Davidow, J.H., Bothe, A.K., & Bramlett, R.E. (2006). The stuttering treatment research evaluation and assessment tool (STREAT): Evaluating treatment research as part of evidence-based practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 15, 126-141.
This article focuses on the issues surrounding the Stuttering Treatment Research Evaluation and Assessment Tool (STREAT). The STREAT assists in critically analyzing reports concerned with stuttering treatment research and was developed based on previously published recommendations. The article discusses the seven different sections and items in the STREAT, including: The Five Basic Characteristics, Strategy/Participants/Sample Size, Dependent Variables, Treatment Fidelity, Data Fidelity, Data Analysis, and Results, in addition to Reliability. The conclusion of this research is that the STREAT is an accurate reflection of the previously published recommendations concerning evidence-based practice in the area of stuttering treatment research.
Davidow, J.H., Bothe, A.K., & Bramlett, R.E. (2006). The stuttering treatment research evaluation and assessment tool (STREAT): Evaluating treatment research as part of evidence-based practice. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY, 15, 169-178.
The Stuttering Treatment Research Evaluation and Assessment Tool (STREAT) is used to ease the task of critical appraisal of stuttering treatment research by students, clinicians, and other readers. It is an evaluation system similar to evidence-based practice (EBP). When critiquing a stuttering treatment program or stuttering treatment investigation, the STREAT highlights seven different sections to be observed: Section I, Five Basic Characteristics; Section II, Strategy/Participants/Sample Size; Section III, Dependent Variables; Section IV, Treatment Fidelity; Section V, Data Fidelity; Section VI, Data Analysis; and Section VII, Results. The main goal of the STREAT is to assist clinicians with providing the most appropriate and effective stuttering treatment services to their clients.
Davis S., Howell P., & Cook F., (2002) Sociodynamic relationships between children who stutter and their non-stuttering classmates. JOURNAL OF CHILD PSYCHIATRY, 43(7), 939-47.
Children who stutter have been bullied by their peers for over 20 years. Previous research has been done noting the differences between children who stutter and children who do not stutter and their roles in leadership, popularity, and bullying. The purpose of this study is to quantify the results from anti-bullying policies that have been implemented in the schools and report the impact of these programs related to the social status of children who stutter. Peer rejection and bullying are still present within the educational system despite the anti-bullying efforts that have been made. Providing strong bullying rules within the school systems is very important. Children who stutter can benefit from peer support systems in their schools.
Davis, S., Shisca, D. & Howell, P. (2006). Anxiety in speakers who persist and recover from stuttering. JOURNAL OF COMMUNICATION DISORDERS, 40, 398-417.
This study investigates the role, state and trait, anxiety plays in the etiology, precipitation and maintenance of stuttering. Fifty-seven participants were enrolled in the study; 19 fluent speakers and 35 individuals who stuttered; those who either persisted or recovered. The State-Trait Anxiety Inventory for Children (STAIC) was administered to all of the participants. Results of the study reveal that there were no trait anxiety differences between the control and experimental groups. State anxiety scores revealed no significant difference between the recovered group and the control group. However, the state anxiety scores were higher for the persistent group than the control group.
Dayalu, V. N., Kalinowski, J., Stuart, A., Holbert, D., & Rastatter M. P. (2002). Stuttering frequency on content and function words in adults who stutter: a concept revisited. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 5, 871-878.
This study investigated stuttering frequency as a function of grammatical word type (i.e., content and function). Ten adults who stutter participated. Participants recited aloud a list of 126 words consisting of an equal number of content and function words, which were presented individually and visually via a laptop computer. Words were matched for initial sound and approximate number of syllables, which belonged to a single grammatical category. The results indicated that adults who stutter exhibited significantly greater stuttering frequency on content words when presented in isolation.
Defloor, T., Van Borsel, J., & Curfs, L. (2000). Speech fluency in prader-willi syndrome. JOURNAL OF FLUENCY DISORDERS, 25, 85-98.
This article reviews a study that explored the speech fluency of 15 subjects, from 9-20 years of age, with a total IQ between 40-94, with Prader-Willi Syndrome (PWS). The four speech modalities the researchers used for speech samples included spontaneous speech, repetition, monologue, and automatic series. These speech samples were then examined for frequency, type and distribution of dysfluencies. Results confirmed that people with PWS are oftentimes dysfluent. Of the 15 subjects, one displayed what the authors called symptoms of "clinical stuttering" and none displayed secondary stuttering characteristics. The research indicated some of the subjects dysfluencies were typical features found in stuttering and others were very atypical. Further research must be done to determine if the dysfluency associated with PWS is related to problems with language.
De Felcio , C.M., Rodrigues, R.L., Vitti, M., & Regalo S.C.H. (2007). Comparison of upper and lower lip muscle activity between stutterers and fluent speakers. JOURNAL OF COMMUNICATION DISORDERS,71,1187-1192
Researchers designed a study to investigate the lip muscle activity between people who stutter and fluent speakers. Lower and upper lip muscle activity was analyzed using electromyographic recording (EMG). Ten fluent speakers and ten individuals who stutter were included in the study. Findings indicated that the activity of the upper lip muscle was significantly lower in the group which contained individuals who stutter. Results also suggested no significant differences in lower lip activity between the two groups. The research did not reveal a connection between greater muscle activity and stuttering.
DeJoy, DA., & Jordan, WJ. (1988). Listener reactions to interjections in oral reading versus spontaneous speech. JOURNAL OF FLUENCY DISORDERS, 13, 11-25.
This study looks at the degree of overlap between normal disfluency and stuttering. The subjects of this study were 383 undergraduate students enrolled in sections of introductory level public speaking, or interpersonal communication courses. The subjects listened to one of six versions of an oral reading passage or to one of six versions of a passage presumed to be spontaneous speech. The passages contained randomly inserted schwa insertions at 0, 1, 5, 10, 15, or 20% of the possible juncture points. Listeners classified the passages as fluent, dysfluent, or stuttered and made other judgments through semantic differential scales. Significant differences in listener reactions to interjections in oral reading versus spontaneous speech were revealed.
Dell, C., & Rastatter, M. (1987). Simple visual versus lexical decision vocal reaction times of stuttering and normal subjects. JOURNAL OF FLUENCY DISORDERS, 1, 63-69.
In this study, the vocal reaction times of stutterers to visually presented linguistic stimuli was discussed and examined. The study suggests there are possible differences in both motor control and auditory-phonemic information processing in persons who stutter. The study included 14 subjects ages 18-36 years. They were tested on vocal reaction times and lexical decision response conditions. The results of the study showed that stutterers' vocal reaction times to visual stimuli were not significantly different from the reaction times of normal subjects. The findings from this study do not correspond with previous findings in the field.
Dembowski, J., & Watson, B. (1991). Preparation time and response complexity effects on stutterers' and nonstutterers' acoustic LRT. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 49-59.
Subjects were 18 adult males, subclassified into PWS, who were mild, and those who were severe. Six subjects were in each group, and there were 6 control subjects, with no history or evidence of stuttering. Subjects were requested to initiate phonation as quickly as possible during structured speaking tasks. Results indicated that individuals who did not stutter produced the shortest laryngeal reaction time. Accordingly, mild PWS produced a longer LRT and severe PWS produced the longest LRT. The effect of stimulus presentation, response complexity, LRT and CNS preparation, and normal CNS function were also discussed.
De Nil, L. F. (1995). The influence of phonetic context on temporal sequencing of upper lip, lower lip, and jaw peak velocity and movement onset during bilabial consonants in stuttering and nonstuttering adults. JOURNAL OF FLUENCY DISORDERS, 20 (2), 127-144.
The purpose of this article was to investigate whether differences in bilabial articulatory sequence patterns were present between stutterers and nonstutterers. Five adult stutterers and four nonstutterers were instructed to produce three utterances. According to the results, no direct relationship between stuttering severity and the type of articulatory sequence pattern was observed.
De Nil, L. F., Kroll, R. M., & Ham, R. E. (1996). Therapy review. Successful Stuttering Management Program (SSMP). JOURNAL OF FLUENCY DISORDERS, 21, 61-67.
In this article, the authors, De Nil and Kroll, review the Successful Stuttering Management Program, a stuttering therapy program designed for group use with adolescents and adults who stutter, which is followed by a response from Ham. The underlying philosophy of the program is stated as being a combination of avoidance reduction therapy and the application of stuttering modification techniques advocated by Van Riper and can be divided into three phases: confrontation naming, modification of stuttering, and transfer and maintenance. A brief overview of each phase is given by De Nil and Kroll. They state that the underlying philosophy of this program is thought to align more with those who advocate a stuttering modification approach rather than a total fluency approach based on fluency shaping. Some concerns listed by these authors regarding this program include: potential for high client drop-out rate due to the high level of difficulty at the initial level phase of therapy, the possibly encouragement of avoidance behaviors through promotion of the substitution method to stuttering modification, and misleading facts given in the program text. Ham responds in support of the SSMP and addresses each of the issues posed by De Nil and Kroll.
DeNil, L., & Bruten, G. (1991). Speech-associated attitudes of stuttering and nonstuttering children. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 60-66.
The Communication Attitude Test was given to 63 males and 7 female Dutch speaking Belgium children who stuttered. The ages of the subjects ranged from 7-14 years for the males and 7-13 years for the females. The control group consisted of 271 Belgium children, 49% male and 57% female, who had no apparent speech, language or hearing problems. True-false questions regarding speech attitudes comprised the CAT-D. The higher score, the less positive the attitude toward speech. The children who stuttered scored almost two times as high as the children who did not stutter. In addition, within the group of children who stuttered, the females scored significantly higher than the males.
De Nil, L., Houle, S., Kapur, S., & Kroll, R. (2000). A positron emission tomography study of silent and oral single word reading in stuttering and nonstuttering adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING, 43, 1038-1053.
This article describes a study that used PET scanning to view lateralization and cortical and subcortical activity in the brains of 10 right handed male stuttering adults and 10 right handed male nonstuttering adults when reading single words both silently and orally. The study confirmed that the stuttering adults exhibited differences in lateralization of language activity, as they showed an increase in activity in the right hemisphere during oral reading, whereas the nonstuttering adults showed an increase in activity in the left hemisphere during oral reading. During silent reading, the stuttering adults exhibited increased activation in the anterior cingulate cortex in the left hemisphere, suggesting that they experienced anticipation reactions related to stuttering. Silent reading did not produce lateralization differences between the stuttering and nonstuttering adults.
DeNil, L. F., & Kroll, R. M. (1995). The relationship between locus of control and long-term stuttering treatment outcome in adult stutterers. JOURNAL OF FLUENCY DISORDERS, 20 (4), 345-364.
The purpose of this investigation was to observe whether the measurement of an individual's locus of control will allow clinicians to predict which of their clients who stutter are more or less likely to show long-term fluency following intensive treatment. Twenty one subjects initially participated in measures during a 3-week intensive treatment program. These measures included a Locus of Control Behavior Scale, Situation Checklist, reading sample, conversational speech sample, and a Fluency Self-Rating Scale. These measures were obtained pretreatment, posttreatment, and two years later. Results revealed a significant improvement in fluency immediately post-treatment. Two-year follow-up results revealed an increase in stuttering frequency in a number of subjects. A clear relationship between locus of control, as measured by the Locus of Control Behavior Scale, and long-term treatment results (measured by the percentage of words stuttered) was not identified.
De Nil, LF., Kroll, RM., Lafaille, SJ., & Houle, S. (2003). A positron emission tomography study of short- and long-term treatment effects on functional brain activation in adults who stutter. JOURNAL OF FLUENCY DISORDERS, 28, 357- 380.
This study utilized positron emission tomography (PET) to determine the effects of short- and long-term behavioral treatment on brain activation patterns in people who stutter (PWS). Twenty-three adult participants were divided into stuttering (n=13) and nonstuttering (n=10) groups. Each participant in the stuttering group underwent a PET scan prior to treatment. The treatment program was a modified version of the Precision Fluency Shaping Program that lasted for three weeks. The intensive schedule required each participant to participate in group and individual fluency treatment for six hours each day, followed by daily activities. During therapy, the participants worked towards gaining new motor skills, acquiring a series of speech targets, self-observation, and systematic cognitive and attitudinal adjustments. After the intensive therapy sessions, the participants underwent PET scans again. This was followed by participation in a year- long maintenance program. At the end of the maintenance program, the participants again underwent PET scanning. The results of this study showed changes in activation lateralization following treatment, particularly a shift toward left-lateralization. In addition, there was a general reduction in overactivation following treatment, especially in the motor cortex.
De Nil, L. F., Sasisekaran, J., Van Lieshout, P. H. H. M., Sandor, P. (2005). Speech disfluencies in children with Tourette syndrome. JOURNAL OF PSYCHOSOMATIC RESEARCH, 58, 97-102.
The purpose of this study was to compare the frequency and types of disfluencies of children with Tourette's syndrome (TS) with those of typically developing children. Speech samples were collected from 69 children diagnosed with TS, ages 4-18, and 27 typically developing children, ages 6-17. In addition, self-report information regarding the presence, nature, and familial incidence of speech and language difficulties was obtained via a questionnaire which was completed by the subjects or their parents. Speech samples were analyzed in terms of _ more typical_ disfluencies, those present in both typical and stuttered speech, and _ less typical_ disfluencies, those present in stuttered speech. Results of self-report data indicated no significant differences in perceived disfluencies between the groups. Results of speech sample analysis indicated increased disfluencies in the more typical category for children with TD. The authors discuss these results in regard to previous literature linking TD and developmental stuttering.
Denny, M., & Smith, A. (1992). Gradation in pattern of neuromuscular activity associated with stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 1216-1229.
The purpose of this study was to investigate if stuttered speech is associated with high levels of EMG activity compared to fluent speech and if tremorlike oscillation in EMG one present in perceptually fluent as well as stuttered speech. Seventeen PWS ages 19-50 years were the subjects of the study. The results indicate that there is not a single set of physiological events that characterize stuttering in all individuals. Results showed that stuttered speech has large tremorlike oscillation in neuromuscular activity, but not in fluent amplitude. EMG amplitude was about equal in stuttered and fluent speech.
Denny, M., & Smith, A. (2000). Respiratory control in stuttering speakers: evidence respiratory high-frequency oscillations. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 1024-1037.
This article describes a study that sought to determine if stuttering speakers differed from nonstuttering speakers in terms of relations between speech breathing and life support breathing. The study used the measurements of maximum coherence in respiratory high-frequency oscillations to compare the neural mechanisms of respiratory function and control between 10 stuttering speakers and 10 nonstuttering speakers. Many variables were discussed, acknowledging that stuttering is a multifactoral and dynamic disorder. The study concluded that no significant differences in the maximum coherence in respiratory high-frequency oscillations in fluent and nonfluent speech was found.
Dietrich, S., Barry, S.J., & Parker, D. (1995). Middle latency auditory responses in males who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(1), 5-18.
This study focused on auditory brainstem response recordings (specifically wave P6) in males who stutter vs males who did not stutter. This difference was noted in the findings. This difference in the latency of the P6 wave between the two groups can also be found in persons with Alzheimer's disease, schizophrenia, and autism. The authors believe that you can't draw firm conclusions from this study. The differences may have been generated after the onset of stuttering as a compensatory response.
Dietrich, S., Jensen, K.H., & Williams, D.E. (2001). Effects of the Label "Stutterer" on Student Perceptions. JOURNAL OF FLUENCY DISORDERS, 26:1, 55-66.
This article addresses people's reactions to terminology used to describe people who stutter. An example provided, was that between 1977 and 1997, when referring to a person who stutterers as a "stutterer", decreased and the use of noun + "who stutters" increased. One published study regarding the effect on terminology of stuttering resulted there were no effects regarding terminology. It was suggested that more research was needed, which led to the present study. This study held 2 purposes: (1) investigate the possibility of subtle discrimination triggered by the noun "stutter" and (2) explore the effects of the gender of the subjects of their ratings of the hypothetical person. A one page survey was handed out to 600 undergraduate students at a state university, and 544 of them were analyzed. Two forms were written out in paragraph form about a situation of a hypothetical person who stuttered. The only difference between the two forms was the terminology. One form used the noun "stutterer" and the other used "student who stutterers" and "stuttering problem". Following the paragraph, there was a list of 9 trait pairs (ambition, employability, tension, adjustment, stability, reliability, decisiveness, esteem, intelligence). The student was asked to rate their first impression of the person discussed in the paragraph. Half of the men and women used one form while the other half used the other form. The findings were: (1) There was no statistically significant difference in terminology usage. (2) Minimal difference and variability among the raters response of the two types of terminology. (3) Female raters gave significantly higher, more positive, ratings on the intelligence, employability and social adjustment traits than the males -and - was higher than the males in the rest, which the exception of degree of tension .
Dietrich, S., & Roaman, M. H. (2001). Physiologic arousal and predictions of anxiety by people who stutter. JOURNAL OF FLUENCY DISORDERS, 26, 207-225.
This study investigated the possible relationship of the perception of speech-related anxiety in people who stutter to their physiological response. Twenty-four adults who stuttered participated in this study. Participants rated their imagined anxiety by using a seven point Likert scale. Individuals' reactions were then measured by skin conduction response when exposed to four different experimental situations. The situations consisted of reading aloud, discussing a personal experience, using a telephone, and discussing his/her experiences with stuttering while being videotaped. The study found that there was no significant relationship between the participant- predicted anxiety rating and the physiological response to anxiety as measured by skin conductance.
Dilollo, A., Manning, W., & Neimeyer, R., (2002). A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment. JOURNAL OF FLUENCY DISORDERS, 1, 19-42.
Relapse following the successful treatment of stuttering is a common problem for many clients. The purpose of this article is to present a theoretical problem for understanding the problem of relapse, and to purpose a useful approach to counseling persons who stutter with the goal of increasing their long-term maintenance of fluency. The article defines its explanation for relapse; it gives a detailed description of "personal construct psychology", and lastly presents a framework for engaging a client into this narrative therapy with the aim of it facilitating their long-term maintenance of fluent speech.
DiLollo, A., Manning, W.H., & Neimeyer, R.A. (2003). Cognitive anxiety as a function of speaker role for fluent speakers and persons who stutter. JOURNAL OF FLUENCY DISORDERS, 28, 167-186.
This study examined cognitive anxiety with fluent speakers and persons who stutter and their dominant and non-dominant speaker role. Results from the Cognitive Anxiety Scale concluded there was increased cognitive anxiety associated with the unfamiliar or non-dominant speaker role for each group. Persons who stutter displayed greater cognitive anxiety in a fluent speaker role (non-dominant). Thus persons who stutter experienced a lack of meaningfulness of the fluent speaker role. Results indicate for maintenance part of therapy, therapist need to increase meaningfulness of fluent speaker role and change self-concept of stutter speaker role for persons who stutter.
DiSimoni, F. (1990). Letters to the editor. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 402-404.
DiSimoni comments on procedures used by Conture, et al. (1988) and Prosek et al. (1988). He claims that "breaches of the scientific process" were committed and DiSimoni goes on to identify those breaches. DiSimoni also suggests that Conture and Prosek are equating theory with fact. Replies by Conture et al. and Prosek et al. follow.
Doi, M., Nakayasu, H., Soda, T., Shimoda, K., Ito, A. & Nakashima, K. (2003). Brainstem infarction presenting with neurogenic stuttering. INTERNAL MEDICINE, 42, 884-887.
This article analyzes the relationship of stuttering and neurological disorders such as stroke or neurodegenerative diseases. The following article reports on the case of a sixty-year-old man who, after suffering from a brainstem infarction, developed acquired stuttering. The patient's speech was characterized by involuntary repetition of mainly the first, and sometimes the last syllable of each word, which are characteristic of neurogenic stuttering. It is known that the brainstem has an important role in speech relating to the formation of stuttering. Thus, an infarction in the brainstem can be attributed to neurogenic stuttering.
Donaher, J. (2007). The client's perspective. JOURNAL OF STUTTERING, ADVOCACY & RESEARCH, 2, 14-15. Retrieved November 23, 2007, from http://www.journalofstuttering.com/ListofArticles.html.
This article discussed an assignment completed by students in a graduate studies program in communication disorders. Students were split into pairs and were to take turns assuming the role of the client and the clinician. The "clinician" was to ask the "client" to discuss a stressful event and allow the "client" to speak uninterrupted for 15 minutes. The purpose of the assignment was to enable the client to better empathize with clients and to better understand what they may be feeling.
Donaher, J. (2008, October 14). New manual for parents of preschoolers who stutter. THE ASHA LEADER, [13(14)], [21].
The purpose of this article was to describe a web-based resource that is currently being completed to help alleviate the frustration and confusion parents of a preschool child with a fluency disorder may have. The Preschool Stuttering Manual is being designed to answer various questions parents may have in regards to general information about stuttering, what happens during an evaluation, how to work with insurance companies, and what their role is. The Preschool Stuttering Manual is edited by parents to ensure it is user friendly and answers specific questions parents may have.
Dopheide, B. (1987). Competencies expected of beginning clinicians working with children who stutter. JOURNAL OF FLUENCY DISORDERS, 12, 157-166.
This study took a competency development perspective towards the problem of improving the professional education of clinicians in order to serve children who stutter. Speech language clinicians providing direct professional services were engaged as "consultants" to talk about the stuttering competencies they would look for in a first year clinician joining the staffs of their programs. Competencies were identified in the areas of assessment and remediation. Results indicated assessment competencies to be directed toward the preparation of a comprehensive description of the child's talking behaviors, as well as probing affective aspects of the child's spoken communication experiences. The remediation competencies identified in this study provide additional indication of direct intervention by clinicians with children who stutter.
Doody, I., Kalinowski, J.A., & Stuart, A. (1993). Stereotypes of stutterers and nonstutterers in three rural communities in Newfoundland. JOURNAL OF FLUENCY DISORDERS, 18 (4), 363- 374.
This study was done to determine if a negative stuttering stereotype existed in small, rural communities in Newfoundland, Canada and to examine the role of exposure and familiar relationships to the perception of stutterers. Results indicated that regardless of personal contact or familial relationship, a strong negative stereotype of stutterers existed. It was also suggested that the negative stereotype was based not on the personality traits of the stutterers but on the strength and vividness of the stuttering behaviors and because the nonstutterers generalized state to trait anxiety.
Dorsey, M. & Guenther, RK. (2000). Attitudes of Professors and Students Toward College Students Who Stutter. JOURNAL OF FLUENCY DISORDERS. 25, 77-83.
This is a discussion of research and the results done on a college campus'. It compared the attitudes professors and college students have about people who stutter. The ratings were based on the professor or students perception of the students who stutter compared to that of a non-stutterer. Both the professor's and students tended to rate stutterers traits more negatively than those students who do not stutter. It is believed that the impressions of stutterers play a major role in the academic and career opportunities. The results of the study show that college professors and students need to be educated about the negative stereotypes associated with people who stutter.
Downey, C.S., Gardner, L.S. & Mallard, A.R. (1998). Clinical training in stuttering for school clinicians. JOURNAL OF FLUENCY DISORDERS, 13, 253-259.
155 school based speech-language pathologists completed a survey regarding their academic and clinical training background of fluency disorders. Results indicated that a high percentage of school-based clinicians have not received adequate academic or clinical training in stuttering to prepare them to competently serve the stuttering population.
Drayna, D.T. (1997). Genetic linkage studies of stuttering: ready for prime time? JOURNAL OF FLUENCY DISORDERS, 22, 237-240.
This article supports the notion that stuttering is caused by genetic factors. Four reasons were given to support this claim- stuttering clusters in families, twin studies agree that monozygotic twins have a higher concordance for stuttering than dizygotic twins, adoption studies suggest stuttering is more related to whether an individuals biological parents stutter than whether the adoptive parents stutter, at least one large family has been ascertained in which stuttering behaves much like a simple, single gene Mendelian trait. The author tells us that at the current time medical professionals are unable to isolate a single gene however he feels with the recent advances in human genetics it may come within our capabilities in the near future.
Druce, T., Debney, S. (1997). Evaluation of an intensive treatment program for stuttering in young children. JOURNAL OF FLUENCY DISORDERS, 22,169-186.
This study evaluated the effectiveness of intensive therapy for disorders for young children. The subjects ranged from 6:9 to 8:1 with a mean of 7:4, there were 15 subjects total. (The subjects had all been stuttering for at least 12 months previous to the initiation of therapy to eliminate the possibility of spontaneous recovery.) The children were treated in groups of 3 or 4. The therapy program ran for 5 days meeting for 6 hours each day, and a maintenance phase which gradually reduced the schedule of visits over a 3 month period. Measurements were based on a taped 2 minute sample and judged for 1. Number of syllables stuttered. 2. Speech rate. 3. Speech naturalness. 4. Subjective stuttering severity. In order to examine the final outcome the children were judged on the following perimeters on the last visit. 1. Classification as a nonstutterer or stutterer. 2. Naturalness rating on a 9 point scale. 3. Subjective severity rating on a 4 point scale. The study was effective in reducing stuttering in the short term in the following categories.
Stuttering frequency
Perceived stuttering
Naturalness
Speech rate
These categories were maintained through the final measurement.
Duchin, S.W., & Mysak, E.D. (1987). Disfluency and rate characteristics of young adult, middle-aged, and older males. JOURNAL OF COMMUNICATION DISORDERS, 20, 245-257.
This study examines the characteristics of the speech of normally fluent males of various ages. Their speaking rates and disfluencies are reported for conversation, picture description, and oral reading tasks. The findings suggest that speech rate slows with increasing age. There is also a statistically significant correlation of speech production with physical health. There is not a noticeable change in disfluencies with age. An oral reading passage is suggested as a useful screening tool for disfluencies in the aging population.
Dworkin, J. P., Culatta, R. A., Abkarian, G. G., Meleca, R. J. (2002). Laryngeal anesthetization for the treatment of acquired disfluency: a case study. JOURNAL OF FLUENCY DISORDERS, 27, 215-226.
The purpose of this study is to document the effect of laryngeal lidocaine anesthesia on acquired disfluency and discuss the possible reasons for its successful result in this case. The subject is an adult male who began experiencing phonatory and articulatory blocks that began and persisted four weeks following a motor vehicle accident. The patient's fluency was evaluated five times during the experimental phase, once pre-injection and again 15 minutes, one week, one month, and five months post injection. Drastic and consistent improvement was noted at each evaluation segment in disfluent moments, number of repetitions, disfluent rate, and speech rate, until finally the subject demonstrated total fluency and normal speech rate at the five-month post intervention evaluation. The authors discuss possible causes for this positive result as being related to psychological response, a physiological response, or a combination of the two.
Dworzynski, K., Howell, P. (2004). Predicting stuttering from phonetic complexity in German. JOURNAL OF FLUNCY DISORDERS, 29, 149- 173.
This article looks at how phonemic complexity affects the stuttering rate in German and how this changes with age. This study looked at an Index Phonetic Complexity (IPC) where words are scored under eight linguistic categories. Results concluded that in German there is a correlation between word types and age groups. The gap between content and function word IPC scores were higher with a stutterer who was older. When comparing the two languages of German and English one similarity was the influence of word shape-word endings in consonants and the increase of stuttering rates. In conculsion, it was noted that the increased complexity of German content words will impact the stuttering rate and IPC scores in fluent to stuttered words in German when compared to English.
Dworzynski, K., Howell, P., Au-Yeung, J., & Rommel, D. (2004). Stuttering on function and content words across age groups of German speakers who stutter. JOURNAL OF MULTILINGUAL COMMUNICATION DISORDERS, 2, 81-101.
This study compared the pattern of disfluencies in English and German speakers who stutter. Research on English speakers who stutter has shown that children have a higher rate of disfluencies on function words while adults have a higher rate of disfluencies on content words, suggesting a shift in the pattern of disfluencies as a person who stutters ages. Research has also shown that in English speakers who stutter, the pattern of disfluency on function words is more likely to occur when the function word precedes a content word, versus following one. This study found similar results in German speakers who stutter.
Dworzynski, K., Howell, P., & Natke, U. (2003). Predicting stuttering from linguistic factors for German speakers in two age groups. JOURNAL OF FLUENCY DISORDERS, 2, 95-113.
The original background for this research study into linguistic variables associated with speech disfluency triggered by Brown (1945). The factors Brown came up with predict the loci of disfluency in English-speaking adults who stutter. These same factors were examined in native German-speaking children and adults who stutter. Speech data of 15 German adults and 17 children were coded according to Brown's factors. The results confirmed the hypothesis that linguistic factors do not affect children in the same way as adults. Comparisons with the adults showed that stuttered words were not associated with as great an increase in linguistic difficulty as were adults. Children stuttered significantly more on the "easier" level (function and short words) of these two factors but significantly lower on the "harder" lever (content and long words). For adults both word type (content/function) and word length increased stuttering rate significantly, whereas changes in stuttering rate for the other two factors were non-significant.
Dworzynski, K., Remington, A., Rijsdijk, F., Howell, P., & Plomin, R. (2007). Genetic etiology in cases of recovered and persistent stuttering in an unselected, longitudinal sample of young twins. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 16, 169-178.
It is believed that one etiology of stuttering is genetics, even though a specific gene has not been found and hereditary patterns remain in the early stages of development. The purpose of this study was to look at patterns of heritability and shared environment of early childhood aged twins, and see if there were any differing genetic and/or environmental influences affecting recovery versus persistence of stuttering. Questionnaires were filled out by parents when the twins were at ages two, three, four, and seven. The twins were placed into a persistent or recovery group based on the questionnaire answers, and analyses were conducted to predict the presence of stuttering by age seven based on genetic and environmental influences. Results found stuttering to be a heritable disorder with little to no environmental effect by age seven for the two groups.
Eichstadt, A., Watt, N., & Girson, J. (1998). Evaluation of the Efficacy of a Stuttering Modification Program With Particular Reference To Two New measures of Secondary Behaviors and Control of Stuttering. JOURNAL OF FLUENCY DISORDERS, 23, 4, 231-246.
The study focuses on speech behaviors and attitudes of a group of people who stutter after they have attended an intensive stutter modification program. The goal of the workshop is to eliminate secondary behaviors and control of stuttering moments. Five PWS attended the workshop and their speech was evaluated immediately following and 2 years post. Data was collected via 2 minute speech samples from videotaped monologues. All samples were transcribed by therapists, students, and fellow stutterers. Attitude measures were assessed via completion of the Attitude Scale by subjects both immediately post-workshop and 2 years later. Due to the small number of subjects in the study, each subject's results are listed individually. In general, there appeared to be a decrease in speech behaviors through time. Attitudes showed significant improvement through time.
Einarsdottir, J. & Ingham, R. J. (2005). Have disfluency-type measures contributed to the understanding and treatment of developmental stuttering?. AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY, 14, 260-273.
This article was a review of available literature aimed at arguing that the use of disfluency typologies to measure and diagnose stuttering has not made any significant contribution to the understanding or treatment of the disorder. Many studies have suggested that children who stutter (CWS) simply have a higher frequency of disfluencies in their speech. However, it is widely believed that CWS exhibit a different class of behaviors that only somewhat resembles normal disfluencies. More research consideration needs to be given to a shift in the basis for creating measures of stuttering behavior.
Einarsdottir, J. & Ingham, R. J. (2008). The effect of stuttering measurement training on judging stuttering occurrence in preschool children who stutter. JOURNAL OF FLUENCY DISORDERS, 33, 167-179.
The purpose of this study was to develop a standardized training program (Stuttering Measurement Assessment and Training (SMAAT-child)) to teach individuals to accurately identify the occurrence of stuttering in young children. The developed program was based on a pre-existing program for adolescents and adults (SMAAT-adult). The participants of the study included 20 Icelandic preschool teachers, who were randomly assigned to either a control group or experimental group. The teachers listened to recorded speech samples of nine Icelandic children, ages 3-5, and were asked to identify stuttered moments of speech. The teachers in the experimental group were then put through the training program before undergoing another attempt to accurately identify stuttered moments of speech. The results of the study revealed that the teachers in the experimental group were able to more accurately identify stuttered speech after undergoing the training program, while the teachers in the control group displayed no difference in identification between the two occurrences.
Eldridge, K. & Felsenfeld, S. (1998). Differentiating Mild and Recovered Stutterers from Nonstutterers. JOURNAL OF FLUENCY DISORDERS, 23, 3, 173-194
Research involved differentiating mild and recovered stutterers from non- stutterers by means of carefully constructed diagnostic interview. Study consisted of 18 adults who stutter and 20 adults who were non-stutterers. Results indicated that such interviews did have potential in differentiation, which would be of particular importance in genetic and/or epidiomological research.
Ellis, J.B., Finan, D.S., & Ramig, P.R. (2008). The influence of stuttering severity on acoustic startle responses. JOURNAL OF SPEECH, LANGUAGE, HEARING RESEARCH, 51, 836-850.
The purpose of the present study was to determine whether or not acoustic startle responses among stutterers may related to severity of stuttering. The thirty participants were in three groups. The groups consisted of 11 moderate/severe stuttering adults, 10 nonstuttering adults, and 9 mild stuttering adults. A waveform generator was used to elicit acoustic startle responses at a level of 95.0dB SPL, consistently to all participants. Results indicated acoustic startle response amplitudes were not statistically significant amongst the three groups. Mean acoustic startle response amplitudes were not significant, which may be due to relatively higher variability within the moderate/severe stuttering group. Differences in habituation rate and median latency of acoustic startle responses were also found to be not significant. In conclusion, the following study proposes that acoustic startle responses are not predicted by stuttering severity.
Engel, D., Martens, C. (1986). Measurement of the sound-based word avoidance of persons who stutter. JOURNAL OF FLUENCY DISORDERS, 11, 241-250.
The motivation of the study was to compare the sound-based word-choosing behavior of persons who stutter with word-choosing ability of people who do not stutter. The subjects consisted of nine people enrolled in an intensive stuttering clinic at the University of North Dakota, six people from audiotapes who were previously enrolled at the clinic, and 40 people who do not stutter. The examiners gathered a spontaneous speech sample, asked the subjects to read for three minutes or until stuttered 10 times, and had the subjects answer questions. The results suggested that 77 percent of the people who admitted to word avoidance showed evidence of sound-based word avoidance. Thirteen that admitted to word avoidance stuttered ten times in the three minute reading task.
Enger, N.C., Hood, S.B., & Shulman, B.B. (1988). Language and fluency variables in the conversational speech of linguistically advanced preschool and school-aged children. JOURNAL OF FLUENCY DISORDERS, 13, 173-198.
The investigation observed the language and fluency of linguistically advanced children and changes which occur with chronological age. 10 preschool and 10 school-aged students were subjects. The Mean Length of Utterance (MLU), Mean Length of Responses (MLR) and Word Morpheme Index (WMI) of a 50- utterance sample were calculated. Frequency of each occurrence was calculated for each disfluency type. The disfluency patterns for both subject types were parallel. Interjections were present more frequently with an increase of age.
Evans, D., Healey, E. C., Kawai, N., and Rowland, S. (2007). Middle school students' perceptions of a peer who stutters. JOURNAL OF FLUENCY DISORDERS, 33, 203-219.
The purpose of the article was to describe how 64 middle school students perceived a teen stuttering while telling a joke. Each middle school student rated the videotaped teen based on eleven statements developed by the authors. These statements were divided into three categories: affective (feelings or emotions), behavioral (speech characteristics) or cognitive (thoughts and beliefs). The results of this study showed that, in general, the students' perceptions of the teen who stuttered did not significantly change based on the severity of the stutter.
Ezrati-Vinacour, R., & Levin, I. (2001). Time estimation by adults who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 144-155.
This study discusses the subject of time estimation by adults who stutter. Past clinical research, suggests that the period of disfluency is overestimated by the stutterer. This study used both the productive and reproduced methods of time estimation. The results of the study indicate that the time estimation of adults who stutter did not differ significantly from that of fluent speakers. However, severe stutterers did estimate time less accurately than mild stutterers.
Ezrati-Vinacour, R., Levin, I. (2004). The relationship between anxiety and stuttering: a multidimensional approach. JOURNAL OF FLUENCY DISORDERS, 29, 135-148.
This study looks at anxiety in relation to those who stutter through a multidimensional model. Various questionnaires were given to measure anxiety. Several tests were given to evaluate the severity of stuttering within the participants. Participants were split into three core groups of, mild stutterers, severe stutterers, and normally fluent speakers. Results concluded that PWS are often more anxious than normally fluent speakers. Although trait anxiety scores in PWS were higher they did not differ between the degrees of severity in a PWS. A difference was noted in social communication were severe stutterers had a higher level of anxiety than mild stutterers. This study supports the idea that anxiety, as a trait is characteristic of PWS. Overall it was noted that anxiety should be taken into consideration with those who stutter both as an inherent characteristic and also during therapeutic assessment.
Ezrati-Vinacour, R., Platzky, R., & Yairi, E. (2001). The young child's awareness of stuttering-like disfluency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 2, 368-380.
This article focused on the development of awareness of stuttering and the theoretical and clinical implications for early childhood stuttering. This study looked at normally fluent children, ages 3-7, in grades pre-school up to first grade. There were 79 children that were divided into five groups. Each group was asked to discriminate between the speech (fluent and disfluent) of two puppets, identify with one who speaks like them, and evaluate the disfluent and fluent speech of the puppets. The results indicated that at age 3, children do show evidence of awareness, but most reach full awareness by age 5. The clinical implications of this state that children who stutter probably possess the similar cognitive abilities. This finding questions the traditional assumptions that awareness of stuttering is lacking at ages at which it begins.
Felsenfeld, S. (1996). Progress and needs in the genetics of stuttering. JOURNAL OF FLUENCY DISORDERS, 21(2), 77-104.
This study investigated the analysis of behavioral genetic studies from 1960 - present, the genetic and neurological studies as a means to our understanding of stuttering, and presented suggestions for future genetic research. Topics discussed in the study included the collection of extensive family history, blood, neurochemical, chromosome, pedigree studies, segregation analysis, and twin studies. A standard battery of tests, family and epidemiological variables, extrinsic factors, genetic linkage analysis, and biological data were among the suggestions for future research considerations.
Fibiger, S., Peters, H. F. M., Euler, H. A., & Neumann, K. (2008). Health and human services for persons who stutter and education of logopedists in East-European countries. JOURNAL OF FLUENCY DISORDERS, 33, 66-71.
This article reported on the health and human services for people who stutter and the education and therapy standards of professionals in East-European countries. An English language questionnaire that focused on therapy of fluency disorders, services opportunities and education of speech-language pathologists was sent to professionals in East-European countries. Results from this questionnaire indicated therapy approaches which are favored in Western countries are also favored by East-European countries, children have more access to therapies than adults, therapies are free only for children, screening, early detection, and intervention programs are superior in development and implementation than in Western countries, efficacy and effectiveness measures are underdeveloped, and resources, information, and social support are deficient for adult persons who stutter.
Finn, P. (1997). Adults recovered from stuttering without formal treatment: perceptual assessment of speech normalcy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 40, 821-831.
This study was designed to determine if there were perceptual differences between the speech of normally fluent speakers and those speakers that indicated they recovered from stuttering without treatment. Fifteen adults who previously had a stuttering problem were compared with fifteen normally fluent speakers. Judges watched videotaped samples of each of the subjects' speech. The judges were asked to indicate whether the subject used to stutter or never stuttered. A separate group of judges were asked to document speech naturalness as observed in the subjects. Results revealed that the speech of unassisted recovered speakers was perceived as perceptually different. Differences in speech quality and an increased number of part-word repetitions differentiated the unassisted recovered speaker from the normally fluent speaker. However, the findings also suggest that for some speakers, unassisted recovery from stuttering results in speech that may be indistinguishable from normally fluent speech. The author suggests more research should be done including subjects that have recovered as a result of fluency therapy.
Finn, P. (2003). Addressing generalization and maintenance of stuttering treatment in the schools: A critical look. JOURNAL OF COMMUNICATION DISORDERS, 36 (2), 153-164.
The author addresses generalization and maintenance of stuttering treatment in schools to help school-based clinicians better prepare for the challenges of this setting. The current typical stuttering treatment approaches used in schools include direct and indirect methods for managing early childhood stuttering and stuttering modification and speech modification for managing persistent stuttering. It is difficult to generalize and maintain stuttering treatment gains in the school because of the influence of complicating factors, such as stuttering severity, the child's age when treated, and negative attitudes, and the fact that no accepted model of recovery exists (though the author suggests self-efficacy). Though further research is needed to fully evaluate their effectiveness for school settings, the author suggests the following strategies for promoting generalization and maintenance in schools: probing and training for generalization, incorporating real-life elements into therapy, and training clients to self-regulate their behavior.
Finn, P. (2003). Evidence-based treatment of stuttering: II. Clinical significance of Behavioral stuttering treatments. JOURNAL OF FLUENCY DISORDERS, 28, 209-218.
This article discussed clinical significance (meaningful change) in evidence-based treatment framework. There are three groups that determine clinical significance in treatment outcome. They are as follows: 1) clinicians and clinical researchers who are trying to administer and develop the most effective treatment approach, 2) clients who are seeking help for their problem, and 3) relevant others who have some interest in the treatment's outcome, such as parents, significant others, teachers, third-party payers, and employers. Each group measured clinical significance through various rating scales such as self-measurement evaluation, speech naturalness scale, and parent evaluations of child's stuttering.
Finn, Patrick. (2003). Self-regulation and the management of stuttering. SEMINARS IN SPEECH AND LANGUAGE, 24, 27-32.
Self-regulation is defined as the process in which individuals learn to direct and control their own behavior, thoughts, and feelings in order to manage or eliminate their stuttering. This article explains the theoretical aspects and main principles of self regulation which encompass goal setting, cue management, self monitoring and self evaluation. The roles of each are explained in the article. Self-regulation apparent implications for school speech and language pathologists. Therapy is a collaboration between client/clinician aimed at meeting the client's treatment goals.
Finn, P. & Cordes, A.K. (1997). Multicultural identification and treatment of stuttering: A continuing need for research. JOURNAL OF FLUENCY DISORDERS, 22(3): p219-236.
This article reviews the past, present , and future issues related to multicultural studies of stuttering. A history of multicultural approaches to stuttering is presented among Native American populations. Prevalence and Descriptions of stuttering among the United states as well as out side of the United states are also presented. The areas out side the United states that are touched on are European countries, African countries, Japan and Pacific Island populations. A section on current cultural issues in assessment and treatment of stuttering is also included. This section covers the areas of establishing the presence of a clinically significant problem, Describing the nature and severity of the person's stuttering, and determining the level of impact the stuttering behavior has on the individual. The last section contains good guidelines that a practicing clinician should constantly be thinking about and aware of as they service individuals who stutter.
Finn, P., Howard, R., & Kubala, R. (2005). Unassisted recovery from stuttering: Self-perceptions of current speech behaviors, attitudes, and feelings. JOURNAL OF FLUENCY DISORDERS, 30, 281-305.
This study focuses on systematically investigating spontaneously recovered speaker's self-reports to find the true extent of their recovery from stuttering. Fifteen participants who had recovered from stuttering without treatment described their speaking behaviors during a semi-structured, open-ended interview. Seven of the participants reported no stuttering behaviors, and eight reported the tendency to stutter occasionally. The purpose of the study was to compare the results from the two groups to see if their self perceptions made a difference in how fully recovered they were. The results showed that complete recovery from stuttering is possible, but although the participants who reported occasional stuttering may be partially recovered, there are key differences in their speech characteristics and their self perceptions from those that are fully recovered.
Finn, P., & Ingham, R.J. (1994). Stutterers' self-ratings of how natural speech sounds and feels. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 326-340.
The purpose of this study was to determine whether PWS are consistent in self-rating how natural speech sounds and feels. Also of interest was whether there are differences between PWS self- ratings of how natural speech sounds and feels when stopping and starting speech at random intervals. The results indicated that the subjects may produce satisfactory levels (76%) of self agreement when rating the naturalness of their recorded speech. While speaking, self agreement fell to 61% for how natural speech felt and to 62% for how natural speech sounded. Ratings of how speech sounded were based on perceptions of continuity, rhythm, and stuttering, while ratings of how speech felt were based on the ability to monitor the production of speech. Subjects reported that their usual speech felt more natural than any form of rhythmic speech even if frequency of stuttering was higher.
Fitch, J. & Batson, E. (1989). Hemispheric asymmetry of alpha wave suppression in stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 14, 47-55.
This study's purpose was to analyze differences in hemispheric alpha wave suppression between a population of stutterers and nonstutterers using different sensory modalities and types of stimuli using electroencephalogram (EEG). Twelve right-handed stuttering males, ages 10-15 years, were used as an experimental group and twelve right-handed aged-matched males that did not stutter were used as a control group. Asymmetry was not displayed by the non- stutterers as it was by the stutterers. There was a statistically significant difference in the alpha percentage in the right-hemisphere of the stutterers. The needs for additional studies are discussed.
Fitzgerald, J. E., Djurdjic, S. D., & Maguin, E. (1992). Assessment of sensitivity to interpersonal stress in stutterers. JOURNAL OF COMMUNICATION DISORDERS, 25, 31-42.
The WPS-R (Willoughby Personality Schedule-R) was given to adult Yugoslav stuttering males. Results of the WPS-R revealed American stutterers and Yugoslav stutters to be the same. Speech situation and word specific anxiety were studied. General anxiety was determined to moderate stuttering severity. Hypersensitivity to stutterers interpersonal stress is thought to be general anxiety for the stutterers. The stress is not one of "overwhelming anxiety" but is thought to occur along a continuum. Personality variables may serve to moderate and mediate speech fluency and the WPS-R may be a plausible tool for assessing anxiety and the role it plays in stuttering.
Floyd, J., Zebrowski, P. M., & Flamme, G. A. (2007). Stages of change and stuttering: A preliminary view. JOURNAL OF FLUENCY DISORDERS, 32, 95-120.
The stages of change model can help determine where a person is in the process of change. This is also known as the transtheoretical model. It explains the concept of intentional change, that behavior change is influenced by decision-making and the readiness to change is a key component to the process of change. The development of treatment is closely related to the patterns of intentional change. The six stages of change include: precontemplation, contemplation, preparation, action, maintenance, and termination. The purpose of this study was to determine whether the responses from a modified version of the Stages of Change Questionnaire would be similar to other clinical observations. Participants in the study were prompted to complete a questionnaire and mark whether they agree or disagree by using a 5-point rating scale. Each of the questions were related to the different stages of change. The results revealed that 26 of the 32 items were significantly related to the hypothesized stages.
Foundas, A. L., Bollich, A. M., Corey, D. M., Hurley, M., & Heilman, K. M. (2001). Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering. NEUROLOGY, 57, 207-215.
The purpose of this study was to learn more about the neurobiology of stuttering by studying the anatomy of speech-language areas in the brains of adults with persistent developmental stuttering (PDS) and controls through the use of MRI techniques. The authors hypothesized that participants with PDS would have more variations in the anatomy of speech-language areas in comparison to matched controls. Sixteen adults with PDS and 16 controls matched for writing hand, sex, age, and education were included in the study. The study revealed three significant findings: 1) size and asymmetry of the frontal speech-language areas did not differ between the groups, but specific frontal gyral variants differed between groups; 2) the planum temporale was larger in individuals in the PDS group, and planar asymmetry was reduced in magnitude; and 3) aberrant gyral patterns were more common in individuals with PDS.
Fosnot, S.M. (1993) Research design for examining treatment efficacy in fluency disorders. JOURNAL OF FLUENCY DISORDERS, 18, 221- 251.
This article presents theoretical background information as well as a longitudinal study on the efficacy of evaluation and treatment of preschool children with fluency disorders. Forty-six preschool children were evaluated treated, and followed over a 5 year period. A fluency precision model of treatment was utilized with 90.91% of the children remaining fluent during the 5 year follow-up period. A bi-directional, transactional observation/evaluation model is emphasized. A single-subject design was implemented to demonstrate how data can be collected on a young child who stutters.
Fox, P. T. (2003). Brain imaging in stuttering: where next? JOURNAL OF FLUENCY DISORDERS, 28, 265-272.
Brain functional imaging is having a significant impact on research in developmental stuttering. Tests such as the statistical parametric images (SPI) and the positron emission tomography (PET) are assessing the brain while the person is speaking. From this they are obtaining information about what is happening in the brain as the person is stuttering. The question they pose is where next? How do they use the information they've obtained from brain imaging to improve the research on stuttering. One way would be through structural imaging. This type of imaging would help discover the relationships between abnormalities of functional organization and developmental abnormalities of the brain structure. Another advancement that can be made is in genetics. Both functional and structural imaging could be used to obtain pedigree analyses and linkage mapping. By studying these genes we may be able to tell if a person is going to be a candidate for inheriting stuttering. A third area that needs more advancement is the neural system in order to explain how speech production is organized and also how it is executed. Also to learn why some people produce execution errors collectively termed stuttering and how fluency inductions and treatments achieve behavioral normalization. Finally, people with persistent developmental stuttering are good candidates for these imaging methods. Since this is a disorder in which the behaviors can be eliminated therefore brain images are able to be studied both before and after treatment. Also, people with persistent developmental stuttering serve as good models for neural systems and neural disorders, which not only brings benefits to them but also to other people with a wide range of brain disorders.
Franck, A.L., Jackson, R.A., Pimentel, J.T., & Greenwood, G.S. (2003). School-age children's perceptions of a person who stutters. JOURNAL OF FLUENCY DISORDERS, 28, 1-15.
The authors of this study sought to gain insight into the perceptions school-age children have of people who stutter. Specifically, this study examined whether the children's perceptions of people who stutter would differ from their perceptions of people who do not stutter. Additionally, the study looked at whether the children differentiated between personality and intelligence characteristics. Seventy-five 4th and 5th grade students between the ages of 9 and 11 years old participated in the study. Subjects viewed videos in their regular classrooms of people who were fluent or of people who stuttered. Later, the children rated the speakers on a 7-point rating scale of adjective pairs. Results indicated that the overall mean rating of the disfluent person on the videotape was more negative than the overall mean rating of the fluent person. No significant difference was found between ratings of personality and intelligence. These findings suggest that school age children may have a negative perception of people who stutter and this may be established by the 4th or 5th grade. Such findings support the idea of educating students and teachers about the nature of stuttering.
Franic, D. M. and Bothe, A. K. (2008). Psychometric evaluation of condition-specific instruments used to assess health-related quality of life, attitudes, and related constructs in stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 17, 60-80.
The purpose of this study was to review and evaluate ten instruments to determine if they could adequately measure the quality of life of PWS. The ten instruments were evaluated on "fifteen measurement standards related to conceptual model, reliability, validity, responsiveness, interpretability (norms), burden (respondent and administrative), depth and versatility". Results showed that no more than 8 of the 15 measurement criteria were met on any of the ten instruments. These results indicate that a stuttering specific health-related quality of life indicator still needs to be developed.
Franken, M., Boves, L., Peters, H., & Webster, R. (1992). Perceptual Evaluation of the Speech Before and After Fluency Shaping Stuttering Therapy. JOURNAL OF FLUENCY DISORDERS, 17, 4, 223- 242
This study investigated the Precision Fluency Shaping Program in order to gain insight as to the perceptual qualities of speech following therapy. Speech samples were made of 32 severe stutters before, after and 6 months post an intensive 4 week fluency shaping therapy. The samples were compared with speech samples of 20 non-stutters and rated on a 14 point scale by groups of untrained listeners. Results indicated that the speech of stutters was perceptually different from the non-stutters both pre and post therapy.
Franken, M. C., Boves, L., Peters, H. F.M., & Webster, R. L. (1995). Perceptual rating instrument for speech evaluation of stuttering treatment. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(2). 280-288.
This instrument can be used to assess the results of stuttering treatment, yielding a comprehensive and detailed summary of speech qualities including, articulation, phonation, pitch, loudness, naturalness. The analysis of psychometric characteristics and methodological processes with evaluation of stuttering instruments are also discussed.
Franken, M.J., Kielstra-Van der Schalk, C.J., & Boelens, H. (2005). Experimental treatment of early stuttering: A preliminary study. JOURNAL OF FLUENCY DISORDERS, 30 (3), 189-199.
In this study, the Lidcombe Program (LP) treatment and the Demands and Capacities Model (DCM) treatment, two treatments for stuttering in preschool-age children, were compared. Thirty families were randomly assigned to treatment groups (LP, n=15; or DCM, n=15), with equal number of boys in each group. The treatment was terminated after 12 weeks or earlier if certain criteria were met. The stuttering frequencies and severity ratings were obtained immediately before and after treatment. The stuttering frequencies and severity ratings were greatly reduced for both treatment groups and no differences were found between them. Most of the parents were cooperative and most parents continued to collect data after the treatment. No differences between the parents were found on scales that measured their satisfaction with the two treatment programs.
Franklin, D.E., Taylor, C.L., Hennessy, N. W., & Beilby, J.M.(2008). Investigating factors related to the effects of time out- on stuttering in adults. INTERNATIONAL JOURNAL OF LANGUAGE COMMUNICATION DISORDERS,43, 283-299
Researchers designed a study to investigate the effects of using the time out strategy with adults who stutter. The study included thirty participants who were placed in the _ time out_ group and thirty participants who were placed in the control group. The sixty participants had their speech analyzed during two twenty minute sessions. The members of the experimental group were instructed to cease talking when a red light was illuminated. Findings indicated that the time out strategy was effective in reducing stuttering behaviors. Research also suggested that the time out strategy was more effective for participants with a severe stutter.
Fukawa, T., Yoshioka, H., Ozawa, E., & Yoshida, S. (1988). Difference of susceptibility to delayed auditory feedback between stutterers and nonstutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 94-99.
This study describes a new index, the susceptibility to DAF between stutterers and nonstutterers. There were 40 stutterers and 40 nonstutterers, each tested using DAF for susceptibility while reading passages under amplified delay conditions. Results indicate that stutterers were more susceptible to DAF than nonstutterers. In the nonstutterers group, men were more susceptible than women, in the stutterers group there were no significant difference between men and women. Finally, men who stuttered were more susceptible to DAF than nonstuttering women. The overall investigation showed stutterers were more sensitive to DAF than nonstutterers. Stutterers tend to monitor and rely on auditory feedback for speech control more than nonstutterers
Furnham, A. & Davis, S. (2004). Involvement of social factors in stuttering: A review and assessment of current methodology. STAMMERING RESEARCH, 1, 112-122. http://www.stamres.psychol.ucl.ac.uk
Social factors and emotions play a key role in the development of stuttering. It is believed that the cause of stuttering is multi- dimensional and that social and emotional factors are one of the dimensions. The purpose of this article was to review previous research about the role of social factors in stuttering and to provide information to readers about the differing methods that can be used to assess the role of social factors in stuttering that are being utilized in social psychology. Factors that were focused on included intelligence, personality, attitudes, temperament, effects of bullying, self-esteem, and anxiety for preschool to adult-aged participants. Occupational influences were also addressed with adults. From conducting a review of the literature, authors found social and emotional factors to be a major component to the onset and persistence of stuttering.
Gabel, R. (2006). Effects of stuttering severity and therapy involvement on attitudes towards people who stutter. JOURNAL OF FLUENCY DISORDERS, 31, 216-277.
The purpose of this study was to investigate whether stuttering severity, the knowledge that a person who stutters was enrolled in therapy, and the combination of those factors will change the attitudes of individuals who do not stutter toward those who do. In a university setting, 260 students (ages 19 to 48) who were not people who stutter were given surveys with one of four scenarios. The four randomly assigned conditions included: a male who stutters severely and has chosen treatment to improve his stuttering, a male who stutters mildly and has chosen treatment to improve his stuttering, a male who stutters severely and has chosen not to seek treatment to improve his stuttering, and a male who stutters mildly and has chosen not to seek treatment to improve his stuttering. A significant effect was found for stuttering severity and therapy status individually; however, the interaction of the two factors was not found to be significant. The data support that people who stutter mildly are perceived more positively than those with greater severity, and people who attend therapy to improve their stuttering are perceived more positively than those who do not.
Gabel, R. M., Blood, G. W., Tellis, G. M., & Althouse, M. T. (2004). Measuring role entrapment of people who stutter. JOURNAL OF FLUENCY DISORDERS, 29, 27-49.
The purpose of this study was to explore vocational stereotypes and how PWS suffer from role entrapment. The Vocational Attitude Scale was used to assess 385-college student's attitudes toward appropriate employment choices for PWS and PWNS. The study used a traditional survey method to obtain information from the participants. The results indicated that PWS were less likely to be advised to perform 20 of the careers. Most of the 20 careers the PWS were advised not to perform were in the field of public speaking or customer relations (i.e. Attorney, minister). The career ranked third, that a PWS would not likely be advised to perform, was a speech- language pathologist.
Gabel, R.M., Hughes, S., & Daniels, D. (2008). Effects of stuttering severity and therapy involvement on role entrapment of people who stutter. JOURNAL OF FLUENCY DISORDERS, 41, 146-158.
This article analyzes whether undergraduate or graduate students' perceptions of stuttering affect the career choices of Person Who Stutters (PWS). The article also explores whether individuals who have varying levels of stuttering severity and therapy involvement affect perceptions of role entrapment. The Vocational Advice Scale was completed by the 260 student participants in order to examine role entrapment. Results of this study revealed that role entrapment related to career choice was not evident for PWS and that stuttering severity and therapy involvement did not improve the participants' attitudes towards those to stutter.
Gaines, N., Runyan, C., & Meyers, S. (1991). A comparison of young stutterers' fluency versus stuttered utterances on measures of length and complexity. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 37-42.
Twelve 4-6 year old children who stuttered were videotaped during a 10 minute free-play interaction with their mothers. The children's' sentences were transcribed and analyzed for length and grammatical complexity. Results showed that children stuttered on one of the first 3 words in sentences which were more complex. Information was given regarding clinical applications of these findings, both in therapy and at home.
Geetha, Y., Pratibha, K., Ashok, R., & Ravindra, Ravindra, S. (2000). Classification of childhood disfluencies using neural networks. JOURNAL OF FLUENCY DISORDERS, 25, 99-117.
The article discusses one way to distinguish between the normal nonfluency (NNF) of childhood and stuttering. Ten data variables from two groups of disfluent children who were less than 6 years old, were gathered in an attempt to differentiate between children with NNF and children who stuttered (CWS). Group I data, from 25 children, was used to train the computer program, called Artificial Neural Network (ANN). Group II data, of 26 children, predicted the diagnosis. The ANN predicted with 92% accuracy, the different classes of children with NNF and CWS. In an attempt to use diagnostic procedures objectively with stuttering, ANN can be a helpful tool.
Georgieva, D. (2006). The treatment of fluency disorders: Experience in Bulgaria. Recent history and contemporary issues. BULGARIAN JOURNAL OF COMMUNICATION DISORDERS, 1, page 66-78.
This study focuses on the periods of speech and language development (logopedics), with emphasis on fluency, in Bulgaria. Contemporary therapies regarding stuttering are comprised of eclectic approaches that idolize fluency shaping techniques. Although they are currently used by SLPs in Bulgaria; stuttering modification, management, desensitization, and counseling are the least preferred methods of treatment. Bulgaria has not yet begun any support groups for people who stutter.
Georgieva, D., and Miliev, D. (1996). Differential diagnosis of cluttering and stuttering in Bulgaria. JOURNAL OF FLUENCY DISORDERS 21, 249-260.
This study was done to show the prevalence of cluttering, stuttering and mixed cluttering and stuttering in young clients often referred to as stutterers. The 15 subjects participating in this study all with fluency disorders were involved in a series of diagnostic evaluations. Results according to the Bulgarian system, showed five clutterers, six stutterers and four mixed clutterers and stutterers. Four case studies are also presented to demonstrate how the criteria can be used. The article also compares Daly's Checklist with the Bulgarian system. Georgieva, D., Simonska, M., (2006). Evidence-based practice in stuttering in Bulgaria: First steps. BULGARIAN JOURNAL OF COMMUNICATION DISORDERS, 1, 55-66.
This journal article examines current evidence based practice (EBP) techniques and procedures in Bulgaria in regards to Logopedics. Specifically, it focuses on the evaluation procedures and its effectiveness. The treatment protocol was based on Tcheveleva's therapy program for disfluent children consisting of fluency shaping techniques including soft contact, easy onset and prolonged speech. The main steps in the therapy process included: 1) propaedeutics, 2) accompanying, 3) finalized, 4) planned and 5) stabilized. Eight children who stutter were involved in the 9 month program. Results of this program showed that disfluency was remarkably reduced in one group, and the rate of speech (SR) and stuttering severity rating (SSR) was reduced in the second group but disfluency was not totally eliminated.
GianPietro, S., Giovanni, A.C., D'Onofrio, M., Deriu, M.G., & Rosati, G. (2006) Disfluent speech in patients with partial epilepsy: beneficial effect of levetiracetam. EPILEPSY & BEHAVIOR, 9:521-523.
Several antiepileptic drugs including gabapentin (GPT), topiramate (TPM), phenytoin (PHT), and lamotrigine (LTG) have been suggested to induce stuttering in individualÕs with epilepsy, while only a few (i.e. levetiracetam (LEV) and divalproex sodium (VPA)) have been known to reduce disfluencies. This study evaluates the effects of levetiracetam in five individuals with partial epilepsy and disfluent speech. Results showed LEV increased the rate of fluency in the participants with partial epilepsy and disfluent speech.
Gilman, M., & Yaruss, J. (2000). Stuttering and relaxation: applications for somatic education in stuttering treatment. JOURNAL OF FLUENCY DISORDERS, 25, 59-76.
This article reviews the history of the use of relaxation techniques in stuttering treatment approaches. The article views relaxation as a dynamic and active process rather than a passive process and it states that somatic education during stuttering treatment may facilitate the habituation of relaxation techniques outside of the treatment setting. The terms active and passive relaxation are described in detail and examples of each are given. The presumed benefits of somatic education are discussed.
Goberman, A.M., & Blomgren, M. (2003). Parkinsonian speech disfluencies: effects of L-dopa-related fluctuation. JOURNAL OF FLUENCY DISORDERS, 28, 55-70.
This study investigated the speech characteristics of patients with Parkinson's disease under 3 conditions: before morning dose of L-dopa medication, 1 hour after medication, and 2 hours after medication. The basis for the study lies in the excess dopamine theory of stuttering. Nine patients at the University of Connecticut Health Center participated in the study. Subjects were between the ages of 51 and 86 years old and were between 3 and 19 years post-diagnosis of having Parkinson's disease. All subjects had experienced motor fluctuations related to their medication. Audio recordings of patients reading the Rainbow Passage and a 3 '5 minute monologue of each patient were used to gather data. Each session was conducted on a morning after the subjects had not taken the medication for at least 8 hours the night before. Results showed that 8 of the 9 patients were most impaired prior to taking any of the medication. Additionally, 8 of the 9 patients were least impaired 1 hour after taking the medication. There was no overall group change in disfluency levels related to low or high dopamine levels. The authors concluded that speech disfluencies might be related to decrease or increase of dopamine levels in the brain.
Godinho, T., Ingham, R.J., Davidow, J., Cotton, J. (2006). The distribution of phonated intervals in the speech of individuals who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 49, 161-171.
This study examines phonated intervals (PIs) in the speech of people who stutter (PWS). A group of adolescents and adults who stutter were compared to a gender and age matched control group of subjects with normal speech on an oral reading task. During the oral reading activity, it was shown that PWS have a similar PI distribution to individuals in the control group. Rate of speech and the number of PIs produced during the reading task did differ between the two groups. However, results from this study suggest phonation patterns in PWS do not constitute an underlying relationship to the presence of stuttering behaviors.
Gordon, PA. & Luper, HL. (1989) Speech disfluencies in nonstutterers: Syntactic complexity and production task effects. JOURNAL OF FLUENCY DISORDERS, 14, 429-445.
This study investigated the relationship between syntactic difficulty and normal disfluencies. Sentence imitation and modeling tasks were performed by 3, 5, and 7 year old children, who did not stutter. Each task took place with three levels of syntactic complexity (affirmative declarative, future and passive). The study found an increase in disfluencies correlated with: younger age, increased syntactic complexity and task difficulty. Passive sentences were the most disfluent, with the affirmative declarative and future tense eliciting equal numbers of disfluencies. Sentence modeling, with use of picture stimuli, elicited more disfluencies than sentence imitation.
Gordan, P.A., & Luper, H.L. (1992). The early identification of beginning stuttering I: Protocols. AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY: A JOURNAL OF CLINICAL PRACTICE, 1, 43-53.
In this tutorial, a reviewer of six protocols designed to differentiate between incipient stuttering and normal disfluencies. The general format and criteria, clinical data collection procedures, documentation, and relative use of quantification in six protocols were examined and discussed. The advantages and problems in the use of diagnostic protocols for children that need treatment were presented in a forthcoming article.
Gordon, P.A., & Luper, H.L. (1992). The early identification of beginning stuttering II: Problems. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY: JOURNAL OF CLINICAL PRACTICE, 1(4), 21-27.
This article addresses questions about the weaknesses and strengths of protocols and considerations when using a protocol. Decreasing the possibility of false positives and false negatives, consider spontaneous recovery, obtaining a representative speech sample, consider quantification issues, and examining reliability and validity of the protocols are solutions to the problems of protocols. Advantages and disadvantages of differential diagnosis protocols are also addressed.
Gordon, P., Luper, H., & Peterson, H. (1986). The effects of syntactic complexity on the occurrence of disfluencies in 5 year old nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 151-164.
This study focused on how syntactic complexity correlates with the amount of disfluencies in speakers who are 5 years old and do not stutter. Sixteen 5 year olds who had average language skills were included in this study. Their speech was analyzed during sentence imitation tasks and through sentence modeling. An example of sentence- modeling is the examiner looking at a picture and saying "the dog is chasing the cat," and the subject would then look at a different picture and say "the man is painting the fence." Interjections, part-word repetitions, whole-word repetitions, phrase repetitions, revisions, incomplete phrases, dysrhythmic phonation, and tense or inappropriate pauses were counted as disfluencies. Results showed a large difference between the number of disfluencies on the sentence imitation task and the sentence-modeling task. More disfluencies occurred on the sentence-modeling task.
Gottwald, S. R., & Starkweather, C.W. (1995). Fluency intervention for preschoolers and their families in the public schools. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 26, 117-121.
This article describes a fluency therapy program for preschoolers based on Starkweather's Demands and Capacities Model. This approach focuses heavily on educating and counseling the parents and teachers of the child in order to align the communicative demands with the communicative capacities of the child. These capacities are assessed in a thorough speech and language assessment. Then, the parents and teachers are educated on speech and stuttering, attitude change and behavior change. The clinician interacts at the syntactic and language level of the child to enhance fluency. Two intervention programs are discussed; speech modification and fluency shaping. In either program, the complexity of the communication advances at a pace set by the child while following the prescribed procedures. As the child progresses, the issues of transfer, termination and follow-up are discussed.
Gow, M.L., & Ingham, R.J. (1992). Modifying electroglottograph- identified intervals of phonation: The effect on stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 495-511.
Electroglottograph-identified intervals of phonation were measured using a computer-assisted biofeedback system. An adolescent and an adult male who stuttered demonstrated that their stuttering could be controlled by modifying the frequency of phonation intervals within short duration ranges. The findings were demonstrated to be independent of changes in the speaking rate, or alterations to other intervals of phonation, and produced little disruption to speech naturalness.
Gregg, B. A., & Yairi, E. (2006). Phonological skills and disfluency levels in preschool children who stutter. JOURNAL OF COMMUNICATION DISORDERS, 40, 97-115.
This study examined the link between stuttering and phonological skills. Children who stutter are much more likely to have a co-occurring phonological delay then those who do not stutter. This study examines the link between the severity of stuttering and phonological disorders. Two groups of children were included, those whose stuttering was considered severe, and those whose stuttering was considered mild. Both groups had a recent onset of stuttering, parent diagnosis and an SLP diagnosis. Both groups were very closely matched in age and gender. Both groups were analyzed for stuttering severity as well as phonological deviation. This study was found to validate previous studies as it found little correlation between stuttering severity and phonological skill.
Gregory, H.H. (1993). A clinician's perspective: comments on identification of stuttering, prevention, and early intervention. JOURNAL OF FLUENCY DISORDERS, 18 (4), 389-402.
Response to Curt Hamre's (1992) article concerning the identification and prevention of stuttering. A review of research findings is included that provides a frame of reference for Gregory's Continuum of Disfluent Speech. Included is information on Prevention an Intervention, the Diagnosogenic Theory, Bloodstein's Contributions, and the Loss of Control and Stuttering.
Gregory, H. H. (1995). Analysis and commentary, LANGUAGE SPEECH AND HEARING SERVICES IN THE SCHOOLS, 26 (2), 196-200.
This article is a summary of the articles presented in the entire issue. It is observed that therapy models for stuttering are being based on research and clinical observation more than in the past. All of the articles presented addressed the issue of attitude; both in the child and the parent, along with counseling as an integral part of therapy. Concomitant problems and the nature and treatment of cluttering were also presented in this collection of articles. Transfer and follow-up were recognized as necessary parts of effective therapy. Service delivery models were discussed by the contributing authors. Clinical skills were recognized as being inadequately developed among students. Gregory addressed the urgent need for more thorough clinical preparation within speech pathology educational programs.
Greiner, JR., Fitzgerald, HE., & Cooke, PA. (1986). Speech fluency and hand performance on a sequential tapping task in left and right handed stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 55-69.
The purpose of this study was to examine the differences in hemispheric functioning in right and left handed stutterers and nonstutterers. Twenty adult stutterers (15 right handed, 5 left handed) and twenty adult nonstutterers (15 right handed, 5 left handed) were asked to complete four tasks: finger tapping, tapping and spontaneous speech, tapping and reading, and tapping while singing. Results indicate that stutterers seem to have differences related to temporal regulation in the right hemisphere. The study also supports the belief that individuals who are left handed have a strong tendency for bilateral organization in the brain.
Grinager Ambrose, N. & Yairi, E. (1999). Normative Disfluency Data for Early Childhood Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 42, 4, 895-909
The basis of this article is a research study conducted to establish an adequate normative reference to help in providing information on differential diagnosis of stuttering from non-stuttering. Study consisted of 90 stuttering children (ages 2-5 years) and 54 non-stuttering children (ages 2-5 years). Results of study found that early on, all children exhibit disfluent patterns at some time. Age and gender of child did not play a significant role in any situation. It also does not indicate that child at early age with disfluencies should not be considered for evaluation This study offers a normative reference for parents and clinicians in guidance through the earlier stages of stuttering.
Grube, M. M. & Smith, D. S. (1989). Paralinguistic intonation-rhythm intervention with a developmental stutterer. JOURNAL OF FLUENCY DISORDERS, 14(3), 185-208.
This study examined the effects of teaching paralinguistic rules to a disfluent child. The theory behind the study is that children who stutter don't know these rules, and if they can be taught the rules when they are young they will become part of the child's speaking repertoire. The researchers chose to focus on intonation as the paralinguistic skill in this study. The subject was a 5-year-old boy who stuttered. This therapy combined motor movements of the body with different intonation patterns. The use of movement was gradually introduced and eventually phased out. The therapy also included the use of auditory training before and after each session. The results showed decreases in all types of disfluencies produced by the child as well as a decrease in his word finding difficulties. These decreases continued even after therapy was discontinued. The researchers provide compelling evidence that more research should be done in this area.
Guitar, B. (1982). Fluency shaping with young stutterers. JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS, 6, 50-59.
This article introduces steps needed to teach a child to use slow, normal-sounding speech where stuttering might otherwise occur. Case selection is discussed with mention that children without much fear, shame, or embarrassment are best candidates for fluency shaping. Traditional measures of recording baseline and probe presentation are mentioned. Also included are successful fluency- inducing stimuli such as clapping or a metronome or one-word utterances shaped into longer utterances. Arrangement of a hierarchy to take the child from a slowly uttered word to conversation in daily life is mentioned. Suggestion of a token reward system is given as are concrete ideas (i.e. use of picture cards) for establishing fluency. Gradual transfer of fluency is then supported with long-term contact suggested with a child to enforce maintenance.
Guitar, B. (2003). Acoustic startle responses and temperament in individuals who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 233-241.
The purpose of this research study was to compare the acoustic startle response as one assessment of temperament between adults who stutter and adults who do not stutter. The study included 14 adults who stutter and 14 adults who do not stutter. Procedures for the study included a hearing screening, presentation of 10 bursts of white noise, a 2- minute conversation, and a 200-syllable passage reading. Results of the study found significantly greater eyeblink responses in the stuttering group, as compared to the nonstuttering group. These results suggest that the temperament of people who stutter may be more reactive than the temperament of people who do not stutter.
Guitar, B., Guitar, C., Neilson, P., O'Dwyer, N., & Andrews, G. (1988). Onset sequencing of selected lip muscles in stutterers and nonstutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 28-35.
Electromyography (EMG) was used to examine the lip muscle activity during speech production of initial /p/ words of stutterers and fluent speakers. There was a difference between persons who stutter and fluent speakers in which muscle was activated first for the production of initial /p/, especially during stuttering. The difference in muscle activity could be attributed to mistiming or to a physiologic anxiety reflex before a stuttering event.
Guitar, B., & Marchinkoski, L. (2001). Influence of mother's slower speech on their children's speech rate. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 4, 853-861.
This study looked at the affects on children's speech rates when their mothers slowed their rate of speech. The subjects included six mothers and six children (3 boys and 3 girls) between the ages of 3 and 4 who were considered normal speakers. The subjects were recorded during normal play and conversation in four 10-mintue segments completed within one session. The results found that in five of the six cases, the children decreased their rate of speech when their mothers decreased their speech rates. It is important to note that if these findings were to be applied to children who stutter, it must be considered whether those mothers must reduce their rates dramatically and consistently to influence their child's fluency.
Guitar, B., Schaefer, H., Donahue-Kilburg, G., & Bond, L. (1992). Parental verbal interactions and speech rate: A case study in stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 742-754.
This study is based on the idea that parent-child interaction is an integral part of the environment of a child who stutters. The purpose of the study was to investigate how the parent's behaviors and the child's stuttering changed with therapy. The study was divided into two parts. The results indicated that the mother's speech rate was significantly correlated with the child's stuttering. The study also divided the child's stuttering into primary and secondary. It was found that mother's speech rate and percent of talk time were correlates of primary stuttering but these did not effect secondary.
Haasler, S. K., & Hulit, L. M. (1989). Influence of suggestion of the nonfluencies of normal speakers. JOURNAL OF FLUENCY DISORDERS, 14, 5, 359-369.
The purpose of this study was to determine if normal speakers could become disfluent with the suggestion of difficulty. The study looked at the affect of suggestion of difficulty in normal speakers. They took 60 normal-speaking adult males and had them read three tongue twisters. The subjects had to read them under six conditions from "easy" to "extremely difficult" and "extremely difficulty" to "easy". Suggestions of difficulty were offered to the subjects both orally and in print. The suggestion did not affect rates of fluency. Also, the tongue twisters did not consistently generate disfluencies. Though the reading passages they were approximately equal in length, the reading times were not equal. The study concluded with a discussion as to possible reasons why the rates of disfluency were not affected by the suggestion of difficulty.
Hadden K.B., Skinner R.D., Wall P.T., Metzer W.S., Drummond S.S. (1997). Application of nonlinear methods for analyzing rate of speech production. JOURNAL OF FLUENCY DISORDERS, 22, 205-217.
The purpose of this study was to gather information in the variability of speaking rates through the use of nonlinear methods. When using nonlinear methods you are able to plot points and results on a graph which lets us visualize the results as regularities or irregularities. The only subject was a 28-year old man. There were four experimental procedures, Spontaneous Speaking Rate, Auditory-Click Controlled Spontaneous Rate, Auditory-Click Controlled Accelerated Rate and Auditory-Click Controlled Accelerated Rate + Tone-Burst at Spontaneous Rate. In all of the experiments the subject was asked to repeat the word "pop-pop" for a total of 1050 productions per test. After the subject had completed 21 repetitions he was allowed a one minute resting period in order to coordinate respiratory and speech performances. The data was plotted sequentially in phase plots and analyzed for regularities. The findings of this study confirm that nonlinear techniques may be useful in observing the qualitative changes in fluency disorders.
Hageman, CF., & Greene, PN. (1989). Auditory comprehension of stutterers on a competing message task. JOURNAL OF FLUENCY DISORDERS, 14, 109-120.
The focus of this study was the auditory processing abilities of stutterers versus nonstutterers. One of the theories of the cause of stuttering involves deficits in auditory processing. Previous research has produced evidence to suggest that there is a difference in auditory processing in people who stutter. The purpose of this study was "to quantify and describe the auditory processing skills of listeners who stutter as compared to listeners who do not stutter in order to more clearly define the level of CAP disfunction in stutterers" (p. 111). The experimenters used the Revised Token Test (RTT) and the adapted competing message RTT (ARTT) to test their subjects. The data were analyzed quantitatively by completing a one- way analysis of variance and qualitatively by reporting pattern predominance as a percentage of occurrence. Results revealed that stutterers and normal speakers differed significantly quantitatively on the ARTT. However, results did not show a significant difference qualitatively. These results suggest that stutterers do not process information differently than nonstutterers. The findings suggest that stutterers are less efficient in their auditory processing abilities.
Hagstrom, F., & Daniels, D. E. (2004). Social identity and the stuttering experience. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS. 31, 215-224.
This article illustrates the need to address personal perspective and social identity when working with people who stutter. Working with social identity in the clinical setting can offer new ways to think about challenges that confront clients and clinicians. The authors reflect that personal identity is the link to the origins of personality, and the ways individuals deal with emotions, feelings, and self concept.
Hakim, H.B., & Ratner, NB. (2004). Nonword repetition abilities of children who stutter: An exploratory study. JOURNAL OF FLUENCY DISORDERS, 29, 179-199.
This is an exploratory study that examines the performance of eight children who stutter (CWS) and eight normally developing children (ND) on tests of nonword repetitions of increasing length, of increasing syntactic complexity, and of variation in lexical stress differing from English-like stress. Nonword repetition is considered a more sensitive measure of children's linguistic abilities than the results of standardized diagnostic inventories that identify language impairments. The CWS performed more poorly than the ND children on measures of Number of Words Correct and Number of Phoneme Errors at all nonword lengths and on measures of lexical stress variations in nonwords. The fluency for the CWS group did not change systematically with increasing nonword length. The conclusion is that the CWS may have diminished ability to remember and/or reproduce novel phonological sequences and further investigation may shed light on the emergence and characteristics of childhood stuttering.
Hall, N. E. (1996). Language and fluency in child language disorders Changes over time JOURNAL OF FLUENCY DISORDERS, 21, 1-32.
This study examines language and fluency overtime in children with language disorders in attempts to answer the following two questions: Do preschool children with language disorders identified as exhibiting increased disfluencies continue to present greater frequencies of disfluencies than would be expected at school-age? and Do changes in language skills overtime (specifically profiles of linguistic abilities) relate to changes in fluency skills? Sixty children between the ages of 3:0 and 5:11 were studied and, in answer to question one, it was found that children with language disorders, although diminishing in frequency, exhibit higher rates or disfluencies that often become increasingly stuttering-like. Although inconclusive, the author states that fluctuations in fluency likely signal changes in language skills.
Hall, KD., Amir, O., & Yairi, E. (1999). A longitudinal investigation of speaking rate in preschool children who stutter. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 42, 1367-1377.
Three groups of preschool children had language samples evaluated for articulation rate, over a two year period (three samples, 12 months apart). All children increased rate between first and second sample, with no significant increase between the second and third sample. The children who stuttered made two groups: recovered and persistently stuttering, and the control consisted of normally fluent children. The control group spoke with a faster rate (phones/second) than either stuttering group. The recovered group spoke significantly more slowly for all three samples. Rate was also measured in syllables / second, but results were similar for all three groups. The samples used only fluent segments of speech, without artificial manipulation. The results support previous studies which indicate a slower rate enhances fluency.
Hall, N. E., & Burgess, S. D. (2000). Exploring developmental changes in fluency as related to language acquisition. JOURNAL OF FLUENCY DISORDERS, 25, 119-141.
This one-year case study traced the fluency development in the context of language acquisition of a preschooler. Analyses of fluency, semantic, syntactic, pragmatic, and phonological behaviors were conducted on spontaneous speech and language samples taken every 4-months. Changes in fluency that often accompany changes in language behaviors are described. Clever procedures for examining fluency and language are outlined. Guidance for improving the study of linguistic interaction in speech and language development is provided.
Hall, D., Lynn, J., Altieri, J., Segers, V., & Conti, D. (1987). Inter-intrajudge reliability of the stuttering severity instrument. JOURNAL OF FLUENCY DISORDERS, 12, 167-173.
The purpose of this study is to extend and clarify the interobserver reliability of the Stuttering Severity Instrument (SSI), as well as provide estimates of intraobserver reliability. Intra- and interjudge reliability were measured for two stutterers using the SSI as scored by nine judges. The judges viewed and scored each subject individually or in groups of two or three on a RCA video monitor. After one week's time, judges again viewed each stutterer and scored them using the SSI procedures. Results indicate good intrajudge reliability, but call interjudge reliability into question. Judges did tend to rate the stutterers as having different severities, however the relatively poor interjudge agreement suggests the need for extreme caution when interpreting SSI scores. It would appear that judges are in good agreement only when evaluating very mild (and, perhaps very severe) stuttering. The relatively high intrajudge agreement suggests that judges are able to maintain stable ratings over time.
Hall, K., & Yaira, E. (1992). Fundamental frequency, jitter and shimmer in preschoolers who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 1002-1007.
The purpose of this study was to compare speaking fundamental frequency, jitter and shimmer in fluent utterances of children who stutter to children who do not stutter. The results showed that the children who stutter had significantly higher amounts of vocal shimmer perturbations in fluent speech than did children who did not stutter. There was no difference in fundamental frequency or jitter between the children who stutter and nonstuttering children.
Hall, N. E. (2004). Lexical Development and Retrieval in Treating Children Who Stutter. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35 (1) 57-70.
This article reviews literature on lexical development in children and also describes the process of acquiring lexical items in stuttering by looking at three aspects, (1) how children learn words, (2) the relationship between lexical and syntactic development and the emergence of disfluencies in typically developing children, and (3) what is known about these phenomena in children who stutter (CWS). The role of linguistics "trade-offs" or dysynchronies in language skills during the possible onset and development of stuttering are also discussed in the relationship between lexical development and disfluencies. In conclusion the article throws light on the on treatment of stuttering based on the cases studies and the interaction between fluency and language.
Ham, RE. (1988). Unison speech and rate control therapy. JOURNAL OF FLUENCY DISORDERS, 13, 115-126.
This therapy program is a rate/prosody control program. It was developed for use by clinicians that lack access to instrumentation and to develop a consistent, reusable stimuli resource. It can be used in most therapy settings including preschool aged and group therapy. A rate/prosody control therapy using unison speech as the method to impose a desired speech rate and pattern of production. This method simply requires audiotape cassettes along with clinician modeled unison speech. Stimulus materials, procedures, and treatment phases are outlined.
Ham, R., (1989). What are we measuring? JOURNAL OF FLUENCY DISORDERS, 14, 231-243.
This study was conducted to find out what specific stuttering behaviors are being measured and what practices are used while measuring stuttering. Professional, published clinicians were surveyed by questionnaire to address how they personally assess stuttering spasms, stuttering avoidance behaviors, the criteria used in word/syllable counting, and speech models selected for measurement. It was found that a majority of the participants did measure some common core behaviors and did follow similar procedures, but overall the way clinicians measure stuttering is just as unclear as every other aspect of stuttering.
Ham, R. (1992). I know the chapter, but what's the verse? JOURNAL OF FLUENCY DISORDERS, 17, 39-41.
This article is a critical commentary of an article presented by Hamre. The author criticizes Hamre's chain of logic and system of proof, which the author found highly selective and often to be interpreted unidimensionally. The author agrees with Hamre's contentions that identification of stuttering is not as practically difficult as some people think, and that stuttering does not necessarily develop from normal disfluencies. However, the author suggests that we also have the ability to identify behaviors that are nonstuttering. The author also provides evidence that lay persons do not always use basic level effects such as prolongations to categorize stuttering. He further disputes Hamre's position that stuttering simply "is", since it does not suggest how stuttering does occur, and ignores the fact that stuttering may sometimes develop from normal disfluencies in some people. The author criticizes Hamre's discussion of covert stuttering as a red herring, and suggests that stuttering ranges in its covert characteristics for different individuals.
Ham, R. (1992). Response to "Stuttering prevention II:" Deja vu, again. JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 87-88.
This is a commentary by Richard Ham in response to Curt Hamre's article Stuttering Prevention II: Progression which is contained in this same issue. Ham sums up Hamre's article as containing information that is dated and professes that Hamre does not suggest any changes that are new.
Ham, R. (1995). Treating disordered speech motor control: For clinicians by clinicians Vogel, D. and Cannito, M. P. (Eds.), (1991). Austin, TX: Pro-ed. JOURNAL OF FLUENCY DISORDERS, 20(1).77-80.
Although the reviewer makes some criticisms of the text book, he suggests that the book be used by those for whom neuromotor and neurosymbolic disorders are of interest, as well as those who work with stutterers. He says the chapters are informative, generally clear, and contain many informative aspects important to the student, teacher, or clinician. He believes the entire book is well worth reading.
Ham, R. E. (2002). Book review. [Review of the book Foundations of stuttering] JOURNAL OF FLUENCY DISORDERS, 27, 353-355.
Included in Wingate's book are numerous chapters describing the history, statistics, definitions, and symptoms associated with stuttering. It gives insight into facts and concepts regarding stuttering. Wingate describes the process involved in normal speech production and compares it with that of people who stutter. He touches on the neurological aspect of stuttering, and finally on therapy techniques for people who stutter. The book is filled with many valuable insights, but the reader needs to be open minded to opinions outside the book. It would not be a good book to use for therapy ideas, but may serve as a good reference book.
Ham, R., & Holbrook, A. (1986). Oral/manual motor reaction times and delayed auditory feedback disturbances among normally speaking females. JOURNAL OF FLUENCY DISORDERS, 11, 117-129.
This research looked at normal speaking female's reaction time in correlation with the DAF (delayed auditory feedback) instrument. Thirty-nine females participated in the study. All had normal hearing, no neurological problems, none were taking any medication, and no one had used the DAF instrument before. It should also be noted that none of the subjects were dextral in handedness or had athletic scholarships. Reaction times for both oral and motor aspects were studied. The subject's ability to read a standardized passage while using the DAF instrument was also tested. The study focused on if there was any correlation between the number of speaking errors while using the DAF instrument and the subject's oral and motor reaction times. People who had faster oral and motor reaction times did tend to have more speaking errors while using the DAF instrument. However, no significant correlation was made.
Hammond, K., & Leikin, J. B. (2008). Topical pyrethrin toxicity to acute-onset stuttering In a toddler. AMERICAN JOURNAL OF THERAPEUTICS, 15, 323-324.
Hammond and Leikin report on a case of a two year old girl who had multiple exposures to topical pyrethrin for head lice within a short period of time. The chief complaint after the repeated exposure to topical pyrethrin was general clumsiness and acute stuttering that resolved after a brief period of time. The authors discuss the two different types of pyrethrin extracts, type I and type II, and further discuss the variables of this particular case that may have led to the acute onset of stuttering in the toddler.
Hamre, C. (1992). Stuttering prototypes: another look. JOURNAL OF FLUENCY DISORDERS, 17, 141-150.
The author suggests stuttering be placed not in a classical category, but in a prototypic category, where categories are placed in one or more dimensions of a continuum. He does not feel this continuity hypothesis has been disproved. This has proven boundaries of categories are being fixed, no category members are better than others, the discrimination between categories is done automatically, and infants are able to discriminate between categories equally as well as adults. He identifies several studies that he feels are consistent with his claims that Curlee, his critic feels are not and defends them. The author defends his position that stuttering should be placed on the same continuum as normal disfluencies (ND), but that each should be placed in different categories. He admits to being confused about the difference between diagnosogenic (DG) and the continuity hypothesis (CH), but does not feel lonely. He explains the role of the environment regarding stuttering acquisition to colleagues confused about his position in the issue. He clarifies his understanding of primary prevention when criticized for including the Temple Program as part of it. Finally, Hamre admits stuttering needs to be treated, but that no means of preventing it are available.
Hamre, C. (1992). Stuttering prevention I: Primacy of identification. JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 3-23.
The article critically evaluates information relating to the difficult distinctions between stuttering and normal disfluencies found in children. The author evaluates the diagnosogenic and continuity hypotheses (Iowa school) and argues that they are invalid. The author maintains that stuttering is qualitatively different from other disorders and parents can differentiate between normal disfluencies and stuttering. Hamre believes that a treatment construct should replace the prevention construct.
Hamre, C. (1992). Stuttering prevention II: Progression. JOURNAL OF FLUENCY DISORDERS, 17, 63-79.
This article is part two of a discussion on stuttering prevention. Hamre provides evidence that stuttering does not grow out of a period of normal disfluency in childhood, and suggests that stuttering is categorically different from fluency. He discusses ASHA's positions on primary, secondary, and tertiary prevention in relation to stuttering. He disputes the ideas of diagnosogenic theory or progression from normal disfluency as causes of stuttering. He further provides evidence that stuttering does not increase gradually over time. Therefore, he suggests that the concepts of primary and secondary prevention are not applicable since preventing stuttering (primary) and "catching" stuttering early (secondary) are not relevant. He argues that normal disfluencies are a normal part of adult speech, whereas stuttering typically declines or disappears after childhood. Overall, he suggests that while future research may help determine primary prevention strategies, current knowledge allows us to simply recommend treatment for children who stutter because we cannot predict which children will overcome it on their own, and it is much easier to show young children how to talk easily than to do so for children who have stuttered a year or more.
Hancock, K. & Craig, A. (1998). Predictors of stuttering relapse one year following treatment for children aged 9 to 14 years. JOURNAL OF FLUENCY DISORDERS, 23, 31-48.
Currently there is very little research into relapse of stuttering following therapy in children and adolescents. The purpose of this study was to establish specific predictors which might identify those children who will relapse after stuttering treatment. When determined, this information would be very valuable so remedial action can be taken before a relapse occurs. Maintenance therapy could be more intensive and continue for longer periods for those who show early predictors of relapse. This study found two measures which may predict relapse: pretreatment percent syllables stuttered and immediate post-treatment trait anxiety. The authors suggest further research should also include ratings of communicative attitudes.
Hancock, K., A. Craig, C, NcCready A, McCaul D, Costello, K. Campbell, and G. Gilmore (1998). Two-to Six-Year Controlled-Trial Stuttering Outcomes for Children and Adolescents. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 1242-1252.
This study looks at the effectiveness of 3 stuttering treatments: intensive smooth speech, parent-home smooth speech, and intensive electromyography feedback. The purpose of this study was to see if treatment gains at 12 months following therapy for stuttering was maintained 2 to 6 years later. In all three types of stuttering treatment, the majority of subjects maintained their treatment gains long-term.
Hanrahan, L., Inouye, L., Langlois, A. (1986). A comparison of interactions between stuttering children, nonstuttering children, and their mothers. JOURNAL OF FLUENCY DISORDERS, 11, 263-273.
The motivation for this study was to identify patterns of interactions between the mothers of children who stutter and the mothers of children who do not stutter. Another important focus was if mothers verbal communication affects the child's communication abilities regardless of presence of disability. Eight children who stutter, eight children who do not stutter, and the mothers were observed in the personal homes and audio taped. The results provided that mothers of children who stutter may place more communication pressure on the children. For example, mothers of children who stutter asked more questions-placing more demands on the child. Findings supported that stuttering is related to environmental demands and stress.
Hardin, C., Pindzola, R., & Haynes, W. (1992). A Tachistoscopic Study of Hemispheric Processing in Stuttering and Non-stuttering Children. JOURNAL OF FLUENCY DISORDERS, 17, 4. 265-281
This study investigated hemispheric processing in 20 children, 10 stutterers and 10 non-stutterers. Linguistic and non linguistic stimuli were presented to the left and right visual fields. Results found that no differences existed in the subjects processing patterns based on their reaction times and accuracy data.
Hargrave, S; Kalinowski, J; Stuart, A; Armson, J; and Jones, K, (1994) Effect of Frequency-Altered Feedback on Stuttering Frequency at Normal and Fast Speech Rates, JOURNAL OF SPEECH AND HEARING RESEARCH, Vol. 37, 1313-1319.
This study was conducted to determine the effect of frequency- altered auditory feedback (FAF) on stuttering. Fourteen subjects were asked to read passages at normal or fast rates under conditions of no auditory feedback, and then under four different frequency altered feedback conditions. The results indicated that each of the frequency altered conditions was a significant fluency enhancer at both a normal and fast rate of speech. The article suggests that further study be conducted on the role of using prosthetic devices to enhance fluency.
Harrington, J. (1988). Stuttering, Delayed Auditory Feedback, and linguistic rhythm. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 36-47.
In this study, the author proposes and tests a model of speech which depends on an internal rhythmic structure which regulates time intervals between stressed vowel productions and perceptions. Under this model, stuttering may be explained as a failure in the stutterer's rhythmic structure to predict when the next stressed vowel production should occur. The effects of Delayed Auditory Feedback on fluent and non-fluent speakers are discussed. This model supports the notion that self- perceptions and anticipation of stuttering events can cause stuttering.
Harris, V., Onslow, M. Packman, A., Harrison, E., Menzies, R. (2002). An experimental investigation of the impact of the Lidcombe Program on early stuttering. JOURNAL OF FLUENCY DISORDERS, 27, 203-214.
The purpose of this study is to find if the Lidcombe program's effect on stuttering is greater than that of natural recovery. Twenty-three children were given a selection criteria screener and then randomly assigned to the experimental group (12 sessions in the Lidcombe program) and the control group (same length of time with no treatment). Pre- intervention baselines showed similar means of 8.6 %SS for the experimental group and 8.4 %SS for the control group. Post-intervention measurements were 3.5 mean %SS for the experimental group, a 39% reduction, compared to post-intervention 5.8 mean %SS for the control group, a 26% reduction. Study results suggest that Lidcombe treatment has an immediate effect on the natural course of stuttering.
Harrison, J.C. (1997). Zen in the art of fluency. JOURNAL OF FLUENCY DISORDERS, 22(3): p243-246.
This article reviews the concept of Zen principles and relates it to stuttered speech. Zen principles, which come from Japan, are taught to the person who wants to master archery. The principles include things like relaxation and giving over control to the "it" or higher self. Comparisons of these principles are made to a couple of sports and then are related to stuttered speech. An explanation of what is happening when the speech system breaks down is given using the principles of Zen. The issue of how successful a person can be at becoming fluent is explained using the Zen principles.
Hartfield, K., & Conture, E. (2006). Effects of perceptual and conceptual similarity in lexical priming of young children who stutter: Preliminary findings. JOURNAL OF FLUENCY DISORDERS, 31, 303-324.
Research suggests that speech-language planning of people who stutter differs slightly from the planning of those who do not stutter, specifically in the area of lexical retrieval. The purpose of this study was to investigate that hypothesis by examining children three to five years of age who stutter (CWS) and children of the same age range who do not stutter (CWNS). The authors examined the influence of physical, categorical, and functional properties on speed and accuracy of lexical retrieval during picture naming tasks. CWNS had faster reaction times in all categories, but no significant difference was found when comparing errors. CWS were more influenced by functionality than the perceptual properties assessed. These findings lead to the conclusion that preschool children who stutter do vary in speech-language planning as compared to preschool children who do not stutter.
Hartinger, M. & Mooshammer, C., (2008). Articulatory variability in cluttering. FOLIA PHONIATRICS ET LOGOPAEDICA. 60(2). 68-71.
This study was developed to investigate the spatial and temporal kinematic variability of the fluency disorder cluttering by means of electromagnetic midsagittal articulography (EMMA). Six subjects were used, three with cluttering and three without. All subjects were native speakers of German. They were all assessed on repetitive CV syllables and loan words because people who clutter tend to struggle with long words with a complex syllable structure. The results indicated some differences however no overall significance was observed.
Hartman, B. T. (1997). Response to John Van Borsel's review. JOURNAL OF FLUENCY DISORDERS, 22, 71.
Hartman states that Van Borsel "missed the point" when reviewing his book. Sufficient evidence is not found in support for any stuttering theory, so where is the sufficient data refuting his theory.
Hasbrouck, J. M., Doherty, J., Mehlmann, M. A., Nelson, R., Randle, B., & Whitaker, R. (1987). Intensive stuttering therapy in a public school. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 18, 330-343.
Two intensive stuttering treatment programs, designed for implementation within a school setting were discussed. The first program was completed during the summer months, for 4 hours per day, 5 days per week, for 4 weeks in length. A combination of the following treatment procedures was used: airflow training, tension/relaxation, EMG feedback, and discriminative stimulus control. Results of this program indicated that all 6 of the subjects had reduced their percent of stuttered words to less than 1%, but none of them were able to maintain these fluency levels until the 7-month follow-up session. The second program was completed using a similar schedule as the first program. It involved a combination of the following treatment procedures: airflow training, tension/relaxation training, quiet biofeedback training, and discriminative stimulus control. Results of this program indicated that all of the 9 subjects had reduced their percent of stuttered words to less than 1 %, and that 6 of the 9 subjects maintained their fluency levels until the 7- month follow-up session.
Hasbrouck, J.M. & Lowry, F. (1989). Elimination of stuttering and maintenance of fluency by means of airflow, tension reduction, and discriminative stimulus control procedures. JOURNAL OF FLUENCY DISORDERS, 14(3), 165-183.
This study presented a comprehensive and demanding therapy program for stuttering. The therapy program combined a controversial airflow procedure with three other therapy procedures. Those procedures were tension relaxation, EMG biofeedback, and discriminative stimulus control. The researchers thought that by combining the airflow procedure with other therapy techniques stutterers would receive effective and lasting fluency skills. The subjects were required to proceed through each component of the therapy by passing strict requirements. The results were mixed. Most of the subjects maintained their fluency, but some relapsed. Differences were noted in how those who did maintain and those who relapsed ranked the stimuli in the discriminative stimulus control component of the program. This study shows that for some individuals an airflow procedure combined with other techniques may be effective.
Healey, E.C., Howe, S.W., (1987). Speech shadowing, characteristics of stutterers under diodic and dichotic conditions. JOURNAL OF COMMUNICATION DISORDERS, 20(6), 493-506.
This study investigated stutterers and nonstutterers fluent speech patterns. One nonshadowed reading and two speech shadowed conditions were presented, Results did indicate that stutterers produced fewer speech-production errors than nonstutterers during each shadowing condition. Stutterers favored word by word speech shadowing strategy, nonstutterers used both word by word and small phrase shadow strategy. Stutterers demonstrated longer vowel and phrase duration than nonstutterers during shadowing condition
Healey, E.C., Gabel, R.M., Daniels, D.E., & Kawai, N. (2007). The effects of self-disclosure and non self-disclosure of stuttering on listeners' perceptions of a person who stutters. JOURNAL OF FLUENCY DISORDERS, 32, 51-69.
Negative stereotypes exist about people who stutter (PWS) mostly because of listeners' negative perceptions and reactions to PWS. In order to deal with this issue, clinicians have integrated the use of self-disclosure techniques into their therapy sessions with PWS. It is thought that self-disclosure helps to reduce the negative reactions of listeners and relieve anxiety and tension felt by the person who stutters. The purpose of this study was to examine listeners' perceptions of a man who does or does not disclose that he stutters, and examine if the place of disclosure within a monologue effected the listeners' perceptions. Three groups of listeners viewed one of three different videotapes made by a man who stutters who disclosed his stuttering at the beginning of the monologue, the end of the monologue, or not at all. Listeners were asked to rate six different statements and answer three questions. The results were compared to a previous study, which found listener reactions to be more positive after self-disclosure. This study did not find any significance between the use and non use of self-disclosure. Reasons for this were addressed.
Healey, E.C., Norris, J.A., & Trautman, L.S. (2001). The effects of contextualization on fluency in three groups of children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 3, 564-576.
It has been researched that for children with normal communicative development, children with language disorders, and children who stutter, the frequency and distribution of disfluencies seem to be influenced by grammatical complexity and constrained language formulation requirements. Beyond the limited comparisons of spontaneous and imitated sentences, however, little research has focused on the relationship between speech fluency and developmental language formulation demands. This article studied the effects of contextualization on fluency in 12 school-age children who stutter, 11 children with language impairment, and 12 with normally developing fluency. The children were between 8 and 12 years old. The results showed, for all three groups, both decontextualized situations produced greater frequencies of normal- type disfluency and mazing. The findings from this research would support Starkweather's Demands and Capacities model in which stuttering arises from a need for more time to plan or revise utterances in response to increasing linguistic demands.
Healey, E. C., & Ramig, P. R. (1986). Acoustic measures of stutterers' and nonstutterers' fluency in two speech contexts. JOURNAL OF SPEECH AND HEARING RESEARCH. 29, 325-331.
In this study, 22 adult stutterers were age and sex matched with 22 adult non-stutterers. Each participant was given two different speech tasks to elicit responses. Fluency was evaluated and considered acceptable using five standards. Following the collection of samples, four acoustic measures were calculated and tested for statistically significant differences. The results signify that there exists a greater difference between stutterers' and nonstutterers' fluent durational measures in acoustic means during reading samples than during short phrase samples.
Healey, E.C., & Reid, R. (2003). ADHD and stuttering: A tutorial. JOURNAL OF FLUENCY DISORDERS, 2, 79-93.
The first purpose of the article is to provide a description of key diagnostic features of attention deficit hyperactivity disorder (ADHD), which is divided into three categories. The second purpose is to provide information and give suggestions about treating children who stutter and who have been diagnosed with ADHD. The article gives three educational objectives: (1) identify diagnostic criteria for children with ADHD; (2) differentiate pharmacological, environmental, and behavioral interventions for children with ADHD; (3) examine effective instructional techniques for children who stutter and have ADHD. Specific information is provided regarding medication used to treat ADHD symptoms as well as documented evidence of its impact on stuttering, which gives conflicting evidence.
Healey, EC, Trautman, LS & Susca, M. (2004). Clinical applications of a multidimensional approach for the assessment and treatment of stuttering. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 41-48.
In this article, Healey, Trautman and Susca describe a multidimensional model of stuttering which they developed. Before the discussion of this model, they provide brief reviews of six other multidimensional models of stuttering. The model developed by Healey et al., is called CALMS because it looks at the cognitive, affective, linguistic, motor and social components of stuttering. The CALMS model is based on the fact that the five components do not and cannot function independently. The authors discuss how to use this model in assessing clients who stutter and in treating clients who stutter. When discussing the treatment, Healey et al. show how to used the CALMS model in both planning and implementing treatment. They end the article with a case example of how the model is used with a specific client.
Healey, E.C., & Scott, L.A. (1995). Strategies for treating elementary school-age children who stutter: An integrative approach. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 26, 151-161.
This article describes a model of service delivery for school-age children who stutter. The model emphasizes the integration of fluency-shaping and stuttering modification approaches. The authors suggest a service delivery model that is divided into three phases. Phase I involves the identification and understanding of fluency and stuttering. Phase II focuses on the instruction and integration of fluency-shaping and stuttering modification procedures. The authors provide a description of each procedure along with a discussion of ways it can be integrated into therapy. Phase III deals with the concern of transfer and maintenance of speech improvement to speaking situations outside the clinic environment. Eight principles that form the foundation of treatment with school-age children who stutter are identified and discussed.
Healey, E. C., Scott, L. A., & Ellis, G. (1995). Decision making in the treatment of school-age children who stutter. JOURNAL OF COMMUNICATION DISORDERS, 28(2), 107-124.
This article includes ten decisions that should be addressed before, during, and when dismissing a child who stutters; for example, determining success or failure of an intervention approach. It provides the reader/clinician with information regarding long-term goals to parent involvement. In addition, this article presents questions which clinicians should ask themselves when dealing with children who stutter.
Hearne, A., Packman, A., Onslow, M., & Quine, S. (2008). Stuttering and its treatment in adolescence: The perception of people who stutter. JOURNAL OF FLUENCY DISORDERS, 33, 81-98
The authors of this article addressed the experiences of adolescents who stutter in regards to five main categories: 1. Their experience of stuttering during the adolescent years, 2. Reasons for seeking or not seeking therapy during the adolescent years, 3. Barriers to seeking therapy during the adolescent years, 4. Their experience of therapy during adolescent years, and 5. Suggested improvements to therapy for adolescents. 13 adolescents and young adults participated in the study. Seven individual interviews and two focus groups were conducted. The researchers concluded that teachers, parents, and other adolescents associated with the participants in the study seemed to have a lack of awareness regarding stuttering. They also found that, for the most part, the participants did not feel the need for treatment just because they stutter. Group therapy was well liked, however, in the event of the adolescents seeking help.
Hearne, A., Packman, A., Onslow, M., & O'Brian, S. (2008). Developing treatment for adolescents who stutter: A phase I trial of the camperdown program. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 39, 487-497.
This study evaluated the individual responsiveness of three adolescents who stutter to a stuttering treatment. The treatment program used in this study was the Camperdown Program which consists of four stages: individual teaching sessions, group practice day, individual problem-solving sessions, and a performance-contingent maintenance stage. Outcome measures of the program were collected before treatment and five occasions after treatment. Of the three participants, only one responded well to the treatment. The study indicated that the adolescent who performed well presented a high level of self-confidence and maturity. The study also concluded that decreased parent influence and increased peer influence and self-direction seemed to make an impact on the outcome of treatment. The authors of this study also discussed the possibility of how a group format treatment program would lead to better results than delivering treatment primarily individually as done in the Camperdown Program.
Hegde, M. (1992). Comments on Hamre's Stuttering Prevention. JOURNAL OF FLUENCY DISORDERS, 17, 131-139.
Hamre's critical analysis of the concepts and methods on which stuttering is based is critically analyzed further. Hegde, who has reviewed the article Hamre wrote on stuttering prevention, agrees with him that current technology does not allow stuttering prevention. Hegde feels that Hamre's point may be concluded without placing it in the continuity hypothesis. To evaluate prevention, one needs only to say that there are no manipulable signs that appear before stuttering. Hegde also points out that Hamre is making a false distinction between stuttering being part of the continuous versus the categorical model. Hamre is contradicting himself by claiming stuttering is categorically different from disfluencies. Generally, Hegde agrees with Hamre's views on stuttering progression and prevention, while some of his questionable arguments are presented. Nevertheless, Hegde applauds Hamre for critically evaluating professional practices in stuttering prevention because they only seek to serve the profession.
Hegde, M. N. (1995). Measurement and explanation of stuttering: A retrospective appreciation of Gene Brutten's contribution. JOURNAL OF FLUENCY DISORDERS, 20, 205-230.
This article elaborates on Gene Brutten's two-factor theory on stuttering and presents recent trends in research that still support his main ideas. Hegde describes and illustrates how Brutten's insistence that stuttering be defined and measured more precisely is still a relevant and unresolved issue. He also provides a detailed description of how two historically opposing views on stuttering, classical vs. operant conditioning, share commonalities within Brutten's etiological investigations. Finally, the author suggests that the recent neurophysiological research, which has replaced the conditioning and learning paradigm, indirectly supports interaction of environmental and physiological variables that Brutten advocated.
Hedges, D. W., Umar, F., Mellon, C. D., Herrick, L, C., Hanson, M. L., & Wahl, M. L. (1995). Direct comparison of the Family history method and the family study method using a large stuttering pedigree. JOURNAL OF FLUENCY DISORDERS, 20(1). 25-34.
The family history method (inquiry only) is compared to the family study method (direct family member interviews) in order to collect a sampling of subjects with a stuttering phenotype. This study supports previous data which proposes that the sensitivity of the family history method is reduced when compared to the family study method. In addition, this study confirms earlier findings which state that affected family; members are more accurate in-formants than non-affected family members. Family members asked to focus only on first-degree relatives, accuracy of sensitivity decreases, which suggests that familiarity may play a role in the failure to identify affected family members.
Hennessey, N. W., Nang, C. Y., Beilby, J. B. (2008). Speeded verbal responding in adults who stutter: Are there deficits in linguistic encoding? JOURNAL OF FLUENCY DISORDERS, 33 (3): 180-202.
The purpose of this study was to determine the processes responsible for linguistic encoding in PWS. Hennessey et al. studied the linguistic encoding of 18 PWS to see if verbal response time differed from normally fluent speakers on tasks of words vs. non words and picture naming. They determined that linguistic word encoding does not cause an increased delay in speech motor control of PWS. Further research needs to be completed to determine where the deficit is in the speech motor system that is responsible for delays in response time.
Herder, C., Howard, C., Nye, C., & Vanryckeghem, M. (2006). Effectiveness of behavioral stuttering treatment: A systematic review and meta-analysis. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 33, 61-73.
The purpose of this study was to conduct a systematic review and meta-analysis of the effectiveness of behavioral stuttering treatment for people who stutter. Inclusion criteria for this study included the following: participants who were diagnosed as people who stutter, treatment method was behavioral, outcomes were of speech behavior, and participants who were randomly assigned to an experimental and control condition before the intervention. The studies researched were split into two groups: (a) studies that compared a treated to a non-treated group and (b) those that compared a treated group to another treated group. Results indicated a significant effect size for the outcomes of treated versus non- treated participants and a non-significant effect size for the compared effectiveness of two different treatments. It was found that the data reported in this study supported the claim that intervention for stuttering results in an overall positive effect. It was also found that no one treatment approach for stuttering demonstrated significantly greater effects over another treatment approach.
Hill, DG. (1995). Assessing the language of children who stutter. TOPICS IN LANGUAGE DISORDERS, 15 (3), 60-79.
This article looks at theories explaining the relationship between language and stuttering and includes a review of studies focusing on the co-occurrence of speech and language problems in children who stutter. The importance of a multidimensional evaluation of children is emphasized. The author provides a description of differential evaluation including: 1) a case history; 2) a fluency assessment; 3) a broad-ranging skills assessment covering language, articulation, and motor-speech areas; and 4) parent-child analysis. Each of these areas are broken down and discussed in detail with special attention given to the description of language assessment.
Homzie, MJ., Lindsay, JS., Simpson, J., & Hasenstab, S. (1988). Concomitant speech, language, and learning problems in adult stutterers and in members of their families. JOURNAL OF FLUENCY DISORDERS, 13, 261-277.
This study was developed to determine if a significant number of adult stutterers report of having exhibited early speech, language, and learning disorders; and if other members of their families also reported these same disorders. A questionnaire was developed and sent out to gather data about the speech and language history of the subjects and their families. The result of the questionnaire report that stuttering appear to be associated with delayed language, articulation disorders, and reading, writing, and spelling disorders.
Horii, Y., & Ramig, P. R. (1987). Pause and utterance durations and fundamental frequency characteristics of repeated oral readings by stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 12, 257- 270.
Adaptation effects of repeated oral readings on the duration of pauses and utterances and on fundamental frequency were investigated in a group of stutterers and a group of non-stutterers. Analysis indicated significant differences in pause duration, speaking-time ratio, and total speaking time between the two groups. There were also differences between the first reading and the last reading. Analysis of reading errors showed different types of errors between stutterers and non-stutterers. There were no significant differences in fundamental frequency.
Howell, P. (2004). Assessment of some contemporary theories of stuttering that apply to spontaneous speech. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCES AND DISORDERS, 31, 123-140.
This article discussed different approaches to stuttering and looked at whether stuttering is caused by a problem linguistically or at the motor level, or if it is a combination of both. This article summarized the linked covert repair hypothesis, which is a complex system where there is a hierarchical linguistic system. Errors can happen at different points, they go through a monitoring system, and works through a cycle. This article also summarized the EXPLAN model, which had to do with planning and executing, and that they are two separate processes. EXPLAN said that failures in interaction between these two parts are what could cause dysfluencies. This article broke down the different parts of the EXPLAN model and described what each step meant.
Howell, P. (2004). Effects of delayed auditory feedback and frequency-shifted feedback on speech control and some potentials for future development of prosthetic aids for stammering. STAMMERING RESEARCH, (1)1, 31-46. http://www.stamres.psychol.ucl.ac.uk
Two known ways to improve fluency in a person who stammers is to use a device that makes noise so the stammerer can't hear their own voice (altered auditory feedback), and similar to this, to manipulate the sound of a person's voice before they hear it (making the voice high or low-pitched). This article reviews how these two methods affect the fluency of people who stammer and also covers how these methods are introduced to the speaker. Results indicated that alterations to recurrent auditory information - ARAI (another term for altered auditory feedback) helps stammerers produce speech that sounds nearly fluent, even if only temporary. Further research is needed to determine if ARAI could play a role in long-term fluency recovery from stammering.
Howell, P. (2004). Comparison of two ways of defining phonological words for assessing stuttering pattern changes with age in Spanish speakers who stutter. JOURNAL OF MULTILINGUAL COMMUNICATION DISORDERS. 2(3), 161-186.
This study is based on speech samples from 46 monolingual native speakers of Penisular Spanish that have a stutter and range in age from 3-68. Spontaneous speech samples were obtained and then segmented into phonological words in function words as satellites to content words as nuclei and as a word with stress as the nucleus of a phonological word. These segmentations were then analyzed as similar or different to try to predict patterns in dysfluency. The patterns found in phonological words in English were similar to those found in Spanish. Stressed or content words are possibly not the only factors that can affect the words around the phonological word nuclei.
Howell, P. (2005). The effect of using time intervals of different length on Judgments about stuttering. STAMMERING RESEARCH, 1, (4), 364-374. www.stamres.psychol.ucl.ac.uk
In an effort to increase reliability, time interval analysis has been used rather than traditional procedures. Through samples of speech from participants of this study, time interval procedures were assessed and evaluated as either fluent or stuttered. The speech samples judged by the participating members were reviewed using a scale based on 1-s and 5-s intervals as stuttered or fluent. Through different studies it has been found that different length intervals can alter the effect of speech through different treatment procedures. The need for a specific, set, time interval length is crucial for every study, or within each individual clinic setting, to make the procedure reliable.
Howell P. (Feb. 2008) Do individuals with fragile X syndrome show developmental stuttering or not? Comment on "Speech fluency in fragile X syndrome" by van Borsel, Dor and Rondal. CLINICAL LINGUISTICS AND PHONETICS. 2:163-7.
This article looks into whether or not the speech of nine males with fragile X syndrome is similar to those with developmental stuttering. Many different aspects of speech were looked at and five areas were reported as different. 1. Distribution of types of dysfluency 2. Dysfluency and word class 3. Effect of word length on fluency 4. Number of elements repeated in word and phrase repetitions 5. Effect of different types of material on dysfluency. There were similarities noted, however, it was decided that the five differences proved that fragile X syndrome and developmental stuttering speech is different. The authors studied these nine subjects and compared their information from various studies done and information produced over the years.
Howell, P. & Au-Yeung, J. (1995). Syntactic determinants of stuttering in the spontaneous speech of normally fluent and stuttering children. JOURNAL OF FLUENCY DISORDERS, 20(4), 317-330.
Howell and Au-Yeung review the literature pertaining to language factors associated with stuttering, specifically, the contradicting findings of the relationship between linguistic complexity and stuttering. This study consisted of 31 stutterers and 48 fluent speakers recorded in conversational episodes with an interviewer. Subjects were divided by fluent/stutterer categories and by age. The age range was 2:7 - 12:7. All recordings were narrowly phonetically and prosodically transcribed. Data parsing was done according to the procedure used previously in a study done by Wall, Starkweather, And Cairne (1981). Results of this study conclude that: 1) child stutterers differ in syntactic constructions they use in comparison with Wall's investigations, 2) the rank ordering of which syntactic categories were used did not differ significantly from that of Wall's investigation, and 3) the analysis of stuttering within clauses showed that young children exhibited a marked tendency to stutter at the clause boundary.
Howell, P. & Au-Yeung, J. (1995). The association between stuttering, Brown's factors, and phonological categories in child stutterers ranging in age between 2 and 12 years. JOURNAL OF FLUENCY DISORDERS, 20(4), 331-344.
This investigation examines the claim phonological difficulty of a word is not a factor in children who stutter. Two specific issues are addressed: 1) phonological difficulty does not differentiate which sounds will be stuttered and which will not, and 2) what influence do Brown's factors have on the relationship between phonological difficulty, age group, severity, and whether a word is stuttered or occurs after a stuttering. Thirty one children who stuttered and 48 fluent speakers were subjects. Age range was from 2:7 to 12:7 , and subjects were matched for age and educational level. All subjects were recorded in conversation with an interviewer. These recordings were narrowly phonetically and prosodically transcribed. Implications reveal that the measure of phonological difficulty showed differences in phonological ability for children of different ages. No dependence of stuttering on phonological category was observed for age group, stutterer's severity, or word types. Thus, phonological difficulty does not appear to be a major factor influencing the incidence of stuttering in children.
Howell, P., Au-Yeung, J., Sackin, S., Glenn, K., & Rustin, L. (1997). Detection of Supralexical Dysfluencies in a Text Read by Children Who Stutter. JOURNAL OF FLUENCY DISORDERS, 22, 299-307.
This study looks at the difference in detecting supralexical dysfluencies between a computer and human judges. Supralexical dysfluencies are made up of interjections, revisions, incomplete phrases, and phrase repetitions. Subjects used in this study were six stuttering males age 10-13 years. Speech samples were obtained by having each subject read the passage, "Arthur the rat". Results indicate that the computer software can detect speech errors more accurately than trained human judges. The computer was able to locate 100% of the discrepancies while the human judges made 8.5- 12.8% errors in the speech error detection task.
Howell, P., Au-Yeung, J., & Sackin, S. (1999). Exchange of stuttering from function words to content words with age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 42, 345-354.
A study was performed to determine the reason why dysfluent or fluent speakers stutter or hesitate on function words rather than content words and if the patterns are consistent with all age groups. A frequent pattern was observed; repetition and hesitation on function words occurred when they preceded content words. They study consisted of 51 individuals who exhibited stuttering behaviors divided into five categories: ages 2-6, 7-9, 10-12, teenagers, and adults. It also consisted of 68 control speakers. Two minute spontaneous speech recordings were taken from all subjects in a relaxed atmosphere. Results indicated that fluent speakers use repetition on function words and people who stutter attempt a content word when their language plans are incomplete. The results varied across the age groups.
Howell, P., & Davis, A. (2005). Elements of statistical treatment of speech and hearing science data. STAMMERING RESEARCH, 1, 333-343. Retrieved November 21, 2007, from http://www.stamres.psychol.ucl.ac.uk
The purpose of this article was to provide information for students so they can apply it to other texts. The article gives us two important specifics. The first one is the "experimental design and choice of data." This has information about the procedures for looking at information, such as populations, sampling, biases, estimating means, estimating proportions, and estimating variances. The second specific is "statistical terms involved in inference to the population mean from the sample mean." This includes simple hypothesis testing, an analysis of variance, and non-parametric tests.
Howell, P., Davis, S., Bartrip, J., and Wormwald, L. (2004). Effectiveness of frequency shifted feedback at reducing disfluency for linguistically easy, and difficult, sections of speech. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, Vol. 1, Issue 3, 309-315.
This study investigated the effects of frequency shifted feedback (FSF) on fourteen children between 9 and 18 years of age. Two reading tests were given to each participant containing difficult and easy passages as determined by increased sentence and word length. The FSF device was switched off or on while participants read the passages. The readings were taped and evaluated for reading time and number of disfluencies. Results indicated that difficult passages took longer to read than easy ones under normal conditions and using FSF. There was no significant reduction in reading time using FSF when compared to normal reading conditions. There was, however, a decrease in disfluencies when FSF was switched on, which was equal to the increase in disfluencies when FSF was switched off. The conclusion of the authors is that FSF is equally effective whether test material is easy or difficult, and the results have implications for using FSF as a tool to reinforce or elicit fluency. They also see the possibility for future potential as a long-term fluency treatment, with further research
Howell, P., Davis, S., & Williams, S.M. (2005). Auditory abilities of speakers who persisted, or recovered, from stuttering. JOURNAL OF FLUENCY DISORDERS, 31, 257-270.
This article focuses on determining a difference in auditory tasks between people who persist in stuttering behaviors and those who have recovered in an effort to determine the degree to which auditory functioning is a predictor of recovery. Thirty people who stutter (25 males and 5 females) were assessed through the Stuttering Severity Instrument (SSI-3), were determined to be either a persistent developmental stutterer (PDS) or a recovered developmental stutterer (RDS), had their parent(s) interviewed, had a home visit that lasted approximately 90 minutes, and a hearing test. Results indicate that there is a significant threshold difference between the PDS and RDS groups for the backward-masked stimulus with thresholds being higher for the PDS group. Results conclude that backward masking scores are one factor that differentiate speakers who recover from speakers who persist in stuttering behaviors.
Howell, P., Davis, S., & Williams, R. (2008). Late childhood stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 51, 669-687
In this article, the authors analyzed the presence or absence of factors that may lead younger children who stutter to continue to do so into pre-teen years. 76 children, ages 8-12 participated in the study; they were all assessed initially as stuttering. After speech-language pathologists conducted treatment over the course of 12 months, the children were assessed again. A trained researcher completed the assessments after a minimum of 12 months post-treatment. The children were then classified as persistent or recovered. Of the 76 participants, 41 participants were classified as recovered, and the research showed that males are more affected by late childhood stuttering. It was noted by the researchers that dysfluency types changed with age, as well as performance on sensory, motor, and temperamental tasks. The researchers also concluded that the longer a child is in therapy, the longer the child will stutter.
Howell P, Davis SR, Williams R. (2008 Sep 9). The effects of bilingualism on stuttering during late childhood. ARCHIVES OF DISEASE IN CHILDHOOD (EPub ahead of print - www.ncbi.nlm.nih.gov/pubmed/18782846)
This article focuses on the effects of bilingualism and the onset of stuttering, school performance and the recovery rate of stuttering. There were three groups that were followed through many years: BIL-bilingual from birth, LE-learned English at school and MONO-monolingual speakers who stutter. All three groups had the same criteria to qualify the participants. Different measurements were used such as a parent/caregiver interview, the SSI-3, etc. Results show that the mean age of onset was within 6 months for all three groups, the school performance was not significantly different between all the groups and the recovery rate of stuttering was 25% for the BIL group and 55.5% for the LE-MONO combined.
Howell, P., & El-Yaniv, N. (1987). The effects of presenting a click in syllable-initial position on the speech of stutterers: Comparison with a metronome click. JOURNAL OF FLUENCY DISORDERS, 12, 249-256.
The speaking rates and number of disfluencies were compared with normal auditory feedback, with a metronome, and with a click at syllable onset for a group of 10 stutterers. Speaking rates were higher when the click was presented at syllable onset. The number of disfluencies was less with the metronome or syllable-onset click compared to normal auditory feedback. Listeners judged speech produced when a click was heard at syllable-onset as sounding more natural than with normal auditory feedback or with the metronome.
Howell, P., and Huckvale, M. (2004). Facilities to assist people to research into stammered speech. STAMMERING RESEARCH, 1(2), 130-242. http://www.stamres.psychol.ucl.ac.uk
The article's purpose was to inform others that audio tapes of PWS will be made available to the public thanks to the University College of London and Wellcome Trust. It will provide an archive of speech samples that have already been analyzed and allow others the opportunity to provide any corrections, if needed, to the supplied data. Transcriptions of the speech samples will also be made available. The purpose of creating such an archive that is publicly available is so more research can be conducted related to stuttering. Various software programs will be available for free, so researchers are able to analyze the speech samples free of cost and also have the option of what particular software package they prefer to use.
Howell, P., Sackin, S., & Rustin, L. (1995). Comparison of speech motor development in stuttering and fluent speakers between 7 and 12 years old. JOURNAL OF FLUENCY DISORDERS, 3, 243-255.
This study examined fluent children and stuttering children's abilities to perform three tasks deemed necessary for producing fluent speech. The tasks included (1) production of voiced plosives varying in place of articulation (indicative of laryngeal/supraglottal coordination) (2) moving the lower lip to follow the movement of a sinusoidally-varying target (indicative of supraglottal movement alone) (3) making the minimum possible articulatory movement either with or without attendant visual feedback (indicative of use of kinesthetic feedback). Results revealed that the stutterers produced longer voice onsets in the plosives which the authors view as potentially a problem in coordination. The children who stutter were also found to have larger tracking errors; however, the authors state that it is accuracy rather than the nature of the movement that differs for stuttering children. Finally, the stuttering group produced bigger minimal movements when no visual feedback was provided, suggesting that this group may be less sure of where the articulator is held.
Howell, P., Sackin, S., &Williams, R. (1999). Differential effects of frequency- shifted feedback between child and adult stutterers. JOURNAL OF FLUENCY DISORDERS, 24, 127-136.
This study focuses on the influence of frequency-shifted feedback on adult vs. child stutterers and the effects of fluency enhancement. A group of eight boys (ages 9 -11) and eight men (ages 20 -24) who stuttered and had no history of therapy were enrolled in an intensive two-week therapy course. The therapy course analyzed speech under two different listening conditions; frequency- shifted feedback (FSF) and normal auditory feedback (NAF). It was predicted that adult stutterers' fluency would significantly increase as compared to the child stutterers' fluency due to differences in the rate of speech and the effects of FSF on the temporal lobe. Results indicated this to be true.
Hubbard, CP. (1998). Reliability of judgments of stuttering and disfluency in young children's speech. JOURNAL OF COMMUNICATION DISORDERS, 31, 245-260.
The purpose of this study was to investigate interobserver reliability in the speech of young children regarding judgements of stuttering vs. disfluency. More specifically, the author examined whether interobserver agreement was higher for judgements of speech disfluency or for judgements of stuttering. Speech samples by eight preschool children identified as stuttering were used. Five adult women, each with more than one year of experience in perceptual judgements of stuttering and disfluency, were the judges. Results showed that interobserver reliability was not significantly higher for judgements of speech disfluency than judgements of stuttering. Both forms of judgement differentiated variation among the subjects.
Hubbard, CP. (1998). Stuttering, Stressed Syllables, and, Word Onsets. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH. 41: 4, 802-808.
Research was done on ten adult stutterers (age 17 years to 62 years) to see if there is a relationship between stuttering and syllabic stress, stuttering and word onsets, and stuttering and word position. Results indicated that there was no significant difference in the proportion of stuttering on stressed versus unstressed syllables. It also indicates that stuttering occurs more frequently on word-initial syllables versus word-final syllables, and that stuttering occurs more frequently on the first four words of a sentence versus the last two words.
Hubbard, C.P., & Prins, D. (1994). Word familiarity, syllabic stress pattern, and stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 564-5 71.
The purpose of this study was to determine whether stuttering frequency in adults varies with changes in word familiarity and syllabic stress pattern during an oral reading task. A groups of ten people who stutter and a control group of ten fluent subjects were studied. The authors found that significantly more stutter events occurred on sentences containing less familiar words in the group of subjects who stutter. This factor did not influence the fluency of the control group. Syllabic stress pattern did not alter the fluency in either of the two groups.
Hubbard, CP. & Yairi, E. (1988). Clustering of disfluencies in the speech of stuttering and nonstuttering preschool children. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 228-233.
This study examined clustering formation, the occurrence of two or more disfluencies on the same or adjacent words, in a spontaneous speech sample of 500 syllables for each of 15 preschool stuttering children and 15 nonstuttering control subjects. Results indicated both sets of children produced higher percentages of disfluencies in clusters than expected by chance. These results are consistent with past studies that found a similar percentage of clustered disfluency by nonstuttering children; indicating that clustering is a significant factor in the speech of stuttering and nonstuttering children.
Hubbard Seery, C. (2005). Differential diagnosis of stuttering for forensic purposes. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY, 14, 260-273.
This article was a case study about a male in his 30s charged with armed robbery. A speech-language pathologist was asked to perform an assessment on the man because he claimed to be a person who stutters (PWS) but was suspected of malingering. The assessment took place in the jail where the man was being held, lasting two hours and consisting of speech samples, oral reading, observing of various speaking situations, communicative attitudes, information from a case history, and background information gathered. Results showed extreme dysfluency during speech samples of 104 dysfluencies per 100 words, no secondary behaviors, and frequent eye contact during stuttering. Severe stuttering was also evidenced in oral reading, imitated words, imitated phrases, imitated sentences, whispering, shouting, automatic speech, and other situations. Results from a communicative attitude scale scored the man in a range similar to other PWS or at the extreme end of people who do not stutter. The man's jail records reported a 'recent diagnosis of seizures and brain aneurysm,' 'poor word-finding and memory problems,' and 'psychosis not otherwise specified.' Assessment information from the speech-language pathologist as well as other information gathered found that the man probably was a PWS, but also exaggerated his stuttering and included a certain amount of malingering. Future studies should explore differential diagnosis protocols and case history questions to find which aspects are most revealing in decision-making.
Huinck, W.J., Langevin, M., Kully, D., Graamans, K., Peters, H.F.M., & Hulstijn, W. (2006). The relationship between pre-treatment clinical profile and treatment outcome in an integrated stuttering program. JOURNAL OF FLUENCY DISORDERS, 31, 43- 63.
The purpose of this study was to determine if there is a difference in treatment outcome based on the method used to characterize a person who stutters and the severity of stuttering. The study included 25 adults who stutter (17 male, 8 female; ages 17-53 years). Participants all had a reported onset of stuttering before age 6, they had no motor development problems, no unrelated speech or language problems, no medication use that would interfere with the study, no psychiatric history, and normal hearing. Participants were divided into mild and severe groups based on their stuttering severity (assessed with the Stuttering Severity Instrument) and their secondary factors (Perceptions of Stuttering Inventory, Stuttering Severity Scale, and Inventory of Interpersonal Situations). The stuttering therapy was provided in a three-week intensive format and included principles of fluency-enhancing and stuttering modification. The study found that there is a difference in treatment outcome based on the subtype of stuttering; that the severe stutterers showed the biggest gains in treatment, yet also the biggest regression; and finally that there is no relationship between severity of stuttering and the secondary characteristics of negative emotional and cognitive reactions.
Huinck, W. J., van Lieshout, P. H.H.M., Peters, H. F. M., & Hulstijn, W. (2004). Gestural overlap in consonant clusters: effects on the fluent speech of stuttering and non-stuttering subjects. JOURNAL OF FLUENCY DISORDERS, 29, 3-25.
This study was designed to further explore what influence consonant clusters in initial and medial positions, have on reaction times and word durations of people who stutter (PWS) and people who do not stutter (PWNS). Browman and Goldstein's Gestural Phonology Model was used. In this study 12 monosyllabic and 12 bisyllabic non-words were used. Ten PWS and 10 PWNS participated in the study. The focus of the study was on perceptually judged, fluent utterances. The results indicated that PWS have slower reaction time, but these results were not statistically different from the group of PWNS. Also, the results of the word duration section indicated no significant differences. However, there was a significant coloration between group, cluster type, and cluster location.
Hulit, L. M. (1989). A stutterer like me. JOURNAL OF FLUENCY DISORDERS, 14(3), 209-214.
Every year Lloyd M. Hulit gives his class the same assignment. His students are instructed to pseudo-stutter for a certain length of time and then write a paper reflecting on their experience. In this article he records and discusses the comments made by 29 female students. These comments are divided into four categories: physical reactions, emotional reactions, listener reactions, and insights gained. Hulit, himself a stutterer, feels as though his students experience many of the same feelings and emotions as those of an actual stutterer. Some people question the usefulness of this activity. A fluent speaker will never know what it is like to stutter because the fluent speaker knows that they can always return to fluency. However, this assignment gives the fluent speaker the best insight into what a stutterer goes through.
Hulit, L.M. & Wirtz, L. (1994). The Association of Attitudes Towards Stuttering with Selected Variables. JOURNAL OF FLUENCY DISORDERS, v19, n4, Dec.
A stuttering inventory was made by the authors who borrowed (with the author's permission) questions on several tests. This test was given to 203 people with varying education and professional backgrounds in the North-Central Illinois area. This test was given to assess how people view people who stutter Each question has a five point continuum. When asked about attitudes, most people avoided the extreme ends of the scale indicating that the subjects may not be certain what response is appropriate.
Ingham, J. C. (1993). Current status of stuttering and behavior modification -I: Recent trends in the application of behavior modification in children and adults. JOURNAL OF FLUENCY DISORDERS, 18, 27-55.
The purpose of the article is to provide an overview of behavior modification research since the 1980's. Most of the studies involve adult clients working on treatments incorporating stutter- free speech. Ingham comments " The results of these treatments are mixed, but generally positive."
Ingham, J.C. (2003). Evidence-based treatment of stuttering: I. Definition and application. JOURNAL OF FLUENCY DISORDERS, 28,197-207.
The article defines evidence-based treatment as the conscientious, explicit, and judicious use of current best evidence. Evidence-based treatment is dependent on research evidence, clinical expertise, and client preferences. A clinician can practice evidence-based treatment by following these four steps: 1) ask a clinically relevant question, 2) track down the best evidence, 3) critically evaluate the evidence that you discover, 4) integrate the best evidence with clinical judgment and the client's circumstances. The article addresses the need for more research in treatment efficiency, the treatment that shows the most improvement. This research would aid evidence-based treatment.
Ingham, JC.; Riley, G. (1998). Guidelines for Documentation of Treatment Efficacy for Young Children Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41: 4, 753-770.
The authors discuss the importance of documenting the outcomes of treatment by following a few guidelines. Their guidelines include: conditions of documentation, the dependent variables, treatment integrity, and verification of the relationship between treatment and outcome. Following the descriptions of these guidelines, two cases are looked at as examples of how to apply these guidelines.
Ingham, Roger J. (2007) Yaruss, Coleman, & Hammer. (2006): An exemplar of non-evidence-based practice in stuttering treatment. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS 38:283-286.
This articles focuses on the importance of evidence based practice in stuttering treatment. It is used as an example of what is NOT an EBP article as there are four main problems in the original report: failure to provide clinicians with replicable procedures, failure to collect valid and reliable speech performance data, failure to control for predictable improvement in children who have been stuttering for less than 15 months and the advocacy of procedures for which there is no credible research evidence. The author goes into great detail outlining the errors and giving examples for each of the main problems in the original report.
Ingham, R. J., Finn, P., & Bothe, A. K. (2005). "Roadblocks" revisited: Neural change, stuttering treatment, and recovery from stuttering. JOURNAL OF FLUENCY DISORDERS, 30, 91-107.
This paper discussed the importance of research in the area of neural plasticity and reorganization of adolescents and adults who stutter. The authors suggest that a lot of information about how the brain reorganizes and compensates can be learned from individuals who have recovered from stuttering with and without any formal treatment. Further neural examination of adults and adolescents who have recovered from stuttering will aid in understanding of the nature and treatment of chronic stuttering. For example, the authors suggested these individuals could be a "benchmark" for evaluating current and future stuttering treatment.
Ingham, R.J., Fox, P.T., Ingham, J.C., Xiong, J., Zamarripa, F., Hardies, L.J., & Lancaster, J.L. (2004). Brain correlates of stuttering and syllable production: Gender comparison and replication. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 321-341.
The purpose of this study was to identify neural regions that are functionally related to stuttered speech in females and investigate possible gender specific regional activation. The participants included 10 females who stutter and a control group of 10 fluent females. Each participant was given nine PET scans while completing a speech task (oral reading from text, choral reading, and rest). PET scan results were then compared to speech performance data collected during the scan, including measurements of stuttering rate, syllable production rate, and speech naturalness. During non-stuttered speech, activation patterns were similar between sexes and between people who stutter and the controls. During stuttered speech, the results showed activation in the right anterior insula and deactivation in the left inferior frontal gyrus and right Brodmann area 21/22 of both genders. Several gender differences in neural functioning were also seen during stuttered speech. Females showed bilateral activation of the anterior insula and bilateral deactivation of the Brodmann area 21/22 during stuttered speech. Males showed activation in the left medial occipital lobe and the right medial cerebellum. The results evidence a possible link between specific neural regions and stuttered speech. The researchers suggest that abnormal neural activation patterns may contribute to a system in which stuttered speech occurs. In addition, the results indicate gender differences in the neural regions involved with the functional control of stuttering.
Ingham, R. J., Ingham, J. C., Finn, P., & Fox, P. T. (2003). Towards a functional neural systems model of development stuttering. JOURNAL OF FLUENCY DISORDERS, 28, 297-318.
This article discusses recent developments in an ongoing program of brain imaging research on developmental stuttering called the San Antonio studies. These studies used imaging of different speaking tasks of persistent stutterers, recovered stutterers and controls in order to isolate the neural regions that are associated with stuttering. A model of the neural basis of speech production was proposed by Jurgens. This is a box and arrow model of neural regions and structures involved in speech production. It provides information on the sequence i! n which particular regions participate in different speech tasks. It also helps to focus research in areas that are inactive or overactive in people with developmental stuttering. This model was used to reanalyze the findings used in this study. An overview of the San Antonio studies was discussed. In this study neural regions were isolated and functionally associated with stuttering. The first study included ten adult male stutterers and ten matched controls. The purpose of this study was to assess the neural region activations by stutterers and controls during oral reading. In the second study a comparison was done to find the differences between the neural activations of stutterers, late recovered stutterers, and the normally fluent controls. The main purpose was to study the fully recovered developmental stutterers as a way to create a neurophysiological measure of recovery and treatment outcome. A third study dealt with identifying neural regions that distinguish between temporary and sustained improvements in fluency by people who stutter. The main goal was to distinguish between improvements that were temporary and those that were maintained. The final study in the San Antonio studies was an across-study analysis which made comparisons of different studies in order to identify regions and structures that were active or inactive. This was done to test the validity of the Jurgens Model and to isolate the regions that are associated with stuttering. The results of this study conclude that the Jurgens Model is a strong predictor of neural regions for developmental stuttering.
Ingham, R.J., Kilgo, M., Ingham, J.C., Moglia, R., Belknap, H. & Sanchez, T. (2001). Evaluation of a stuttering treatment based on reduction of short phonation intervals. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 1229-1244.
This study evaluated the efficiency of a treatment for stuttering named Modifying Phonation Intervals (MPI). Through a training process, stutterers learn how to reduce the frequency of short phonation intervals during connected speech in all speaking situations. The MPI is a computer based program which involves pretreatment, establishment, transfer, and maintenance phases. The study subjects, five men, ages 18-28, were able to choose when therapy took place and the duration of therapy sessions as well as the out of clinic tasks. They were evaluated three times during each phase for %SS (percent of syllables stuttered), SFSPM (stutter-free syllables per minute), and Na (speech naturalness rating). Results of the therapy were a decreased %SS and an increased SFSPM and Na which were consistent for all subjects. When tested 12 months post treatment, all subjects had maintained their levels of fluency. Evaluation results of this study indicate the MPI could be used independently or in conjunction with other treatment strategies. Further investigative research using a larger population is indicated to prove the reliability and validity of this treatment.
Ingham, R. J. (1993). Current status of stuttering and behavior modification -II. Principal issues and practices in stuttering therapy. JOURNAL OF FLUENCY DISORDERS, 18, 57-79.
The purpose of the article is to determine why there has been a decline in the behavior-therapy research in recent years. This is achieved by focusing on the emergent issues in the areas as follows: treatment for children, stuttering measurement, neurophysiological perspective, treatment issues, generalization and maintenance, and assessment and evaluation. Ingham believes behavior therapy influenced more individuals to question stuttering therapy and therapy problems. He proposes the current decline in therapy research may be due to the conflicts between current research and previous stuttering therapies.
Ingham, R.J. (1993). Stuttering treatment efficacy: Paradigm dependent or independent. JOURNAL OF FLUENCY DISORDERS, 18, 133-149.
In this article the author points out that over the past decade stuttering treatment efficacy evaluation has been largely influenced by a model designed to assess the interaction between environmental factors and variability in stuttering frequency. The model outlined in this article blends treatment process and outcome evaluation and may or may not be paradigm dependent. The author explains this model thoroughly and discusses whether the model does depend on paradigm-based concepts of stuttering.
Ingham, R. (1997). Valid distinctions between findings obtained from single-subject and group studies of stuttering: Some reflections on Kalinowski et al.(1995). JOURNAL OF FLUENCY DISORDERS, 22, 51-56.
This article argues whether data obtained in a single-subject design study of people who stutter gives information that is markedly different from information obtained in a group study of people who stutter. The author is of the opinion that the differences between the two approaches and what they can show about behavior may be substantial. This is in opposition to a recent article by Kalinowski et. al. (1995).
Ingham,R G., & Cordes, AK. (1992). Interclinic differences in stuttering-event counts. JOURNAL OF FLUENCY DISORDERS,17,171- 176.
This study was designed to determine if there are differences in identifying stuttering events across research centers as well as among groups of judges. The results of this study indicate that counting of stuttering events does differ across research centers as well as among groups.
Ingham, R. & Cordes, A. (1997). Identifying the Authoritative Judgments of Stuttering: Comparisons of Self-Judgments and Observer Judgments. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 40, 581-594.
The purpose of this study was to compare stuttering judgments from 15 adults who stutter, judging their own speech; the same adults who stutter, judging each other's speech; and a panel of 10 authorities on stuttering research and treatment. The study included three separate but interdependent experiments including the Concurrent Judgments Experiment, the Stability Experiment, and the Multispeaker Experiment. Five adults who stuttered since childhood were used for the Concurrent Judgments Experiment. The original five adults and an additional 10 adults who stuttered that served as both speakers and judges participated in the Stability Experiment. The Multispeaker Experiment was made up of the 15 adults from the previous experiment plus a group of 10 researchers and clinic directors. Results indicate substantial differences in stuttering judgments across speakers, judges, and judgment conditions. In conclusion, there are marked differences between the judgments of stuttering made by speakers while they are talking and the judgments made after the fact by the speaker or observer.
Ingham, R. & Cordes, A. (1998). Treatment Decisions for Young Children Who Stutter: Further Concerns and Complexities. AMERICAN JOURNAL OF SPEECH- LANGUAGE, 7, 3, 10-18
Study was done to find if interval-based training could improve judgement by individuals in assessing a stuttering event. Study consisted of 20 university students (20-35 years) who participated in three assessment sessions and one training session. It was found that judges of stuttering could be trained to provide judgment of spontaneous speech in a more accurate and reliable way.
Ingham, R.J., Cordes, A.K., & Finn, P. (1993). Time-interval measurement of stuttering: Systematic replication of Ingham, Cordes and Gow (1993). JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 1168-1176.
This study repeated Ingham, Cordes, and Gow's 1993 study, in an effort to expand their results of time-interval judgments of stuttering. Thirty four grad and undergrad students served as judges. Each was required to decide if each of the 143 intervals of speech was or was not perceived to contain stuttering. Interjudge agreement was 80% and intrajudge reliability was 88.4% These results were fairly consistent with the previous study. The present study found little difference between audiovisual and audio only conditions, experience vs. inexperienced student judges, or significant differences across two different university research settings.
Ingham, R. J., Cordes, A. K., Ingham, J. C., & Gow, M. L. (1995). Identifying the onset and offset of stuttering events. JOURNAL OF SPEECH AND HEARING RESEARCH, 38 (2). 315-326.
The onset and offset of individual stuttering events produced in the spontaneous speech of chronic stutterers is analyzed by four experienced stuttering researchers. The researchers view each speaker on videodisk during which time they attempt to locate the aspects of stuttering previously mentioned. The reliability and validity of this study is challenged, due to interjudge disagreement.
Ingham, R. J., Moglia, R.A., Frank, P., Ingham, J. C., & Cordes, A. K. (1997). Experimental investigation of frequency-altered auditory feedback on the speech of adults who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 40, 361-372.
This study entailed a series of single-subject experiments evaluating the effects of frequency-altered auditory feedback (FAF) on the speech performance of four adult males who stutter. In the past, FAF has been reported to reduce stuttering frequency, and have comparable or superior results to DAF, continuous masking, and voice-actuated masking. The purpose was to determine within- subject effects of two different types (one octave above and one octave below) of FAF on stuttering, speech rate, and speech quality during reading and spontaneous speech. Results indicated that the effects of FAF are not consistent across all persons who stutter, over extended periods of speech, or between oral reading and spontaneous speech. Clinical implications were discussed.
Ingham, RJ.; Siegel, GM. (1999). Review of Stuttering: A Short History of a Curious Disorder, by Marcel Wingate. JOURNAL OF FLUENCY DISORDERS, 24: 1, 77-83.
Ingham and Siegel state their opinions of Marcel Wingate's Stuttering; A History of a Curious Disorder. They start out by describing Wingate's background and accomplishments in the field of stuttering. Then they point out the good and bad portions of the book, and how it could have been made better.
Ingham, R.J., Warner, A., Byrd, A., & Cotton, J. (2006). Speech effort measurement and stuttering: Investigating the chorus reading effect. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 49, 660-670.
The purpose of this study was to research the effect of chorus reading on the effort used in speech production. A secondary purpose was to investigate the effect of a speech effort measurement highlighting strategy. Twelve adults who stutter persistently (PS) and twelve adult controls participated in the ABA experimental study. Participants read a passage for one minute to obtain a base rate, and then read in unison with a recording for one minute. The process was repeated until three base rates and two choral readings were completed. After each reading the individuals would rate themselves on the amount of effort used on a nine-point scale, and trained judges would rate them on stuttering frequency, rate, and naturalness of speech. Chorus reading led to more fluent and natural sounding speech for PS, and they reported less effort. The highlighting strategy, reminding participants of their previous effort ratings, had no significant difference on future readings.
Jackson, E. (2006). A stutterer's perspective: a stutterer's challenge. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1, 114-118. Retrieved from http://www.journalofstuttering.com/ListofArticles.html
Many people who stutter show avoidance behaviors or are embarrassed because of their stuttering. This article discusses Eric Jackson's experience with coping strategies such as advertising stuttering and voluntary stuttering. Learning to manage psychological and emotional reactions to stuttering is also a large piece of managing one's disfluencies. Maintaining a positive outlook on stuttering, and its challenges can be reinforced by joining support groups. These groups offer a connection and similar experiences with other people who stutter.
Jaencke, L. (1994). Variability and duration of voice onset time and phonation in stuttering and adults. JOURNAL OF FLUENCY DISORDERS, 19 (1), 21-38.
Eighteen male stutterers and sixteen male nonstutterers who were matched according to age and social status were required to speak test words ( /kakakas/ /tatatas/, and /papapas/) with stress on the middle syllable at two different speech rates. Duration of phonation, voice onset time, and coefficients of variation were computed and analyzed. It was shown that stutterers produced, even during nonstuttering periods under repetitive articulation, an enhanced variation of voice onset time and an increased variability of the duration of phonation associated with the production of the first syllable. Furthermore, this experiment did not confirm the often reported differences in voice onset time and vowel duration between stutterers and nonstutterers (p. 21).
Jancke, L., Bauer, A., Kaiser, P., & Kalveram, K. (1997). Timing and Stiffness in Speech Motor Control of Stuttering and Nonstuttering Adults. JOURNAL OF FLUENCY DISORDERS, 22, 309-321.
The purpose of this study was to determine whether or not there is a difference between the jaw movements of stutterers and nonstutterers when producing a nonsense word across various trials. Twelve stutterers and 12 nonstutterers were asked to say the word /papapas/, stressing either the first or second syllable over three speech rates. Results show that jaw kinematics vary with speech rate and stress pattern. Durations of total jaw movement decreased with an increase in the rate of speech. Peak velocities were found to be slower for stressed syllables than for unstressed syllables. Overall, stutterers and nonstutterers exhibited the same strategies for jaw movements of accented and unaccented syllables. However, stutterers were shown to use motor compensations such as lengthened jaw opening and closing and reduced peak velocities to obtain fluent speech.
Jankelowitz, D.L., and Bortz, M.A. (1996). The interaction of bilingualism and stuttering in an adult. JOURNAL OF COMMUNICATION DISORDERS,29, 223-234.
Correlation between stuttering and bilingualism was investigated in one bilingual adult . Language proficiency tests and cloze were used to assess the English and Afrikaans linguistic ability. Practical clinic information was obtained in the assessment of disfluency in a bilingual person who stutters when examining adaptation, anticipation and consistency. Information was given on stuttering as well as bilingualism. Distribution, frequency and nature of disfluency were all influenced by language ability. For the individual the predominant language was more proficient and less stuttered in.
Janssen, P., Kloth, S., Kraaimaat, F., & Brutten, G. J. (1996). Genetic factors in stuttering: A replication of Ambrose, Yairi, and Cox's (1993) study with adult probands. JOURNAL OF FLUENCY DISORDERS, 21(2), 105-108.
This study was a replication of the Ambrose, Yairi, and Cox's study (preschool probands) from 1993. However, this study investigated adult probands, gender, and incidence among relatives. Self report questionnaires were obtained from 106 adult stutterers (77 males, 29 females) which referenced first, second, and third degree relatives. Results revealed no evidence that relatives of females probands are more likely to stutter than male probands. Thus, genetic transmission of stuttering in questioned.
Johannsen, H.S. & Victor, C. (1986). Visual information processing in the left and right hemispheres during unilateral tachistoscopic stimulation of stutterers. JOURNAL OF FLUENCY DISORDERS, 11, 285-291.
Using tachistoscopic stimuli, this study attempts to determine whether or not there are differences in brain dominance for language between people who stutter and people who do not stutter. The subjects were asked to name the number and then a nonsense syllable presented to them on different sides of the number. Subjects who recognized more syllables on the right side of the number were known as right lateralized while those who recognized more syllables on the left side were known as right lateralized. The results show that over twice as many people who stutter had dominance in the right hemisphere of the brain.
Johnson, G. F. (1987). A clinical study of Porky Pig cartoons. JOURNAL OF FLUENCY DISORDERS, 12, 235- 238.
Porky Pig has been stuttering since 1935. His often bizarre stuttering has not stopped him from being successful in a variety of occupations. An analysis of 37 of his cartoons yields a rate of stuttering on approximately 23% of his spoken words. The cartoons may be useful in therapy with children who stutter by having them analyze behaviors and situations or having them explain to Porky Pig how to not stutter.
Johnson, G. (1987). Ten commandments for long-term maintenance of acceptable self- help skills for persons who are hard-core stutterers. JOURNAL OF FLUENCY DISORDERS, 1, 9-18.
This article introduced and explained in detail the ten commandments for long- term maintenance skills for persons who consider themselves to be hard-core stutterers. The report is directed towards persons who stutter who usually accomplish a therapy program. The article is designed to be a "booster" for any person who stutters who feels they need some additional encouragement or reminders/refreshers. The ten commandments suggested by the author are explained in detail and are extremely well written to be understood and applied by a person who stutters.
Jones, M., Gebski, V., Onslow, M., & Packman, A. (2001). Design of randomized control trials: Principles and methods applied to a treatment for early stuttering. JOURNAL OF FLUENCY DISORDERS, 26, 247-267.
Randomized Control Trials (RCTs) are considered to be the most sound method of testing efficacy of treatment in medical research and other areas, such as psychology. This paper is a tutorial covering the principles and methods of RCTs: the trial protocol, choice of control treatment, eligibility criteria, random allocation, outcomes and hypotheses, sample size, subject recruitment, analysis by intention to treat, interim analysis, stopping rules, safety data monitoring/trial management, and study documentation. Each principle is covered in-depth with reference to previous RCTs on Phase I and Phase II of the Lidcombe Program of early stuttering intervention, and a current RCT of Phase III. Because of the superiority of RCTs, they often lead to change in clinical practice.
Jones, M., Gebski, V., Onslow, M., & Packman, A. (2002). Statistical power in stuttering research: A tutorial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 45, 243-255.
This article discusses the importance of reporting findings when there is no clinically significant difference, otherwise known as null findings. The article states that in regards to stuttering research, the knowledge of null findings would provide useful information for understanding the nature and causes of the condition. The article discusses the power and errors in statistical inference. It also looks at the parameters that influence power such as the nature of the dependent variable, effect size, and population variability. The article also includes demonstrations of how it is calculated.
Jones, M., Onslow, M., Harrison, E., & Packman, A. (2000). Treating stuttering in young children: predicting treatment time in the Lidcombe Program. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 1440-1450.
This study focuses on the concept that many children may recover from stuttering without formal treatment during the first year of onset. This report presents data pertinent to this issue for 261 preschool-age children who received the Lidcombe Program of early stuttering intervention. For children who were treated successfully, logistical regression analyses were used to determine whether age, gender, period from onset to treatment, and stuttering severity related systematically to the time required for treatment. The present data confirmed previous reports that a median of 11 clinic visits were required to achieve zero or near zero stuttering with the Lidcombe Program. Results were also consistent with a preliminary report of 14 children showing a significant relation between stuttering severity and the time needed for the treatment. The present findings are also discussed in relation to natural recovery to stuttering.
Jones, M., Onslow, M., Packman, A., & Gebski, V. (2006). Guidelines for statistical analysis of percentage of syllables stuttered data. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 49, 867-878.
Percentage of syllables stuttered (%SS) is the most widely used method to count stuttering in research studies. The goal of the study was to critique the existing standard analytical techniques to determine the most appropriate way to analyze the %SS. Analysis of variance (ANOVA) was found to be a reliable technique in the majority of the studies. The study described two examples where ANOVA was inappropriate, small sample size (<20) or in studies with significant disparities between sample sizes and variances of the groups.
Jones, M., Onslow, M., Packman, A., Williams, S., Ormond, T., Schwarz, I., & Gebski V, (2005). Randomized controlled trial of the Lidcombe programme of early stuttering interventions. BRITISH MEDICAL JOURNAL. 24, 331:659
The purpose of this study was to evaluate the efficacy of the Lidcombe program of early stuttering intervention. This study included 54 participants from two different speech clinics in New Zealand and were randomly assigned to either the Lidcombe program or a control group. The children were between the ages of three and six and were required to have a frequency of stuttering on at least 2% of syllables. The results indicated that the control group reduced their stuttering an average of 43% compared to an average of 77% in the treatment group. These results provide evidence that the Lidcombe program is an effective treatment for stuttering in children.
Joukov, S. (2004). Trial software for frequency shifted and delayed auditory feedback. STAMMERING RESEARCH, 1, 316-325. URL: http://www.stamres.psychol.ucl.ac.uk/Vol1-Issue3.pdf
This article discusses different fluency products that Stammering Research has explored. The DAF/FAF Assistant runs on most Windows programs and requires a head set and microphone. Once installed, the device can be adjusted for playback and recording in the Volume Control Properties panel of a computer. Once this is set up, the DAF/FAF Assistant can be used during basic reading exercises and increasingly complex speaking situations as the individual becomes more comfortable with the device. The Pocket DAF/FAF Assistant is also available. Like the DAF/FAF Assistant, the Pocket version also requires headphones and a microphone. Additionally, this program allows the use of iPAQ cell phone headsets that have Bluetooth technology. This program is used in the same way as the DAF/FAF Assistant. Some research has shown that the short delays provided by these products immediately reduces stuttering by a significant degree.
Kaderavek, J. N., Laux, J. M., & Mills, N. H. (2004). A counseling training module for students in speech-language pathology training programs. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 153-161.
The purpose of this article was to describe a training program designed to train counseling skills to speech-language pathology graduate students. Ten first-year female graduate students participated in the study. The counseling training procedure taught skills in three areas including: Therapeutic Relationship/Attending Behaviors; Open Versus Closed Questions/Focusing on Feelings; and Paraphrasing and Summarizing Feelings. The results indicated there was a significant difference in the pre and post counseling skills of the graduate students.
Kalveram, KT., Natke, U., Pietrowsky, R., Sandrieser, P., & Van Ark, M. (2004). Linguistic stress, within-word position, and grammatical class in relation to early childhood stuttering. JOURNAL OF FLUENCY DISORDERS, 29. 109-122.
This study investigates if the stress effect is present in preschool children who stutter. Areas studies included, within-word position, grammatical class and stress, stuttering frequency, and stuttering frequency with respect to disfluency type. Results concluded that there is a strong relationship between grammatical class and stress. Children stutter more often on function words than on content words thus there is a clear word-initial stress effect seen in children. Overall, it was stated that there is a stress effect not only for adults and adolescents but also for preschool children. This study concludes that stress effect is related to its origin rather than being a consequence of stuttering.
Kalinowski, J., Armson, J., & Stuart, A. (1995). Effect of normal and fast articulatory rates on stuttering frequency. JOURNAL OF FLUENCY DISORDERS 3, 293-302.
This study investigated the effect of increased articulatory rate on stuttering frequency in a sample of adult stutterers. The authors found no statistically significant difference in stuttering frequency between normal and fast speech rate conditions. A significant difference was noted for articulatory rate (in syllables per second). That is, there was no statistically significant change in stuttering frequency with an increase in articulatory rate. The authors discuss the findings, suggesting that increased articulatory rate does not determine stuttering frequency with the same consistency as does decreased articulatory rate.
Kalinowski, J. S., Lerman, J. W., & Watt, J. (1987). A preliminary examination of the perceptions of self and others in stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 12(5), 317-331.
This research study examines the views of stuttering and non-stuttering subjects regarding perception of self and perceptions of others. Each group filled out two scales that were two pages in length. A comparison of the two groups' responses found that people who stutter have similar perceptions of self as those indicated by the non-stuttering group. However, the ratings of perceptions of the opposite group were contrastive in nature. Non-stutterers had negative connotations of stutterers whereas people who stutter viewed non-stutterers in a more positive way.
Kalinowski, J., Noble, S. Armson, J., & Stuart, A, (1994). Pretreatment and posttreatment speech naturalness ratings of adults with mild and severe stuttering. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY, 3(2), 61-66.
The purpose of this study was to compare the naturalness of pre- treatment stuttered speech to post-treatment fluent speech in people with both mild and sever stuttering. Sixty-four college students served as subjects and all completed the Precision Fluency Shaping Program during the course of the study. The researcher predicted that the subjects with mild stuttering would sound more natural after treatment and the subjects with severe stuttering would have fluent but unnatural sounding speech. All subjects who stuttered exhibited a reduction in stuttering frequency following treatment, however, all subjects were judged to have significantly less natural sounding speech. This study suggests that simply producing perceptually fluent speech may not be a sufficient end product of treatment, that the perceptual attributes of speech also needs to be addressed.
Kalinowski, J., Stuart, A., & Armson, J. (1996). Perceptions of stutterers and nonstutterers during speaking and nonspeaking situations. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 2, 61- 67.
This study was an examination of how the general public views a hypothetical adult male stutterer and a nonstutterer in speaking situations versus nonspeaking situations. One hundred and eight respondents from a telephone survey who agreed to receive, complete, and return a questionnaire served as participants. Results indicated that a negative stereotype of stutterers was perceived whether people were asked to describe stutterers in speaking or in nonspeaking situations.
Kalinowski, J., Stuart, A., & Armson, J. (1997). Response to Ingham: Seeking the truthfulness of stuttering research data. JOURNAL OF FLUENCY DISORDERS, 22, 57-59.
This article argues points made in the Ingham (1997) article (this issue) regarding single-subject versus group designed studies of people who stutter. The authors still support that findings from both approaches combined can lead to a better understanding of stuttering.
Kalinowski, J., Stuart, A., Wamsley, L., & Rastatter, MP. (1999). Effects of monitoring condition and frequency-altered feedback on stuttering frequency. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 42, 1347-1354.
This study engaged 8 people who stutter in oral reading situations using normal auditory feedback (NAF) and frequency altered feedback (FAF). The reading environment occurred with three monitoring levels: no monitoring, audiovisual monitoring and audiovisual monitoring with two people present. The occurrence of stuttering increased with the people present, when using the NAF. However, changing the monitoring situation did not affect the speech output of the readers while using the FAF. Frequency altered feedback significantly decreased the stuttering in all situations.
Kamhi, A. G., (2003). Two paradoxes in stuttering treatment. JOURNAL OF FLUENCY DISORDERS, 28, (3), 187-196.
There are two inconsistencies that clinicians face when dealing with people who stutter. The listener paradox is the multiple ways that typical listeners and clinicians respond to stuttering. The communication paradox is the use of treatment procedures that may have negative consequences on communication. The author notes that often clinicians request that the person who stutters alter their speech, which affects communication. The goal of the author is to make clinicians aware of the two paradoxes and to integrate the information into their treatments.
Kandi-Hanifi, K., & Howell, P. (1992). Syntactic analysis of the spontaneous speech of normally fluent and stuttering children. JOURNAL OF FLUENCY DISORDERS,17, 151-170.
This study assessed the syntax of the spontaneous speech of children who stutter. The analysis was conducted on three age groups to establish developmental trends in syntax for children who stutter and fluent children. Analyses were made on the mean length of utterance, the frequency of usage of syntactic categories, and frequencies of stuttering. In general, the more complex the syntactic category, the higher the stuttering frequency. This relationship depended on age with the youngest children who stuttered exhibiting the most difficulty.
Kamhi, A.G. (2003). Two paradoxes in stuttering treatment. JOURNAL OF FLUENCY DISORDERS, 28, 187- 196.
The author comments on two inconsistencies for clinicians and treatments for people who stutter. The first one is called the listener paradox. Clinicians are taught to maintain eye contact with client during moment of stuttering. In reality, typical listeners respond with shifting eye gaze, a natural reflex, to speaker's shift in gaze or as a response to distracting stimulus associated with stuttering. Clinicians need to let clients know about this reflex and that the listener is not being insensitive. The second inconsistency is the communication paradox. The treatment strategies for stuttering, such as fluency shaping and voluntary stuttering, may elicit negative reactions from listeners due to the artificial speech it produces. The author concludes that clinicians need to be aware of these inconsistencies during therapy and make effective communication as a main focus during treatment.
Karrass, J., Walden, T.A., Conture, E.G., Graham, C.G., Arnold, H.S., Hartfield, K.N., & Schwenk, K.A. (2006). Relation of emotional reactivity and regulation to childhood stuttering. JOURNAL OF COMMUNICATION DISORDERS, 39 (6), 402-423.
This article describes a study that was conducted to examine childhood stuttering versus typically developing, and its relation to emotional reactivity and regulation. 65 children who stutter (CWS) and 56 children who do not stutter (CWNS) met a certain set of criteria and participated in the study. Children were tested twice; once at home for speech/language skills and once at a laboratory for hearing screenings and further speech/language assessment. Parents were given a Behavior Style Questionnaire (BSQ), at the home visit that was specifically designed with three types of grouped questions. The questions focused on emotional regulation, emotional reactivity and attention regulation. Results indicated that preschool CWS, in stressful/intense situations, were more emotionally reactive than CWNS. It was also found that the ability to regulate emotions as well as control attention was more difficult for the CWS. These findings suggest that the reduced ability to regulate emotions and control attention along with the increased emotional reactivity, experienced by the CWS, limits their abilities to produce speech and language with normal fluency.
Kelly, E. M. (1995). Parents as partners: Including mothers and fathers in the treatment of children who stutter. JOURNAL OF COMMUNICATION DISORDERS, 28, 93-105.
While restating the utility of including parents, this article also investigates the possible differences between the mother's and father's role in their child's stuttering therapy. Kelly discusses two sides to this issue. First, some studies reveal no significant differences between the mother's and father's influence on their child's fluency. However, other studies indicate differences, such as speaking rate and pragmatic style, can exist and affect the child's fluency. Kelly summarizes: with an increase in parental involvement, it would be advantageous to clinicians, family, and researchers to clearly outline the variables of the mother's and father's child interactions separately. This may prove to be an efficient approach to therapy for dysfluent children who are influenced differently by each parent.
Kelly, E.M., & Conture, E.G., (1991). Speaking rates, response time latencies, and interrupting behaviors of young stutterers, nonstutterers, and their mothers. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 1256-1265.
The purpose of this study was to assess the relationship of speaking rate, response time and latencies have to speech disfluencies in conversation between mothers and stuttering sons and nonstuttering sons and their mothers. No significant differences were found between the speaking rates of stutterers and nonstutterers, but the mothers of the nonstutterers had faster rate of speaking than either group of children. No significant differences in interruption in any child or mother groups, but most interruptions occurred when children were disfluent.
Kelly, EM., & Conture, EG. (1998). Acoustic and perceptual correlates of adult stutterers' typical and imitated stutterings. JOURNAL OF FLUENCY DISORDERS, 13, 233-252.
This study was used to determine if there are any externally observable, objective differences between stutterers' self-reported controlled stutterings versus uncontrolled stutterings. The results indicate that the stutterers were generally more certain of their perceptual judgments of initiated stutterings when compared to uncontrolled stutterings. There were no significant differences between adult stutterers' perceived typical and imitated stuttering.
Kelly, E.M., Martin, J.S., Baker, K.E., Rivera, N.I., Bishop, J.E., Krizizke, C.B., Stettler, D.S., & Stealy, J.M. (1997). Academic and clinical preparation and practices of school speech-language pathologists with people who stutter. LANGUAGE, SPEECH AND HEARING SERVICES IN SCHOOLS, 28(3), 195-212.
A survey was sent out to 157 Indiana School SLP's to determine the adequacy of their education and training in stuttering. Results indicate insufficient academic and clinical preparation. With the recent action taken by ASHA SID 4 (Fluency Disorders Special Interest Division), to devise a continuum of educational and clinical opportunities, future SLP's may be better prepared and feel more confident to meet the needs of people who stutter.
Kelly, EM., Smith, A., & Goffmann, L. (1995). Orofacial muscle activity of children who stutter: A preliminary study. JOURNAL OF SPEECH AND HEARING RESEARCH, 38, 1025-1036.
This study examined the relations between stuttering development and the maturation of speech motor processes. The subjects of this study consisted of nine children who stutter and their age-sex matched normally fluent peers. Electomyographic (EMG) activity was recorded from the orofacial muscles of the subjects during conversational speech. The preliminary results from this study suggest that the production of stuttering may be responsible for tremorlike oscillations in the orofacial muscle of children who stutter.
Kiefte, M., & Armson, J. (2008). Dissecting choral speech: properties of the accompanist critical to stuttering reduction. JOURNAL OF COMMUNICATION DISORDERS, 41, 33-48
Researchers investigated the consequences of using choral speech and altered auditory feedback (AAF) for people who stutter. The study included seventeen participants. Researchers altered various aspects of the choral speech components. Findings indicated that both choral speech and AAF led to a decrease in stuttering frequency. However, research revealed that AAF produced less significant reductions in stuttering behaviors when compared to choral speech. These findings were consistent with findings uncovered in previous research.
Killin, H., McCaul, A., & Murdoch, B. E., (1989). A kinematic analysis of respiratory function in a group of stutterers pre-and post- treatment. JOURNAL OF FLUENCY DISORDERS, 14, 5, 323-350.
This study looked at the respiratory abilities of seven stutterers in a variety of speech tasks prior to treatment, following treatment, and 1-month post treatment. They used kinematic analysis by means of measurement. The analysis studied the direct relationship between volume displacement of the lungs and displacement of the chest wall. Thus, changes in lung volume during breathing can be measured kinematically through combined displacements of the rib cage and abdominal walls. Movements of the chest wall during both steady speech tasks and conversation speech were found to alter following treatment. The changes in respiratory function correlated with the improvement of disfluencies. The authors stated the potential of a kinematic techniques with traditional stuttering therapy procedures can be effective for treatment and beneficial in delaying relapse of stuttering following treatment.
Kinger, H., (1987). Effects of pseudostuttering on normal speakers' self-ratings of beauty. JOURNAL OF COMMUNICATION DISORDERS, 20(4), 353-58.
This study evaluated the feelings of undergraduate and graduate students before and after a pseudostuttering experience. Areas evaluated include self evaluations of outer and inner beauty before and after a pseudostuttering experience. Results varied somewhat between undergraduate and graduate students. However, overall, results did indicate that the pseudostuttering experience can lower self-image, giving the normal speaker empathy for the person who stutters.
Kiser, A.M., Lass, N.J., Lockhart, P., Mussa A.M., Pannbacker, M., Ruscello, D.M., & Schmidt, J.F. (1994). School administrators perceptions of people who stutter. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 25, 90-93.
A questionnaire was developed and distributed to school administrators in Alabama, Louisiana, Texas, and West Virginia. Respondents were required to lost adjectives to describe male and female children and adults who stutter. Of the 197 adjectives listed by respondents, 143 were negative, 39 were positive, and 15 were neutral. The adjectives shy, nervous and quiet were the most frequently reported. Such a large number of negative personality traits may have an adverse effect on the education of students who stutter. The researchers concluded that stuttering needs to be addressed in pre-service coursework and continuing education programs to heighten awareness and reduce negative stereotypes.
Klein, J., Cervini, M., & Clemenzi, K. (2006). When do I get to shut the door? The pseudostuttering experiences of two undergraduate students. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY, AND RESEARCH, 1, 36-41. Retrieved from http://www.journalofstuttering.com/ListofArticles.html
Pseudostuttering assignments have become common in college fluency classes, because it is thought that they help future clinicians understand what stuttering is, how to do it, and feelings associated with it before working with clients who stutter. This article discussed the experiences of two undergraduate students. The students were assigned to stutter in various situations such as when speaking on the phone, in a restaurant, at home, etc. and then write about their experiences. The two undergraduate students' encountered quite opposite experiences. One experienced feelings of embarrassment, self-consciousness, and nervousness based on her own reaction to her stuttering and not the reaction of the person with whom she was talking. The other student felt angered and guilty based on the reactions she received from others. Even though the two experiences were opposite, they both still reflected real feelings of what it is like to be a person who stutters.
Klein, J., & Hood, S. B. (2004). The impact of stuttering on employment opportunities and job performance. JOURNAL OF FLUENCY DISORDERS, 29, 255-273
In this article 232 people who stutter took a 17 item survey containing questions that focused on thoughts and feelings about how stuttering affects their job performance and employability. The results show that 70% of the participants see stuttering as an interfering factor in job attainment and promotion while 36% indicated that stuttering interferes with their work performance. Of the individuals surveyed, more men and minorities viewing stuttering as a handicap than did women and Caucasians.
Kleinow, J. & Smith, A. (2000). Influences of length and syntactic complexity on the speech motor stability of the fluent speech of adults who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43(2), 548-559.
This study examines the stability of the lower lip during phrases varying in length and complexity. It looks at fluent adult speakers and the fluent speech of adults who stutter. The researchers used a measure that looks at the stability of movements over repeated trials called the spatiotemporal index (STI). There were 16 subjects included in the experiment, 8 speakers who stutter and 8 fluent speakers. The subjects were asked to say a baseline phrase alone, and then other utterances that contained the baseline phrase. Results showed that stutterers had less motor stability than non-stutterers, and the complexity of the utterance seemed to cause more instability. Length didn't have an effect on either group. The researchers point out the need for more research and better ways to separate length and complexity.
Klompas, M., & Ross, E. (2004). Life experiences of people who stutter, and the perceived impact of stuttering on quality of life: personal accounts of South African individuals. JOURNAL OF FLUENCY DISORDERS, 29, 275-305.
This study included 16 South African adults who stutter with an age range of 20 to 59 years of age. The participants were interviewed and asked questions pertaining to the affects of stuttering on; education, social life, employment, speech therapy, family and marital life, identity, and beliefs and emotional issues. Of the 16 participants 62% believed that stuttering had a negative impact of their academic performance, 56% viewed stuttering as having a negative impact on their social life, 25% reported factoring in stuttering when they chose there jobs, almost 95% of the participants have had speech therapy at some point in their life with eighty seven percent of those reporting speech therapy as non- helpful. Fifty six percent of the participants said that stuttering did not affect the relationship with their parents. Most of the participants interviewed believed that stuttering had affected their self-esteem and self image.
Kloth, S., Jansen, P., Kraaimaat, F., & Bruten, G. (1998). Child and Mother Variables in the Development of Stuttering Among High-Risk Children: A Longitudinal Study. JOURNAL OF FLUENCY DISORDERS, 23, 4, 217-230.
The article was a study done to evaluate the development of articulation and language in children who have a parental history of stuttering and have begun to stutter and also in terms of their mother's communicative styles and speaking behaviors. Data collection involved obtaining 10 minute speech samples from mother-child interaction from 30 minute play time sessions. Language skills were assessed using the Reynell, PPVT, and MLU. Articulation skills were assessed using an acoustical temporal analysis to find a syllable rate per second. The mothers communicative style was assessed by using an interaction-analysis developed by the authors. Speaking behaviors for mothers were measured with the same procedure. Results showed that the children who stuttered in the study had increased articulation rate and increased receptive and expressive skills one year after initial testing. Mothers noted an increased language complexity as measured by MLU.
Kloth, S. A. M., Janssen, P., Kraaimaat, F. W., & Brutten, G. J. (1995). Speech-motor and linguistic skills of young stutterers prior to onset. JOURNAL OF FLUENCY DISORDERS, 20(2), 157-170.
This article presents the one year results of a 3-year longitudinal study of 93 preschool children. At initial testing, all 93 two year old subjects were not dysfluent. The study objectives included gaining knowledge about the relation between genetic, physiologic, linguistic, and environmental factors relating to the onset and development among at-risk children (1 or more parents stutter). Test procedures included a parental disfluency questionnaire, the Reynell Language Development Scale, PPVT, and 10 minutes of spontaneous speech. Results found at the one year follow-up that 26 children (16 boys, 10 girls) were considered stutterers by their parents. There were no significant differences between stutterers and nonstutterers in both receptive and expressive language. Notably, the pre-onset articulation rate of the 26 dysfluent children was significantly faster than the nonstuttering subjects (3.7, 3.45 syll/sec. respectively). The rate of the at-risk nonstutterers was notably slower than non-risk age equivalents in a study by Walker (1992). The authors suggest that this relatively slow speaking rate served as a protective factor against a fluency breakdown.
Kloth, S. A. M., Janssen, P., Kraaimaat, F. W., & Brutten, G. J. (1995). Speech, motor and linguistic skills of young stutterers prior to onset. JOURNAL OF FLUENCY DISORDERS, 20 (2), 157-170.
In this prospective study, 93 children with a parental history of stuttering were the subjects. Initially, all subjects were viewed as nonstutterers, but one year later, 26 were regarded as stutterers. It was noted that prior to the onset of stuttering these children did not differ from the others, but their rate of articulation was significantly faster. Therefore, it was concluded that the children who stuttered did not differ in their expressive or receptive language abilities, but that a slower rate served as a buffer against fluency breakdowns.
Kraaimaat, F., Janssen, P., Brutten, GJ. (1988). The relationship between stutterers' cognitive and autonomic anxiety and therapy outcome. JOURNAL OF FLUENCY DISORDERS, 13, 107-113.
This study looked at the relationship between anxiety and the outcome of therapy for people who stutter. Thirty-three male stutterers aged 13-16 were chosen as subjects for this study. The subjects were all diagnosed as stutterers. Each subject was videotaped prior to therapy and then again 7 months after the termination of therapy as they read aloud a 384-syllable passage. The tapes were used to determine the frequency of 1. fast repetitions of sounds, syllables, or one-syllable words, 2. Silent or oral prolongation's, and 3. Slow repetitions or interjections of a sound, syllable, word, or phrase. Anxiety was autonomically assessed using measures of heart rate and skin conductance. Anxiety was also cognitively assessed using the emotional reactions portion of the speech situations checklist and self-rating scales. Therapy took place over 70 hours for four consecutive weeks. Ten booster sessions were then held bimonthly. Therapy was given in groups of twelve and involved training in relaxation and regulated breathing, desensitization of speech-associated anxiety, cognitive restructuring, and self-control. The results indicated that improvement in anxiety levels was evident despite the fact that normal fluency was not achieved. However, subjects of this study did show fewer fluency failures following therapy than in the pretreatment period.
Kraaimaat, FW., Vanryckeghem, M., & VanDam-Baggen, R. (2002). Stuttering and social anxiety. JOURNAL OF FLUENCY DISORDERS, 27, 319-331.
The topic researched in this article was the difference of emotional tension in social situations with people who stutter compared to people who do not stutter. The subjects consisted of 89 adults ranging from 18 to 50 years of age who stuttered, and 131 adults who did not stutter. The subjects used a 5 point scale to self-evaluate discomfort levels and frequency of occurrences in various social situations. Both groups showed emotional tension in social situations, but the group of people who stuttered showed significantly higher amounts. These findings suggest that speech therapy should include strategies to help reduce anxiety for people who stutter.
Kramer, M.B., Green, D., & Guitar, B., (1987). A comparison of stutterers and nonstutterers on masking level differences and synthetic sentence identification tasks. JOURNAL OF COMMUNICATION DISORDERS, 20(5), 379-90.
This study was conducted to determine the performance differences between stutterers and nonstutterers on 2 central auditory processing tasks. The 2 tasks the Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM) and Masking Level Difference (MLD) were administered to 10 subjects. There were 8 males and 2 females in each group. The mean age of the participants was 32.6. Results indicated that there was no significant difference between stutterers and nonstutterers on the SSI-ICM, but stutterers did perform poorer on the MLD.
Krishnakanth, M., Haridas, P. V., & Muralidharan, K. (2008). Clozapine-induced stuttering: a case series. PRIMARY CARE COMPANION JOURNAL OF CLINICAL PSYCHIATRY. 10(4), 333-334.
This article provides the cases of 3 patients between the ages of 23-35 who had developed stuttering while taking clozapine. The patients involved in this study developed stuttering at 200-250 mg/day of clozapine. Past research has shown stuttering to be associated with a higher dose of clozapine, between 400-700 mg/day. When decreasing the dose of clozapine in one of the patients, his stuttering was resolved. This suggests that stuttering is related to the dose of clozapine taken.
Kumar, A. & Balan, S. (2007) Fluoxetine for persistent developmental stuttering. JOURNAL OF CLINICAL NEUROPHARMACOLOGY. 30(1), 58-59.
This article describes the definitions of stuttering, developmental stuttering, and persistent developmental stuttering. It discusses a case of a 22-year-old male who had persistent developmental stuttering the positive affects that fluoxetine had on his stuttering. In this article the affects that fluoxetine can have on persistent developmental stuttering are discussed.
Kuniszyk-Jozkowiak, W. (1995). The statistical analysis of speech envelopes in stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 20(1). 11-24.
This article is a portion of a research project which attempts to develop an objective fluency evaluation method. Acoustic analysis is used to evaluate utterances, distinguishing between fluent and dysfluent speech. Results indicate that differences in speech envelopes of stutterers and non-stutterers may be used to analyze degrees of speech non-fluency, proving the hypothesis which states that dysfluency results from a dys-synchronization, a disorder of timing, between laryngeal function and vocalizing activities.
Kuster, J.M. (2008, October 14). International Stuttering Awareness Day is Oct. 22. THE ASHA LEADER, Vol. 13, No. 14, p. 18
The purpose of this article was to highlight the 2008 International Stuttering Awareness Day (ISAD) by briefly describing its history, its present success, and its future in the lives of people who stutter (PWS) and the professionals working with them. This article also explains the ISAD online conferences, which were launched ten years ago, when the ISAD was first recognized. The conferences are live worldwide once a year in October for three weeks. Participants in the conferences post articles, stories, therapy ideas, and tips or ideas. While the conference is live, readers can post questions or comments to the author(s) of the material. The ISAD online conferences are available to PWS, professionals, family members, students, or to anyone who is interested in learning more about stuttering.
Ladoucheur, R., & Saint-Laurent, L. (1986). Stuttering: A multidimensional treatment and evaluation package. JOURNAL OF FLUENCY DISORDERS, 11, 93-103.
The treatment goals of this study were to eliminate behavioral, emotional, and cognitive difficulties that are associated with stuttering. Eight people who stutter and eight people who do not stutter were involved in this treatment study. Subjects were treated in a group setting with a total of four people in each group. They met twice each week for two-hour sessions. Treatment focused on five sessions related to regulated breathing, two sessions dealing with desensitization, and one session that focused on structuring cognitive thinking to be more positive. Results indicated no significant changes between different speech acts, such as, talking on the telephone, speaking to someone in person, or public speaking. There were significant changes in the subjects' amount of stuttered syllables. Due to treatment stuttering was reduced and the reduction in stuttering was maintained in follow up studies.
Langevin, M., & Boberg, E. (1996). Results of intensive stuttering therapy with adults who clutter and stutter. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 315-327.
Criteria for evaluating the relative importance of cluttering and stuttering symptoms appears to be a clinically useful tool in identifying persons who clutter and stutter. This study presents such criteria. Results of the study indicate a positive response of cluttering-stuttering subjects to therapy, but greater gains may have been made with additional therapy time and expanded therapy goals. Pretreatment and posttreatment measures of articulatory rate as a more sensitive measure of change for cluttering-stuttering clients is also indicated.
Langevin, M., Huinck, W.J., Kully, D., Peters, H.F.M., Lomheim, H., & Tellers, M. (2006). A cross-cultural, long-term outcome evaluation of the ISTAR comprehensive stuttering program across Dutch and Canadian adults who stutter. JOURNAL OF FLUENCY DISORDERS, 31(4), 229-256.
The primary purpose of the investigation was to evaluate the effectiveness of the ISTAR Comprehensive Stuttering Program (CSP) at 2 years post-treatment within and across client groups from the Netherlands and Canada and to evaluate the global treatment effect across the groups. The secondary purpose was to examine any observed differences and to consider whether they may be due to cultural, methodological, or other factors. Participants in this study were (a) 25 clients who were treated with the CSP in the Netherlands, and (b) 16 clients treated with the CSP in Canada. The CSP evaluated in this study was a 3-week intensive group therapy program for adults who received 90 hours of therapy (6 hours per day). The program consisted of three phases which included: acquisition of fluency and cognitive behavioral skills (weeks 1&2), transfer (week 3), and maintenance (continued practice of skills in the months and years following the 3-week intensive program). It was found that the 2 year post-treatment outcomes of the CSP in the Netherlands were positive and similar to those of the Canadian Group. Results indicated that there were no differences across the cultures in outcomes which were measured by the following: stuttering frequency, speech related attitudes, confidence, and perceptions of struggle, avoidance, and expectancy to stutter. Two differences were noted between the groups in speech rate and perception of self. It was reported that the CSP appeared to be similarly effective in both cultures.
Langevin, M., Kleitman, S., Packman, A., & Onslow, M. (2008). The peer attitudes toward children who stutter (PATCS) scale: an evaluation of validity, reliability and the negativity of attitudes. INTERNATIONAL JOURNAL OF LANGUAGE COMMUNICATION DISORDERS, Sep: 25, 1-17
This article analyzed the relationship of the Peer Attitudes Toward Children who Stutter (PATCS) scale through an evaluation of validity, reliability, and the negativity of attitudes. The study surveyed third through sixth grade students from a variety of schools to determine attitudes toward children who stutter (CWS). A confirmation factor analysis (CFA) was performed to determine the validity and reliability of the PATCS scale. The article included results that support the utilization of the PATCS scale to determine the attitudes of peers toward children who stutter, and indicates the need for school-based education about stuttering, similarities and differences among children who do and do not stutter, and making personal choices about children who stutter.
Langevin, M. & Kully, D. (2003). Evidence-based treatment of stuttering: III. Evidence- based practice in a clinical setting. JOURNAL OF FLUENCY DISORDERS, 28, 219-236.
This article addresses the probability that evidence-based practice can be carried out in the clinical setting. The article went through the process of collecting data on treatment programs for teens, adults, and school-age children. Data was collected pre-treatment, post-treatment, and follow-up. Methods of data collection were percentage syllable stuttered, syllable spoken per minute, naturalness ratings, severity ratings, and attitude and perception inventories. The process of evaluation data for clinical and research purpose was shown through a case example. The authors conclude by saying they believe that evidence-based practice can be carried out daily in most clinical settings, with some needing assistance from researchers.
Langlois, A., & Long, S.H. (1988). A model for teaching parents to facilitate fluent speech. JOURNAL OF FLUENCY DISORDERS, 13, 163- 172.
The paper reports an indirect treatment for incipient stuttering focusing on parental behavior. Rate, turn taking and utterance types of the parent's conversational speech were analyzed. A teaching program introduced mirroring, self-talk, parallel talk, reflecting, expansion and speech pattern modification techniques.
LaSalle, L. R. (1995) Dysfluency clusters of children who stutter: Relation of stutterings to self-repairs. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(5). 965-977.
Speech dysfluency clusters in sixty 3 to 6 year-old children, half of whom stutter, is studied resulting in the following information: children who stutter exhibited significantly more "stuttering- stuttering," as well as "stuttering-repair" of clusters, while children who are considered nonstutterers were less likely to stutter and repair their disfluencies with stutters.
LaSalle, RL., & Conture, EG. (1995). Disfluency clusters of children who stutter: Relation of stutterings to self-repairs. JOURNAL OF SPEECH AND HEARING RESEARCH, 38, 965-977.
The purpose of this study was to examine the frequency, type, and possible origins of speech dysfluency clusters in the spontaneous speech of 3-6 year old children. The subjects consisted of 30 children who stutter and 30 who do not stutter. Three types of speech dysfluencies were analyzed; overt self-repairs, covert self- repairs, and within-word dysfluencies, and the dysfluency clusters they compromised. The results indicate that children who stutter produce significantly more stuttering clusters and stuttering repair clusters.
Lass, NJ., Ruscello, DM., Pannbacker, MD., Schmitt, JF., & Everly- Myers, DS. (1989). Speech-Language Pathologists' Perceptions of Child and Adult Female and Male Stutterers. JOURNAL OF FLUENCY DISORDERS, 14, 127-133.
A questionnaire was given to speech-language pathologists and were asked to list adjectives describing four hypothetical stutterers. The research was done to determine the overall perception speech clinicians have about people who stutter. Personality characteristics were the most common descriptors and most of the characteristics listed by the speech-language pathologists were negative stereotypes. These findings may impact the development and possibly the onset of the stuttering problems. The results reflect a possible need in making clinicians aware of their attitudinal beliefs concerning stuttering. This assessment of beliefs needs occur to prevent these biases from interfering with stuttering therapy.
Lass, N.J., Ruscello, D.M., Schmitt, J.F., Pannbacker, M.D., Orlando, M.B., Dean, K.A., Ruziska, J.C., & Bradshaw, K.H. (1992). Teachers' perceptions of stutterers. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 23, 78-81.
A questionnaire asking 103 elementary and secondary teachers to list adjectives describing four hypothetical stutterers (a typical 8 year old female, 8 yr. old male, adult female and adult male stutterers). The majority of the reported adjectives were negative stereotypical personality traits, indicating perceptions of stutterers similar to other groups, including speech-language pathologists, special educators, parents, college students, and professors. Pre-service and continuing education programs were suggested to prevent an adverse effect on the assessment, instruction, and educational progress of stutterers in the teacher's classes.
Lattermann, C, Euler, H.A., Nueman, K. (2007). A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers. JOURNAL OF FLUENCY DISORDERS, 33(1), 52-65.
Forty-six similar German-speaking preschoolers, ages 3;0 and 5;11 years, participated in a 16 week long research study to determine if the Lidcombe Program is an effective intervention to reduce stuttering compared to natural recovery. The children were divided into two groups, a treatment group or a wait-contrast group. For the treatment group participants, therapy took place immediately within the home and was monitored and modified by the parent, who was trained by the speech-language pathologist. The parent would give verbal and non-verbal reinforcement to the child during stuttering episodes (i.e. "That was great talking", "There was a little bump", and "That was smooth"). Progress was charted weekly, for both groups, through a spontaneous speech sample, collected by the SLP, and a measurement of a stuttered syllable percentage; as well as, a daily stuttering severity rating by the parent. Results indicated that over a 4 month period, preschoolers involved in the Lidcombe Program decreased stuttering behaviors significantly greater than children involved in the wait-contrast group.
Lattermann, C., Shenker, R. C., & Thordardottir, E. (2005). Progression of language complexity during treatment with the Lidcombe Program for early stuttering intervention. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 14, 242-253.
The purpose of this article was to determine if fluency was achieved through the Lidcombe Program because of a reduction of linguistic complexity. Four male preschool children who stuttered participated in the study. Language samples were taken prior to therapy, during therapy, and 6 months after completing the program. The samples were analyzed for mean length of utterance (MLU), number of different words (NDW), amount of sentences containing complex syntax, and percent of syllables stuttered. Results of the study indicated all of the children decreased the severity of their stuttering, MLU was age appropriate, demonstrated an increase in syntactic complexity, and NDW remained consistent. Overall, the data suggests these preschool children did not have a reduction in linguistic complexity while increasing their fluency.
Leahy, M. M. (2004). Therapy Talk: Analyzing therapeutic discourse. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35, 70-81.
This article discusses the importance of clinicians getting away from traditional discourse with clients; where the clinician asks a question, the client answers, and the clinician evaluates the response and asks another question. The author suggested clinicians should begin attending more to the roles the client and clinician traditionally fall into; clinician in the authority role and client in the error-maker role. Leahy recommends limiting the use of the words such as we, I, OK, and now. These words put the clinician in an authority role and may limit the verbal exchange between clinician and client. Qualitative research methods for analyzing therapeutic discourse related to stuttering are discussed (i.e. ethnography of communication, conversational analysis, and framing in discourse). Leahy provides a fluency case study of a discourse analysis. The author found that the clinician in the case study was listening more to how the client was speaking than the words the client was speaking. Overall, Leahy suggests that roles need to be flexible in therapy, especially with individuals who stutter. These individuals need to develop a sense of being a competent speaker and not feel as though there speech is constantly full of errors.
Leahy, M.M. (2005). Changing perspectives for practice in stuttering: Echoes from a Celtic past, when wordlessness was entitled to time. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 14, 274-283.
This article viewed the changing perspectives for practice in stuttering therapy by outlining the evolution of The International Classification of Functioning, Disability, and Health (ICF; World Health Organization, 2001) which has a sociological emphasis with a focus on the ability and functioning of the person. The evolution of the ICF was outlined by moving from an impairment-based focus to a more sociological perspective. A view of speech disability in an ancient Irish society was described with tales from Irish folklore, where the central theme was that stuttering did not affect society's recognition of an individual's general ability and talent. This view differed from the impairment-based focus that has been the heritage of the speech- language pathology profession in the 20th century. The review of changing perspectives showed the dominance of the impairment- based medical model in speech-language pathology and how it was used to structure therapy for stuttering in the development of the profession during the 20th century. It was reported that the revision of the ICF broadened the scope of the previous classification system (emphasizing impairment as the source of disability and handicap) and included concepts of health, activities, and participation. It was also reported that the broad social perspectives of an ancient Celtic society are echoed in the principles of the ICF.
Lebrun, Y. (1996). Cluttering after brain damage. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 289-295.
Acquired cluttering after brain damage in adults is suggested based on observations made in two patients and on published cases. Hypotheses are made regarding the patho-physiology of the disorder and the importance of auditory feedback in the regulation of speech rate.
Lebrun, Yvan (1998). Clinical Observations and Experimental Research in The Study of Stuttering. JOURNAL OF FLUENCY DISORDERS, 2, 119-122.
This article is a reaction to a previous paper in the same journal by Mowrer. The author focuses on a portion of that paper in which a mother claims her son's stuttering began suddenly on February 28, 1992. The mother, and other observers, noted eye blinks and head jerks and other involuntary movements in the boy, believed to be the result of struggle during the stuttering. The writer concludes, these associated movements are more likely the result of extrapyramidal disease. The paper concludes that while experimental research contributes statistical data for efficacy in the treatment of stuttering, it cannot be used in substitution for clinical observation.
Leder, S.B. (1996). Adult onset of stuttering as a presenting sign in a parkinsonian-like syndrome: A case study. JOURNAL OF COMMUNICATION DISORDERS, 29(6): p471-478.
This case study describes a 29-year-old white male who began stuttering as a result of psychological stress. The man's stuttering was diagnosed as severe and a description of the man's speech characteristics are provided. An Interesting feature reported on the subjects speech was that no starters or secondary characteristics, no specific word fears or avoidances, and no situational fears were exhibited. A neurological exam done on the subject found a resting tremor in the hands and legs as well as lingual fasciculations, gait imbalance, and numbness and tingling of the hands and feet. All the symptoms found by the neurological exam were progressive in nature. An outline of the subjects rehabilitation plan is given along with a description of the medical intervention that was implemented. This case study shows how important it is for the clinicians to consider the possibility of a neurological disease as a possible etiology for patients with adult onset of stuttering.
Lees, R.M. (1988). The effect of foreperiod length on the acoustic voice reaction times of stutterers. JOURNAL OF FLUENCY DISORDERS, 13, 157-162.
The purpose of the study was to compare the voice reaction times of stutterers and nonstutterers to investigate the phonatory behavior of people who stutter. Six stutterers and six nonstutterers were subjects. The response to the offset of a stimulus tone was measured. The length of the tone and preparatory period were controlled. Results state stutterers were slower at all tone directions, but failed to reach statistical significance.
Lees, R., Anderson, H., & Martin, P. (1999). The influence of language disorder on fluency: a pilot study. JOURNAL OF FLUENCY DISORDERS, 24, 227-238.
This was a pilot study done on the influence of language disorders on fluency. The basis for the study is the fact that young, normally developing children experience a period of dysfluency during language growth. It was hypothesized that if a child is having difficulty with language, it could lead to an increase in dysfluency. There were 16 children that participated in the study who were divided into four groups: children receiving speech and language treatment, children receiving stuttering treatment (divided into 2 age groups), and children with no fluency problems. The results were examined in a variety of ways: language impaired vs. non-language impaired, stuttering vs. nonstuttering, and modeling vs. imitation. The results showed a clear pattern of non-relationship between dysfluency and language impairment.
Lees, R.M., Boyle, B.E., and Woolfson, L. (1996). Is cluttering a motor disorder? JOURNAL OF FLUENCY DISORDERS 21, 281-287.
Because of the inadequate definition of cluttering certain problems exist and are discussed in this article. It goes on to suggest the importance of assessing speech rate and other aspects of motor speech. This article discusses the results of tests done with a 15 year old male who was assessed for a fluency disorder not though of as stuttering.
Levine, S. Z., Pertrides, K. V., Davis, S., Jackson, C. J., & Howell, P. (2005). The use of structural equation modeling in stuttering research: Concepts and directions. STAMMERING RESEARCH, 1(4). http://www.stamres.psychol.ucl.ac.uk
This article discusses the use of an analytical data technique known as Structural Equation Modeling (SEM) and how it is used/will be used within the field of stuttering. SEM is described as being a broad range of procedures which assist in factor analysis, time growth analysis, multi-level latent modeling, and simultaneous equation modeling. The strengths of SEM includes: permitting statistical analyses accounting for measurement of error, providing a rigorous approach to model testing, flexibility, accommodating to tests of mediation and moderation, and permitting for statistical testing of theoretical models. The article discusses in detail new possibilities that SEM offers which includes analysis for stuttering data. From the implications of this article, SEM offers researchers a new way to approach hypothesis testing by replacing conventional data analysis techniques, more comprehensive theoretical statements, and providing a way for researchers to study the developmental pathways of stuttering.
Lewis, C., Packman, A., Simpson, J.M., & Jones, M. (2008). A phase II trial of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 17, 139-149
This article evaluated the efficacy of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention to determine the number of children showing an 80% reduction in the percent syllables stuttered scores over a nine month period. The study included 22 participants including the ages of 3-6 years. The treatment was performed by parents and correspondence took place via telephone consultations with a speech-language pathologist, typically on a weekly basis. The article includes results that support the use of telehealth delivery of the Lidcombe Program for preschool children who are unable to receive clinic based treatment.
Lewis, K. (1991). The structure of disfluency behaviors in the speech of adult stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 492-500.
Videotaped monologues of 139 males and 41 females made up the subject sample in the current study. Subject files were taken from five university speech clinics, and one private practice clinic. For each subject, all instances of the nine disfluency types were marked and totaled. The interrelationships observed among the nine disfluency types indicated that the idea of a twofold classification of stuttering behavior has some merit.
Lewis, K.E. (1994). Reporting Observer Agreement on Stuttering Event Judgments: A Survey and Evaluation of Current Practice. JOURNAL OF FLUENCY DISORDERS, v19, n4, Dec.
This article discusses finding agreement of people observing and how it is valid or nonvalid in three national journals dating from November 1988 to September 1992. Five common agreement procedures, which account for 92% of the articles, include: Sander's Agreement Index, Pearson Product-Moment Correlation r, Mean difference Scores, Tests of Deviation from known Distributions, and Percentage Agreement. The author discusses problems with these five agreement procedures and suggests some alternative procedures such as: Occurrence Agreement and Chance Occurrence Agreement, Scott's Pi, and Kappa.
Lewis, K. (1995). Do SSI-3 scores accurately reflect observations of stuttering behaviors? AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY, 4(4) 46-59.
The purpose of this investigation was to answer the question, "Do scores obtained on the Stuttering Severity Instruments for Children and Adults accurately reflect observations of stuttering behaviors?" The results from this study indicate they do not. These findings indicate a considerable range of stuttering behaviors underlie a given SSI-3 severity level score. It is clear that clinicians and researchers have a need for instruments that provide valid and reliable measures of numerous aspects of stuttering. However, the present data indicates that need is not met by the SSI-3. For the many reasons addressed in this article, continued use of the SSI-3 is not supported.
Lewis, K.E., Harrison, N., & Haring, M. (1998). Toward a mentoring model for fluency specialty recognition. JOURNAL OF FLUENCY DISORDERS, 23, 59-71.
Special Interest Division for Fluency and Fluency Disorders (SID-4) is ASHA's first specialty recognition program. The purpose of this article was to work at developing steps towards a mentoring relationship which all professionals in different stages of their careers could utilize for SID-4. Members of SID-4 participated in this study and worked towards giving a desirability rating to multiple areas/ functions studied. The authors developed two main phases of functions- adjusting and development. The results of this study give further direction towards implementing mentoring models for specialty recognition programs in the future.
Liles, B.Z., Lerman, J., Christensen, L., & St. Ledger, J. (1992). A case description of verbal and signed disfluencies of a 10 year old boy who is retarded. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 23, 107-112.
Disfluencies in the verbal and signed language of a 10 year old moderately mentally retarded boy were analyzed from video samples of spontaneous communication and structured language lessons. The boy had normal hearing with speech and language commensurate to his mental age. The subject was observed to be disfluent in verbal communication and in verbal and manual communication produced simultaneously. Repetitions, prolongations, and blockages were described as occurring at the time across communicative modes during the use of total communication. Accurate characterization of stuttering in manual communication and the appropriate approaches to management were discussed.
Lincoln, M., & Onslow, M. (1997). Long-term outcome of early intervention for stuttering. AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY, 1, 51- 58.
This paper reports on the long-term outcome of treatment from two previous studies that evaluated the effect of a parent- administered, operant, nonprogrammed stuttering treatment on their children. This study provides outcome data on the children at 2 and 7 years post-treatment. Results indicate near-zero stuttering levels achieved post-treatment and maintained in the long term. These findings indicate that preschool-age children treated for stuttering may not need to re-enter treatment for up to 7 years after their initial treatment.
Lindsay, J., (1989). Relationship of Developmental Disfluency and Episodes of Stuttering to the Emergence of Cognitive Stages in Children. JOURNAL OF FLUENCY DISORDERS, 14, 271-284.
This article explores the relationship between cognition, language and fluency in an attempt to find answers for the diagnosis and treatment of stuttering and if stuttering is associated with developmental stages. Piaget's stages were investigated as well as the stages of stuttering and normal dysfluencies. The hesitation phenomenon was discussed and it was found that there is a relationship between fluency and cognitive complexity. Overall, findings that relate stuttering to the emergence of new cognitive stages in children need to be further studied.
Lincoln, M., Onslow, M., Lewis, C., & Wilson, L. (1996). A clinical operant treatment for school-age children who stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 2, 73 - 85.
The purpose of this study was to determine the effectiveness of a nonprogrammed, operant treatment for school-age children who stutter. Treatment was administered by clinicians and parents to 11 children between the ages of 7 and 12 years. After treatment the children's speech was assessed in three everyday speaking situations over a 12-month post-treatment period. Results found that all children maintained decreased stuttering rates at 12 months post- treatment. Parents were all "satisfied" or "very satisfied" with their children's speech post-treatment.
Lincoln, M.A., Onslow, M., & Reed, V. (1997). Social validity of the treatment outcomes of an early intervention program for stuttering. AMERICAN SPEECH-LANGUAGE PATHOLOGY, 6, 77-84.
The focus of this study contained two parts of social validity of the Lidcome program (a procedure based on response contingent stimulation(RCS). The first part of the investigation focused on a comparison of the percentage of syllables stuttered (%SS) in children who stuttered and children who did not. The 2nd part of the investigation focused on judgments made by experienced clinicians and unsophisticated listeners to the speech of the same children. Results indicate that the treatment outcome of the Lidcome program appears to be socially valid.
Logan, K.J. (2001). The effect of Syntactic Complexity Upon the Speech Fluency of Adolescents and Adults Who Stutter. JOURNAL OF FLUENCY DISORDERS, 26:2, 85-106.
Previous research indicated that in young children, syntactic complexity affects stuttering. The present study tried to answer 3 questions. (1) Do adolescent and adult speakers stutter more often in syntactical complex utterances than they do in syntactically simple utterances? (2) Does the extent of any such syntactic effect vary with speaking context? (3) Do adolescent and adults who stutter produce syntactically complex sentences at a different speaking rate than syntactically simple sentences? The study involved 12 adolescent and adult stutterers, with mean age being 23, who interacted for about 15 to 20 minutes with a research assistant who was blinded to the purpose of the study. The conversation was structured around a list of open-ended requests pertaining to the participants communication skills, hobbies, career/schooling, and also, a prepared sentences within a reaction time task was given. The finding were: (1) There was no difference in the number of clauses or syntactic constituents per utterance in the analysis of length-matched stuttered and fluent conversational utterances. (2) There appeared to be no difference in dysfluency rates across the for levels of syntactic complexity associated with the tasks in the analysis of prepared sentences. (3) There was no support that no type of syntactic structure affects the speech fluency of adolescents and adults more than any other type of syntactical structure. (4) The speakers articulated syntactically complex sentences more rapidly than simple sentences in the prepared sentence tasks. (5) Seemed to be less stuttering frequency during prepared sentences that during length-matched conversational utterances.
Logan, K.J. (2003). The effect of syntactic structure upon speech initiation times of stuttering and nonstuttering speakers. JOURNAL OF FLUENCY DISORDERS, 28, 17-35.
The purpose of this study was to determine how syntactic structure of a sentence affects the rate of initiation of speech in people who stutter and people who do not stutter. The stimuli used in this investigation were adapted from those used in a similar study by Ferreira (1991). Participants in this study included 11 people who stutter and 11 people who do not stutter. Subjects' ages ranged from adolescent to early adult. Subjects who stuttered had done so since early childhood and ranged from mild to severe. After reviewing various versions of 96 target sentences, subjects were to repeat the sentences when given auditory and visual cues from a computer. The sentences appeared on the screen and subjects were instructed to begin speaking them as soon as possible after the stimulus. Results revealed that 10 of 11 people who stuttered had speech initiation times longer than the group mean for people who did not stutter. Additionally, 7 of 10 people who stuttered had an overall speech initiation time that was greater than one standard deviation above the mean for the group of people who do not stutter. Overall the results did not support the idea that a speaker's speech initiation time was affected by the syntactic complexity of a sentence. It was indicated that slowness in motor planning might not necessarily be present in stuttered speech.
Logan, K. J. (2003). Language and fluency characteristics of preschoolers' multiple- utterance conversational turns. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 178-188.
The purpose of this research study was to examine the effect of conversational turn length on preschoolers' speech fluency and length and complexity of the utterances they produce, as well as to determine whether conversational turns of children who do stutter differ from those of children who do not stutter in their complexity or pragmatic function. The study included 15 3- and 4-year-old children who stutter and 15 age- and gender- matched children who do not stutter. Data collection for the study was achieved through a 15-minute parent-child interaction, conducted in a play setting. Results of the study indicated that there were not significant differences between the 2 groups of children.
Logan, K. J. & Conture, E.G. (1995). Length, grammatical complexity, and rate differences in stuttered utterances of children who stutter. JOURNAL OF FLUENCY DISORDERS, 20(1). 35-62..
Length, grammatical complexity, and articulatory rate are used to assess differences in stuttered and perceptibly fluent conversational utterances produced by children who stutter, resulting in the fol- lowing: syllabic rate for stuttered utterances is significantly greater than perceptibly fluent utterances, length and/or grammatical complexity are significantly greater for stuttered utterances than for perceptibly fluent utterances, and perceptibly fluent utterances are considered to be low in length and/or grammatical complexity. Articulatory rate is said to have no influence on utterances, whether stuttered or perceptibly fluent.
Logan, Kenneth J., LaSalle, Lisa R. (2003). Developing intervention programs for children with stuttering and concomitant impairments. SEMINARS IN SPEECH AND LANGUAGE, 24, 13-19.
Children who stutter often present with concomitant impairments that creates difficulty in the treatment process. In a recent survey of speech language pathologists, results revealed that more than 40% of children who stutter also meet state eligibility requirements for phonological and language impairment. The article summarized four priorities that should be addressed in the initial assessment. It also provides clinicians with potential treatment models, treatment principles and treatment strategies for children who stutter. There are suggestions for parents and teachers regarding the intervention plan.
Logan, K., Morey, M., Pretto, A., & Roberts, R. (2002). Speaking slowly: effects of four self-guided training approaches on adults' speech rate and naturalness. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 2, 163-174.
Speech-language pathologists often ask the parents of children who stutter to reduce their rate of speech when talking with their children. Little is known about how to help parents do this, or how much this affects the child's resulting speech. In this article two experiments were done to examine this issue. In experiment 1 adult females altered their speech rate with one of the four self-guided methods. Speech rates post therapy was slower in all the experimental groups compared to the control group. The extent of rate reduction varied across all, and the speakers rated their speech as unnatural. In the second experiment 39 females rated the naturalness of sentences from the groups in experiment 1. Across the board, the slower a speaker's post training rate, the less natural it sounded to its speakers. Results suggested that adults can readily slow their speech using self-devised methods, and that speaker perceptions of speech naturalness may differ, and this must be considered in training.
Logan, K., & Yaruss, J. (2002). Evaluating rate, accuracy, and fluency of young children's diadochokinetic productions: a preliminary investigation. JOURNAL OF FLUENCY DISORDERS, 1, 65-86.
Diadochokinetic rates are commonly used to assess children who posses speech and language disorders, even though it is not clearly known how to apply the results of this measure. The study in this article explored the possibility of the accuracy and fluency of the DDK rates as being more reliable measures than just a rate number. Through the study of 15 boys between the ages of 3 and 7, analysis revealed and errors and disfluencies did not affect the DDK rate, suggesting that this may be an insensitive measure of children's speaking abilities. Findings suggested that DDK accuracy and fluency may provide information on a child's speech development more closely related to oral motor development than rate. It is suggested that rate measures be supplemented with the measurements of accuracy and fluency when evaluating a child's speaking abilities.
Loucks, T., De Nil, Luc, & Sasisekaran, J. (2007). Jaw-phonatory coordination in chronic developmental stuttering. JOURNAL OF COMMUNICATION DISORDERS, 40, 257-272.
This journal article examines if jaw-phonatory coordination in Adults Who Stutter (AWS) showed less accuracy and more variability than adults with normal speech fluency to determine if a deficiency in sensorimotor integration is a factor of developmental stuttering. Specific measures consisting of total variability (TV), variable error, peak velocity and movement time were examined. Subjects included 11 right handed men who stutter and 11 right handed men who did not stutter (control group). Results indicated that the AWS group showed greater error in jaw-phonatory coordination in comparison to the control group.
Louko, LJ. (1995). Phonological characteristics of young children who stutter. TOPICS IN LANGUAGE DISORDERS, 15 (3), 48-59.
This article reviews the research exploring the co-occurence of disordered phonology and stuttering in children. There is a general consensus in the research that children who stutter are more likely to exhibit speech sound disorders when compared with children who do not stutter. A review of studies focusing on the speech sound errors and/or phonological processes of children who stutter was also included in the article. These studies provide information about the type of errors/processes exhibited by children who stutter. This article also discusses therapy issues and provides suggestions for the treatment of phonological problems that co-occur with stuttering.
Lubinski, R., Pollack, J., Weitzner-Lin, B. (1986). A pragmatic study of child dysfluency. JOURNAL OF FLUENCY DISORDERS, 11, 231-239.
The purpose of the case study was to examine the conversational breakdown in a mother and child interaction. Conversational breakdowns, repairs, and resolutions were examined between a 3 year old female and her mother. The girl displayed hard contacts, repetitions of words and phrases, and secondary behaviors. The examiners videotaped the interactions, book reading, telling time, tracing numbers, and writing, for 20 minutes. The results indicated that 37 breakdowns, 47 repairs, 37 resolutions occurred within the 20 minutes of interaction. The study helped professionals identify the conditions in which people who stutter may display an increase in dysfluencies.
Ludlow, C.L., & Braun, A. (1993). Research evaluating the use of neuropharmacological agents for treating stuttering: Possibilities and problems. JOURNAL OF FLUENCY DISORDERS, 18, 169-182.
This article reviews and discusses the findings of twenty-two neuropharmacologic studies. A description is given as to what types of agents were used in each of the studies. The authors describe in detail the common findings in each study. The authors found after reviewing all twenty-two studies that 65% of the stutterers had a significant positive response to treatment. At the end of the article the authors provide some recommendations for the development and evaluation of neuropharmacological approaches to the management of stuttering.
Ludlow, C. L., & Loucks, T. (2003). Stuttering: a dynamic motor control disorder. JOURNAL OF FLUENCY DISORDERS, 28, 273-295.
The purpose of this study is to improve understanding of the fundamental mechanisms that are involved in stuttering and to determine which neural mechanisms may be dysfunctional. Since speech is a rapid motor control task, they looked at the rapid inter-relationships between neural events prior to and during speech gestures and stuttering interruptions in different regions of the brain through Magnetoencephalography (MEG). They also looked at the location of the brain injury and found that the location and the type of lesion can cause acquired stuttering. Results indicate that lesions that appear on structures that are involved with rapid communication between brain regions such as the corpus cal! losum, the basal ganglia and the thalamus might be related to acquired stuttering. The final area this study discussed was the similarity and differences between stuttering and other speech motor control disorders. They looked at sensory deviations, muscle interference, central abnormalities, basal ganglia abnormalities, and vulnerable systems in people who stutter and as compared to individuals with dysotonias, spasmodic dysphonia, and Tourettes syndrome.
Lutz, K.C. & Mallard, A.R. (1986). Disfluencies and rate of speech in young adult nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 307-316.
The authors use the Precision Fluency Shaping Program with young adults who stutter and hope to be able to compare the young adult's post-therapy disfluencies with the disfluencies of young adults who do not stutter. Normative data was gathered in this study in order to make that comparison. Fifty students completed the study by answering ten questions and reading the first paragraph of the Rainbow Passage. Every subject had some disfluencies during conversational speech while only 68% of the subjects had disfluencies while reading. The data obtained from the study will allow clinicians to objectively analyze the disfluencies of young adults' post-therapy speech.
Mackey, L. S., Finn, P., & Ingham, R. J. (1997). Effect of speech dialect on speech naturalness ratings: A Systematic replication of Martin, Haroldson, and Triden (1984). JOURNAL OF SPEECH AND HEARING RESEARCH, 40, 349-360.
This study investigated the effect of dialect on listeners' speech naturalness ratings using three groups of speaker samples. Two groups had General American Dialect - one with persons who stutter and one with persons who do not stutter. The third group consisted of speakers who do not stutter, but spoke non-General American dialect. Undergraduate speech and hearing students made judgments from a one-minute speech sample regarding the speech rate, frequency of stuttering, frequency of normal disfluencies, and speech naturalness. The findings were consistent with previous research that listeners' naturalness ratings differed between each group, with stutterers judged as least natural sounding, non- stutterers judged as most natural sounding, and non-stutterers with non-general dialect in between. Implications for evaluating stuttering treatment were discussed.
MacKinnon, S. P., Hall, S., & Macintyre, P. D. (2007). Origins of the stuttering stereotype: Stereotype formation through anchoring- adjustment. JOURNAL OF FLUENCY DISORDERS, 32, 297-309.
Stereotypes of people who stutter have been well documented. School teachers, parents, community members and even SLP's have been found to associate negative personality trait stereotypes such as shyness, insecurity, avoidance, hesitance and nervousness with people who stutter. The current study examines how these ' stereotypes are formed. Testing the anchoring and adjustment theory of stereotype formation this study investigates how 183 psychology students relate to 3 hypothetical males. The first male is presented as a trait stutterer, the second as a normally fluent adult who has a brief episode of disfluency and regains fluent speech (state stutterer), the third speaker a normally fluent adult man. Participants are asked to rate these hypothetical people on 25 different personality scales. Results supported the anchoring and adjustment theory of developing personality stereotypes.
Maguire, G.A., Yu, B.P., Franklin, D.L., Glyndon, D.R. (2004). Alleviating stuttering with pharmacological interventions. EXPERT OPINION ON PHARMACOTHERAPY, 5(7), 1565-71.
The authors of this article suggest that stuttering may be associated with dopamine hyperactivity within in the brain. This is why they suggest pharmacological drugs, such as risperidone and olanzapine, as a way to reduce the instances of stuttered speech. Physicians can use this as an opportunity as a foundation to treat stuttering more effectively.
McKinnon, D.H., McLeod, S., and Reilly, S. (2007). The prevalence of stuttering, voice, and speech-sound disorders in primary school students in Australia. LANGUAGE SPEECH AND HEARING SERVICES IN SCHOOLS, 38, 5-15.
This Australian study examined the prevalence of communication disorders in 10,425 primary school students. The study examined stuttering, voice disorders and speech-sound disorders in relation to gender, grade-level (K-6), and socio-economic status along with other factors including teacher perceptions of students' required level of support vs. learning support provided to students, curriculum adaptation, IEP and the involvement of outside agencies. The study found significant differences in prevalence by gender and grade, but no differences across disorders or socioeconomic groups (SEGs), although students in higher SEGs were more likely to be diagnosed. Results indicate that 1.51% of primary schools children have a communication disorder and that over half of them were not receiving necessary services of classroom accommodations. Results may not translate directly to other countries due to structural differences in school systems and treatment delivery systems for communication disorders.
MacLeod, J., Kalinowski, J., Stuart, A. & Armson, J., (1995). Effect of single and combined altered auditory feedback on stuttering frequency at two speech rates. JOURNAL OF COMMUNICATION DISORDERS, 28, 217-228.
Based on previous studies that indicate fluency improves under altered auditory feedback conditions, this study investigated the additive effects of combining delayed auditory feedback (DAF) with frequency altered feedback (FAF). It also investigated the hypothesis that altered feedback improves fluency by slowing down the rate of speech. Ten adult subjects read eight different passages of 300+ words under conditions of nonaltered feedback (NAF), DAF, FAF, and combined DAF and FAF at both slow and fast rates of speech. The results found that fluency substantially improved under all altered conditions, but that the combination of DAF and FAF did not lead to more fluency than did each condition alone. The authors suggest that this lack of additive effect could be the result of a floor effect where the DAF or FAF alone created such fluency that there was no room for improvement in the combined condition. Future studies could alleviate this situation by testing subjects with more severe stuttering or decreasing the effects of the altered feedback. It was also found that fluency was improved at both fast and slow rates of speech, refuting the claim that altered feedback improves fluency by slowing rate of speech. Recommendations for therapeutic strategies based on these findings are provided.
Mahr, G., & Leith, W. (1992). Psychogenic stuttering of adult onset. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 283- 286.
The key characteristics of psychogenic stuttering of adult onset were reviewed and four cases of this disorder were presented. The four cases described represented conversation reactions. Criteria or elements available for the diagnosis of stuttering as a conversation reaction were presented.
Mahr, G. & Torosian, T. (1999). Anxiety and social phobia in stuttering. JOURNAL OF FLUENCY DISORDERS, 24, 119-126.
This study focuses on comparing the symptoms of anxiety among 22 stutterers to social phobics and nonpatient controls. If a substantial relationship is seen between social phobia and stuttering, then therapeutic interventions that have been useful in treating social phobia could also aid in treating stuttering. Measures included the experience of distress in social situations and the avoidance of social situations; fear and avoidance of being negatively evaluated by others; general anxiety; and specific fears including agoraphobia, social phobia, and the participants own primary fear. Results indicated that the group of stutterers did not show symptoms of social phobia although they do have avoidance behaviors that are related to their own fear of stuttering.
Mallard, A.R. (1998). Encouraging a Broader Perspective in Judging the Effectiveness of Stuttering Therapy. JOURNAL OF FLUENCY DISORDERS, 2, 1 23-125.
The article addresses Mallard's perspective of a family based fluency program for children. The paper is a precursor to a study done by Mallard, published in the same journal issue. He refutes "scientific method studies" saying they have done little to solve the daily problems encountered by those who stutter. He believes in a family bases therapy program and emulates an approach, using family management procedures for dealing with stuttering, by Rustin for his study.
Mallard, A. R. (1998). Using Problem-Solving Procedures in Family Management of Stuttering. JOURNAL OF FLUENCY DISORDERS, 2, 127-135.
The study provides results from an program at Southwest Texas State University modeled after therapy described by Rustin, which emphasizes social skill training, and parental involvement, for children who stutter. Twenty-eight families participated in the program. The focus was never on the frequency of words stuttered but rather teaching the child, and their families, to manage their stuttering. A combination of fluency shaping, stuttering modification and other practices based on the needs of the client were used with the groups. A year later, follow up interviews were performed and found 23 of the children were no longer enrolled in any type of therapy. That is not to say they no longer stuttered but that 82% of the children and their families were managing their stuttering and did not require further assistance.
Mallard, AR., Gardner, LS., & Downey, CS. (1988). Clinical training in stuttering for school clinicians. JOURNAL OF FLUENCY DISORDERS, 13, 243-259.
A survey was developed to determine the educational and clinical backgrounds of speech-language pathologists working in school setting. Research points to that the academic and clinical training of speech-language pathologists are insufficient to prepare professionals to work with stutters. The results from the survey indicate a high percentage of clinicians working in school settings seem to have neither the academic or clinical experience in stuttering that prepare them to be accountable with fluency disorders.
Mallard, AR & Westbrook, JB (1988) Variables Affecting Stuttering Therapy in School Settings. Language, Speech, and Hearing Services in Schools, 19, 362-370
A two year project within two school districts in San Antonio, Texas was designed to document the variables that affect stuttering therapy in the school. The participating schools had a traditional, itinerant schedule. The two school districts used serviced different populations, one was an urban setting while the other was suburban. Two therapy programs were used. The first year the therapy presented by Van Riper (1973) was used. The second year the therapy program was the Monterey Fluency Program. Results indicate that stuttering children may need more assistance than can be provided by two therapy periods a week of 30-45 minutes duration.
Manning, W. (2004). "How can you understand? You don't stutter! ". CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 58-68.
Manning talks about how many clinicians who work with people who stutter do not have enough experience or education. He believes that a clinician can be a good and effective clinician for a person who stutters even if he or she has never stuttered before. Manning's article provides suggestions as to how to be a good and effective clinician, and gives clinicians ways to respond when a clients says, "You don't stutter so you don't understand! " Some of Manning's suggestions include: listening closely to the client and their stuttering, listening to the client's nonstuttered speech, doing activities outside of the therapy room and attending self-help meetings. However, the key point of this whole article is that not everyone is going to understand, but if a clinician has the basic clinical skills, is desensitized to and unafraid of stuttering, he or she is capable of being a good clinician for people who stutter.
Manders, E., and Bastijns, P. (1989). Sudden recovery from stuttering after an epileptic attack: a case report. JOURNAL OF FLUENCY DISORDERS, 13, 421-428.
This is a case report about a little boy with myolomeningocele, complicated with hydrocephalus. At the age of two, he was seen at the University Speech and Hearing Rehabilitation Center in Belgium because of language retardation. The parents were offered advice concerning language stimulation at home a periodical follow-up was scheduled. He caught up to his language delay when he was 4 years, 6 months of age. When the little boy was 5, his mother contacted the clinic and stated that his son has been stuttering since his fifth birthday. Following an evaluation of his speech, an abnormal disfluency was evident. Parents were given advice and an appointment for three months later was scheduled. At the three- month appointment, mother shared that her son had a short, focal epileptic attack and immediately after this seizure, the stuttering had completely disappeared. The reevaluation indicated no disfluencies, normal speech, and his language remained at a high level.
Mansson, H. (2000). Childhood stuttering: incidence and development. JOURNAL OF FLUENCY DISORDERS, 25, 47-57.
This article reviews the results of a study on the incidence and development of early childhood stuttering in which the entire population of children born within a 2-year period in Bornholm was surveyed. The results of the study indicated that the incidence of stuttering among this group reached a level of 5.19%. Regarding the development of stuttering among these children, it was reported that 71.40% of their stuttering ceased after two years following the initial survey and more children continued to stop stuttering after that evaluation. Factors such as age of onset, character of onset, and stuttering severity were taken into consideration.
Marshall, C. (2005). The impact of word-end phonology and morphology on stuttering. STAMMERING RESEARCH, 1(4), 375- 391. http://www.stamres.psychol.ucl.ac.uk
This article describes a study conducted that analyzes stuttering and its association with morphological and phonological complex word endings. In study one, a specific set of materials were presented to participants (stuttering adults/adolescents) by an interviewer. After thorough analyses of responses, it was concluded that stuttering rates in ordinary speech is not affected by ending clusters in words. It was also found that morphological complexities do not influence stuttering. Studies two and three were conducted on children and young adults. Study two involved a non-word repetition task and study three involved an elicitation task. Results from these two studies showed that stuttering rates are not affected by words ending in a morphological and phonological complexity in most children and young adult participants. However, there was a small amount of participants, during the elicitation task, who stuttered on morphologically complex word-endings. Therefore, word ending phonological complexities do not affect stuttering, but morphological could affect some people who stutter.
Marshall, R. C. & Neuburger, S. I. (1987). Effects of delayed auditory feedback on acquired stuttering following head injury. JOURNAL OF FLUENCY DISORDERS, 12(5), 355-365.
The purpose of this study was to determine whether DAF could effectively reduce stuttering behaviors in individuals exhibiting acquired stuttering. The subjects of this study were three men who began to stutter following a head injury. Baseline measures were obtained for the number of stuttering events and number of words spoken per minute during a description of action pictures, a description of sequences of action pictures, and narrative discourse. Treatment involved utilization of the DAF for each of the preceding tasks. Focus was placed on one task while the remaining tasks stayed at the baseline level. Results found that stuttering behaviors decreased for each of the three subjects within each treatment task. This indicates that DAF may be an effective tool for treatment of individuals with acquired stuttering.
Martin, R. (1993). The future of behavior modification of stuttering: What goes around comes around. JOURNAL OF FLUENCY DISORDERS, 18, 81-108.
The article begins by discussing various research pertaining to the onset and modification of stuttering via operant conditioning. The endeavors of research have been unsuccessful in explaining the onset and development of stuttering. It has been suggested that future operant analysis should focus on generalization and maintenance because these are the most important issues to the people who stutter and their everyday activities.
Martin, RR. & Haroldson, SK. (1988). An experimental increase in stuttering frequency. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 272- 274.
The purpose of this study was to look at the effect, if any, on stuttering after speaking with an adult male conversationalist. In this study, 8 men and 2 woman, with age ranges from 22 to 48 years, talked first for 10 minutes alone, then with an adult conversationalist who started out by commenting or asking a question about the topic the stutterer spoke of in the initial 10 minutes and then the conversationalist spoke as little and consistent as possible, keeping the conversation alive. Finally, the conversationalist male left the room, and the stutterer continued to speak for 10 minutes. Results indicated that stuttering did increase in the conversationalist situation, but decreased during the last 10 minutes as compared to the baseline (initial 10 minutes).
Martin, RR., Haroldson, SK., & Woessner, GL. (1988). Perceptual scaling of stuttering severity. JOURNAL OF FLUENCY DISORDERS, 13, 27-47.
The article presents a review and an integration of research concerning the perceptual scaling of stuttering severity. The results of two experiments are reported. In Experiment I, observers judged stuttering severity on a seven-point scale. The observers identified each stuttering instance, judged the severity of each instance, and judged stuttering severity of the overall speech sample. In Experiment II, stutterers spoke normally and under DAF while an observer judged "on-line" the severity of each instance of stuttering on the same seven-point scale used in Experiment I. The results were: 1) Observer reliability was satisfactory for scaling severity of individual stuttering, overall speech samples, and instances of stuttering severity "on-line". 2) Stuttering severity scale value for the overall sample was higher than the mean scale value for individual stuttered words within the sample. 3) A complex relationship obtained between the measures of stuttering frequency, severity, and other characteristics of the speech signal.
Martin, R.R, & Haroldson, S.K. (1992). Stuttering and speech naturalness: Audio and audiovisual judgments. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 521-528.
Recorded stutterer and nonstutterer speech samples were judged by unsophisticated raters (using 9-point interval scales) for speech naturalness and stuttering severity. The audio only and audiovisual presentations were judged separately by the raters. The raters judged the audiovisual presentation more unnatural than the audio presentation of the same sample for the stutterer samples. For the nonstutterer samples, there was no difference between the audio and audiovisual naturalness ratings.
Max, L., and Caruso, A. (1998). Adaption of Stuttering Frequency During Repeated Readings: Associated Changes in Acoustic Parameters of Perceptually Fluent Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 1265-1281.
This study investigates further the motor learning hypothesis of stuttering adaptation. It also looks at a whether there is a relationship between stuttering and the variability of certain acoustic parameters, especially vowel duration. There were 8 subjects used in this study. The results of this study support the hypothesis that stuttering adaptation may be a result of motor learning. The study discusses the variability of acoustic parameters individually.
Max, L., Caruso, A. J., & Gracco, V. L. (2003). Kinematic analysis of speech, orofacial nonspeech, and finger movements in stuttering and nonstuttering adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 215-233.
The purpose of this research study was to investigate the question of whether or not neuromotor differences between individuals who stutter and individuals who do not stutter are limited to the movements involved in speech production. The study included 10 gender- and age-matched stuttering and nonstuttering adults. Kinematic data was obtained as participants performed tasks involving speech movements, orofacial nonspeech movements, and finger movements. Results of the study found significant differences between stuttering and nonstuttering participants on measures of lip and jaw closing movements during perceptually fluent speech. The study also found differences in the finger movements of the two participating groups. These results indicate that the neuromotor differences between stutterers and nonstutterers are not limited to speech production movements.
Max, L., Caruso, A.J., & Vandevenne, A. (1997). Decreased stuttering frequency during repeated readings: A motor learning perspective. JOURNAL OF FLUENCY DISORDERS, 22, 17-33.
A study done by Frank and Bloodstein (1971) was reproduced and extended. Ten subjects who stutter completed readings of a 300- word passage under two conditions. The first condition included six readings of a 300-word following an adaption procedure. The second condition included ten readings of a different 300-word passage in succession. The first five times in this condition the readings were done together with the clinician and the second five readings were done alone. This study indicated that stuttering frequency in the sixth reading of both conditions is the result of subsequent readings rather than repeated stuttering.no great difference in the sixth readings of both conditions.
Max, L., & Gracco, V. (2005). Coordination of oral and laryngeal movements in the perceptually fluent speech of adults who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 48, 524-542.
The study was designed to examine oral and laryngeal movements in the perceptually fluent speech of people who stutter and of people who do not stutter. The study was based on a modified version of the oral-laryngeal discoordination hypothesis. Previous studies on oral and laryngeal movement have found differences in duration, but duration does not sufficiently indicate the speaker's coordination of the oral and laryngeal mechanism. The results of the study found the fluent speech of the stutterers was characterized by a slower initiation of phonation rather than a deficit in the coordination of the oral and laryngeal mechanism.
Max, L. , Guenther, F. H. , Gracco, V. L. , Ghosh, S. S. , & Wallace, M. E. (2004). Unstable or insufficiently activated internal models and feedback-biased motor control as sources of dysfluency: A theoretical model of stuttering. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCES AND DISORDERS, 31, 105-122.
This article focused on neural processes and sensorimotor mechanisms that could be involved in stuttering. This article reviewed a lot of literature and it concluded with two hypothesis. One was that stuttering had to do with "unstable or insufficiently activated internal models", which means that a child may have problems achieving stable and correct pathways between the motor and sensory portions of the brain. The second hypothesis was that stuttering had to do with a "weak feedforward control and overreliance on afferent feedback". The article reviewed topics such as speech movements, nonspeech movements, and brain activation patterns.
Max, L. & Yudman, E. M. (2003). Accuracy and variability of isochronous rhythmic timing across motor systems in stuttering versus nonstuttering individuals. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 146-163.
The purpose of this research study was to compare the abilities of adults who stutter with those of adults who do not stutter in tasks of speech and nonspeech isochronous rhythm timing. The study included 10 adults who stutter and 10 adults who do not stutter. Administration of the experimental tasks included the completion of the following isochronous rhythmic movements: orofacial structures for speech production movements, orofacial structures for nonspeech movements, and index finger and thumb movements. Results of the study indicated that stuttering and nonstuttering participants showed highly similar level of both timing accuracy and timing variability.
Max, L., & Yudman, E.M. (2004). Understanding stuttering will require theoretical models that fit the data rather than attempts to make the data fit the preferred models: A response to Howell (2004). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 105-113.
The purpose of this letter was to defend previous research done by the authors, which Howell (2004) disagreed with. Max and Yudman (2004) addressed all of the issues Howell pointed out. They discussed how Howell's arguments reflect a theoretical perspective on stuttering that has little, or no, empirical evidence, he didn't acknowledge studies that agreed with that of the authors, experimental procedures were misrepresented, subjective judgments were suggested instead of the objective experimental procedures administered, and Howell misrepresented the statistical analysis and conclusions. Max and Yudman (2004) did not believe they had previously included or implied the conclusions Howell was against. They, instead, stated that there is a need for further research, and that scientific knowledge about stuttering must be based on theoretical models that fit the data presented.
McAllister, J., & Kingston, M. (2005). Final part-word repetitions in school-age children: two case studies. JOURNAL OF FLUENCY DISORDERS, 30, 255-267.
This study examined final part-word repetitions in two healthy 7 year-old boys. Because final part-word repetitions are relatively rare characteristics of a person who stutters, the authors were interested in expanding the small body of literature concerning the topic. Expressive and receptive language abilities were assessed to ensure that the boys were both age appropriate. Each boy completed two spontaneous speech samples, a reading aloud task, and a sentence repetition task. Results indicated that both boys were at an age appropriate level regarding their language skills. Results indicated that both boys exhibited the majority of total disfluencies during spontaneous speech, although some were recorded during the other tasks. The boys did not appear aware of the disfluencies and no secondary behaviors were observed for either child. Phonological structures of each child's final part-word repeated fragment were predictable after analyzing the disfluencies.
McClean, M. D. (1996). Lip-muscle reflexes during speech movement preparation in stutterers. JOURNAL OF FLUENCY DISORDERS, 21, 49-60
The premise behind this study is that neural processes underlying speech initiation involve reduction in the excitability of sensory input from mechanoreceptor that mediate speech movements. The hypotheses is that this reduced excitability is not as great in individuals who stutter. This was tested by analyzing lip-muscle reflexes prior to speech initiation in people who stutter and comparing this data to that of nonstutterers. Fourteen stutters and nonstutterer's mechanically evoked reflex levels just prior to productions of/p/ were studied. It was found that, as a group, stutterers showed less lip-muscle reflex attenuation or the lower tip prior to fluent speech when compared to the nonstutterers. Reflex modulation associated with dysfluent speech was quantified in three stutterers and showed marked increases in relative magnitude of lip- muscle reflexes prior to dysfluent speech as opposed to fluent speech trials. Based on these results, it is suggested that reduced attenuation of mechanoreceptor input at the time of speech-movement initiation contributes to speech dysfluency.
McClean, M., Kroll, R., & Loftus, N. (1990). Kinematic analysis of lip closure in stutterer fluent speech. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 755-760.
In an attempt to evaluate previous observations regarding the fluent speech of stutterers and to describe the possible effects of speech therapy, the authors of this study analyzed the lip and jaw motion of 28 subjects. The subjects were divided as follows; 10 normal speakers, 10 stutterers with no recent speech therapy, and 8 stutterers who had recently undergone intensive therapy including rate reduction strategies. Very little difference was found between the normal speaking subjects and the stutterers who had no recent therapy. Stutterers who had recently been through therapy demonstrated increased jaw movement durations and longer times to lip and jaw velocity peaks related to the acoustic onset of the vowel. The authors state that this finding implies that abnormalities of the physical aspects of a stutterers' fluent speech are the result of acquired modification of output rather than a problem with the speech neuromotor system.
McClean, MD., & Runyan, CM. (2000). Variations in the relative speeds of orofacial structures with stuttering severity. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 1524-1531.
This study focuses on the ideas that stuttering can be characterized in part as a disorder in the coordination of different muscle systems. To test this idea, an electromagnetic system was used to obtain measures of lip, tongue, and jaw speed in thirty-eight adults (29 PWS and 9 normally fluent speakers, NFS). The subjects repeated a simple speech utterance at a normal rate. The results indicated that by using the categorical rating of stuttering severity, ratios of tongue speed to jaw speed were significantly greater in PWS rated as severe, compared to NFS and other PWS. Sources of the speed differences are discussed in relation to underlying muscle activity, motor compensation processes in adults, and the development of orofacial motor control in children who stutter.
McClean, M., Tasko, S., Runyan, C. (2004). Orofacial movements associated with fluent speech in persons who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 294-303.
The purpose of the study was to replicate and expand on earlier studies that found differences in the opening and closing movement of the vocal tract in the fluent speech of people who stutter and people who do not stutter. This study was also interested with speed ratios among the articulators in relation to stuttering severity. This study did not replicate all of the previous findings, but it indicated some correlations. The study along with its predecessors was successful in supporting several means to measure speed and duration of vocal tract opening and closing.
McDonough, A., Quesal, RW. (1988). Locus of control orientation of stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 13, 97-106.
This study was completed to assess the validity of the Speech Locus of Control (SP-LOC) scale and what factors, if any, influence the speech locus of control in stutterers. Twenty-one adult stutterers and twenty-one adult nonstutterers were chosen as the subjects for this study. A 173-item scale was used as a testing instrument. All the subjects completed the battery of scales and engaged in conversation that was recorded and analyzed to determine stutterers percentage of stuttered words. The results showed that stutterers as a group tended to be more external in their locus of control orientation as it relates to speech. The SP-LOC was shown to differentiate between stutterers and nonstutterers. The results also showed that stutterers do not significantly differ from the general population on personality measures. This study provided evidence that the SP-LOC scale is a valid measure that does indeed differentiate stutterers from nonstutterers.
McLaughlin, S. & Cullinan, W. (1989). Disfluencies, utterance length, and linguistic complexity in non-stuttering children. JOURNAL OF FLUENCY DISORDERS, 14, 17-36.
This investigation was to examine the relationship of disfluencies to utterance length and linguistic complexity, with several objectives. Ten male and ten female non-stutterers were used as subjects. A test battery was administered along with a spontaneous language sample and modeling procedures to elicit four sets of utterances representing two levels of utterance length and two levels of complexity. Higher rates of overall disfluencies occurred in the modeling tasks involving more complex utterances. Disfluency rates also appeared to increase based on the sex of subjects and length of utterances. Theoretical and clinical implications were also discussed.
McKeehan, A. (1994). Student experiences with fluency facilitating speech strategies. JOURNAL OF FLUENCY DISORDERS, 19(2), 113- 121.
This article discusses the results of a study conducted on 16 graduate students who spent seven days speaking with fluency facilitating strategies, such as lengthening vowels, short utterances and frequent pauses. The students recorded perceived listener reaction, their own feelings and attitude towards speaking and how, as future clinicians, they benefited from experiencing commonly employed fluency facilitators. Among the findings were that a majority of listener's reactions were neutral, students avoided speaking and felt embarrassed or weird. Students reported developing respect for people in treatment while realizing how difficult it is to change speech behaviors. Discussion of the results focuses on preparing student clinicians to be effective therapists and on directions of future research.
McKnight, R., & Cullinan, W. (1987). Subgroups of stuttering children: speech and voice reaction times, segmental durations, and naming latencies. JOURNAL OF FLUENCY DISORDERS, 12, 217-233.
Speech and voice reactions times, speech segment durations, and object-naming latencies were obtained from a group of nonstuttering children and two subgroups of stuttering children: one subgroup (stuttering-plus) consisting of those who needed special education services for problems in addition to stuttering, and the other subgroup (stuttering-only) whose only apparent problem was stuttering. Each child was tested individually using a speech-language screening task, administered an experimenter. The total administration time for four tasks ranged from 1 to 2 hours with a break between each of the tasks. Results indicated the stuttering-plus child! ren had significantly longer speech and voice reaction times and naming latencies than did the stuttering-only and nonstuttering children. The stuttering-only children differed from the nonstuttering children only in voice termination times. The three groups did not differ in speech segment durations or in the variability of such measures. The results in the present investigation clearly demonstrate the importance of subgrouping stuttering children when making experimental comparisons with nonstuttering children.
Medeiros de Britto Pereira, M., Rossi, J. P., & Borsel, J. V. (2008). Public awareness and knowledge of stutterin in Rio de Janeiro. JOURNAL OF FLUENCY DISORDERS, 33, 24-31.
This article explained an investigation of the general public's knowledge and awareness of stuttering in Rio de Janeiro, Brazil. The results were obtained by a questionnaire given to 606 people recruited off the street. The results only represent the city of Rio de Janeiro and is should not be taken as a complete representation of Brazil. The results indicated that the knowledge about stuttering is still quite limited. The use of self-help groups in the area to raise awareness and publicly campaign for persons who stutter may help increase public knowledge. The study was compared to similar ones completed in other parts of the world. This study did not differ from the other studies rather it paralleled the other studies results.
McLean-Muse, A., Larson, C., & Gregory, H. (1988). Stutterers' and nonstutterers' voice fundamental frequency changes in response to auditory stimuli. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 549-555.
An investigation analyzed stutterers' and nonstutterers auditory-laryngeal reflexes in hopes that it may provide a non invasive means of determining whether or not brainstem level reflex activity differs between stutterers and nonstutterers. This study presented compares adult male stutterers' and adult male nonstutterers' auditory- laryngeal reflexes by sustaining phonation at a constant pitch and intensity level while receiving bilateral auditory click stimuli. Each person's fundamental frequency signal averages were generated and measured. The data indicated that there were no differences between stutterers and nonstutterers frequency of reflex occurrence.
Meltzer, A. (1992). Horn Stuttering. JOURNAL OF FLUENCY DISORDERS, 17, 4. 257-264
This paper presents a case study of an adult male stutterer who also stutters while playing the French horn. The client attended an intensive precision fluency shaping program 7 hours a day for 1 month. Results indicate that respiratory, laryngeal , and oropharyngeal dysfunction perceived as stuttering can occur in activities with similar demands.
Menzies, R., Onslow, M., & Packman, A. (1999). Anxiety and Stuttering: Exploring a Complex Relationship. AMERICAN JOURNAL OF SPEECH- LANGUAGE PATHOLOGY, 8, 3-10.
Although there is a lot of evidence , it has not yet been proven that people who stutter demonstrate higher levels of anxiety than those who do not stutter. The authors describe the evidence that supports a positive relationship between the two, and explain reasons why it has not yet been proven. The authors state some biases that have occurred in research that have led to negative findings in the relationship between anxiety and stuttering. Some biases discussed are: the construct of anxiety, small subject numbers, treatment status of subjects, using only single-speaking tasks, and trait anxiety measures.
Messenger, M., Onslow, M., Packman, A., & Menzies, R., (2004). Social anxiety in stuttering: Measuring negative social expectancies. JOURNAL OF FLUENCY DISORDERS, 29, 2001-212.
This study looks at whether expectancy of social harm is associated with speech related anxiety in those who stutter. Two clinical measurements of anxiety, the Fear of Negative Evaluation (FNE) Scale and the Endler Multidimensional Anxiety Scales-Trait (EMAS-T), are administered to thirty-four stuttering and thirty-four control participants to determine how anxiety relates to expectancies of social harm in people who stutter. For chronic stuttering management, the management of anxiety must consider the extent and the precise details of the nature of the anxiety. The results indicate that those who stutter differ from control subjects in their expectations of negative social evaluations in the contexts of Social Evaluations and New/Strange Situations. Further, the FNE and the EMAS- T are demonstrated as appropriate psychological tests of anxiety for use with stuttering clients in a clinical setting.
Meyers-Fosnot, S. (1995). Some contemporary approaches in treating fluency disorders in preschool, school-age, and adolescent children. LANGUAGE SPEECH AND HEARING SERVICES IN THE SCHOOLS, 26 (2), 115-117.
This article is an overview and introduction to the entire April 1995 issue of LSHSS focusing on the treatment of preschool and school-age children who stutter. Current intervention strategies and procedures presented by experts in the field such as Starkweather, Ramig, Daly, Healey, Ratner, and St. Louis are highlighted in this introductory article. According to Meyers-Fosnot, fluency disorders can be managed effectively and efficiently with age-appropriate treatment refined to the individual needs of the client. Early intervention should be a pivotal focus, and clinicians should become proficient fluency specialists in the school environment through reading of recent literature, education, and workshops. It is also noted by the author that the information in this April 1995 issue is by no means exhaustive, and the reader in encouraged to review other approaches for treating fluency disorders.
Meyers, S.C. (1986). Qualitative and quantitative differences and patterns of variability in disfluencies emitted by preschool stutterers and nonstutterers during dyadic conversations. JOURNAL OF FLUENCY DISORDERS, 11, 293-306.
The purpose of the study was to determine whether or not there are quantitative and qualitative differences in disfluencies in children who do and do not stutter. There were twenty-four sets of children and mothers involved in the study. Each mother interacted with their own child, an unfamiliar child who stuttered and an unfamiliar child who did not stutter. The results show that the children who stuttered are quantitatively and qualitatively different from the children who did not stutter. Both had similar amounts of normal disfluencies however, the children who stuttered used more part word repetitions, prolongations and tense pauses. Another important result was that the frequency of disfluencies was not significantly affected by the identity of the child's conversation partner or by the child's familiarity with the testing room.
Meyers, SC., Ghatak, LR., & Woodford, LL. (1989). Case descriptions of nonfluency and loci: Initial and follow-up conversations with three preschool children. JOURNAL OF FLUENCY DISORDERS, 14, 383-397.
This study compared disfluencies of three children, ages 3 years 8 months to 3 years 9 months. One child stuttered, one was language impaired and one had normal speech and language. The data was collected during child and mother play, on two occasions, six months apart. The child who stuttered was the only one to receive intervention services during the six month interval. The child who stuttered reduced dysfluencies (18% to 1%) and increased disfluencies (2.5 - 7.5%), with an overall decrease in nonfluencies from 20.5 - 8.5%. The language impaired child decreased dysfluencies (4 - 2%) and disfluencies (5.5 - 4.5%). The child who had no stuttering or language impairment remained consistent with dysfluencies (.5%) and reduced disfluencies (4.5 - 2%). For all children, a high percentage of the dysfluencies occurred on conjunctions and pronouns. Future studies will use larger groups to obtain more conclusive results.
Meyers, SC., Strang, HR., & Hall, EL. (1989). Impact of Microcomputer Simulation Training on Student-Clinicians' Ability to Effectively Intervene with Preschool Stutterers. JOURNAL OF FLUENCY DISORDERS, 14, 135-151.
This is a program that was developed to help future speech- language pathologists learn effective techniques to use with preschool stutterers. It was used with twenty graduate students with twenty subjects (ten control subjects, and 10 computer-defined stutterers). They were given eight intervention categories to use for coding measures. These measures include: explain/describe, slow talk, positive feedback, model, interrupt, fast talk, negative feedback, and inappropriate questions. The outcome of the computer training showed tremendous value. It provided the students with therapy experiences and more confidence.
Miles, S. & Ratner, N. B. (2001). Parental language input to children at stuttering onset. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44 1116-1130.
This study examined the effects of parental linguistic input in relation to the onset of stuttering. Participants included twelve stuttering children, twelve non-stuttering counterparts, and the mothers of the children in each group. Spontaneous language samples were gathered for each parent-child dyad within the two groups. The language samples were analyzed in relation to the language samples lexical diversity, rarity, and syntactic complexity. Results indicated that there was not a significant difference between the two groups of parents on measures of syntactic complexity, lexical diversity, rarity, or conversational participation.
Millard S., K., Nicholas A., & Cook F., M. (2008) Is parent-child interaction therapy effective in reducing stuttering? JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 51, 636-650.
The purpose of this article was to look at the efficacy of parent-child interaction therapy in the population of children who stutter. Therapy sessions were conducted on pre-kindergarten aged children who stutter with 6 sessions of clinic-based therapy and 6 weeks of parent lead intervention. Data collected during therapy and 12 months post therapy indicated that there was a reduction in stuttering behaviors in 4 of the 6 participants. Those that showed little or no improvement by the end of 12 weeks were said to require additional intervention. The number of participants was low due to it being a single subject design and it is suggested that future research be designed to represent larger populations of children who stutter.
Miller, S., & Watson, B.L. (1992). The relationship between communication attitude, anxiety, and depression in stutterers and nonstutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 789-798.
The purpose of this study was to investigate the relationship between state and trait anxiety, depression, and communication attitude of PWS and nonstuttering subjects. Fifty Two PWS and 52 nonstutterers were involved in the study. The results showed that there were no significant differences between the two groups on anxiety, or depression. The communication attitude was poorer for the PWS and become worse as self-ratings of stuttering were more severe.
Mol Debes, N. M. M., Hjalgrim, H., Skov, L. (2008). Validation of the presence of comorbidities in a Danish clinical cohort of children with Tourette syndrome. JOURNAL OF CHILD NEUROLOGY, 23 (9): 1017- 1027.
The purpose of this study was to validate the presence of comorbid symptoms in people who have Tourette syndrome. Specifically, Mol Debes et al. looked at the following comorbid symptoms: ADHD, obsessive-compulsive disorder (OCD), sleeping disorders, stuttering, anxiety, depressive symptoms and outbursts of extreme anger. The study had 314 participants, all of whom had Tourette syndrome. Of that population, 32 participants (10.2%) were determined to have Tourette syndrome with no comorbid symptoms, 39.7% had Tourette syndrome and OCD, and 37.1 % had Tourette syndrome and ADHD. Results from this study are reported to be similar to those previously found in research. It was also noted by Mol Debes et al. that the associated symptoms of Tourette syndrome often have a bigger impact on the quality of life than the tics.
Molt, L.F. (1996). An examination of various aspects of auditory processing in clutterers. JOURNAL OF FLUENCY DISORDERS 21, 215- 225.
This study consisted of three male clutterers, aged 9:7, 11:4, and 12:6, and three male normal speaking subjects who were involved in an examination of auditory processing abilities. The first clutterer had ADD/H and was learning disabled. The second clutterer had ADD/WO, was learning disabled and had previously been classified as a stutterer. The third clutterer had ADD/WO. The subjects underwent a CAP battery including the SSW, LPFS, PPS, SRT, and a subtest of the SMMT. An AEP measure was also done. The cluttering subjects all should CAP and AEP deficits. Because the three subjects had diagnosis of ADD/WO or ADD/H, results of this study cannot be summarized to other clutterers.
Moore, WH,. Jr. (1986). Hemispheric alpha asymmetries of stutterers and nonstutterers for the recall and recognition of words and connected reading passages: some relationships to severity of stuttering. JOURNAL OF FLUENCY DISORDERS, 11, 71-89.
This study examined the presence of morphologic asymmetries of the two cerebral hemispheres in PWS, compared to NS. Thirty-six subjects (12 NS males, 12 NS females, and 12 PWS males) of all ages were asked to listen to a male voice recording while wearing an electrode cap. The participants were then asked questions to test recall and recognition. The results indicated right hemisphere alpha suppression was greater among stutterers in memory and stimulus tasks compared to NS whose left hemisphere showed greater alpha suppression.
Morgan, M., Cranford, J., & Burk, K. (1997). P300 Event-Related Potentials in Stutterers and Nonstutterers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 40, 1334-1340.
The purpose of this study was to investigate the differences between adult stutterers and nonstutterers in the P300 event- related potential. The P300 response measures cognitive functioning in response to an unexpected event. P300's were recorded and analyzed to whether or not stutterers show patterns of interhemispheric activity that differ from nonstutters. Subjects were 16 adult males comprised of 8 stutterers and 8 nonstutterers. As a result of the study, all 8 nonstutterers showed a higher amplitude P300 activity in the right hemisphere for tonal stimuli. Five out of the 8 disfluent subjects showed a higher left hemisphere amplitude activity. Results of the study indicate that stutterers and nonstutterers may possess differences between hemispheres in processing some types of nonlinguistic stimuli.
Moscicki, E. K. (1993). Fundamental methodological considerations in controlled clinical trials. JOURNAL OF FLUENCY DISORDERS, 18, 183-196.
The purpose of this article is to present a discussion of fundamental issues that need to be addressed in any test of treatment efficacy. A major focus of this article is on the principles of experimental epidemiology. The authors intent of the article is to present the basic principles of randomized controlled clinical trials in a framework that can be used as a guide for future research on the efficacy of stuttering treatments. Some of the ground covered in this article will be familiar to the stuttering researcher; while other areas will represent unexplored territory.
Mowrer, D. (1987). Reported use of a Japanese accent to promote fluency. JOURNAL OF FLUENCY DISORDERS, 1, 19-39.
This article introduces an 18 year-old Caucasian man who used a Japanese accent to eliminate his stuttering symptoms. He apparently imitated the accent from a group of Japanese exchange students he had known in high school. Although this young man had never been labeled a stutterer, he felt he had communication problems throughout his life. The article examines the speech patterns and general speech characteristics of the subject. Speech samples are taken and analyzed to determine if he is a stutterer or a clutterer. The findings of the study revealed a difficulty to label him either of the two. In the final discussion of this young man, it was determined that his perceived communication difficulties may have stemmed from psychological needs rather than abnormal speech and language issues.
Mowrer, D. (1998). Alternative Research Strategies for the Investigation of Stuttering. JOURNAL OF FLUENCY DISORDERS, 23, 89-97.
This article promotes the use of many different research methods to find out more about stuttering. Mowrer describes some of the research methods as well as the pro's and con's of each. The research methods discussed are: expiremetal method, scientific research, behavioral research, and four types of observational designs. The observational designs are: case study, natural observation, simulation observation, and content analysis. This article strongly emphasizes the importance of clinical observation in the study of stuttering.
Mowrer, D. (1998). Analysis of the Sudden Onset and Disappearance of Disfluencies in the Speech of a 2 1/2-year-old boy. JOURNAL OF FLUENCY DISORDERS, 23, 103-118.
This is a case study about a 2 1/2 year old boy who experienced a sudden onset of disfluent speech, after being with a babysitter, that lasted for 10 days, disappeared and then came back again 12 days later at the mention of the babysitters name. The disfluent speech disappeared again after 18 days and never came back (followed for 5 years). The mother reported that her son has on several occasions been very upset when left with babysitters and is anxious for his parents return. There were two methods used to record and assess data. The mother kept a journal in which she recorded significant events before, during and after the time in which her son had disfluent speech. She also videotaped several conversations she had with her son. There are several factors that may have contributed to the boy's onset and disappearance of disfluencies. Personality characteristics of the child, characteristics of the parents and environmental factors may have all played a role.
Murphy, W. & Quesal, R. (2002). Strategies for addressing bullying with the school- age child who stutters. SEMINARS IN SPEECH AND LANGUAGE, 23, 205- 211.
One of the factors increasing the challenge of treating stuttering in the school setting is the bullying experienced by the child who stutters. Bullying can diminish self-worth, reduce school performance, increase social rejection, and lead to depression and feelings of helplessness and loneliness. In addition to the impact on a child''s self-confidence, bullying can also aggravate stuttering behavior, increase negative thoughts, and reduce therapy progress. The intervention model proposed includes four components: (1) desensitize children to stuttering behaviors, (2) teach children who stutter to be assertive, (3) increase children's self-esteem, and (4) educate classmates about stuttering and bullying behaviors.
Murphy, WP & Quesal, RW. (2004). Best practices for preparing students to work with people who stutter. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 25-39.
This article considers the need for training of stuttering in the classroom and clinic settings. It has been reported that many clinicians do not feel prepared to work with or write treatment goals for clients who stutter. The authors talk about some suggestions for how to teach stuttering in the classroom, how to find clients who stutter so that students can have experience working with clients who stutter and how to supervise student clinicians who are working with clients who stutter. Murphy and Quesal discuss the characteristics of a good fluency clinician and supervisor. They say that a client who stutters should have the same supervisor throughout the duration of treatment. Murphy and Quesal recommend that supervisors should watch at least twenty minutes of every other session for a client who stutters. In this article, Murphy and Quesal discuss a formal model for supervision. They recommend both group and individual meetings with clinicians working with clients who stutter. Murphy and Quesal end the article with some additional advice for instructors, supervisors and students.
Murphy, W.P., Yaruss, J.S., and Quesal, R.W., (2007). Enhancing treatment for school-age children who stutter: I. Reducing negative reactions through desensitization and cognitive restructuring. JOURNAL OF FLUENCY DISORDERS, Vol. 32, Issue 2, 121-138.
This is a case study of an 8-year-old boy with a moderate-to- severe stutter who expressed self-awareness of his avoidance behaviors. He reported negative attitudes and emotions regarding his own communication, other students' comments, and therapy techniques. He had also experienced bullying related to his speech. Treatment included education about stuttering, desensitization to stuttering, cognitive restructuring, stuttering modification and fluency-enhancing techniques. The focus of therapy was on achieving good communication rather than fluency. Post-therapy scores on the CAT-R (measuring attitudes) and SSI-3 (measuring severity) were improved, and there was a reduction in frequency of disfluencies. Reported results included increased communication in the classroom, and use of speech modification techniques, although the client reported some apprehension about using the techniques in new situations.
Murphy, W. P., Yaruss, J. S., & Quesal, R. W. (2007). Enhancing treatment of school-age children who stutter II: Reducing bullying through role-playing and self-disclosure. JOURNAL OF FLUENCY DISORDERS, 32, 139-162.
This article discusses several strategies for handling bullying situations for children who stutter. These include learning about bullying, role-playing, and educating classmates about stuttering. When applied in a treatment program, these strategies gave Noah, the child in the case study, more confidence in dealing with bullies, and more knowledge on how to handle a bully-type situation. This knowledge helped his overall self-esteem and improved his negative feelings towards being bullied. Additionally, classroom education resulted in decreased negative reactions and comments by the child's classmates. Results suggest that including strategies for reducing bullying in therapy along with additional stuttering education and treatment may be beneficial to the child.
Myers, F.L. (1996). Annotations of research and clinical perspectives on cluttering since 1964. JOURNAL OF FLUENCY DISORDERS 21, 187- 199.
This paper includes 36 annotated bibliographies on almost everything that has been written about cluttering since Weiss's 1964 publication.
Myers, F.L. (1996). Cluttering: A matter of perspective. JOURNAL OF FLUENCY DISORDERS 21, 175-185.
This article gives a brief history on cluttering including views of the past. The article then discusses the "current trends" of cluttering. It goes on to say how clinical studies on therapy approaches are needed and that in the near future cluttering shouldn't be a disorder that is "lost in the woods."
Myers, F.L., & St. Louis, K.O. (1996). Two youths who clutter, but is that the only similarity? JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 297-304.
This article presents similarities and differences for two young male subjects who clutter. Fluency, rate, language, articulation, and other factors are compared. As knowledge is gained on the nature and symptomatology of cluttering, it is concluded that clutterers are not constricted to a homogeneous population.
Myers, F. L., & St. Louis, K. O., (2006). Disfluency and speaking rate in cluttering: Perceptual judgements versus counts. BULGARIAN JOURNAL OF COMMUNICATION DISORDERS, 1, 28-34.
This is a retrospective study focusing on an experimental therapy for people who clutter. The original study was conducted in 1996 and focused on 2 people who cluttered. The original study used DAF in oral reading, monologue and conversation or dialogue. During each task, each subject used the DAF at 4 different levels and was required to meet criteria for rate and fluency at each level. Nontreatment probes were recorded before treatment and after each stage. The current study compared scaled perceptual judgments and fluency counts for each of the probes that were conducted during the original study. The study found that a nine point perceptual scale was not accurate enough to replace time consuming rate and fluency counts.
Nachman, G. (2006). Learning and discovering: A parent's journey with stuttering. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1 (1), 111-113.
Gerrie Nachman begins by discussing her and her husband's initial finding of their son's articulation and phonological delays along with his dysfluencies. A SLP conducted free screenings at their son's preschool. The SLP suggested he be seen for further evaluation. After a difficult journey, they found an SLP who came to their home and helped their son. Gerrie sat in on lessons to discover ways to help him at home and within time he became significantly more fluent. When they began to tackle his articulation deficits it seemed his stuttering became worse. Their SLP suggested he take a break from therapy and just focus on fluency. They eventually found a young clinician at a private practice who worked with their son for 6 years. Gerrie discusses how her son eventually became more confident and engaged with others. She strongly believes this is due to the SLP emphasizing being a good communicator and the self-help community they joined which teaches parents to view stuttering in a different light. Their family engaged in many programs related to stuttering such as FRIENDS (The Association of Young People Who Stutter). With the help from their surroundings, Gerrie and her husband began to focus more on their son's life rather than his fluency difficulties. Her experiences with the clinicians, learning new skills to use at home with her son and participating in the stuttering community has had a remarkable influence on her journey with her son and his stuttering.
Namasivayam, Aravind Kumar, Pascal van Lieshout, Luc De Nil. (July-August, 2008) Bite-block perturbation in people who stutter: Immediate compensatory and delayed adaptive processes, JOURNAL OF COMMUNICATION DISORDERS, Vol. 2, Issue 4, 372-394
This study takes a look at speech motor control in stuttering and the results of when bite-block perturbations are used. The bite block immobilizes the jaw and it is said that the subject can overcome this with motor equivalence. A subject must learn to adjust so that they can produce speech targets, which may take some time to do. The authors looked at 5 PWS and 5 PNS to take a look at their sensory _ motor mechanisms using stimuli from the EMMA protocol. Bite-blocks were inserted and the subjects were tested on five different test sessions. Results in the article are from two syllable non-words. Results showed that both the PWS and PNS groups had similar effects from the bite-blocks. In regards to the motor control of the subjects, the compensation caused both groups to have less variability. The results were different for fast rates of speech for the PWS and PNS groups. To have more control in faster rate situations, PWS need to rely on compensatory strategies learned to help with motor control. Since only a small amount of people were tested, more testing needs to be done to verify the results.
Namasivayam, A. K. & van Lieshout, P. (2008). Investigating speech motor practice and learning in people who stutter. JOURNAL OF FLUENCY DISORDERS, 33, 32-51.
The purpose of this study was to compare speech motor practice and speech motor learning of people who stutter (PWS) and people who do not stutter (PNS). Participants included five male PWS, ages 18-41, and five male PNS, ages 22-32. Participants were asked to repeat a series of nonsense words at both normal and fast rates during three sessions. The first two sessions (T1 and T2) occurred on the same day. Practice effects were measured by comparing data from T1 and T2. The third session (T3) occurred one week later. A comparison of T1 and T3 data was made in order to measure learning. Results indicated similar practice effects and learning for both groups in terms of individual movement variables, but reduced practice effects and learning for the PWS group as compared to the PNS group in regard to variables involving coordination of movement patterns. Results are discussed relative to a review of the literature indicating possible speech motor limitations of PWS.
Natke, U., Grosser Karl, J., & Kalveram, T. (2001). Fluency, fundamental frequency, and speech rate under frequency-shifted auditory feedback in stuttering and nonstuttering persons. JOURNAL OF FLUENCY DISORDERS, 26, 227-241.
The purpose of this study was to expose whether frequency shifting changes fundamental frequency in ongoing speech and whether these changes related to fluency enhancement. Two groups of ten stuttering and ten nonstuttering males, whose native language was German, participated in the study. The participants had to use spontaneous speech for five minutes under three conditions of auditory feedback: raised _ octave of frequency-shifted auditory feedback (FAF), lowered _ octave FAF, and non altered auditory feedback. The fluency-enhancing effect of FAF was measured by the percentage of discontinuous speech time (PSDT). Results showed that in persons who stuttered, the downward shift led to a fluency enhancement of twenty-five percent measured by the PSDT, while the upward shift led to a fluency enhancement of twenty-one percent. An effect on global fundamental frequency in nonstuttering persons was indicated between the non altered and the upward shift condition. Persons who stuttered, as a group, did not show a change in global fundamental frequency.
Natke, U., Grosser, J., Sandrieser, P., & Kalveram, KT. (2002). The duration component of the stress effect in stuttering. JOURNAL OF FLUENCY DISORDERS, 27, 305- 319.
This article gives information on language factors related to stuttering and the effects of stressed syllables with adults who stutter. A case study was described where 16 adults with a mean age of 33 who stutter mildly to very severely were tested to compare the instances of stuttering on stressed versus unstressed syllables of words. The German subjects read aloud from a text. The researches analyzed the stuttering instances on short and long stressed and unstressed syllables in the initial and medial positions of words. Data revealed stuttering events occurred more often on short first stressed syllable of words than on unstressed, long stressed, or intermediate stress syllables of words.
Natke, U., Sandriese, P., Pietrowsky, R., & Kalveram, K. T. (2006). Disfluency data of German preschool children who stutter and comparison children. JOURNAL OF FLUENCY DISORDERS, 31, 165- 176.
This study compared disfluency types in German-speaking preschool children who stuttered (CWS) and age-matched children who do not stutter (CWNS). Speech samples recorded during play sessions in a research laboratory were transcribed and analyzed for disfluencies. Disfluencies were separated by type: prolongations, blocks, repetitions of sounds, syllables, and one-syllable words, and other disfluencies. Results showed that CWS produced significantly more stuttering-like disfluencies (prolongations, blocks, and repetitions) at any age than CWNS. The groups did not differ on measures of other disfluencies (interjections, revisions, interrupted utterances, multisyllabic word repetitions, and phrase repetitions). These results are concurrent with previous studies in that early stuttering is different from normal disfluency and that the presence of stuttering-like disfluencies should not be considered normal language development.
Neiman, G.S. and Rubin, R.B. (1991). Changes in communication apprehension, satisfaction, and competence in foreign dialect and stuttering clients. JOURNAL OF COMMUNICATION DISORDERS 24, 353-366.
Research indicates that speech-impaired clients' attitudes and psychological predispositions significantly affect their therapy progress. This study looked at whether communication predispositions are altered as a function of speech therapy. The results indicated that there were significantly lower levels of communication apprehension and higher levels of communication competence after 30 months of therapy.
Nelson, L.A. (1996). Critical review of the special edition on cluttering. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 345-348.
This article provides a general overview of cluttering and its components. It focuses on what is known about cluttering, what has recently been learned about cluttering, and what has yet to be learned about cluttering.
Neiman, G.S. & Rubin, R. B. (1991). Changes in communication apprehension, satisfaction, and competence in foreign dialect and stuttering clients. JOURNAL OF COMMUNICATION DISORDERS, 24(516): p353-366.
This is a study done on two groups of subjects, international graduate students and persons who stutter. The groups consisted of 15 male adults enrolled in accent reduction therapy and 13 male adults enrolled in stuttering therapy. The research design was set up to find out how the subjects perceptions of their communication competence, communication apprehension, and general satisfaction with their communication, developed over the course of their therapy. The results indicated that both groups had significantly lower levels of communication apprehension and perceptions of communication competence had increased after 3 months of therapy. The individual clients also improved significantly on the speech parameters that their therapy focused on.
Neumann, K., Euler, HA., Giraud, AL., Lanfermann, H., Gall, V., & Preibisch, C. (2003). The nature and treatment of stuttering as revealed by fMRI: A within- and between- group comparison. JOURNAL OF FLUENCY DISORDERS, 28, 381-410.
The purpose of this study was to use fMRI to identify changes in the activation patterns attributed to improved fluency resulting from an intensive fluency shaping therapy. Participants in this study included five male adults with developmental stuttering. The Kassel Stuttering Therapy, a modified version of the Precision Fluency Shaping Program, was used as the therapy model for this study. The participants underwent fMRI measures prior to starting therapy, immediately after therapy, and two years post- therapy. The results of the fMRI measures were compared within group and against a control group. Prior to therapy, the PWS group showed higher and more distributed activation than the control group during overt reading tasks. Immediately following therapy, the activation patterns were even more distributed and left-hemisphere focused. Functional MRI measures conducted two years after therapy indicated slightly reduced activation patterns, with a trend to more right-sided involvement.
Neumann, K., Preibisch, C., Euler, H.A., Gudenberg, A.W., Lanferman, H., Gall, V., & Giraud, A. (2005). Cortical Plasticity Associated with Stuttering Therapy. JOURNAL OF FLUENCY DISORDERS, 30(1), 23-39
Findings of functional neuroimaging studies have indicated disturbances between the left sensorimotor cortex, inferior frontal speech regions (Broca's area), and temporal regions of the brain during speech production in persistent developmental stuttering (PDS). In addition (fMRI) images also reveal a systematic overactivation of the right frontal operculum (RFO) in PDS subjects. In this study comparisons of speech related neural activation patterns in nine stuttering and nonstuttering adults males during fluent reading and silent semantic decision making tasks have been studied before and with 12 weeks after fluency shaping therapy. Results indicate that there were higher and extended activations after therapy than before therapy, predominantly left-sided and bilateral temporal. Observations also reveal that the areas with increased activation post therapy were in the left insula and the left Rolandic operculum which were in the surrounding areas of the recently found white matter lesion (Sommer et al., 2002). In conclusion this study does support that successful fluency-shaping therapy shifts brain activity form right-hemisphere circuits to left hemisphere speech related regions with intensive treatment. Additionally, post-treatment activation supports a higher degree of compensation after a successful treatment.
Newman, L. (1987). The effects of punishment of repetitions and the acquisition of "stutter-like" behaviors in normal speakers. JOURNAL OF FLUENCY DISORDERS, 1, 51-62.
This study uses punishment tactics with normally fluent speakers to try to elicit stuttering like behaviors. The punishing stimulus delivered to normally fluent speakers was contingent on repetitions. In an effort to avoid the punishing stimulus, the subjects changed their speaking behavior to decrease repetitions in their speech. This resulted in an unnatural way of speaking, characterized by reduced speech rate. Every normally fluent subject responded with some type of behavior. From this study, it appears that speech rate slows with awareness of speech mistakes, making speech less fluid and more effortful overall.
Newman, P., Channel, R., & Palmer, M. (1986). A comparative study of the independence of unilateral ocular motor control in stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 105-116.
The purpose of this study was to determine if people who stutter and people who do not stutter have the same unilateral ocular motor control. The study involved nineteen people who stutter and nineteen people who do not stutter. Thirteen people who stutter were considered mild, four were considered moderate, and two were considered severe. Each person had photographs taken of their eyes wide open and also closed. This was done for measurement purposes. Next photographs were taken when they closed only the right eye, and also when they closed only the left eye. The results indicated a difference between people who stutter and people who do not stutter in their ability to close one eye and keep the other eye open.
Newman, P.W., Fawcet, K. D., & Russon, K. V. (1986). Cognitive processing in stuttering as related to translating slurvian. JOURNAL OF FLUENCY DISORDERS. 11, 251-256.
The purpose of this research study was to compare the performances of stutterers and nonstutterers in translating slurvian. A slurvian consists of a meaningless phrase or sentence, which by the manipulation of juncture and stress patterns, can be rephrased or translated into a meaningful statement. The study consisted of 18 stutterers and 18 nonstutterers. Administration of the experimental task included 2 sets of slurvians, which the subjects had 30 seconds to translate each slurvian into a meaningful statement. Results of the experiment were variable, with the stutterers as a whole, performing more poorly than the nonstutterers. Results suggest that the population of stutterers is not homogeneous and that a relationship between stuttering and inferior performance in translating slurvians exists in some cases.
Newman, PW., Harris, RW., & Hilton, LM. (1989). Vocal jitter and shimmer in stuttering. JOURNAL OF FLUENCY DISORDERS, 14, 87-95.
This study focuses on the laryngeal dynamics of vocal jitter and shimmer in people who stutter. "Vocal jitter and shimmer are acoustic measures of those vocal perturbances obtained from sustained vowel phonations." ( p. 88). If the magnitude of either jitter or shimmer in stutterers is found to be greater than that of nonstutterers, it would provide a further basis for the hypothesis that stutterers may have less neurophysiologic control over their mechanisms of phonation and respiration. Subjects were told to phonate and sustain 4 different vowels 9 different times for at least five seconds each. A miniature accelerometer was used to record the subjects. The results showed that for both jitter and shimmer the mean percent was larger for stutterers than for nonstutterers. For jitter the percentage was not significant but for shimmer it was. These results suggest that "stutterers have less stable neuromuscular control over events regulating the aerodynamics of the laryngeal and respiratory systems during sustained fluent vowel articulations than nonstutterers" (p. 94).
Newman, R.S., and Ratner, N.B. (2007). The role of selected lexical factors on confrontation naming accuracy, speed, and fluency in adult who do and do not stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 50, 196-213.
This study examines the effects of lexical features on word retrieval abilities in adults who stutter and those who do not. Participants entered into the study consisted of 25 adults who stutter and 25 adults who do not. Each of the 50 subjects completed 107 trails which targeted one of three lexical components: neighborhood frequency, neighborhood density, or word frequency. Each response was judged based on the subjects reaction time, fluency and response accuracy. Results of the study reveal a small but insignificant difference in the reaction times of individuals who stutter vs. those who do not on all three lexical components. Adults who stutter had lower accuracy rates on the confrontational naming tasks. However, with the exception of word frequency, the fluency of adults who stutter was not influenced by neighborhood frequency or density.
Nippold, M. A. (1995). Parents' speech and children's stuttering: A critique of the literature. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(5). 978-989.
The literature reviewed in this article finds little or no difference between parents of children who stutter and parents of children who do not stutter. The manner in which parents talk to their children, as well as the parents' speech behaviors, are the criteria upon which these conclusions are derived
Nippold, M. (2002). Stuttering and phonology: is there an interaction? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 2, 99-110.
Speech-language pathologists have been interested for many decades in the phonological skills of children who stutter. Many investigators have reported that children who stutter are often more likely to have a phonological disorder than their peers who do not stutter. It is commonly reported that 30%-40% of children who stutter have a co-occurring phonological disorder. Reports of this nature have prompted researchers to examine the possibility that stuttering and phonology may interact in some way. In the intervention literature, it is recommended that treatment for children who stutter and have a phonological disorder take an indirect approach. Many examinations of children were alluded to in the article but in the end the results indicated that children did demonstrate normal phonological development when being classified as a mild to severe stutterer, and that children with phonological disorders did not necessarily stutter more severely than those with normal phonological development.
Nippold, MA., & Rudzinski, M. (1995). Parents' speech and children' s stuttering: A critique of the literature. JOURNAL OF SPEECH AND HEARING RESEARCH, 38, 978-989.
This article is a review of the literature concerning the role of parents in the onset and development, of their children's stuttering. This article examines the literature from three decades and suggests that although much research has been conducted concerning the roll of the parent, it still cannot be stated with confidence that a parent' s speech behaviors or modification of speech contribute to their child' s stuttering. Thus, the authors provide treatment and research implications.
Nowak, WJ., Stone, ER. (1987). Acquired Stuttering and Bilateral Cerebral Disease. JOURNAL OF FLUENCY DISORDERS, 2, 141-146.
Two cases of adult (females, ages 21 and 55) acquired stuttering are presented. Both patients best fit into the category of acquired, or cortical stuttering (ACS). The onset of ACS was abrupt in both cases and from neither patient, could a history of speech problems prior to now, be elicited. Both patients had an onset of ACS coincident with evidence of bi-hemisphere dysfunction. Speculation that ACS is due to a multiple series of insults to the brain, rather than a single, specific cerebral location is explored.
Nuck, M.E., Blood, G.W., & Blood, I.M. (1987). Fluent and disfluent normal speakers' responses on a synthetic sentence identification (SSI) task. JOURNAL OF COMMUNICATION DISORDERS, 20, 161-169.
This study addresses the question of a relationship between fluency and central auditory processing. Prior research suggests a central auditory problem as a possible etiology in stuttering. This study examines any differences in tests of auditory processing for groups of male and female, fluent and disfluent normal speakers. It reports significant differences for speakers at this end of the fluency spectrum, suggesting that a momentary lapse in fluency may be attributed to a deficiency in central auditory processing at the time. No significant differences were found between genders.
Nudelman, H.B., Herbrich, B.D. Hoyt, B.D. & Rosenfield, D.B. (1989). A Neuroscience Model of Stuttering. JOURNAL OF FLUENCY DISORDERS, 14, 399-427.
This study considers stuttering using a theoretic two loop speech production model. In this model, an outer loop is responsible for formulating ideas, linguistic planning and monitoring. An inner loop is responsible for the phonologic production and monitoring. Analyzation of humming output of adults, who did and did not stutter, revealed wider variability in timing with those who do stutter. Timing in speech could increase in the outer loop due to time required for linguistic planning and for the inner loop with complex articulation or frequency changes required. Common methods to eliminate stuttering are explained by this multiloop theory. Slowing speech rate allows more time for the processing and executing speech movements. Rehearsal minimizes time needed for planning, increasing fluency (adaptation). Stuttering is the result of instability in the system, and the system's response to the instability.
Nwokah, EE. (1988). The imbalance of stuttering behavior in bilingual speakers. JOURNAL OF FLUENCY DISORDERS, 13, 357-373.
This study looks at the varying incidence of stuttering from one culture to the next. The purpose of the study was to answer two questions: 1. "Do people who are bilingual or multilingual and stutter do so equally in each language?" and 2. "Do some stutterers speak totally fluent in one language but stutter in another?" Sixteen stutterers between the ages of 16 and 40 living in Anambra State, Nigeria were chosen as the subjects for this study. All of the subjects received a minimum of five years of high school education and were balanced bilinguals, meaning they are equally competent in both languages of English and Igbo. Each subject completed a questionnaire and read aloud a 300-word passage both in English and Igbo. The readings were tape-recorded and the tapes were analyzed for occurrence of stuttered words. The results showed that all but one subject stuttered more in one language than the other in both spontaneous speech and reading activities. Almost all of the stutterers were aware of which language they stuttered the most. Socio-cultural aspects of bilingual stuttering were also overviewed in relation to the findings.
O'Brian, S., Onslow, M., Cream, A., & Packman, A. (2003). The Camperdown program: outcomes of a new prolonged speech treatment model. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 933-946.
This program is a prolonged-speech (PS) treatment which focuses on control of chronic stuttering. PS treatment can be used for mild to severe adults who stutter. It is a four stage intervention that focuses on individual teaching sessions, group practice, individual problem-solving, and performance contingent maintenance. Sixteen participants were involved in a limited, 20 hour clinic program. The intervention utilizes videos, from which the client imitates, and self-evaluation and self-monitoring, as opposed to traditional client-clinician instruction. The study found favorable outcomes and generally positive self-reported benefits.
O'Brian, S., Packman, A., Onslow, M. (2004). Self- Rating of stuttering severity as a clinical tool. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY, 13(3), 219-227.
This study was conducted by employing 9 men and 1 woman adult stutterers to investigate the 9 point self-administering severity rating scale. The most important aim was to establish the extent to which clients' ratings of stuttering severity, made both within and outside of the clinic, agreed with those of treating clinicians. This procedure was carried out by rating 6 recorded samples in which each of the subjects and the clinician rated the severity, based on predetermined criteria. Results indicated that the ratings of the clinicians were in good agreement with the client's self-rating of stuttering severity by 78%. In conclusion this study reveals that the 9-point rating scale is a reasonably reliable tool for clients to judge or rate their severity in natural as well as in therapy environments.
O'Brian, S., Packman, A., Onslow, M., O'Brian, N. (2003). Generalizability theory II: Application to perceptual scaling of speech naturalness in adults who stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 718-723.
The purpose of this study was to test the Generalizability theory, which is a method for estimating the reliability of observational data. In this study, 15 unsophisticated raters utilized the Nine-Point Speech Naturalness Scale of R. R. Martin, S. K. Haroldson, and K. A. Triden (1984) to evaluate the speech of a group of people who stutter and an age and sex-matched group of people who don't stutter. The G-theory analysis provided a way to calculate how many raters and how many ratings are required to obtain a reliable rating from an observation scale. Results of this study suggest that this type of analysis is effective when used to evaluate observational scales on a case-by-case basis.
O'Bian, S., Packman, A., & Onslow, M. (2008). Telehealth delivery of the camperdown program for adults who stutter: A phase I trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 51, 184-195.
This article explained a study conducted to find if Phase I of the Camperdown Program would still have success when delivered strictly by email and telephone. There were 10 adult participants included in the study that were unable to attend treatment due to schedule conflicts. The telehealth variation of the Camperdown Program still included the main ideas. The results indicated the telehealth model reduced stuttering short term. Since the participants could attend the program at home there were no drop outs and no missing data. The long term effects of the telehealth program are still unknown. The follow-up posttest indicated a slight increase in participants stuttering. Further observations of the telehealth model are still needed to study the benefits. Overall, this telehealth method of the Camperdown Program seems effective and helps clients to attain treatment that would not be able to.
O'Brian, S., Packman, A., Onslow, M., & O'Brian, N. (2004). Measurement of stuttering in adults: Comparison of stuttering- rate and severity-scaling methods. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 1081-1087.
This study investigated the comparative reliability of 2 stuttering measurement tools: percentage of syllables stuttered (%SS) and a 9-point severity scale (SEV). These tools were compared in terms of (a) their distribution for a stuttering population, (b) their relative reliability, and (c) the degree to which scores on one tool predicted scores on the other. The participants included 90 stuttering adults and 10 non-stuttering adults. The judges were 12 speech- language pathologists experienced in the treatment of stuttering. The judges watched 3-minute videotapes of each participant and rated %SS and severity. Results indicated a very high intrajudge and interjudge agreement for both measures and a strong linear correlation between %SS scores and SEV scores. The authors concluded that the 2 measures are reliable and could largely be used interchangeably for the measurement of stuttering. Overall, the study supported the use of either a %SS measure or a 9-point SEV scale in research and clinical practice.
O'Donnell, J.J., Armson, J., & Kiefte, M. (2008). The effectiveness of SpeechEasy during situations of daily living. JOURNAL OF FLUENCY DISORDERS, 33, 99-119.
The purpose of the following multiple single-subject design study was to look at the effect of SpeechEasy on stuttering during spontaneous conversation and to determine subjective impressions about the effectiveness of the SpeechEasy of speech produced in situations of daily living (SDL). Participants of the study included seven adults and exhibited at least a 30% reduction in their stuttering while using the SpeechEasy device upon admission to the study. Data was recorded at several stages during the 16 week study with and without the use of the device in the laboratory and SDL, along with a questionnaire regarding the participants' ability to wear and use the device. Results indicated that all seven participants exhibited less stuttering with the device than without the device. Five participants demonstrated constant amounts of stuttering reduction during long term use of the SpeechEasy device. In conclusion, it is recommended that the long-term effectiveness of the SpeechEasy in SDL should be further investigated.
Olsen, LT., Steelman, ML., Buffalo, MD., & Montague, J. (1999). Preliminary information on stuttering characteristics contrasted between African American and white children. JOURNAL OF COMMUNICATION DISORDERS, 32, 97-108.
The main purpose of this study was to determine if any behavioral or attitudinal characteristics differed between African American and white children who stuttered. More specifically, the authors examined whether there were differences in verbal and/or visual disfluency behaviors and whether attitudes towards various speaking situations varied between the groups. Fifteen African American children and fifteen white children participated in this study. Both conversational and reading speech were used as the speech sample. Verbal disfluencies and accessory (visual) characteristics were measured using a disfluency checklist. Each subject was also administered the Children's Attitude Test (CAT). Results showed no significant differences in verbal and/or visual behaviors for the reading speech. For the conversational speech, a significant difference was noted only in one category, but it was thought that this was due to a Type 1 statistical error and not a meaningful difference. Results of the CAT indicated that there were no significant differences in attitudes towards speaking situations between the groups. One question out of the thirty-five did have a significant difference, but again it was attributed to a Type 1 statistical error.
Olson, E., & Bohlman, P. (2002). IDEA '97 and children who stutter: evaluation and intervention that lead to successful, productive lives. SEMINARS IN SPEECH AND LANGUAGE, 23, 159-164.
The Individuals with Disabilities Education Act (IDEA) '97 is an important component to developing appropriate evaluation and treatment programs for the child who stutters. There are unique needs of the child who stutters that are essential to the formulation of an effective Individualized Education Program (IEP). Information is provided concerning an appropriate evaluation process and determination of eligibility. IEP goals and benchmarks, therapy frequency and location, a transition plan, involvement of parents, and criteria for dismissal are provided.
Olswang, L.B. (1993). Treatment efficacy research: A paradigm for investigating clinical practice and theory. JOURNAL OF FLUENCY DISORDERS, 18, 125-131.
This article deals with the clinical and theoretical framework that is used in therapy. The author provides some questions that might be of use in assessment and intervention of stuttering clients. The author also stresses the importance of co-mingling practice and theory when providing assessment and intervention.
Onslow, M. (1992). Choosing a treatment procedure for early stuttering: Issues and future directions. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 983-993.
The purpose of this paper was to evaluate the conceptual and practical aspects of the early stuttering treatments used and overview early intervention procedures and to investigate pros and cons and issues associated with each procedure. From this investigation, the authors concluded that all treatment showed deficits in one or more of the following areas: conceptualization, specificity and empirical verification. The use of prolonged speech is far less effective for children than it is for adults. The study found that operant methodology may be a potential early intervention technique.
Onslow, M. (1992). Identification of early stuttering: Issues and suggested strategies. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY: JOURNAL OF CLINICAL PRACTICE, 1(4), 21-27.
This article addressed the need for strategies of early identification of stuttering. The major areas discussed are as follows: rational and empirical progress, positive identification of early stuttering, negative identification of early stuttering, false positives and false negative identification clinical strategies for identifying early stuttering, positive identification components, negative identification components (At risk register), and issues in early identification and service provision. The author comments on over identification and preventing it by placing questionable children on a At Risk Register where they can be observed regularly.
Onslow, M. (2003). Evidence-based treatment of stuttering: IV. Empowerment through Evidence-based treatment practices. JOURNAL OF FLUENCY DISORDERS, 28, 237-245.
This article discusses evidence-based treatments for stuttering and how the use of these treatments is beneficial to the professional development of clinicians. Onslow feels that evidence-based treatments are professional investments. It is an investment of growth within the profession and an investment not only for effective treatment for professionals now, but also for future professionals. Evidence-based treatments allow for professional development in two ways. The first is to be a scientist practitioner and the second is to develop and diversify professional activities. This article also discusses what effective treatments are to be based on the clients. Onslow states, "Evidence-based practice is about the clients getting better from their disorder." The final topic discussed in this article is professional empowerment. Since evidence- based treatment is an investment which provides professional development and diversity and ensures effective treatments it is thought to be professionally empowering for clinicians to use this treatment.
Onslow, M. (2004). Advice to students of stuttering treatment. CONTEMPORARY ISSUES IN COMMUNICATIN SCIENCE AND DISORDERS, 31, 5-24.
This article offers advice to students regarding stuttering treatment. Students are advised to stay away from the notion of a continuum between normal disfluencies and nonnormal dysfluencies by using a system that counts the number of stuttering-like disfluencies, SLD's, in clinical practice. Students are also advised to be careful about their choice of treatments and not to do any therapy that is based solely on a theory of stuttering. The reasoning being that if a stuttering theory cannot account for the explanation of what is known about stuttering, the theory is probably wrong. Instead of theories, students are advised to look to evidence based practice clinical trials to establish treatment for their clients. Finally, students are advised to challenge themselves to be accountable for stuttering treatments by being specific about treatment goals, using speech measures to determine outcomes, and benchmarking clinical performance. Further, the benefits of accountability are argued and some questions are posed for reflection.
Onslow, M., (2007). Oliver Bloodstein: Reflections on a career. JOURNAL OF FLUENCY DISORDERS, 32, 330-337.
This journal article is a look into the life of Oliver Bloodstein. Via email interview between Mark Onslow and Oliver Bloodstein in February of 2007, Bloodestein's life is depicted through a number of specifically selected questions. It dives into his beginning days at the University of Iowa studying under Wendell Johnson, to the creation of his self written book "Handbook of Stuttering" which is in preparation of its 6th edition, to his personal views on many topics regarding stuttering. It is a personal account of the career of a very important figure in the stuttering world.
Onslow, M., Adams, R., & Ingham, R.J. (1992). Reliability of speech naturalness rating of stuttered speech during treatment. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 994-1001.
This study evaluated the reliability of judges' repeated ratings on the same subjects, to compare the reliability of speech naturalness rating of experienced and inexperienced judges, and to examine the effect on reliability of duration of the rated interval of speech. The judges listened to speech samples of 10 clients in therapy whom were using prolonged speech. The intrajudge reliability was 72.4%. The interjudge reliability was 59.2%.
Onslow, M., Costa, L., Andrews, C., Harrison, E., & Packman, A. 1996. Speech Outcomes of a Prolonged-Speech Treatment for Stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 4 734-749
This study attempts to quantify the effects of an intensive prolonged speech treatment program. The study included 12 subjects who's speech was evaluated for stuttering severity, speech rate, and speech naturalness, prior to treatment as well as post- treatment. Results indicated that after 2-3 years the 12 subjects had reached zero to near-zero stuttering with speech considered "natural ".
Onslow, M., Gardner, K., Bryant, K.M., Stuckings, C.L., Knight, T., (1992). Stuttered and normal speech events in early childhood: The validity of a behavioral data language. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 79-87.
A set of 200 utterances (each contained a disfluency) from stuttering and normally speaking children aged 2-4 years was obtained. Five sophisticated listeners, 10 clinician listeners, and 10 unsophisticated listeners rated the utterances using Johnson's eight disfluency categories. According to the results, it is concluded that it is justifiable to question the validity of the data, language used by researchers to describe stuttered and normal speech in early childhood.
Onslow, M., Hayes, B., Hutchins, L., & Newman, D. (1992). Speech naturalness and prolonged speech treatments for stuttering: Further variables and data. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 274-282.
This study wanted to show that unusual speech quality may result from stuttering treatments that are based on prolonged speech. The results indicated that speech quality assessments of post treatment clients gave similar results regardless of whether they were based on monologues or conversations. Speech naturalness scale scores were presented for nonstutterers and post treatment stutterers and the data was compared with the existing findings.
Onslow, M. & O'Brian, S. (1998). Reliability of clinicians' judgments about prolonged- speech targets. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 969-975.
This article investigates a program which utilizes prolonged speech to establish fluency through soft contacts, gentle onsets, and continuous vocalization. The success of this type of therapy depends upon correct feedback and the skills of the clinician to recognize correct and incorrect productions. The purpose of this study was to determine intra-clinician and inter-clinician reliability when working to detect prolonged speech procedures. There is a lack of consistent terminology to explain prolonged speech measures; recognizing and learning these techniques is difficult without a manual or specific instruction. This study used clinicians who were familiar with the prolonged speech program. Their findings prove that both inter-clinician and intra-clinician measures were at inadequate levels. As a result of these findings, the authors suggest further research to investigate whether or not the feedback given in treatment affects relapse following treatment.
Onslow, M. & A. Packman (1999). Treatment recovery and spontaneous recovery from early stuttering: the need for consistent methods in collecting and interpreting data. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 42, 398-402.
This letter was written regarding the issue of initiation of treatment in young stutterers. The article was written to focus attention on the presence and the subsequent absence of stuttering in preschool children. Some factors that should be addressed when considering therapy are: period since onset, extent to which the child's communication is disturbed, and the extent to which the condition distresses the child and family. The critique also emphasizes different ways of collecting data. Onslow and Packman critique the study done by Yairi and Ambrose. A particular aspect they critiqued was the infrequent speech sampling and their methods of measuring recovery and follow-up. Onslow and Packman claim there is currently no scientific data to support that any child has spontaneously recovered from stuttering.
Onslow, M., & Packman, A. (2001). Ambiguity and algorithms in diagnosing early stuttering: Comments on Ambrose and Yairi (1999). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 3, 593-594.
Mark Onslow and Ann Packman wrote this article in response to the Ambrose and Yairi (1999) report on diagnosing early stuttering. The authors drew attention to three issues that they believe undermined the conclusions and the recommendations for differentiating stuttering from non-stuttering children. The issues are as follows: 1) the criterion that was used was to high so that the likelihood that borderline or ambiguous cases were left out of the study, 2) the authors used their weighting procedure in such a fashion so as to make unexplained overlap between the two groups disappear, and 3) the authors failed to differentiate between stuttering and disfluency.
Onslow, M., VanDoorn, J., & Newman, D. (1992). Variability of acoustic segment durations after prolonged speech treatment for stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 529-536.
This study used young clients with no history of treatment based on prolonged speech. The investigators obtained pretreatment and posttreatment acoustic measures from spontaneous speech samples. The acoustic measures showed no significant posttreatment increases in durations of acoustic segments. The posttreatment speech samples showed significantly reduced variability for the acoustic measure of vowel duration and articulation rate measure.
Onslow, M., & Yaruss, J. S. (2007). Differing perspectives on what to do with a stuttering preschooler and why. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 16, 65-68.
This was a debate regarding which stuttering treatment is more appropriate or effective for children. Onslow and Yaruss asked questions of each other related to stuttering therapy and responded to the other's questions. Yaruss was in support of a more individualized approach while Onslow preferred to use the Lidcombe therapy method. Yaruss argued that the Lidcombe approach relies on the child's parents to take on an important and integral role in treatment but this type of parental involvement is not always realistic. Onslow eluded that the Lidcombe approach may be seen as the better approach because it contains better evidence regarding its effectiveness. Onslow also mentioned that he believed that stuttering could be related to a neuroanatomical problem. Yaruss refuted the idea of stuttering being related solely to a neuroanatomical problem but rather that stuttering is related to multiple factors.
Osborne, C., (2006). Student participation in the international stuttering awareness day 2006 online conference. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY & RESEARCH, 2, 16-19. http://www.journalofstuttering.com/ListofArticles.html.
This journal article illustrates how the Online Stuttering Conference can be used effectively in university curriculum. Charlie Osborne describes how The University of Wisconsin-Stevens Point involves student participation and involvement in an assignment given for his students. Additionally, the article introduces and explains what the Online Stuttering Conference is, as well as providing the purpose and a brief history about it.
Osawa, A., Maeshima, S., & Yoshimura, T. (2006). Acquired stuttering in a patient with Wernicke's aphasia. JOURNAL OF CLINICAL NEUROSCIENCE, 13, 1066-1069.
The authors present a case study of an individual who was shown to demonstrate the occurrence of acquired stuttering after developing Wernicke's aphasia as a result of a left posterior temporal and parieto-occipital lobe cerebral infarction. The individual's non-fluent speech was characterized by repetition of the initial syllables of words, which persisted beyond four weeks after onset even though the impairments resulting from aphasia gradually improved. The authors also review the history of reported cases that involved the occurrence of acquired stuttering as a result of cerebral infarction.
Packman, A., Onslow, M., & Van Doorn, J. (1994). Prolonged speech and modification of stuttering: Perceptual acoustic and electro- glottographic data. JOURNAL OF SPEECH AND HEARING RESEARCH, 37(4), 724-737.
This study looks into prolonged speech and its use as a therapy tool in stuttering. It investigated speech patterns in individuals who were not given specific instructions in its use. Some of the findings suggest that some subjects achieve natural sounding, stutter free speech after brief exposure to prolonged speech. The study uses acoustical wave form analysis and EGG studies to support their findings. They also believe that variability is an important issue in stuttering. the relationship in unclear.
Paden, EP., Yairi, E., & Ambrose, NG. (1999). Early Childhood Stuttering II: Initial Status of Phonological Abilities. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH. 42, 1113- 1122.
Research has been done linking stuttering and phonological deficits. However, because a child has difficulty with correctly producing a sound doesn't affect the probability of it being stuttered on. One study found that at a younger age, those who stuttered were found to have fewer articulation errors than older children who stutter. These poor phonology results suggest that children who are showing initial signs of stuttering should be monitored for permanent stuttering.
Paico, J., Healey, E.C., Brouwer, K., & Susca, M. (2005). Listener perceptions of stuttering across two presentation modes: A quantitative and qualitative approach. JOURNAL OF FLUENCY DISORDERS, 30, 65-85.
The purpose of this study was to determine if listeners' showed differences in their quantitative and qualitative perceptions of mild, moderate, and severe stuttering without secondary behaviors. Each participant was presented with various speech samples in either audio or audiovisual modes. They were then asked to complete a six-item Likert scale and were asked four open-ended questions. The comments made by the participants were divided into positive and negative comments and then further divided into five other clusters. The results revealed no statistically significant differences across the participants Likert Scale ratings. There were also non- significant differences in the positive and negative comments, which suggest that the type of presentation mode (audio and audio-visual) does not appear to affect listeners' perceptions of stuttering. However, the results did provide some support for the view that as the frequency of stuttering increases, listeners tend to make more negative comments about the speaker.
Paul-Brown, D. (1990). Consumer corner national stuttering project. AMERICAN SPEECH AND HEARING ASSOCIATION, p. 35.
The article provides a description of the National Stuttering Project and its purpose. The NSP is a support group whose purpose is to educate and support people who stutter. Information about how to contact the NSP is provided.
Pellowski, M. W., & Conture, E.G. (2002). Characteristics of speech dysfluency and stuttering behaviors in 3- and 4-year-old children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 45, 20-23.
This study sought to quantitatively and qualitatively characterize stuttering behaviors in relationship to time since onset of stuttering, within separate groups of 3- and 4-year-old children who stuttered. It also compared the disfluent behavior of these children to normally fluent children of the same age and gender by utilizing measures of speech disfluency. Participants consisted of thirty-six children who stuttered and thirty-six children who did not stutter. A spontaneous speech sample of at least three hundred words was collected during a thirty-minute conversational speech task between the child and his/her mother. Each child's speech dysfluencies were measured according to total disfluencies, other disfluencies, stuttering-like disfluencies (SLD), number of repetition units, and weighted SLD. Results showed a significant overall difference between the two groups in regards to total disfluencies, percentage of stuttering-like disfluencies, weighted SLD measure, and mean number of repetition units. There was not a significant difference between the two groups for other disfluencies. A within-group analysis was also completed to determine if there was a relationship between a child's chronological age and time since onset of stuttering. Results showed a significant relationship between the time since onset and the percentage of stuttering-like disfluencies.
Pellowski, M.W., Conture, E.G. (2005). Lexical priming in picture naming of young children who do and do not stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 48, 278-294.
The purpose of this study was to determine a relationship between semantic priming and childhood stuttering. The study involved 46 children; 23 who stutter and 23 typically-fluent peers. They were matched on the basis of age (range 3;0- 5;11). Children were placed into the stuttering group if he or she had more than three disfluencies per 100 words of conversational speech, and if he or she was rated higher than 11 on the Stuttering Severity Instrument for Children and Adults, Third Edition (SSI), and placed into the non-stuttering group if the child exhibited fewer than three disfluencies per 100 words of conversational speech, and if he or she was rated lower than 8 on the SSI. The task consisted of naming pictures on a computer screen, whereas there was a no-prime, related-prime, or unrelated-prime condition. Children who stutter were found to have slower reaction times than their typically fluent peers during the related-prime condition. There was no significant difference between reaction time in the other two conditions. For children who do not stutter, speech reaction time decreased as receptive vocabulary scores increased. Findings of the study propose a relationship between linguistic variables and childhood stuttering.
Perkins, W.H., (1992). Fluency controls and automatic fluency. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY: A JOURNAL OF CLINICAL PRACTICE, 1, 9-10.
The article contains William Perkins' view on automatic fluency promotion with fluency controls. Perkins' did not believe that fluency controls ever become habitual or automatic, and he briefly justifies why a stutterer cannot control fluency day in and day out, because the nature of speech does not operate that way.
Perkins, W. H. (1992). Stuttering prevention: Academic exercise or clinical relevance?. JOURNAL OF FLUENCY DISORDERS, 17, 33-38.
This article is a critical commentary on an article presented by Hamre. Hamre argues that parents and clinicians identify stuttering by two prototypical characteristics: Multiple repetitions and prolongations. He argues that prototype theory offers an appropriate basis for distinguishing stuttering from non-stuttered speech, and that perceptual features alone can readily identify stuttering. The author believes that it is true that listeners identify stuttering in this manner. However, he suggests that this theory has no clinical relevance in treatment of stuttering, since this is not how people who stutter themselves distinguish their moments of stuttering. He provides evidence that people who stutter typically identify moments of stuttering by the loss of control, and that overt stuttering (or lack thereof) does not always reflect these moments. He argues that treatment focused on conditions resulting in loss of control is appropriate.
Perkins, WH. (1992). "Stuttering prevention II:" Plaudits with problems. JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 89-94.
This is a commentary by William Perkins in response to Curt Hamre's article Stuttering Prevention II: Progression which is contained in this same issue. Perkins expresses concern that Hamre has misrepresented his position and hopes that this has not occurred with quotes of others. Perkins suggests that there are flaws and alternatives to Hamre's arguments but credits him for confronting "unsupported positions".
Perkins, W. H. (1993). The early history of behavior modification of stuttering: A view from the trenches. JOURNAL OF FLUENCY DISORDERS, 18, 1-11.
William Perkins addresses how behavior modification became so prevalent in the field of stuttering through four personal experiences. He comments on psychoanalytic and psychotherapy techniques that did not prove successful with his clients. However, one client in particular triggered his conversion to the behavior approach while incorporating Goldiamond's approach of the DAF. He also states fluency skills are powerful tools in therapy because they are the reason for seeking therapy.
Perkins, W.H., Kent, R.D., & Curlee, R.F. (1991). A theory of neuro- psycholinguistic functioning in stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 734-752.
This article proposes a neuropsycholinguistic theory to define stuttering. It is an explanation of the stuttering behaviors, not the stutterer. The neuropsylinguistic theory views stuttering as a breakdown in two areas: the signal system (paralinguistic system) or the symbol system (linguistic system). Stuttering is a result from dyssynchrony in these systems. The basis of the theory is that when stuttering occurs, these systems are not functioning together properly. How the speaker reacts to the dyssynchrony determines whether they will experience stuttered or nonstuttered dsyfluency.
Peters, H., Boves, L. (1988). Coordination of aerodynamic and phonatory processes in fluent speech utterances of stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 31(3), 352-361.
This research investigation examines the relationship between respiration, phonation and articulation between people who stutter (PWS) and non stutterers. It describes the observations of aerodynamic, laryngeal and acoustic processes in 2 non random groups of subjects. Data was collected and analyzed on 10 PWS and 7 controls. Three conclusions were drawn between these two groups. PWS are significantly different from controls in the build up of subglottal pressure. According to the EGG analysis PWS used abrupt voice onset more often than nonstutterers. Finally, findings indicate that the levels of the process of speech production are independent to varying degrees, one level does not necessarily predict the outcome of another level.
Peters, H. G., & Starkweather, W. (1989). Development of stuttering throughout life. JOURNAL OF FLUENCY DISORDERS, 14, 5, 303- 321.
This article discusses the stages of stuttering development. They classify them into 5 stages with the increments of 2-6 years, 6- 12 years, 12-17 years, 18-30 years, 30+ years. The five stages are assumed in the development of three aspects of human development: motor behaviors, language competency and performance, and social/emotional and cognitive behaviors. They discuss both normal and abnormal development in the aspects of human development and how it relates to stuttering. This article suggests that stuttering behaviors are influenced by a great number of internal and external factors. It is also stated the phase discrimination will be helpful for the assessment of stuttering.
Pill, J. (1988). A comparison between two treatment programs for stuttering: a personal account. JOURNAL OF FLUENCY DISORDERS, 13, 385-398.
Jaan Pill, a person who stutters (PWS) and the author of this article has featured a personal evaluation of two treatment methods for stuttering, the Precision Fluency Shaping Program (PFSP) in Roanoke, Virginia and the Comprehensive Stuttering Program (CSP) at the Institute for Stuttering Treatment and Research in Edmonton, Alberta. The CSP helps the PWS speak in smooth phrases rather than the word by word approach promoted by the PFSP. The author was particularly impressed by the Institute's staff clinician asking his expectations of the program and sharing her thoughts that his goals appeared realistic. Equipment used at the Institute included skilled clinicians to do the work rather than the use a voice monitor used in the PFSP and learning how to clock syllables. The author also liked being able to independently calculate the rate of a recorded passage. Video equipment was used in pre- and post-treatment assessments at the Institute. The CSP provided individualized instruction as compared to the PFSP in which instruction consisted of a written description in the manual. The CSP emphasized speech naturalness, a structured approach toward transfer, and systematic instruction for after treatment for maintenance. At the Institute, clinicians rotated from one client to the next, which helped the author, maintain a level of interest and to focus on the content of the instruction. The author does offer suggestions on how the treatment program may be improved. In the conclusion, the author states that his fluency skills, as a controlled stutterer, have developed as a result of both programs.
Plexico, L., Manning, W.H., & DiLollo, A. (2005). A Phenomenological Understanding of Successful Stuttering Management. JOURNAL OF FLUENCY DISORDERS, 30(1), 1-22.
The primary intention of this study was to investigate and understand, form the speaker's perspective, the essential structures that helped selected individuals to successfully manage their stuttering. The experiences of stuttering before and after successful management have also been addressed across three temporal stages. A total of six adult males and one adult female each with a history of stuttering participated in this study. There were three levels of analysis conducted in order to understand the individual's experiences, common themes and finally the phenomenon that describes those essential structures. The six recurring themes that emerged during the transition stage form unsuccessful to successful management are: (1) support, (2) Successful therapy, (3) self therapy and behavioral changes, (4) cognitive changes, (5) utilization of personal experience, and (6) and high levels of motivation /determination. The other recurring themes (1) gradual awareness, (2) negative reactions of listeners, (3) negative emotions, (4) restrictive life style, (5) avoidance, and (6) inadequate therapy were related with previous experiences of unsuccessful management. The five predominant themes of the present experience in which stuttering was effectively managed were: (1) continued management, (2) self acceptance and fear reduction, (3) unrestricted interactions, (4) sense of freedom, (5) and optimism. The reader of this article can gain insight into (1) the common experiences of this particular group of people with stuttering and the significant themes interrelated with both successful and unsuccessful management of stuttering, (2) give details as to how this group of seven individuals achieved successful management of their stuttering, (3) and clarify the rationale and procedures associated with phenomenological analysis.
Pointdexter, M., Rosenfield, D., & Viswanath, N. (1999). Overt phonological errors during part-word repetitions: Some theoretical implications. JOURNAL OF FLUENCY DISORDERS, 24, 107-117.
This article focuses on a single-subject study of a male stutterer who produces systematic overt phonological errors only during part-word repetitions. Two different studies were done to determine linguistic competency and also to evaluate several aspects of the Covert Repair Hypothesis (CRH). Results indicated a deficiency in the production processes since there was no evidence of linguistic incompetence. The study also attempts to look at where possible breakdowns occur on the CRH, which is difficult to determine (ie. Overt errors originating at the phonetic vs. phonological stage).
Postma, A., & Kolk, H. (1993). The covert repair hypothesis: Prearticulatory repair processes in normal and stuttered disfluencies. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 472-487.
This study was done to examine the Covert Repair Hypothesis. It states that PWS have an auditory and internal monitoring process involved in their speech before the onset of speech. The PWS is constantly monitoring the speech that is to occur, attempting to repair the speech in anticipation of a stutter (this is internal, i.e. not consciously controlled by the PWS). The constant repair processes are what cause the articulatory error. The same is true, to a lesser extent, in the speech of nonstuttering speakers. The article describes the major premises behind the hypothesis in great detail. The article does not, however, provide empirical evidence for the hypothesis and the authors recognize the need for such further research.
Postma, A., & Kolk, H. (1992). Error monitoring in people who stutter: Evidence against auditory feedback defect theories. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 1024-1031.
Theories of speech-auditory feedback hypothesize that PWS have defects in speech auditory feedback and predict that PWS performance on error defection is poorer than normal speakers. The purpose of the study was to investigate if there are differences between PWS and those who do not in detecting phonemic speech errors while speaking in normal auditory feedback and auditory feedback masked by white noise. It was found that error detection in the two above situations did not significantly differ between PWS and those who do not. False alarm rates and detection latencies of the PWS were the same as people who do not stutter. These findings are contradictory to the auditory feedback theories.
Poulos, M., & Webster, W. (1991). Family history as a basis for subgrouping people who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 5-10.
The subjects of this study were 169 adolescents and adults seen for assessment and treatment of stuttering at the Ottawa Rehabilitation Center between May 1982 and February 1989. Of the subjects, 87% were male and 13% were female. Family history information was gained through either direct interviews or personal telephone interviews. Sixty-six percent of the respondents were aware of one or more family members who stuttered, while 34% were not aware of any family member who stuttered. Of these results, 68% of the relatives were male, and 50% were female. The authors of this study also discussed that through this retrospective investigation of family history, adult PWS could be subgrouped into those who had genetically inherited a predisposition for stuttering, and those who had sustained early brain damage which caused stuttering.
Prasse, J. E., & Kikano, G.E. (2008, May). Stuttering: An overview. AMERICAN ACADEMY OF FAMILY PHYSICIANS, 77(9), 1271-1276.
Prasse and Kikano discuss the central issues relating to and describe the different forms of stuttering. The authors discuss aspects such as the contributing factors that may lead to stuttering, the importance of parental involvement in children who stutter, assessment, the severity of stuttering, and examples of common treatments. Included is a description of the three classifications of stuttering; developmental, neurogenic, and psychogenic, with developmental noted as the most common.
Preibisch, C., Neumann, K., Raab, P., Euler, H., von Gudenberg, A., Lanfermann, H., & Giraud, A. (2003). Evidence for compensation for stuttering by the right frontal operculum. NEUROIMAGE, 20, 1356-1364
In this study, the researchers were looking for evidence to support the hypothesis that the right frontal operculum displays compensation for stuttering in people who stutter. Thirty-six male subjects, ranging from 19-51 years of age, participated in the study. Sixteen of the subjects stuttered and sixteen were fluent, as assessed by a trained speech-language pathologist. Two experiments were performed in the study. The subjects read 78 short sentences aloud in the first experiment. In the second one, the subjects participated in a passive visual semantic decision task. Functional magnetic resonance imaging (fMRI) was performed on the subjects during the tasks; the resulting images were then compared and contrasted. The combined results indicated that the role of the right frontal operculum is not restricted to the final stages of the production of speech; rather, it serves a compensatory role that is nonspecific.
Preus, A. (1996). Cluttering upgraded. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 349-357.
This article presents information on the relationship of cluttering to other speech and language disorders, the etiology of cluttering, and nature of cluttering. It also presents encouraging advances in assessment and treatment of cluttering. Recommendations for further research and development are suggested.
Prins, D. (1993) Models for treatment efficacy studies of adult stutterers. JOURNAL OF FLUENCY DISORDERS, 18, 333-349.
The author of this article describes a defensive behavior model for the nature of stuttering in adults using social cognitive and self- efficacy theories to explain this behavior and it's resolution through treatment. A review of the literature pertaining to these theories as well as a discussion on how they can be used to guide the questions, designs, and measures used to study the treatment efficacy for adult stutterers is presented. The author also gives some guidelines for the future course of efficacy studies with an emphasis in discovering "why" a procedure yields a certain outcome.
Prins, D, & Hubbard, C. (1988). Response contingent stimuli and stuttering: Issues and implications. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 696-709.
This article evaluates past issues concerning effects of response contingent stimuli (RCS) on stuttering and speech disfluency, which was published about 45 years ago. Research on RCS flourished until about 1980 and few studies have been reported since. RCS was composed of two differentiating purposes; to explain the nature of stuttering and to define procedures that modifies its frequency. Conclusions concerning procedures that modify stuttering frequency indicate that some individuals' stutterings may be either decreased or sometimes increased when stimuli closely follow the occurrence of the RCS behavior. Conclusions about the nature of stuttering are less certain. The purpose of this paper is to examine these conclusions in relation to certain unresolved issues and to suggest directions for future study.
Prins, D., Hubbard, C.P., & Krause, M. (1991). Syllabic stress and the occurrence of stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 1011-1016.
Throughout stuttering literature, it has been stated that stuttering occurs on stressed syllables in connected speech. However, there has been no conclusive data to prove this. This study was conducted to identify if connected speech coincides with stuttering and syllabic stress. There were 10 stutterers in the study who were observed for stuttering on stressed and unstressed syllables in connected speech. Results from the study indicated a relationship between stuttering and syllable stress. In addition, stuttering occurred most frequently between on the first three words of the sentence. However, these results are independent of syllable stress.
Prins, D., & Hubbard, C. (1990). Acoustical durations of speech segments during stuttering adaptation. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 494-504.
The authors of this study examined 4 acoustical durations of stutter-free speech segments taken from Readings #1 and #5 in an adaptation series. Subjects included 4 who were determined to be highly adaptive, 4 who were determined to be low adapters and 4 non-stuttering subjects. The acoustical durations chosen for measurement include: intervocalic interval with and without stop consonants; stop gap; voice onset time and vowel duration. Results indicate that all three groups of subjects demonstrated no distinguishable change in durations from Reading #1 to Reading #5. The authors conclude then that stuttering frequency in adaptation trials declines independently of change in duration.
Prins, D., & Hubbard, C.P. (1992). Constancy of interstress intervals in the fluent speech of people who stutter during adaptation trials. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 799-804.
In a previous study, the constancy of interstress intervals (ISIs) was measured in stutter-free speech of 4 PWS. Two of the subjects in the study served as the subject in this follow-up study because they had high levels of adaptation whether ISIs increased from reading 1-5. the results found that the PWS ISI duration was constant through all readings, PWS had less rhythmic syllabic stress than nonstutterers, and ISI duration was longer with complex speech motor movements for PWS than nonstutterers.
Prins, D., & Ingham, R. (2005). Reviewing the literature: Comments on "the Camperdown program: Outcomes of a new prolonged- speech treatment model" for stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 48, 1025-1028.
The purpose of this letter was to discuss an article previously written by O'Brian, Onslow, Cream, and Packman (2003) about the effects of the Camperdown Program. The previous article introduced a prolonged speech (PS) model that had similar results to an earlier program that consisted of a more traditional approach that required more time. Prins and Ingham agreed with O'Brian et al. (2003) in that modeling is successful, but the authors of this letter thought it was important to provide the readers with rationale for modeling in the form of evidence from previous studies. The authors of this letter also stated that by replacing traditional target responses with "perceptually faithful reproduction," O'Brian et al. avoided the issue of operationalization. O'Brien et al. made a bold conclusion without empirical support when they decided that programmed instruction is not necessary with PS therapy. Prins and Ingham believed that self- regulation may have actually led to the success of the new program. The main concern of the authors was that, based on their research, O'Brian et al. should not have decided what was not necessary in a PS program, and that more extensive use of current literature would have made their study more favorable.
Prins, D., Main, V., & Wampler, S. (1997). Lexicalization in adults who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 40, 373- 384.
Recent theories have implicated lexical processing failures as a possible source of fluency disruption in persons who stutter. This paper reports two studies. Experiment one investigated whether naming latency, which is dependent on parallel processing, would increase more for persons who stutter than for normally fluent speakers. Subjects performed a picture-naming task generated on a computer screen in which they said the name of the action displayed (e.g. dog run) as quickly as possible. Results indicated that longer latencies were evident in the stuttering group. Experiment two tested the hypothesis that in relation to normally fluent speakers, persons who stutter differ in the relative effects of word frequency and number of syllables on their naming latencies. The results also supported this hypothesis. Implications of these outcomes are discussed.
Prosek, R., Montgomery, A., & Walden, B. (1988). Constancy of relative timing for stutterers and nonstutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 654-658.
The purpose of this study was to examine the relative timing of stutterers' speech in two fluent utterances of the same phonetic content of a 120-word passage five times in succession compared to nonstutterers. In one utterance, first reading, the surrounding speech material included instance of stuttering; the second utterance, fifth reading, was produced in a fluent environment and at a faster rate than the first one. Four separate relative timing ratios were defined by measuring an acoustic period and an acoustic latency and dividing the period by the latency. The results revealed no significant differences between the group's rate changes that occurred between the readings. The data indicated that not all aspects of a stutterer's speech are affected by the stuttering and the relative timing may be a critical parameter of the production of fluent utterances.
Prosek, R.A., Montgomery, A.A., & Walden, B.E. (1990). Letters to the editor. JOURNAL OF SPEECH AND HEARING RESEARCH, 406- 407.
This is a reply to DiSimoni's comments from Prosek and his colleagues. DiSimoni claims that the Prosek study measured unrelated segmental durations and that averaged durations were compared. However, Prosek states that durations were not evaluated in the study; but timing relations among articulatory events were addressed. Other points concerning equating theory with fact and interpretation of data are also discussed.
Prosek, R.A., Montgomery, A.A., Walden, B.E., Hawkins, D.B. (1987). Formant frequencies of stuttered and fluent vowels. JOURNAL OF SPEECH AND HEARING RESEARCH, 30 (3), 310-305.
This study compared normalized and unnormalized formant frequencies of persons who stutter and persons who do not stutter, formant frequencies of vowels produced fluently and nonfluently by persons who stutter in an adaptation task, and the formant frequencies of vowels produced fluently by persons who stutter and persons who do not stutter in an adaptation task. 15 subjects (13 males, 2 females, all persons who stutter) were asked to produce a list of words and read a 120-word passage five times in succession. Vowels that were selected for analysis were vowels that the persons who stutter produced nonfluently on the first reading and fluently on the fifth reading. Results indicated that vowels produced by persons who stutter were no more centralized than those produced by persons who do not stutter. Results also indicated no significant difference between fluency and formant frequency of persons who stuttered or between persons who stuttered and person who did not stutter. The authors conclude that these results do not support the use of vowel centralization to control the speech of persons who stutter.
Quesal, R. W. (1989). Have we forgotten the stutterer? JOURNAL OF FLUENCY DISORDERS, 14(3), 153-164.
In this journal article Robert W. Quesal discusses research in the area of stuttering. In this age of new technology research is focused primarily on the physiological aspects of stuttering. He notes that much of the previous research in the area of stuttering has been questioned and scrutinized. This article points out the need for more research to focus on the stutterer and the psychological aspects of stuttering. Many reasons are given as to why this is not currently happening which range from the field of Speech Pathology trying to distance itself from the field of Psychology, to the difficulty involved with trying to objectively quantify emotions. In any case, Quesal points out that it is necessary to analyze the disorder of stuttering from all possible perspectives.
Quesal, R. W. (2002). Book review. [Review of the book Foundations of stuttering]. Journal of Fluency Disorders, 27, 353-355.
The information in Wingate's book is based on theories from many decades ago, mostly derived from his previous books in which the information is no longer paramount. He states false information which dates his knowledge. The writing style is uneven at times as he spends whole chapters defining simple terms, but quickly moves through complex topics such as neurological aspects of stuttering. The tone of his writing suggests egotism as he ridicules other's work and their mistakes. Little information is given on the stuttering as a human condition because he concentrates more on observable behaviors of stuttering.
Quesal, R., & Yaruss, J. (2002). Academic and clinical education in fluency disorders: an update. JOURNAL OF FLUENCY DISORDERS, 1, 43-63.
In recent year, many researchers and clinicians in the field have become concerned about the academic and clinical training that is being provided to graduate students in training programs that are accredited by ASHA. Thus ASHA sent a survey to 239 accredited programs seeking information about; the courses and clinical experiences they require their students to complete, the expertise of their faculty and supervisors, any changes they had made in their requirements since the 1993 modification of requirements, and what, if any preliminary plans have been made in their program in preparation of the 2005 standards. Results indicated that one-third of the programs that responded allowed their students to graduate without course work in the area of fluency disorders, and two-thirds allowed their students to graduate without any clinical experience in fluency disorders. The findings of this survey suggested that there will be a growing trend toward fewer classes taught in fluency disorders, less experienced faculty teaching in this area, fewer clinical hours will be required, a fewer and fewer students will graduate feeling inadequate to provide services to this population.
Ramig, P.R. (1993). High reported spontaneous stuttering recovery rates: Fact or fiction? LANGUAGE, SPEECH AND HEARING SERVICES IN SCHOOLS, 24, 156-160.
Previous investigations report the spontaneous recovery rate for stuttering to be in the 50%-70% range. This study surveyed families of 21 children that had been diagnosed 5-8 years ago as having a severe stuttering problem and found 19 of the 21 still stuttered (90.5). These findings cause SLP's to question the reliability of previous studies in this area. Invalid findings cause concern because early intervention for children who stutter is key due to the greater chance of reversing and limiting the growth of the development of stuttering in early years.
Ramig, P.R. (1993) The impact of self-help groups on persons who stutter: A call for research. JOURNAL OF FLUENCY DISORDERS, 18, 351-361.
This article gives a definition of, description of, and problems pertaining to self-help groups for people who stutter, including some national organizations. Self-help groups address two major functions, providing social support and maintaining fluency. The author states that there is virtually no systematic research on the efficacy of these groups. However, the few studies that have been done are reviewed, and indicate that most stutterers and researchers perceive the groups as being a positive and beneficial experience. The need for further, more in depth, systematic studies to assess the impact of these groups on the lives of those who stutter is discussed and suggestions to strengthen the validity and reliability of future research are provided.
Ramig, P. R., & Bennett, E. M. (1995). Working with 7-to 12- year old children who stutter: Ideas for intervention in the public schools. LANGUAGE SPEECH AND HEARING SERVICES IN THE SCHOOLS, 26 (2), 138-150.
This article is written for the school SLP. Topics covered include assessment, therapy continuum, parent involvement, teacher involvement, fluency-shaping, attitudes and feelings of the school- age child who stutters, addressing concomitant disorders, grouping and scheduling for therapy, developing clinical skills in working with school-age children who stutter, future trends in the public schools, transfer maintenance, and treatment efficacy. Specifically included are examples of normal nonfluencies and stuttering symptoms, principles to be used in conjunction with fluency-shaping procedures, a conceptual model of stuttering modification therapy, and suggestions for the clinician to assist children experiencing teasing and negative thinking. A representative sampling of programs is included. Mentioned in this sampling are the Fluency Development System for Young Children, the Stuttering Intervention Program, Systematic Fluency Training for Young children, Easy Does It 1 &2, Personalized Fluency Control Therapy, the Successful Stuttering Management Program, Extended Length of Utterance Program, the Fluency Rates Program, and the Easy Relaxed Approach-Smooth Movement procedure.
Ramig, P., Winkler, L. (1986). Temporal characteristics in the fluent speech of child stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 11, 217-229.
The two purposes of this study were to examine the speech timing of children who stutter, and to examine the effects of simple and complex speech on speech timing in children who stutter and children who do not stutter. The subjects were nine boys who stuttered compared to nine boys who did not stutter. The boys repeated a sentence, 10 times in a normal speaking style, and completed a story-retell task. The results provided that people who stutter have longer pauses between words and different speech timings. The children who stutter and do not stutter exhibited longer pauses as the speech task difficulty increased.
Ramig, P., & Wallace, M. (1987). Indirect and combined direct-indirect therapy in a dysfluent child. JOURNAL OF FLUENCY DISORDERS, 1, 41-49.
This study compares the efficacy of an indirect and a direct-indirect intervention approach in a young dysfluent child. The results of the study support the idea that a direct-indirect approach is appropriate for the young child who stutters. Indirect therapy methods were used for the first two treatments, and direct intervention was used in treatment two. Direct intervention revealed a decrease in dysfluencies after treatment two. Several variables including parental involvement, type and schedule of reinforcement, treatment environment and the use of generalization techniques also contributed to the success in this study approach.
Rastatter, M.P., Dell, C.W. (1987). Reaction times of moderate and severe persons who stutter to monaural verbal stimuli: Some implications for neurolinguistic organization. JOURNAL OF SPEECH AND HEARING RESEARCH, 30 (1), 21-27.
The purpose of this study was to measure the reaction times of the left and right hands while stimulating the left and right hemispheres of persons who stutter. Subjects used included 14 persons who stutter (seven males, seven females) and 14 matched normal- speakers. Stimuli used included 24 monosyllabic words (12 minimal pairs) with manner and voice held constant and place of articulation varying among pairs. The stimulus word was presented visually in the form of a picture as well as auditorily in the form of spoken word. Subjects were asked to move their left or right hand to the correct picture (on the left or right) after hearing the word (presented to only one ear). The stimulus words, ear stimulated, and direction of hand movement were presented an equal number of times in a random block design. Results for normal speakers indicated left hemisphere dominance for language processing, with the right hemisphere not being as efficient in processing auditory-visual information. Results for persons who stutter did not indicate a right or left hemisphere dominance (bilateral model of neurolinguistic organization).
Rastatter, M.P., Dell, C. (1987). Vocal reaction times of stuttering subjects to tachistoscopically presented concrete and abstract words: A closer look at cerebraldominance and language processing. JOURNAL OF SPEECH AND HEARING RESEARCH, 30 (3), 306-310.
This study investigated interhemispheric interactions for visual language processing in a stuttering population using tachistoscopic procedures. 14 subjects were presented with the same randomized series of 90 four-letter words: 30 concrete words, 30 abstract words, and 30 nonsense words. The subjects were asked to phonate the vowel /a/ when an actual word was presented, not to phonate when a non-word was presented, and report the number that appeared on the screen after the presentation of the stimuli. Results indicated that there was no significant difference among groups, across visual fields, stimuli, or sex. Authors do suggest that the results obtained for the persons who stutter show that the right hemisphere was capable of more efficient language processing for concrete words while the left hemisphere was more efficient for processing abstract words.
Rastatter, MP., Harr, R. (1988). Measurements of plasma levels of adrenergic neurotransmitters and primary amino acids in five stuttering subjects: a preliminary report (biochemical aspects of stuttering).JOURNAL OF FLUENCY DISORDERS, 13, 127-139.
This study was conducted to measure plasma levels of epinephrine, norepinephrine, dopamine, and amino acids in five stutterers ages 19-29 to determine whether any abnormality was present in these neurotransmitters or amino acid precursors. This study was the first of its kind attempting to test more directly a neurotransmitter theory of stuttering using state-of-the-art medical technology. The results showed that each subject demonstrated an abnormal result for epinephrine, norepinephrine or dopamine. Plasma glutamine was significantly elevated in every case exceeding +4 SD of the mean adult glutamine level, possible indicating an increase in left hemisphere GABAergic activity.
Rastatter, MP., Loren, CA. (1988). Visual coding dominance in stuttering: some evidence from central tachistoscopic stimulation (tachistoscopic viewing and stuttering). JOURNAL OF FLUENCY DISORDERS, 13, 89-95.
This study looks at a previous study on hemispheric information processing and its relationship to linguistic dominance for written material in stutterers. The current study was done to assess central information processing style in a stuttering population using a tachistoscopic viewing procedure employing letter confusion and vocal reaction time. Sixteen stuttering subjects and sixteen nonstuttering subjects were matched. All subjects had normal hearing and were right handed. Eleven capital letters were used as stimuli and were presented centrally by the tachistoscope. Adjusted letter-naming reaction times were obtained for stimulus detection condition. The mean simple vocal reaction times were calculated and subtracted from the mean letter naming response time for each subject. These results indicated that the stutterers showed increased latencies when responding to letters. Each subject produced an approximately 90% error rate. Results also showed that a significant interaction existed between the group and visual confusion variables. The stuttering subjects evidenced significantly more errors that were characterized by auditory confusions while nonstutterers produced errors that were visually based. These finding suggest that when the left and right hemispheres of stutterers were simultaneously stimulated by the tachistoscope, the processing strategy employed by the right hemisphere proved dominant in completing the perceptual task.
Rastatter, M. P., Loren, C. & Colcord, R. (1987). Visual coding strategies and hemisphere dominance characteristics of stutterers. JOURNAL OF FLUENCY DISORDERS, 12(5), 305-315.
This study examined the relationship between coding strategies and linguistic dominance for written material in people who stutter. Normal and stuttering subjects were presented with visual stimuli in the right and left visual field in order to obtain vocal reaction times and data for an analysis of errors. Results found that reaction times for the stimuli presented in the left visual field were not significantly different than the reaction times for stimuli presented in the right visual field for the normal subjects. However, stimuli presented in the left visual field indicated slower reaction times for the stuttering individuals. In addition, stimuli presented in the left visual field showed a higher degree of auditory confusions whereas the right visual field had a higher degree of visual errors. The slower reaction time of people who stutter when presented with stimuli to the left visual field, in addition to the increase in auditory confusion suggests coding deficits in the right hemisphere of stuttering individuals.
Ratner, N. (1995). Treating the child who stutters with concomitant language or phonological impairment. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 26, 180-186.
This article outlines several considerations that surround the treatment of coexisting fluency and other speech and language disorders and provides guidelines for determining treatment objectives. Prior to therapy, these considerations include which area to target first, what order to sequence the goals, and what distinguishes normal developmental disfluencies from stuttering. Other considerations discussed in this article are the variations in attack strategies and parental involvement in the therapeutic process. The author provides descriptions of these different approaches, such as sequential, concurrent, blended and discrete, and how each can be used to facilitate development in the areas of language development, phonology and fluency.
Ratner, Nan Bernstein. (2003). Effective treatment of childhood stuttering. SEMINARS IN SPEECH AND LANGUAGE, 24, 1-3.
This brief introduction provides readers with an outline of topics including information technology in stuttering, multicultural concerns in stuttering assessment and treatment, self-therapy techniques including self-regulation, information on how to achieve generalization of treatment objectives as well as other topics of interest. With the increasing number of children coming from cultural diverse backgrounds, clinicians must be prepared to respond differently to each case. This particular issue of Seminars includes advice for building a strong and effective family-teacher-clinician partnership.
Ratner, N., B. (2004). Caregiver-child interactions and their impact on children''s fluency: implications for treatment. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35, 46-56.
This article discusses the possible consequences of changing parental language patterns and interaction styles as it relates to parents that have children who stutter. The article discusses the difference between older therapy techniques( such as modifications to speech rate and turn taking) as opposed to newer ones( such as the Lidcombe program). The limitations of current research and the direction of future research is also addressed.
Ratner, N.B. (2005). Evidence-based practice in stuttering: Some questions to consider. JOURNAL OF FLUENCY DISORDERS, 30 (3), 163-188.
This article re-evaluates the level of support that is available for a number of popular stuttering therapy approaches that were recently evaluated in the Journal of Fluency Disorders (Vol. 28, Issue 3, 2003). This article also questions the value placed on some types of programs supported by the forum. The author discusses how to evaluate the status of evidence-based practice in fluency disorders, points out concerns about the impact of narrow interpretation of EBP research and practice in the field of fluency disorders and other non- medical interventions. The role of theory in evaluating treatment approaches is discussed along with potential barriers to gathering clinical evidence and its implication by practitioners. The Lidcombe program is also evaluated.
Rastatter, M.P., McGuire, R.A., & Loren, C. (1988). Linguistic encoding dominance in stuttering: some evidence for temporal and qualitative hemispheric processing differences. JOURNAL OF FLUENCY DISORDERS, 13, 215-224.
The study measured naming reaction times of stuttering and nonstuttering subjects to pictures presented unilaterally and tachistoscopically. Data indicated that significant interaction between the stuttering vs. nonstuttering groups and left vs. right visual field variables were existent. Post-hoc analysis of visual field, error types and reaction times are discussed.
Reardon, N. & Reeves, L. (2002). Stuttering therapy in partnership with support groups: the best of both worlds. SEMINARS IN SPEECH AND LANGUAGE, 23, 213-218.
The stuttering support organization can play a significant role in treatment and is a powerful adjunct to formal therapy. One of the most important advantages of a support group is the opportunity to connect with individuals who share common issues. Children are able to share experiences and feelings in a safe and supportive environment that can help them gain a sense of belonging. Parents involved in organizations find much needed support and often become more involved in their child's treatment. School-based SLPs gain support and insight as well as validation from other colleagues. Support groups add a new level to treatment and a partnership among everyone involved.
Reed, P., Howell, P. C., Davis, S., & Osborne, L. A. (2007). Development of an operant treatment for content word dysfluencies in persistent stuttering children: Initial experimental data. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 2, 1-13.
This study was implemented to explore a type of operant treatment for persistent stutterers. It has been found that children who exhibit normal disfluencies tend to stutter on function words rather then content words. Adults and children that exhibit persistent stuttering tend to display disfluencies on content words. Children with high content word disfluencies have a poor prognosis for recovery. The current study aims to use operant conditioning to reduce content word disfluencies using negative reinforcement. Function word disfluencies were rewarded with positive reinforcement. Results found that even though function word disfluencies were rewarded with nonverbal praise, communication was still disrupted and function word disfluencies decreased in frequency. Content word disfluencies also decreased for these children.
Reilly, J., & Donaher, J. (2005). Verbal working memory skills of children who stutter: A preliminary investigation. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 32, 38-42.
This study focuses on exploring the relationship between working memory and stuttering in children. Participants included five children who stutter and five children who don't stutter, matched for age to the children who stutter. All ten children's memory recall was tested using a computer program, while the clinician kept track of verbal responses. Results showed that children who stutter had significantly higher recall than children who don't stutter.
Reitzes, P. (2006). Five fun activities to practice pausing with children who stutter. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1, (3), 202-210.
The main objective of this article is to inform the reader about the effectiveness and use of pausing within therapy activities. It is important that children who stutter know how to pause between words rather than within the word as a whole. The following article lists several activities to help reduce the rate of speech which in turn will potentially reduce the frequency of stuttering. The five activities include: Map Land, Tell Me a Joke, Simon Says, Guess What I am, and Tell Me a Story. The previous activities also may be included into language goals with include: following directions, complete and complex sentences, new vocabulary, expressing objects within a category, comprehensive and expressive language and sequencing events.
Reitzes, P. (2006). Pausing: Reducing the frequency of stuttering. JOURNAL OF STUTTERING THERAPY, ADVOCACY & RESEARCH, 1, 64- 78. http://www.journalofstuttering.com/ListofArticles.html
One method of a speaking strategy that helps people move through moments of stuttering and also helps reduce stuttering behaviors is pausing. While most strategies prolong speech within words, this article looks at the use of pausing when a speaker uses a pause between words to reduce the occurrence of overt stuttering behaviors. Pausing also helps reduce speaking rate without modifying articulation. It is suggested that pausing be used both with other types of speaking strategies and while working on the client's negative thoughts and attitudes about stuttering. This article also includes strategies to help incorporate pausing into therapy for both children and adults.
Reitzes, P. (2007). Teaching graduate and undergraduate students to model stuttering behaviors. JOURNAL OF STUTTERING, ADVOCACY & RESEARCH, 2, 26-31. from http://www.journalofstuttering.com/ListofArticles.html.
Teachers help graduate and undergraduate speech-language pathology students learn how to model stuttering. This is called learning how to pseudostutter. First, the teachers help the clinicians desensitize themselves to stuttering. To help them the teacher will show a film of people who stutter. This will give them an idea of what it is, and different ways people stutter. Next, there will be discussion about stuttering behaviors and normal disfluencies. The teacher will then model different types of stuttering and secondary behaviors, so the student gets an idea of how stuttering might sound. After learning the different characteristics of stuttering, the clinician's try psudeostuttering in small classroom groups, and eventually the clinicians will be psuedostuttering in public. These clinicians learn this because it helps them desensitize themselves to stuttering and helps them understand what it is like to be a person who stutters. A client will appreciate the clinician's time and effort in the future.
Riaz, N., Steinberg, S., Ahmad, J., Pluzhnikov, A., Riazuddin, S., Cox, N., & Drayna, D. (2005). Genomewide significant linkage to stuttering on chromosome AMERICAN JOURNAL OF HUMAN GENETICS, 76 (4), 647-651.
This article hypothesizes that there is a genetic involvement related to stuttering. The study focused on highly inbred families from the city Lahore, Pakistan. They analyzed 199 genotyped individuals, 144 persons who stutter and 55 persons with normal fluency. The results for this sample suggest evidence of linkage on chromosome 12q. The study notes, however, that given the complexity of stuttering numerous loci contribute to this phenotype.
Riley, G. D., & Ingham, J. D. (2000). Acoustic duration changes associated with two types of treatment for children who stutter. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH, 43(4) 965-978.
This study a.) examined the effects of Speech Motor Training (SMT), in young children, on temporal acoustic durations related to their speech motor programming, b.) compared the effects of SMT therapy to the effects of a Extended Length of Utterance (ELU) therapy which did not incorporate speech motor control training, and c.) reviewed the relationship of a reduction in stuttering to changes in acoustic duration. Twelve children who stutter were divided into 2 treatment groups SMT (n=6) and ELU (n=6). Recordings were made of the children repeating "pa" and "taka" before and after their training. Researchers also had a matched reference group of children who did not stutter. Tokens for acoustic measurement were syllables that began with /p/ and /t/. The five measures used to show the temporal aspects of speech motor performance included: vowel duration, stop gap duration, voice onset time, stop gap/vowel duration ratio and total token duration. Results indicated that after SMT training many children displayed measurable increases in vowel duration and small reductions in stop gap duration. Although stuttering was reduced more with the ELU therapy than with the SMT training, the researchers did not find significant effects on the temporal acoustic measures. It is proposed that increased vowel duration provides more time for speech motor planning and that stuttering is decreased because of that longer vowel duration.
Riley, G.D., Riley J. (1982). Evaluating stuttering problems in children. JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS, 6, 15-25.
This article presents criteria to help determine if young children who stutter will outgrow their stuttering habits or if their stuttering will become chronic. The article gives guidelines to differentiate the two groups of young stutters in the following categories. Child's complicating behaviors and attitudes. Listeners complicating behaviors and attitudes. Concomitant speech or language problems including Receptive Language, Expressive Language and Oral Motor Coordination. Treatment and implications including Environment Modification, Attitude Modification and Direct Modification of Stuttering.
Riley, G. & Riley, J. (1986). Oral motor discoordination among children who stutter, JOURNAL OF FLUENCY DISORDERS, 11, 335-344.
There is growing research in the area of oral motor discoordination (OMD). This study hopes to provide support that OMD can be reliably defined and improved by a program that targets aspects of syllable production. This study also looks at the relationship between OMD and perceived stuttering. First, practice tapes were created so that clinicians could practice judging oral motor errors. Next, a treatment program was developed to improve oral motor abilities by controlling the number of syllables, the number of different consonants, the number of unvoiced consonants and the syllable shapes of the targets. Finally, two possible relationships between OMD and stuttering were explained. The first is that of a reciprocal relationship. When either OMD or fluency are targeted and improved, the other is improved as well. The second idea is that oral motor training is a direct modification of stuttering.
Riley, GD. & Riley, J. (1989). Physician's Screening Procedure for Children Who May Stutter. JOURNAL OF FLUENCY DISORDERS. 14, 57-66.
This study was developed to formulate a data based screening protocol. Management of children's disfluencies as soon as they show abnormalities. By enrolling the child into therapy, their risk of social punishment is decreased. There were two purposes of this study, one was to develop a useful procedure for doctors and other professionals to refer a child. The second is to develop criteria for making a referral. Symptoms were developed and divided into six areas. A child is rated and is referred depending on the symptoms that are reported for them. It is yet to be seen if doctors and parents can recognize the symptoms on the referral form.
Riley, J., Riley, G., & Maguire, G. (2004). Subjective screening of stuttering severity, locus of control and avoidance: research edition. JOURNAL OF FLUENCY DISORDERS, 29, 51-62.
The purpose of this study was to determine which individuals who stutter retain anticipatory anxiety and feared word substitution after achieving fluency. Sixteen adults who stutter participated in the study. The Subjective Screening of Stuttering (SSS) was used to assess perceived severity, perceived locus of control, and perceived avoidance. In the SSS the severity, locus of control, and avoidance is based on the percent of syllables stuttered. The results indicated that the percent of stuttered syllables correlated with stuttering severity, and locus of control, but not with avoidance.
Riva-Posse, P., Busto-Marolt, L., Schteinschnaider, A., Martinez-Echenique, L., Cammarota, A., & Merello, M. (2008). Phenomenology of abnormal movements in stuttering. PARKINSONISM AND RELATED DISORDERS, 14, 415-419.
This study analyzes the abnormal movements of PWS in order to examine the incidence and phenomenology of those movements in regards to stuttering behavior. All movements observed were either classified as voluntary or involuntary. Results revealed that involuntary movements accounted for 45.5% more of the abnormal movements than voluntary movements.
Robb, M. and Blomgren, M. (1997). Analysis of F2 transitions in the speech of stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 22, 1-16.
An Acoustical examination of lingual articulation in the fluent speech of stutterers and nonstutterers was done. The slope of the second formant(F2) was found following consonant release, which was used to assess coarticulation. Motor speech skills were discussed characterizing fluent speech production. Because of quicker dimensional changes in vocal-tract behavior stutterers were found to show larger slope coefficients, when compared to nonstutterers.
Robb, M., Blomgren, M., & Chen, Y. (1998). Format frequency fluctuation in stuttering and nonstuttering adults. JOURNAL OF FLUENCY DISORDERS, 23, 73-84.
This article investigates the purpose and clinical use of Format Frequency Fluctuation (FFF) measures of people who stutter. This study examined the steady-rate portion of format 2 (F2) of people who stutter who had been treated for stuttering, people who stutter who have not been treated for stuttering, and normals. The group of untreated people who stutter had the greatest FFF measures while the normal population and treated people who stutter and the most F2 stability. The researchers predict these differences in FFF are due to effects of therapy which emphasizes controlled speech rate, light articulatory contacts, and continuous phonation. FFF may serve as a sensitive measure of fluency, detecting dysfluency which isn't noticed perceptually. A further study could compare FFF when dysfluencies are identified perceptually and FFF measures when there are no perceptual signs of dysfluency.
Robey, R. R. (2004). Reporting point and interval estimates of effect- size for planned contrasts: fixed within effect analyses of variance. JOURNAL OF FLUENCY DISORDERS, 29, 307-341.
This article reviews the state of statistical science regarding effect-size, discusses the importance of effect-size in all forms of research, and shows how effect size can be easily reported. The article includes sections pertaining to: Why the Publication Manual of the American Psychological Association recommends that researchers report estimates of effect-size and confidence intervals around them, what an effect size is, What the appropriate confidence intervals for effect-sizes are, what the various measures of effect-size are and how they differ, which measures of effect-size should be reported in a manuscript, how point-estimates and confidence intervals for effect-size are obtained, how they should be reported in a manuscript, and how to interpret the results.
Robinson, TL., Jr, Crowe, TA. (1987). A Comparative Study of Speech Disfluencies in Nonstuttering Black and White College Athletes. JOURNAL OF FLUENCY DISORDERS, 2, 147-156.
57 college athletes (28 black and 29 white) age 19-24 were screened in the areas of articulation, voice, fluency, and hearing. A 100-word conversational sample and a 200-word reading sample were elicited from each subject. Both samples were rated for disfluency. Results indicated that the black athletes displayed significantly more disfluencies in reading than did the white athletes, particularly in word and phrase repetition. In conversation, there were no remarkable differences found between the groups. The group of white athletes did, however, exhibit significantly more hesitations in conversation than did the group of black athletes.
Robinson, TL. Jr. & Crowe, TA. (1998). Culture-based considerations in programming for stuttering intervention with African American clients and their families. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 29, 172-179.
A model for evaluating and treating stuttering in African American children is presented in this article. This model includes six levels of counseling and therapy which address decisions regarding multicultural programming. They are pre-intervention, intake, evaluation, counseling, treatment, and carryover. Each of these levels takes into consideration cultural variables as well as individual differences within the culture. Although this model was designed for African Americans, it can be applied easily to multicultural populations in general.
Rosseau, I., Onslow, M., Packman, A., & Jones, M. (2008). Comparisons of audio and audiovisual measures of stuttering frequency and severity in preschool-age children. AMERICAN JOURNAL OF SPEECH LANGUAGE PATHOLOGY, 17, 173-178.
The purpose of this study was to determine whether or not there was a difference in the results of stuttering frequency and severity through audio or audiovisual measures. The author's were more concerned with pre-school aged children, as much of the research indicating that the type of measure used has little influence on severity ratings, has been conducted with adults. In this study, the author's question was answered and determined that there were differences in the scores for stuttering frequency between the audio-only and audiovisual mode. The author's explain that because stuttering behaviors are both seen and heard, an audio-only measure may underestimate the severity.
Rousseau, I., Packman, A., Onslow, M., Harrison, E., & Jones, M. (2007). An investigation of language and phonological development and the responsiveness of preschool age children to the Lidcombe Program. JOURNAL OF COMMUNICATION DISORDERS, 40, 382-397.
This study focuses on the treatment for early stuttering and uses variables such as language and phonology to predict treatment time of preschool aged children who stutter. The variables of stuttering frequency and severity have previously been used when predicting the time it takes a CWS to complete Stage 1 of the Lidcombe Program. In this study the children were evaluated based on MLU and CELF scores. Only one of 34 children didn't complete Stage 1 of the Lidcombe Program because of a lack of progress. Typically, children with a higher MLU had shorter treatment times and children with higher CELF receptive scores took longer during treatment.
Ruscello, D. M., Schmitt, J.F., & Pannbacker, M.D. (1994). Special educators' perceptions of stutterers. JOURNAL OF FLUENCY DISORDERS,19(2), 125-132.
This article presents the results of a questionnaire completed by special educators about their perceptions of people who stutter. They listed the adjectives which most accurately represent four groups of stutterers; a male child, a female child, a male adult, and a female adult. The results indicated that a majority of perceptions were negative and described the person's personality, and that the male child received more descriptors than any other group. Implications of these findings in the relationship between special educators and their students who stutter and professional development that addresses the impact of stereotypical behaviors and the stuttering personality are discussed.
Rustin, L., & Cook, F. (1995). Parental involvement in the treatment of stuttering. LANGUAGE, SPEECH, AND HEARING SERVICES IN THE SCHOOLS, 26, 127-137.
The authors provide a thorough review of the literature supporting their view that parental involvement is the key to effective management of children who stutter. Assessment procedures are presented which encourage complete parental involvement from the beginning. Three therapeutic phases, separated according to age rather than stuttering severity, are presented. Each therapy phase suggests differing degrees of parental involvement, with Phase 1 (2- 6 years) requiring the most involvement of parents.
Ryan, B.P. (1992). Articulation, language, rate and fluency characteristics of stuttering and nonstuttering preschool children. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 333-342.
Articulation, language and fluency tests were given to 20 stuttering and 20 nonstuttering male and female preschool children to examine their performance differences between the two groups. The children's speaking rate was also measured. The results between the two groups of children were presented and interpreted. More research is needed to demonstrate the functional relationship between language and stuttering.
Ryan, B.P. (2001). A Longitudinal Study of Articulation, Language, Rate and Fluency of 22 Preschool Children Who Stutter. JOURNAL OF FLUENCY DISORDERS, 26:2, 107-127.
This is a longitudinal study that focuses on speech and language of preschool children who stutter, and was originally studied by Ryan (1992) The present study consisted of 22 children who stutter, ranging in age of 2 to 5. 16 of these children were from Ryan's group (1992), and 6 new children. The children were given the Arizona Articulation Proficiency Scale (AAPS), Peabody Picture Vocabulary Test (PPVT) - alternating forms M & L, Test of Language Development (TOLD), and the FI. 30 trained supervised graduate students over a 10 year period did the testing, computed the scores and were observers. The findings were: (1) Articulation and language test scores showed no significant differences between those recovered and those who persisted. (2) No significant correlation's between articulation and language tests and stuttering. (3) All children showed improvement in articulation and language. (4) 68.2% recovered from stuttering without treatment (5) there was little value in identifying persistent or transient stuttering problems with the measurement of articulation and language skills.
Ryan, B.P., & Ryan, B.V. (1995). Programmed stuttering treatment for children: Comparison of two establishment programs through transfer, maintenance, and follow-up. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(1), 61-75.
Two programs were compared: The delayed auditory feedback (DAF) and Gradual increase in length and complexity of utterance (GILCU). The programs were carried out by 12 clinicians under supervision with 24 clients in a school setting. The study concluded that the results from the 2 programs were similar with the exception of generalization where it appeared the GILCU program produced better generalization of fluency.
Sacco, P.R., & Metz, D.E. (1987). Changes in stutterers' fundamental frequency contours following therapy. JOURNAL OF FLUENCY DISORDERS, 1, 1-8
This article examines the fundamental frequencies of the utterances of stutterers versus non-stutterers. Evidence from previous studies citing normal changes in fundamental frequency and laryngeal tension associated with the voicing characteristics of the stop consonant are discussed. The study included 45 male and eight female stutterers ranging in age from ten to fifty-four years. Stuttering frequency was measured and calculated. Each subject received both group and individual therapy daily for a period of 5 weeks. The principle finding of the study was that stutterers' fundamental frequency declination in pre and post therapy conditions was statistically the same. There was no definitive evidence that therapy has any influence on altering abnormal laryngeal tensions sometimes associated with dysfluency.
Sahin, H. A., Krespi, Y., Yilmaz, A., & Coban, O., (2005). Stuttering due to ischemic stroke. BEHAVIOURAL NEUROLOGY, 16, 37-39.
This article describes acquired stuttering with left parietal infarction. The article describes two cases in which the person suffered a stroke which affected either the supramarginal gyrus or the supramarginal and angular gyrus. As a result of their strokes both people exhibited stuttering behaviors. After both cases were treated with pharmacological agents their speech returned to normal. Acquired stuttering usually results from a lesion in the left hemisphere, but acquired stuttering has appeared with damage the right hemisphere. With damage to or disconnection of the supramarginal and angular gyrus may be the cause of transient episodes of stuttering.
St. Clare, T., Menzies, R. G., Onslow, M., Packman, A., Thompson, R., and Block, S. (2008). Unhelpful thoughts and beliefs linked to social anxiety in stuttering: Development of a measure. INTERNATIONAL JOURNAL OF LANGUAGE AND COMMUNICATION DISORDERS, V, 1-14.
The purpose of this study was to describe the development of a 66-item scale of Unhelpful Thoughts and Beliefs About Stuttering (UTBAS). In the development of the scale, three phases were utilized. Phase 1 outlines the initial formation of the scale. Phase 2 describes the construct validity and sensitivity of the scale and Phase 3 describes the reliability of the scale. Initial results show that this scale is reliable and sensitive and may be able to distinguish between stuttering and non-stuttering actions.
St. Louis, K.O. (1996). A tabular summary of cluttering subjects in the special edition. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 337-343.
This article presents tables summarizing results of questionnaires for 29 clutterers. A second table summarizes targets, procedures, and results of therapy for 15 of the clutterers.
St. Louis, K. O. 1988). Nonstutterers' perceptions of stuttering and speech difficulty. JOURNAL OF FLUENCY DISORDERS, 13, 375-384.
The subject of this paper is Woolf's Perceptions of Stuttering Inventory (PSI) which is an index of self-perception of stuttering abnormality for adolescent and adult stutterers. Among stutterers and nonstutterers, PSI scores are not only influenced by stuttering but also the effects of knowledge or interest in speech pathology and the perception of whether or not one who "stutters" is a "stutterer'. To take into consideration the latter, for the purpose of this paper, the word "stuttering" in the PSI was replaced with "speaking difficulty" and the inventory was renamed the Perceptions of Speech Inventory (PSpI). Three investigations on responses of nonstutterers on the PSI and PSpI were completed. The first experiment compared the performance of nonstutterers in two basic speech pathology classes on the original and revised versions of the PSI. The second experiment involved more carefully controlled comparison of scores of two groups of undergraduate students on the PSI and the PSpI. The third experiment determined the influence of a course devoted entirely to stuttering on self-assessment of speech pathology majors. Knowledge of or the attention to "stuttering" or "stutterers" as well as speech pathology or public speaking course work affected nonstutterer scores. Results of these experiments suggest "normal" scores have not been established.
St. Louis, KO. , Hinzman, AR. (1988). A descriptive study of speech, language, and hearing characteristics of school-aged stutterers. JOURNAL OF FLUENCY DISORDERS, 13, 331-355.
This study was conducted to find out if stuttering usually occurs in isolation or if it tends to coexist with other communication disorders. Previous research on this topic was reviewed and showed that stutters are likely to manifest associated communication disorders particularly articulation deviations and language delays. The data pool was taken from the National Speech and Hearing Survey from 1968-1969. Three groups were formed each having 24 subjects to represent grades 1-12. Two groups of stutterers were chosen to sample stuttering severity levels in two different populations. The third group consisted of nonstutterers and was used as control subjects. Two children were selected to represent each grade level in each group. Various tests were administered to document data in the areas of disfluency, articulation, voice, language, and hearing. The results showed that many school-aged children/adolescents who stutter are likely to have co-existing communication disorders, especially in the areas of articulation, language, and voice. These results were compared to a previous study completed on children who stutter but have no other communication disorders.
St. Louis, K., & Hinzman, A. (1986). Studies of cluttering: Perceptions of cluttering by speech- language pathologists and educators. JOURNAL OF FLUENCY DISORDERS, 11, 131-149.
The purpose of this study was to determine how much knowledge and how comfortable SLPs and educators are with cluttering. It also intended to focus on the amount of people who clutter that also have learning disabilities. 500 questionnaires were sent out to SLPs and 156 were returned. 500 different questionnaires were sent to educators and 169 were returned. Results showed that many SLPs and educators are aware of cluttering and have children who clutter to work with. SLPs showed knowledge in the area of the cause and symptoms of cluttering. Most SLPs and educators felt that they did not have enough training and felt inadequate in the area of treating cluttering. The study also determined that many people who clutter also have learning disabilities.
St. Louis, K. O. & Myers, F. L. (1995). Clinicial management of cluttering. LANGUAGE SPEECH AND HEARING SERVICES IN THE SCHOOLS, 26 (2), 187-195.
St. Louis and Myers present the most recent definitions of cluttering. The authors present six working assumptions concerning the disorder of cluttering. The assumptions are hypothetical; they are selected from clinical experience of practicing clinicians. The assumptions include: 1) Cluttering and stuttering are related but separate disorders. 2) Clutterers manifest a primary disorder of rate and frequently have concomitant disorders of articulation and language. 3) Fluency problems in clients who clutter typically are remediated indirectly. 4) Clutterers have difficulty in self- monitoring. 5). Cluttering therapy should involve the family. 6) Cluttering therapy should involve professionals in allied health and educational fields. Clinical strategies are also presented within this framework. St. Louis and Myers present logical ideas in support of further research into "the orphan of speech pathology" -cluttering. The authors present the available research and also challenge clinicians for more study and answers to the questions cluttering continues to present.
St. Louis, K.O., Myers, F.L., Cassidy, L.J., Michael, A.J., Penrod, S.M., Litton, B.A., Coutras, S.W., Olivera, J.L.R., & Brodsky, E. (1996). Efficacy of delayed auditory feedback for treating cluttering: Two case studies. JOURNAL OF FLUENCY DISORDERS, 21 (3/4), 305-314.
Two case studies are reported to determine the extent to which a delayed auditory feedback (DAF) treatment program was effective in reducing disfluencies and rate anomalies in two young male cluttering subjects. Although both subjects met predetermined fluency criteria during treatment, both clutterers had difficulty transferring gains. Differences in cluttering severity, coexisting disorders, clinical techniques, and results of DAF treatment are examined.
St. Louis, K., Myers, F., Faragasso, K., Townsend, PS, & Gallaher, A., (2004). Perceptual aspects of cluttered speech. JOURNAL OF FLUENCY DISORDERS, 29, 213-235.
This descriptive investigation compared perceptual judgments of speech naturalness with four other attributes of speech-language production (articulation, language, disfluency, and speaking rate) using speech samples of two youth clutterers (ages 11 and 12 years) who differed in cluttering severity. Perceptual impressions are nearly always the first and often the strongest evidence that a person has a fluency disorder. The global measure of naturalness captures important aspects of all of these attributes and should augment the "objective" measures obtained during clinical evaluations, as well as be monitored during treatment. Among the five attributes investigated, rate and naturalness were perceptually least acceptable for both clutters followed by articulation. Disfluency and language were most acceptable. Also, the multi-dimensionality of naturalness judgments is highlighted in this study.
Samar, V.J., Metz, D.E., & Sacco, P.R. (1986). Changes in aerodynamic characteristics of stutterers' fluent speech associated with therapy. JOURNAL OF SPEECH AND HEARING RESEARCH, 29, 106-113.
This report obtained data on four aerodynamic variables (peak volume velocity, voicing offset to oral release, volume-velocity rise interval, peak volume velocity to voicing onset) from 15 people who stutter (PWS) ranging in severity from mild to severe. All participants received identical individual and group therapy on a daily basis for five weeks. Measurements of the four variables were taken pre and post treatment. Results of the study indicated motor control processes directly influenced the volume-velocity rise interval. These results lead to the conclusion that volume-velocity rate is exclusively related to the frequency of stuttering in individuals.
Sasisekaran, J., & De Nil, L. (2006). Phoneme monitoring in silent naming and perception in adults who stutter. JOURNAL OF FLUENCY DISORDERS, 31, 284-302.
Ten males who stutter and 12 males who do not stutter (ages 18 to 48) participated in a study that hypothesized the males who stutter would perform more poorly on phoneme monitoring on silent naming tasks than those who do not stutter, but would perform similarly on auditory perception tasks. This would support the theory of a phonological encoding deficit in people who stutter. The Stuttering Severity Index (SSI) categorized two participants as moderate, two as mild, and six as very mild. The words presented in the silent naming and auditory perception tasks were compound words and noun phrases. For the silent naming task, the participants were presented with the picture and a reading of the word. They were asked to silently name the word and push a green button if the target sound existed in the word and a red button if not. The responses were timed. Then the participants were asked to say the word out loud. Finally, for the auditory perception, participants were instructed to push the button when they heard the target phoneme while listening to the stimuli, which was also timed. Outliers were excluded, but results showed the participants who stutter performing significantly slower on the silent naming task. The participants who stutter performed slower on the auditory perception task, but not to statistical significance. The study supported the hypothesis for difference between groups on silent naming tasks related to phonological monitoring.
Sasisekaran, J., De Nil, L. F., Smyth, R., & Johnson, C. (2006). Phonological encoding in the silent speech of persons who stutter. JOURNAL OF FLUENCY DISORDERS, 31, 1-21.
This study examined phonological encoding skills during silent speech in people who stutter (PWS) and people who do not stutter (PNS) using a phoneme-monitoring paradigm. The participants (11 PWS and 11 PNS) completed five tasks: a familiarization task, a picture naming task, a phoneme-monitoring task, and auditory monitoring tasks, and a simple motor task. Results showed that PWS were significantly slower than PNS on the phoneme-monitoring task, but had scores similar to the PNS on the other tasks. These findings support theories of stuttering that associate delayed phonological encoding with the occurrence of moments of stuttering.
Savage, C. & Lieven, E. (2004). Can the usage-based approach to language development be applied to analysis of developmental stuttering? STAMMERING RESEARCH, 1, 83-100. Retrieved from http://www.stamres.psychol.ucl.ac.uk.
Children learn vocal sounds shortly after birth, which provide the basis for most language development and develops over the course of three years from single words to simple, more complex grammatical utterances. Any difficulties that a child experiences while learning language may result in a different type of fluency problem. This article provides a developmental perspective on stuttering and speech production in general. It is broken into seven sections discussing the following topics: The nature of children's early linguistic knowledge and how it relates to on-line speech production, the mechanisms of speech production and how disfluencies could arise, a specific theory about the development of stuttering (EXPLAN) and how this theory might relate to the language development models, and future directions of research.
Savage, C. & Howel, P., (2008). Lexical priming of function words and content words with child who do, and do not stutter. JOURNAL OF COMMUNICATION DISORDERS. 41, 459-484.
The specific mechanisms that underlie childhood stuttering is still somewhat a mystery. This study was conducted in attempts to gain a better understanding by comparing the effect on fluency of priming different components of a short sentence. Twelve children who stutter (CWS) and 12 children who do not stutter (CWNS) were observed during this study. The results showed that there was a significant effect of priming in that all children produced fewer function word disfluencies after content word primes than after function word primes. It was also determined that there were more disfluencies on functions words than on content words that were produced bye the children in either group.
Savelkoul, E. M., Zebrowski, P. M., Feldstein, S., & Cole-Harding, S. (2007). Coordinated interpersonal timing in the conversations of children who stutter and their mothers and fathers. JOURNAL OF FLUENCY DISORDERS, 32, 1-32.
Coordinated interpersonal timing is essentially a measure of how two people in a conversation are "in tune" with each other. This study focused on the relationship of conversations of mothers and fathers of children who stutter compared to children who speak fluently. Some recording procedures were utilized to simultaneously measure sounds and silences of the mother's and father's speech with their child's speech. The behaviors that the researchers recorded in mother's/father's and the child's speech were vocalizations, pauses, turn switching pauses, interruptive and noninterruptive simultaneous speech. Results showed that the speech of children who stutter may be more influenced by time issues during conversation.
Sawyer, J., Chon, H. & Ambrose, N.G. (2008). Influences of rate, length, and complexity on speech disfluency in a single-speech sample in preschool children who stutter. JOURNAL OF FLUENCY DISORDERS, 33, 220-240
This article analyzed the influences of rate, length, and complexity on speech disfluency in preschool children who stutter. The study included 14 participants ages 33-57 months. Speech samples were analyzed looking specifically at the disfluencies at the end of a long-speech sample. The factors analyzed included length [measured in Mean Length of Utterance(MLU)], grammatical complexity (measured by the number of clauses and clausal constituents per utterance), and articulation rate (measured acoustically in the number of syllables/second). The interaction between the above factors were then explored. The article includes results providing detailed information concerning the influences of rate, length, and complexity on speech disfluency. Additional information in the article includes clinical implications, caveats, and future research directions. A continuing education section to support the educational objectives is also provided in the article.
Sawyer, J. & Ehud, Y. (2006). The effect of sample size on the assessment of stuttering severity. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 15, 36-44.
This study examined the effects of speech sample size on the frequency of disfluency and disfluency length in 20 preschool children who stutter. The 20 participants were aged 33 to 58 months and represented a range of stuttering severity levels. A1200 syllable speech sample was elicited and videotaped for each participant. The number of stuttering-like-disfluencies per 100 syllables was calculated for each sample. In addition, the length of disfluency was calculated by counting the number of repetition units. The disfluency counts were analyzed for the first consecutive 300, 600, 900, and 1200 syllables. A significant difference in the number of stuttering- like-disfluencies was seen between the sample sizes of 300 and 1200 syllables. In addition, when the size of the sample was greater than 300 syllables, a 20% increase in stuttering-like-disfluencies was seen for half of the participants. The effect of sample size on disfluency length was not found to be significant. The researchers conclude that longer speech samples may be necessary for the identification of fluency disorders in preschool children. However, further research is needed before more precise recommendations regarding speech sample size can be made.
Schaeffer, N. & Eichorn, N. (2001). The effects of differential vowel prolongations on perceptions of speech naturalness. JOURNAL OF FLUENCY DISORDERS, 26, 335-348.
This study examined which durations and in which contexts prolonged speech (prolonged vowels, prolongation throughout utterances) as judged by 52 college students was perceived to be unnatural. Prolongation was narrowed to a vowel in the middle of a single syllable word. Results indicated that the length of the utterance, and possibly the context, did influence the perceived naturalness of the word.
Schiavetti, N., Martin, R.R., & Metz, D.E. (1994). Psychological analysis of audiovisual judgments of speech naturalness of nonstutterers and stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 46-52.
The purpose of this study was to measure the validity and reliability of Equal-Appearing Interval (EAI) rating and Direct Magnitude Estimation (DME) scales when measuring speech naturalness of PWS. Forty students were randomly assigned to use one of the two scales to rate speech naturalness of audiovisual recordings. Group reliability was high for both scales, but individual rater reliability was higher for EAI. Both scales were considered to be valid measurement tools.
Schloss, P. J., Freeman, C. A., Smith, M. A., & Espin, C. A. (1987). Influence of assertiveness training on the stuttering rates exhibited by three young adults. JOURNAL OF FLUENCY DISORDERS, 12(5), 333-353.
This study examined the effects of assertiveness training on the stuttering rates of three adult male subjects. The subject's responses and instances of stuttering in relation to three different types of conversational styles: disagreeable, impatient, and patronizing were measured prior to and after training procedures. The training procedures consisted of instruction, modeling, behavior rehearsal, feedback, social reinforcement and homework. Results indicated that all three subject's responses regarding the different types of conversational styles increased following treatment. In addition, a decrease in stuttering following assertiveness training occurred for two of the three subjects.
Scott, L.A., Healey, C., & Norris, J.A. (1995). A comparison between children who stutter and their normally fluent peers on a story retelling task. JOURNAL OF FLUENCY DISORDERS, 3 279-292.
The purpose of this study was to determine if children who stutter produced less sophisticated narratives when compared to their normally fluent peers. In addition, the authors wanted to determine if the number of disfluencies produced during a story-retelling task were related to the sophistication of the narrative structure. The results of this study show that the narrative abilities of children who stutter are not significantly different from those of their normally fluent peers. The authors acknowledge that the literature now reveals accumulating evidence supporting this view. Of interest within this study, is the identification of three subgroups of children who stutter. Identification of such subgroups indicates that for some of these children, subtle language impairment may be a component of the fluency disorder. The authors suggest additional research efforts be done to determine if the subgroup patterns identified in their investigation exist in other samples of children who stutter.
Schwartz, H.D. (1993) Adolescents who stutter. JOURNAL OF FLUENCY DISORDERS, 18, 289-302.
This article discusses typical approaches in adolescent stuttering therapy and highlights the need for further research and modification of current practices. There are few treatment approaches that target the adolescent stutterer. Current treatment approaches typically group the adolescent with either older children or adults, but these models fail to consider the unique behavioral and emotional characteristics of puberty. Discussion focuses on concerns related to the relationship between emotions and stuttering, transfer and maintenance of fluency, service delivery models, and the need for specialty certification.
Schwartz, H.D., & Conture, E.D. (1988). Subgrouping young stutterers: Preliminary behavioral observations. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 62-71.
In this study, 43 children who stutter were videotaped during conversations. Their associated speech and nonspeech behaviors, as well as speech disfluency types were identified and quantified for a sample of their stuttering events. The behaviors and disfluency types were grouped and described in an effort to subgroup the individuals who stutter. Five cohesive clusters of children who stutter were identified and described based on the associated speech and nonspeech behaviors and within- word disfluency type. Future research can consider similarities within the groups and differences between groups in order to better understand the nature of stuttering and its onset and development.
Schwenk, K. A., Conture, E. G., Walden, T. A. (2007). Reaction to background stimulation of preschool children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS, 40, (2), 129-141.
This study examined attention maintenance and environmental adaptation of both children who stutter and children who did not stutter. A total of 36 children between the ages of 3 and 5 were selected to participate. In order to judge attention maintenance, the children were observed interacting with a caregiver. Eye gaze breaks were measured for number of instances and duration of the break. In order to judge environmental adaptation, the children's reaction to camera movement was recorded. Findings indicated that children who stutter were more likely to shift attention by breaking eye gaze and were more sensitive to environmental changes. This may suggest that children who stutter are highly aware of their environment and changes to it which may cause them to compensate for their disfluencies by using physical tension and increased rate.
Seery, C. H., Watkins, R. V., Mangelsdorf, S. C., & Shigeto, A. (2007). Subtyping stuttering II: Contributions from language and temperament. JOURNAL OF FLUENCY DISORDERS, 32(3), 197- 217.
This article focuses on language abilities and temperament variables that may be related to subtypes of young children who stutter. The article is second in a series of two papers discussing areas in which research may be conducted to differentiate subtypes of stuttering. Language and temperament were the focus of the research conducted for this article because when stuttering onset is most likely to happen there are significant changes in both areas, both areas have been studied extensively throughout time, and the research that has been conducted pertaining to both areas has not addressed developmental stuttering. The authors of this article go into great detail about subtypes in language disability and in temperament, the review of literature concerning stuttering and child temperament, and the common insights from the domains of language and temperament. The authors also integrate language and temperament for further research pertaining to subtyping stuttering. This research would include a larger group of children, relative strengths and weaknesses of development, and observing linguistic gaps between language, temperament, and disfluencies.
Shames, GH. (1989). Stuttering: An RFP for a Cultural Perspective. JOURNAL OF FLUENCY DISORDERS. 14, 67-75.
Stuttering has been given much attention. Most data however comes from the majority of the American population. There have been a high number of errors and questions about overgeneralizing our information to minority groups. Researchers need to develop appropriate demographic information about stuttering for all groups. There are beliefs that a cultures way of life or stresses can influence their speech and health. Treatment for fluency disorders can be helpful, however the outcome of the therapy can range due to numerous cultural factors. Clinicians and researchers need to take a close look at the responsiveness and sensitivity given to an individual. Cultural dissimilarities need to be evaluated when treating a stutterer.
Shields, Lynne W., Kuster, Judith Maginnis. (2003). Finding good resources for treating school-age children who stutter. SEMINARS IN SPEECH AND LANGUAGE, 24, 7-12.
Clinicians working in the school systems often have a difficult time locating appropriate resources in treatment for children who stutter. There are many options available for clinicians. Four of these resources include the Stuttering Foundation of America, the National Stuttering Association, another self-help organization called FRIENDS and The Stuttering Homepage. These resources are open to adults and children who stutter. It is important that clinicians tailor the available material to fit the needs of the client. By researching these sites thoroughly, clinicians are able to find appropriate materials to help their students succeed in stuttering treatment.
Shirkey, E. (1987). Forensic verification of stuttering. JOURNAL OF FLUENCY DISORDERS, 12, 197-203.
The subject of this report is a 33 year-old man who was accused of child molestation, and whose speech was a decisive issue in an earlier trial. In his previous trial, he was found not guilty due to indications that he is a person who stutters and no reports indicated the attacker to be a stutterer. The subject was later arrested for attacking six girls, ages 4-11, and one adult woman. A speech-language pathologist was brought in to determine if this subject was an actual stutterer or pseudostuttering stuttering. The results of a speech assessment indicated that the subject was probably a stutterer, although there was no feasible means to determine his actual severity. It is suggested that, for several reasons, he probably could have been fluent during the criminal circumstances described by the victims. In such a situation the speech pathologist could only attempt to determine whether the defendant was, at the time of the assessment, a normally fluent speaker. If speech were used as the sole determinant of guilt or innocence, it would be difficult for the speech pathologist to determine whether the defendant had faked the stuttering at the time of the crime.
Siegel, GM. (1992). Prevention of stuttering: A response to Hamre. JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 113-120.
This is a commentary by Gerald Siegel in response to Curt Hamre's articles Stuttering Prevention I: Primacy of identification and Stuttering Prevention II: Progression which are contained in this same issue. Regarding Hamre's rejection of the diagnosogenic theory of stuttering, Siegel criticizes Hamre for going to the extremes. Siegel disagrees with Hamre on several points but also compliments him for looking critically at the prevailing views of stuttering which will ultimately stimulate more discussion on this subject.
Siegel, G. M. (1993). Stuttering and behavior modification: Commentary. JOURNAL OF FLUENCY DISORDERS, 18, 109-114.
This article provides an overview of behavioral modification through explaining the history, detailing the research, and predicting what the future holds. Even thought behavioral modification has been studied for over 20 years many aspects have been left unsolved. However, behavior modification has had a lasting influence by providing a framework for single-subject research as a prototype for effective data-driven clinical practice. One question remains, will the trend move to physiological studies or will the emergence of behavioral modification make another appearance in up and coming research?
Silverman, F.H. (1997). Telecommunication relay services: An option for stutterers. JOURNAL OF FLUENCY DISORDERS, 22, 63-64.
This article is to inform individuals who have anxiety about talking on the phone that there is a telecommunication service available that can enable them to communicate by telephone without having to speak.
Silverman, FH., (1988). Impact of a T-shirt message on stutterer stereotypes. JOURNAL OF FLUENCY DISORDERS, 13, 279-281.
This study was designed to provide data on how people are likely to react to a stutterer wearing a T-shirt on which is printed, "I stutter. So what!" The results indicate that the stutterers wearing the shirt were judged to have better sense of humor and self- concept, less frightened, more aggressive, brave, calm, interesting, talkative, and uninhibited than the stutterer who was not wearing one. The findings of this study suggest that a T-shirt with an appropriate message is a practical strategy for bringing stuttering out into the open.
Silverman, F.H. (1988). The "monster study". JOURNAL OF FLUENCY DISORDERS, 13, 225-231.
An unpublished thesis project was conducted in the late 1930s under the direction of Wendell Johnson. The study is reported to have turned normally fluent children into children who stutter. Implications are discussed.
Silverman, F. H. and Bohlman, P. (1988). Flute stuttering. JOURNAL OF FLUENCY DISORDERS, 13, 427-428.
This is a case report that addresses stutter-like disturbances in motor functioning for an adult stutterer while playing the flute. The subject of this report had been playing the flute for six years and gradually moved to smaller bands and orchestras. As a junior in high school, fierce competitions in the flute section developed and "challenges" occurred almost weekly. As she would start to play her flute, her throat would tense, facial muscles freeze, and her entire body would stiffen for a total duration of 15 to 30 seconds. Blocking did not occur in her speech; the stuttering exhibited in her speech consisted mostly of repetitions. After the competition lessened, the stuttering while playing flute disappeared. The subject of this case report did not pursue her music interest at the college level.
Silverman, F.H. and Bongey, T. A. (1997). Nurses' attitudes toward physicians who stutter. JOURNAL OF FLUENCY DISORDERS, 22, 61-61.
Questionnaires were given to 20 nurses, ten rating "a physician' and ten rating "a physician who stutters." A 20 item scale was used on the questionnaire to find how members of a certain health field judged the competence of another who stuttered. Results of this study showed that physicians who stutter are regarded as being less competent than their peers.
Silverman, F., Hummer, K., (1989). Spastic Dysphonia: A Fluency Disorder? JOURNAL OF FLUENCY DISORDERS, 14, 285-291.
This study focused on spastic dysphonia and if it should be classified as a fluency disorder. A study was conducted to determine whether listeners judge the speech of a person with spastic dysphonia as having deviant fluency and how they react to a person with this disorder. Twenty people were selected from "the general public" to listen to a tape of a women with spastic dysphonia and then rate her on 81 scales. The results indicated that listeners judge spastic dysphonia as being deviant in fluency and a person with spastic dysphonia is likely to be perceived negatively. The findings suggest that classifying spastic dysphonia as a fluency disorder may give new direction for research on stuttering.
Silverman, S., & Ratner, NB. (2002). Measuring lexical diversity in children who stutter: Application of vocd. JOURNAL OF FLUENCY DISORDERS, 27, 289-304.
This article compares the language abilities of children who stutter with those of fluent children. It includes a case study comparing standardized test results from three vocabulary tests on 15 CWS and 15 fluent peers around 3 years of age. Results were concluded from the standardized tests, Type Token Ratio, and vocd. They showed subtle differences between the two groups, yet enough to indicate that CWS score lower on standardized vocabulary tests than those who are fluent.
Sisskin, V. (2002). Therapy planning for school-age children who stutter. SEMINARS IN SPEECH AND LANGUAGE, 23, 173-179.
Treatment planning for school-based therapy, including careful selection of goals is both required by law and an essential component of the assessment process. The goals of an effective treatment program for school-age children who stutter should address all aspects of the problem and lead to skills that are both lasting and usable in daily life. Characteristics of appropriate therapy goals as well as tools to aid in treatment planning are explored.
Smits-Bandstra, S. & De Nil, L. F. (2007). Sequence skill learning in persons who stutter: Implications for cortico-striato-thalamo- cortical dysfunction. JOURNAL OF FLUENCY DISORDERS, 32(4), 251-278.
There has been research conducted showing relations to basal ganglia dysfunctions and stuttering. People who stutter (PWS) generally, after practice, have learning skill achievement deficits, on non-speech sequencing tasks. Production on speech sequencing tasks tends to be slower and more imprecise. Patients with impaired basal ganglia function and impaired cortico-striato-thalamo-cortical connections tend to have limited ability to develop automaticity after practice and reduced ability in learning sequencing skills. Four recent studies were reviewed and discussed. Results from studies one and two indicated that PWS, when compared to fluent speakers (PNS), exhibit reduced sequenced finger taping skills as well as the reduced ability to sequence nonsense syllables after practice. Results from studies three and four explain that on a double task such as color recognition and simultaneous sequencing, PWS tend to have a slower or more erroneous performance after practice, when compared to PNS. In conclusion, PWS can have automatization and sequence skill learning insufficiencies therefore; this supports the theory that the dysfunction of the basal ganglia and cortico-striato- thalamo-cortical connection may be a factor in the etiology of stuttering.
Smits-Bandstra, S., De Nil, L., & Rochon, E. (2006). The transition to increased automaticity during finger sequence learning in adult males who stutter. JOURNAL OF FLUENCY DISORDERS, 31, 22-42.
This study further investigates the ability of people who stutter (PWS) to learn new motor tasks and acquire high levels of automaticity with practice by comparing twelve PWS to a control group of 12 fluent speakers. This was implemented by having the subjects use a finger tapping pattern and a color identification task either separately or concurrently. Results for finger tapping tasks indicated that control subjects improved at a faster rate and had less variability with practice compared to PWS, who demonstrated slower improvement in automaticity and more variability. Overall, PWS benefited from practice but did not improve at the same rate as the control group of people who did not stutter.
Smits-Bandstra, Sarah, De Nil, Luc F., & Saint-Cry, Jean A. (2006). Speech and nonspeech sequence skill learning in adults who stutter. JOURNAL OR FLUENCY DISORDERS, Volume 31, issue 2,116-136
This motor sequence learning focused on two areas: finger tapping and sequence of nonsense syllables in reading exercises. The premise of the authors is that there is a difference between PWS and PNS in motor skill acquisition and on transfer and retention. The results supported other findings of differences in their skill learning abilities. The differences in sequencing performance with practice were significantly different for finger tapping reaction time than in syllable sequencing. Further studies need to be done to determine the significance of this difference in response and its implications on stuttering.
Smith, A., Denny, M., Shaffer, L. A., Kelly, E. M., & Hirano, M. (1996). Activity of intrinsic laryngeal muscles in fluent and disfluent speech. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 329- 348.
The authors state that many textbooks and articles on stuttering frequently state that disfluency is associated with high levels of activation of intrinsic laryngeal muscles as if this were a widely accepted, empirically demonstrated fact about stuttering. The purpose of this study was to determine if stuttering is associated with unusually high levels of activity in laryngeal muscles. Levels of laryngeal muscle activity of normal speakers and stutterers was determined by EMG measurements. The measurements were based on the following activities: singing an ascending scale, singing a descending scale, phonation of the vowel /i/ as long as possible, maneuver (requires adduction of the vocal folds), quiet breathing at rest, and swallowing water. The results showed no support for the claim that laryngeal muscle activation during disfluent speech is higher than that during normal speech.
Smith, A. & Kleinow, J. (2000). Kinematic correlates of speaking rate changes in stuttering and normally fluent adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 43, 521-536.
This study focuses on how the speech movement patterns of adults that stutter are effected by the rate of speech. It has been the clinical impression that reduced speaking rates enhance fluency. However, the brain mechanisms for this enhancement are not clear. This study used spatiotemporal stability (STI) to assess whether or not changing the speech rate of adults who stutter would affect the stability in the same way that it effects normally fluent speakers. Subjects were asked to fluently repeat the phrase "Buy Bobby a puppy" 20 times at normal (habitual), fast and slow rates. Phrases that contained dysfluencies were not counted. Results of the STI analysis show that both stutterers and nonstutterers show lowest stability at slower than normal rates. In general the results suggest that stutterers and nonstutterers show similar speech movement patterns, although there were subtle differences observed in some of the stutterers when they were asked to repeat at a habitual rate.
Smollen, J. (2006). Stuttering celebration. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1, 29-32.
It is common for children who stutter to get teased or bullied. In stuttering therapy, it is important to address this issue, and one way to do this is to facilitate classroom discussion about stuttering. The client can make a newsletter with facts or even a quiz about stuttering and present it to their classmates. This article displays an excellent example of a classroom stuttering presentation called the "s-s-s-stuttering celebration." The celebration encouraged discussion of how it is okay to be different. The Speech-Language Pathologist also discussed teasing and bullying and how being teased makes you feel. The celebration helped the client's classmates see her for who she is, and not as the girl who stutters.
Snyder, G.J. (2001). Exploratory Research in the Measurement and Modification of Attitudes Toward Stuttering. JOURNAL OF FLUENCY DISORDERS, 26:2, 149-160.
The introduction to this study discusses various studies that tried to change peoples perception of a stutterer and their findings. The present study consisted of 55 first year speech/language pathology graduate students that were involved in this study over a two year span. 21 students completed the first year, and the remaining 34 completed the second year. 2 opted not to complete the research. The graduate clinicians were given the CATS inventory, which consisted of 50 statements with a wide range of beliefs regarding stuttering. Then the first group viewed the documentary "Speaking of Courage", which involved both emotional and informative content. The second group watched a narrated version of "Effects of Altered Audio Feedback on Stuttering Frequency at Normal and Fast Speaking Rates", which showed people who stutter speaking with and without altered auditory feedback. The clinicians were to wait 24 hours, then complete the post video CATS and return the forms within 72 hours. The findings were: (1) The documentary strengthened the belief of operant therapy. (2) The narrated version found two perceptual changes from pre and post testing. (3) There were a few subtle perceptual changes, which indicates that perceptual changes, in regards to stuttering are possible. (4) This research doesn't support pervious findings that persons perceptions of stuttering are stable and resistant to change. Future research findings were also discussed.
Snyder, G., Reitzes, P., & Jackson, E.. (2008, October 14). THE ASHA LEADER. Digital audio and self-help for people who stutter, Vol. 13, No. 14, p. 19
The purpose of this article was to introduce a new self-help support-group option, StutterTalk. StutterTalk is a self-help podcast, similar to an archived radio program, which can easily be downloaded to computers or portable devices. StutterTalk allows people who stutter (PWS), speech-language pathologists (SLPs), and family members of PWS the opportunity to talk or listen freely about stuttering. This podcast includes a wide range of topics, such as: covert stuttering, acceptance, and perspectives from teenagers who stutter. The podcast also holds interviews with well known professionals in the field of fluency disorders as well as with PWS themselves.
Sommers, R.K., & Caruso, A.J. (1995). Inservice training in speech- language pathology: Are we meeting the needs for fluency training? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY,3 (4), 22-28.
Supervisors of SLP's in the schools and directors of university training programs were surveyed regarding inservice training requirements in speech-language pathology. Findings indicate preferences of speech and language disorders by SLPs regarding intervention, and the identification of a lack of specific training as perceived by the supervisors and directors. Fluency training seems to be unmet in inservice training for SLPs. The article identifies particular components for successful inservice programs to improve SLP's competence and learning.
Sparks, G., Grant, D. E., Millay, K., Walker-Batson, D., Hynan, L. S. (2002), The effect of fast speech rate on stuttering frequency during delayed auditory feedback. JOURNAL OF FLUENCY DISORDERS, 27, 187-201.
This study compares the speaking performance of two mildly disfluent subjects and two severely disfluent subjects on reading passages under three DAF conditions (55, 80, and 105 ms delays) and under a no DAF condition. The results show that fluency improved remarkably in the severely disfluent subjects from no DAF to DAF condition in both normal and fast reading. The mildly disfluent subjects' fluency, however, did not improve remarkably from no DAF to DAF condition. These results contradict Wingate's hypothesis that fluency-enhancing effects of DAF can be attributed to reduced speech rate. The authors discuss possible reasons for this result and the need for further research on this topic.
Stager, S.V., Calis, K., Grothe, D., Bloch, M., Berenson, N.M., Smith, P.J., & Braun, A. (2005). Treatment with medications affecting dopaminergic and serotonoergic mechanisms: Effects on fluency and anxiety in persons who stutter. JOURNAL OF FLUENCY DISORDERS, 30, 319-335.
The purpose of this study was to examine the degree to which medications with dopamine antagonist properties (pimozide) and serotonin reuptake inhibitor properties (paroxetine) improve fluency. The study was a randomized, double-blind, placebo-controlled crossover study. The participants were medicated for six weeks, then given a placebo for six weeks, and then medicated again for six weeks. The study was stopped early due to side effects from the withdrawal of the medication paroxetine. Even though the study was terminated early, the results show that dopaminergic mechanisms are more likely to reduce symptoms of stuttering than serotonergic mechanisms, but the side effects of pimozide may outweigh the ability it has to reduce stuttering behaviors.
Stager, SV., Denman, DW., & Ludlow, CL. (1997). Modifications in Aerodynamic variables by persons who stutter under fluency- evoking conditions. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 40, 832-847.
This study was designed to determine a) the relationship between speech intensity and changes in aerodynamic variables of a person who stutters; b) if persons who stutter change aerodynamics in fluency-evoking conditions and if these changes are similar to the speech changes of persons who do not stutter; and c) if aerodynamic variables are related to changes in fluency. Ten subjects ranging in age (22-52) and stuttering severity (moderate to severe) participated in the study. Intraoral air pressure, airflow, electroglottograph (EGG), and acoustic signals were measured under the fluency evoking conditions of choral reading, delayed auditory feedback, metronome-pacing, and masking noise. Data was collected on vowel duration, speech rate, maximum vowel intensity, peak pressure, flow rise time, pressure rise time, and closure duration. Results revealed that the aerodynamic changes that occur under fluency-evoking conditions were related to fluency changes. These changes included a decrease in airflow and intraoral air pressure during fluency-evoking conditions.
Stager, SV., Jeffries, KJ., & Braun, AR. (2003). Common features of fluency-evoking conditions studied in stuttering subjects and controls: An H215O PET study. JOURNAL OF FLUENCY DISORDERS, 28, 319-336.
This study used H215O PET to compare brain activation patterns during fluency- and dysfluency-evoking tasks. The participants in this study were seventeen adults, aged 23- 50, who stutter. The results of their PET scans were compared to those of age- and gender-matched controls. Experimental and control group members were scanned during two fluency- and two dysfluency-evoking tasks, as well as during a resting state. In addition, the presence/absence of dysfluent symptoms and phonation time were measured. Results indicated that increased phonation time evoked fluency in PWS during singing, but not during paced speech. In addition, results were evaluated for common areas of brain activation in both PWS and the controls. Participants in the experimental group showed greater activation of the auditory and motor regions in the left hemisphere of the brain during fluency-enhancing tasks. The authors suggested that more effective self- monitoring (in PWS) may allow motor areas that control the speech mechanism to better modify speech.
Stager, S.V., & Ludlow, C.L. (1993). Speech production changes under fluency-evoking conditions in nonstuttering speakers. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 245-253.
The purpose of this study was to determine the effect of 4 fluency evoking conditions on the speech of people who do not stutter. The authors wished to discover whether speaking under fluency-evoking conditions reliably alters speech production in nonstuttering speaker (changes in fundamental frequency, intensity, word/sentence duration, & vowel formant frequencies). The 4 fluency-evoking conditions were: choral reading (CR), metronome pacing (MET), DAF, and masking noise (NOISE). The authors discovered that nonstuttering speakers had timing variation across all conditions, showed different peak flow and pressure velocities. Vowel durations increased under MET, DAF, and NOISE. Pressure rise time increased under MET, flow rise time increased under NOISE, speech rate decreased under DAF and NOISE. The authors concluded that if similar changes occur in PWS, the changes may be important contributors to enhanced fluency. They suggest that the determination of this is the next plausible step.
Stager, SV., & Ludlow, CL. (1998). The effects of fluency-evoking conditions on voicing onset types in persons who do and do not stutter. JOURNAL OF COMMUNICATION DISORDERS, 31, 33-52.
This study had the four purposes of (1) determining whether speaking under fluency-evoking conditions resulted in producing more breathy than hard onsets by people who stutter and those who do not, (2) determining whether dysfluent words produced by people who stutter in control conditions were associated with hard onsets, (3) determining whether words that changed to breathy onsets under fluency-evoking conditions were previously produced dysfluently under control conditions, and (4) determining whether changes in vowel duration and intensity, which are known to occur under fluency-evoking conditions, were related to changes in voice onset type. Twelve nonstuttering people and ten stuttering people participated in this study. Sentences read in conversational style were used as the speech sample. The results were (1) more breathy than hard onsets were not produced when speaking under fluency- evoking conditions by any of the subjects, (2) hard onsets were not related to dysfluent words by people who stutter at control conditions, (3) changes from hard to breathy onsets were not noted in words that changed from dysfluent in control conditions to fluent in fluency-evoking conditions, and (4) an onset changed in type between conditions was not associated with changes in vower intensity or duration.
Stansfield, J. (1995). Word-final disfluencies in adults with learning difficulties. JOURNAL OF FLUENCY DISORDERS, 20(1). 1-101.
The speech of four dysfluent adults with learning difficulties are analyzed revealing several word-final dysfluencies. Although many speech characteristics and communication disorders are noticed, this article focuses on the word-final dysfluencies discovered by the differential diagnosis.
Starkweather, C.W., (1982). Stuttering in children: an overview. JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS. 6, 5-14.
This article gives a general overview about stuttering. The author defines stuttering, differentiates it from normal childhood dysfluencies and also gives statistics on age and sex ratios of children who stutter. Starkweather also gives some insight on the capacities demand model which may play a role in why some children stutter. He also gives a brief overview of some treatment options for children who stutter including direct and indirect therapy methods.
Starkweather, C. W. (1992). Response and reaction to Hamre: Stuttering Prevention I. JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 43-55.
The article provides a general summary of the author's belief system about stuttering prevention strategies before countering Hamre's position on stuttering prevention. In supporting his arguments against Hamre, the author describes a variety of complex events that can precipitate stuttering behaviors and the level of concern parent's exhibit when their child has fluency difficulty. Finally, Starkweather argues that Hamre has ignored some of the literature that supports preventive strategies and his position on 'Iowa School' is a false premise.
Starkweather, CW. (1992). Responses and reactions to Hamre, "Stuttering prevention II: Progression". JOURNAL OF FLUENCY DISORDERS, 17, 1 & 2, 95-106.
This is a commentary by C. Woodruff Starkweather in response to Curt Hamre's articles Stuttering Prevention I: Primacy of identification and Stuttering Prevention II: Progression which are contained in this same issue. Starkweather criticizes Hamre's logic beginning with the abstract and admonishes Hamre for misrepresenting his position in a quote. Starkweather also disagrees with Hamre's suggestion that most children who are beginning stutterers will recover spontaneously and therefore do not need treatment. These are a few of the points where Starkweather disagrees with Hamre.
Starkweather, C.W. (1993). Issues in the efficacy of treatment for fluency disorders. JOURNAL OF FLUENCY DISORDERS, 18, 151-168.
The purpose of this article is to simply identify some of the important issues in the efficacy of treatment. The author outlines eleven goals for therapy and provides rationale for each one. There are also tips on issues ranging from getting a representative speech sample to assessing the client's environment to identifying stuttering behaviors. Throughout the article the author addresses issues that need to be resolved before efficacy can be assessed.
Starkweather, C.W. (1994). First world congress on fluency disorders: Abstracts Munich, Germany, August, 1994. JOURNAL OF FLUENCY DISORDERS, 19(3) 147-225.
In this issue of the JOURNAL OF FLUENCY DISORDERS, C. Woodruff Starkweather has compiled all of the abstracts of papers, posters, mini seminars, and short courses that will be offered at the congress. He believes this Congress is a landmark event which is the first of its kind. Participants will come from all of the continents and nearly every developed country in the world. The views and approaches to the problems of cluttering, stuttering, and acquired neurogenic and psychogenic stuttering will be, as these abstracts show, very diverse. The diversity will reflect differences in education and training, culture, language, and the history of treatment for speech disorders in each country. Such diversity of knowledge and perspective provides an extraordinary opportunity for all of us to see these problems in ways that perhaps have never been thought of before.
Starkweather, W. (1995). A simple theory of stuttering. JOURNAL OF FLUENCY DISORDERS, 2 (2), 91-116.
The theory presented in this paper states that stuttering is caused by elevated muscle activity. Starkweather provides examples of how this theory explains the many variations in stuttering. These include variations in timing, amplitude and duration of muscle activity, focus of tension (glossal vs. laryngeal), and secondary reactions. Starkweather discusses related data on stuttering which can be explained by this simple theory. These include reaction time, sex ratio, fluency enhancement effects, emotional effects, expectancy, adaptation, and nonspeech incoordination in stutterers. He also discusses related data which are not well explained by this muscle tension theory. These include choral speech, metronomic pacing, easy "stuttering" in children, and the laterality phenomena. In summary, the value of this theory is that it explains much of the data known about stuttering with few constructs.
Starkweather, W. (2002). The epigenesis of stuttering. JOURNAL OF FLUENCY DISORDERS, 27, 269-288.
This paper examines the various ways genetics plays a factor on stuttering relating to the Demands and Capacities Model. It explains how stuttering is polygenetically influenced at the behavioral, physiological, and cultural levels. The stages of development regarding fear, avoidance, and frustration are explained.
Stephenson-Opsal, D., & Bernstein Ratner, N. (1988). Maternal speech rate modification and childhood stuttering. JOURNAL OF FLUENCY DISORDERS, 13, 49-56.
Therapists often recommend that parents of children who stutter decrease their conversational speech rate. The paper reports on the effects of slowed maternal speech on the fluency of young children. The study focuses on two mother-child dyads and recorded a number of occasions both before and after a clinicians suggestion that a slowed maternal speech rate might decrease their child's stuttering. The results of the study confirm that the decreases in maternal speaking rate can produce beneficial changes in children's fluency, and can be maintained over additional observations of the child's speech.
Stewart, R. and Brosh, H. (1997). The use of drawings in the management of adults who stammer. JOURNAL OF FLUENCY DISORDERS, 22, 35-50.
Two case studies are presented in order to see the benefits of incorporating drawing in the clinical management of individuals who stammer. Basic requirements of using art therapy are outlined and specific advantages are listed.
Stewart, T. (1996). Good maintainers and poor maintainers: A personal construct approach to an old problem JOURNAL OF FLUENCY DISORDERS, 21, 33-48.
This study, taken from a larger study, attempts to explain reasons for the success of maintaining fluency in one subject and failure of not maintaining fluency in another subject within the same study. Both were participants in a fluency program which utilized Personal Construct Theory techniques, a strategy for gaining a self-perception of being a fluent speaker. Although it was agreed that the two subjects had different starting points in regard to speech behavior, the comparative analysis of data revealed significant differences in their responses. The following were listed as three major differences: first, during the loosening phase, both achieved an attitude which produced a loosening of their systems, but the unsuccessful subject "tightened" soon afterward while the successful one was found to maintain this into the second phase of treatment; second, the unsuccessful subject did not elaborate the "ideal self" element to the same extent as the successful subject; and third, the successful subject was able to elaborate his self-perception of fluency much earlier than the other.
Stewart, T., Richardson, G. (2004). A qualitative study of therapeutic effect from a user's perspective. JOURNAL OF FLUENCY DISORDERS, 29, 2, 95-108.
This article looks at a qualitative study taken to examine clients who have completed stuttering therapy. Although the client sample was small, the clients discuss in an interview their personal feelings about their stammering therapy after they have completed it. Various themes were identified and analyzed including, current status of communication, covert features, coping strategies, details of content or stages of therapy process, comments on SLP's involved in therapy, support issues, immediate effects of therapy, long term outcome, and suggestions on how therapy programs may be modified.
Stidham KR, Olson L, Hillbratt M, Sinopoli T. (Nov. 2006) A new antistuttering device: treatment of stuttering using bone conduction stimulation with delayed temporal feedback. LARYNGOSCOPE. 116(11):1951-5
Authors combined the use of DAF and bone conduction as a form of therapy for stuttering. SSI-3 results for the nine subjects tested found reduced scores with wearing the device. These subjects wore the device for four hour time periods over a span of four weeks. Two weeks after the ASD was removed some benefit was still noted. Those tested also found that their confidence went up with their improvements in speech. However, some subjects were uncomfortable wearing the device in public. This is a preliminary test of this device. There have been no long term studies done to see if the effects or benefits will last. A positive note, however is that none of the subjects thought their stuttering was worse or that the device was of no help.
Stigora, J., DiSimoni, F., (1989) Resolution of Opposing Forces: An Approach to the Understanding and Clinical Management of Stuttering. JOURNAL OF FLUENCY DISORDERS, 14, 293-302.
This article focused on understanding clinical management of stuttering by viewing it as an opposing muscular force or in other words problems organizing/sequencing motor speech events. It is hypothesized that these forces are potential cause for the dysfluency of stuttering including, increased tension in all areas of the speech mechanisms. It is thought that if these opposing muscular forces are balanced the dysfluencies will fade. This has been attempted in many stuttering therapy techniques including "pull out" or the gliding method, easy onset, and " low energy speech." The article states that this discoordination is the stuttering itself and not the cause of stuttering and the therapies effectively balance the muscular forces.
Strang, H., & Meyers, S. (1987). A microcomputer simulation to evaluate and train effective intervention techniques in listening partners of preschool stutterers. JOURNAL OF FLUENCY DISORDERS, 12, 205-215.
A microcomputer-based simulation is being developed to assist parents and speech clinicians-in-training in intervening effectively with a stuttering child. The experience centers on the participant's maintenance of an active verbal dialogue with a computer-generated preschool stutterer whose speech-synthesized fluency level can be directly linked to the participant's verbal behavior. In an initial test of the system's evaluation efficiency, the intervention behaviors exhibited by a group of eight experienced speech pathologists were compared with those exhibited by a group of eight entry level speech pathology students. The experienced group showed superior intervention particularly on rate-of-speech variables. All clinicians and students rated their participation as enjoyable and as helpful to new students in becoming more skillful in intervening with preschool stutterers. On a personal level, the inexperienced students unanimously agreed that exposure to the simulation positively impacted their confidence as therapists. It is anticipated that the reinforcement, practice, and feedback aspects of the current simulation will produce similar results in speech-language pathology training applications.
Strum, J., & Seery, C. (2007). Speech and articulatory rates of school-age children in conversation and narrative contexts. LANGUAGE SPEECH AND HEARING SERVICES IN SCHOOLS, 38, 47-59.
"An inappropriate rate of speech can interfere with a person's ability to communicate effectively." The purpose of this study was to present an introduction on speech rates in words per minute, speech rates in syllables per minute, and articulatory rates in syllables per minute in conversational and narrative speaking situations. This study was done with 36 typically developing children ages 7, 9, and 11. The questions were: what were the speech rates for these ages, was there a developmental trend, and was there a significant difference in the rates compared to conversational and narrative speaking situations? The results determined that the speaking rate increased significantly between the ages of 7 and 9, and the rates were similar across the procedures. Also, the narrative speaking rate was found to be significantly faster then the conversational speaking rate. This information will allow a clinician to determine what the appropriate speaking rate is for children with communication disorders. This will also help the clinician make an appropriate diagnostic and therapeutic decision for their client.
Stuart, A., Frazier, C.L., Kalinowski, J., & Vos, P.W. (2008). The effect of frequency altered feedback on stuttering duration and type. Journal of Speech, Language, and Hearing Research, 51, 889-897.
This article analyzed the use of Altered Auditory Feedback (AAF), specifically Frequency Altered Feedback, as a way to reduce disfluencies. Previous studies and self reports have shown FAF reduction in the frequency of stuttering. The purpose of this study was to investigate the effect of using FAF in order to reduce the duration as well as the types of stuttering in adults during oral reading. An analysis of data, which had been collected prior to this study, from 12 adults who stuttered, was performed. Speech samples were recorded of the participants reading orally for 20 minutes in an ABA time-series design, 10 minutes with FAF and two 5 minute segments of NAF. These videos were reviewed and the stuttered syllable instances were classified by type and measured for duration. The researchers calculated individual mean values of total duration of stuttering events, duration of stuttering events and proportion of stuttering events. Mean group values were calculated from the individual values. The results of the study showed the average duration of stuttering was reduced by approximately 20% regardless of the stuttering type. The total duration of stuttering was significantly decreased with the FAF by 50%. However there was no difference reported in the type of stuttering with the FAF. Overall, the research concluded FAF improves stuttering by decreasing the proportion of stuttering events as well as reducing the duration of residual stuttering events and total stuttering time during oral reading.
Stuart, A., Kalinowski, J., Armonson, J., Stenstrom, R., and Jones, K. (1996). Fluency effect of frequency alteration of plus/minus one- half and one quarter octave children in auditory feedback of people who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 396-401.
This study investigated the effects of frequency alterations in auditory feedback on stuttering frequency. The subjects, 11 adults and 1 adolescent, were asked to read aloud under nonaltered auditory feedback and four conditions, plus/minus one-half and one- quarter octaves, at normal and fast speech rates. Stuttering frequency was found to be significantly higher while reading aloud with nonaltered auditory feedback relative to all four frequency altered feedback conditions. No differences in stuttering frequency between the four frequency altered feedback conditions were found. The reduction in stuttering frequency was approximately 50% to 60% less than that found with the nonaltered frequency auditory feedback. It is suggested that slight alterations in the frequency of auditory feedback are fluency enhancing.
Subramanian, A., Yairi, E., Amir, O. (2003). Second formant transitions in fluent speech of persistent and recovered preschool children who stutter. JOURNAL OF COMMUNICATION DISORDERS, 36 (1), 59-75.
This study looked at the frequency of change and duration of second formant (F2) transitions in perceptually fluent target segments (syllables embedded in words) recorded close to stuttering onset of preschool children. Subjects used were 30 preschool children: 10 known to eventually persist in stuttering, 10 known to recover, and 10 normally fluent controls. Syllables were divided into three groups based on the placement of their initial consonant: bilabial, alveolar, and velar. Results indicated that the three subject groups produced similar transitions and similar duration measurements for the different places of articulation. The results indicated no signification interactions between place of articulation and group of subjects on any measure. The authors did find a significant difference between the frequency changes in the three groups: near stuttering onset, those children that eventually persisted stuttering had a significantly smaller frequency change of F2 transitions than the children who eventually recovered.
Susca, M. (2002). Diagnosing stuttering in the school environment. SEMINARS IN SPEECH AND LANGUAGE, 23, 165-171.
Stuttering is a multidimensional communication disorder which requires multilevel assessment and evaluation. It is often appropriate to include observations and information from all those involved, including the child, teachers, parents, and any others who may interact with the child. An assessment should also explore the effects of stuttering on the child's social communication with peers and adults. Evaluations of functioning in other communication skills such as language, cognition, and articulation are advised. A thorough and complete assessment is key to the development of an appropriate intervention.
Susca, M., & Healey, EC. (2001). Perceptions of simulated stuttering and fluency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 61-72.
This study was conducted to examine issues regarding listener perceptions of simulated stuttering. The questions that were asked, "How does a listener react to one of three levels of simulated stuttering or one of three levels of fluency?" and "How does a specific level of fluency or stuttering affect listener's perception of a speaker's fluency and ease of reading a passage, as well as the listener's comfort and ease in understanding a passage?" The results of the study established that the levels of simulated stuttering and fluency affected the unsophisticated listener's judgments and perceptions about a disfluent speaker's performance.
Susca, M & Healey, EC (2002) Listener perceptions along a fluency-disfluency continuum: A phenomenological analysis. Journal of Fluency Disorders, 27, 135- 161
This study looks at the listeners' perception of fluent and non-fluent speech. Sixty individuals were asked to listen to one sample chosen from three levels of fluent or disfluent speech. The listeners were interviewed after listening to the sample and the listeners' comments were analyzed for their perception of the speaker's communicative effectiveness. The results indicate that listeners' perception of a speaker's communication effectiveness is affected by a variety of information not just fluent or disfluent speech.
Teigland, A. (1996). A study of pragmatic skills of clutterers and normal speakers. JOURNAL OF FLUENCY DISORDERS 21, 201-214.
This study involved 12 students, ages 13:7 to 16:1. Two students faced each other, one with a complicated map marked with arrows showing two routes. The other student also had a complicated map but without the markings. The first student explains the routes to the other student and that student would mark the route on his map. Students were compared with a normally speaking group. Results show that it is recommended pragmatic skills should be given higher attention in the therapy of clutterers.
Tellis, Glen & Cari. (2003). Multicultural issues in school settings. SEMINARS IN SPEECH AND LANGUAGE, 24, 21-26.
Currently, the caseloads of ethnically and culturally diverse students is increasing at an extensive rate. With this large increase, many clinicians have voiced feelings of uncertainty when dealing with these populations. It is important to incorporate not only the so-called minority groups in this description, but people who are deaf, people from various religious backgrounds, people from different regions of a country are included. It is important to be sensitive to the attitudes and cultural beliefs of the specific culture as well. One must also take into consideration the perceptions of someone's cultural background. This article focuses on perceptions among people who stutter in different cultures and assessment and treatment issues amongst cultures.
Tellis, G., Gabel, R., Smith, D., & Tellis, C. (2002). Information about stuttering internet: A resource for school speech-language pathologists. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 29, 165-172.
The article reviews information directed towards school SLPs about Web sites that address various issues pertaining to stuttering, but the information can be used for all SLPs in any setting. The article provides suggestions for using these sites to improve treatment for students who stutter along with their parents, family, and friends. Various Web sites are addressed and outlined in the review which include the Stuttering Home Page, national and international fluency organizations, support groups, chat rooms, pen pal opportunities and forums. Also mentioned are Web sites for children and teenagers, sites that direct viewers to books, research, and journals about stuttering, and sites that contain information on different treatment techniques and therapy programs.
Telson, K., Packman, A., & Onslow, M. (2003). The Lidcombe behavioral data language of stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 46, 1009-1015.
The Lidcombe Behavioral Data Language (LBDL) does not attempt to identify or measure stuttering or its severity. It presents behavioral terminology for research and clinical purposes. This study investigates intrajudge and interjudge agreement for the LBDL among ten speech-language pathologists who currently work with PWS and ten undergraduates who have not received any formal instruction in the area of stuttering. After given instruction on the classification system, the participants observed videos and were asked to describe the stuttering behaviors of the various PWS from the videotapes. The findings indicate high levels of agreement in describing the behavioral characteristics of stuttering using the LBDL system.
Tetnowski, J.A., & Damico, J.S. (2001). A Demonstration of the Advantages of Qualitative Methodologies in Stuttering Research. JOURNAL OF FLUENCY DISORDERS, 26:1, 17-42.
This article discusses methodologies in regards to stuttering. A brief description of qualitative research (it's purpose and objectives) and qualitative research in communication disorders is addressed, as well as an example qualitative methods in conversational speech. The implications for its advantages discussed were (1) Authentic data will be able to be collected by researchers, that will show how stuttering impacts individuals in the real world. (2) A better description of what stuttering is, focus on actual behaviors, strategies, and resources employed by the PWS before, during and after moments of stuttering will be determined by the researcher. (3) The impact of stuttering on individuals and the ability to collect data from the perspective of the individual person who stutters will be focused upon by the researcher. (4) The PWS and their collaborations with the co-participants within the social context will be looked into by the researcher. (5) Phenomenon will be addressed more by the researcher. -- how it operates, how PWS attempt to reduce its impact in social contexts
Thacker, A.J., and Austen, S. (1996). Cluttered communication in a deafened adult with autistic features. JOURNAL OF FLUENCY DISORDERS 21, 271-279
This case study describes a 36 year old man who is profoundly deaf and has presented with autistic features. Because his speech behaviors cannot definitely be defined as a particular syndrome or condition, the relationship between speech disorders and auditory processing disorders cannot be examined.
Thacker, R.C., and DeNil, L.F. (1996). Neurogenic cluttering. JOURNAL OF FLUENCY DISORDERS 21, 227-238.
This study involved a 61 year-old woman with acquired symptomatic clutterhng and numerous neurogenic problems. This article describes the test findings and results, and the clinical observations of this woman. Treatment that was used is also explained. This woman's case and others with acquired symptomatic cluttering are compared to idiopathic cluttering.
Theys, C., Van Wieringen, A., & De Nil, L.F. (2008) A clinician survey of speech and non-speech characteristics of neurogenic stuttering. JOURNAL OF FLUENCY DISORDERS. 33:1-23.
The main purpose of this study is to educate the reader on neurogenic stuttering following a survey of 58 Dutch speaking patients with neurogenic stuttering and numerous specialists who have experience within the area of neurogenic stuttering. The questionnaire included the following information: personal and medical information prior to the onset of stuttering; onset of neurongenic stuttering; cause of the stuttering; localization of the neurological injury; disfluency-related characteristics and; co-occurring disorders. This article also gives an in-depth overview of the speech and non-speech characteristics, as well as up-to-date therapeutic techniques to use when working with individuals with this type of stuttering.
Thirumalai, S., Gray-Holland, S., & Shah, N.S. (2007). Are we overlooking Tourette syndrome in children with persistent developmental stuttering? JOURNAL OF PEDIATRIC NEUROLOGY, 5, 111-115.
This article's research was based upon observation of nine severe child stutterers during speaking periods and quiet periods to look at whether tic-like behaviors characteristic of Tourette syndrome (TS) could be differentiated from secondary stuttering behaviors. Results of this article suggest that it might be beneficial for a severe chronic stutterer with tic-like behaviors to have a neurological exam in order rule out TS due to the common co-occurrence of TS and stuttering.
Thomas, C, & Howell, P. (2001). Assessing efficacy of stuttering treatments. JOURNAL OF FLUENCY DISORDERS, 26, 311-333.
This report discusses how to study efficacy studies with a specific discussion on key determinants of efficacy: measurement, treatment integrity and design issues. These determinants are discussed in the scope of stuttering and specifically, a meta- analysis is performed on a using a specified set of criteria on eight stuttering studies performed since 1993 on whether they met the criteria. In most cases, it was found that treatment research did not provide strong experimental evidence.
Throneburg, R., & Yairi, E. (2001). Duration, proportionate, and absolute frequency characteristics of disfluencies: a longitudinal study regarding persistence and recovery. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 38-51.
This study was done to understand the differences between two groups of young children who stutter, those who persist and those who recover. This was done by comparing the groups when they were first evaluated soon after stuttering onset. The primary findings of the study found that soon after onset there were few significant differences in disfluencies between children who persist and those who recovered from stuttering. The study also found that in the very early stage of stuttering, the overall level of stuttering like disfluencies is not an indicator of risk for persistency.
Throneburg, R.N., Yairi, E., & Paden, E.P. (1994). Relation between phonologic difficulty and the occurrence of disfluencies in the early stage of stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 504-509.
The purpose of this study was to determine if the occurrence of disfluencies in preschool aged children is influenced by the phonologic difficulty of the disfluent word. Twenty-four preschool children who stutter were randomly selected from a group of 75 children. Five trained examiners transcribed speech samples for each subject. The results of the study indicated that phonologic difficulty was not an influencing factor on the occurrence of stuttering - like disfluencies.
Tutuncuoglu, S., Serdaroglu, G., Kadioglu, B. (2002). Landau-Kleffner syndrome beginning with stuttering: Case report. JOURNAL OF CHILD NEUROLOGY, 17, 785-788.
Landau-Kleffner syndrome is a childhood disorder resulting in a sudden or gradual loss of receptive and expressive language. It is thought to surface from an epileptic disorder in the auditory-speech cortex. This article looks at a 3:5 year old girl who had begun treatment of seizures with valporic acid and corticotropin (ACTH) at the age of 3:5 months after being diagnosed with benign myoclonic epilepsy of infancy. Her seizures were controlled and her EEG returned to normal. This treatment was discontinued two years after a seizure-free period. Three months after the suspension of the antiepilepsy drugs, she began to stutter. An EEG showed multiple spike and wave discharges. She was then diagnosed with Landau-Kleffner syndrome. ACTH and intravenous immunoglobulin was administered and her speech showed improvement within 2 months and was completely normal after 3.5 months of using the medication. This information proposes that Landau-Kleffner should be a consideration if a child who has had previous epileptic activity, with normal language function begins to stutter. The information from this study also implies that the use of medications can help a child with Landau-Kleffner syndrome discontinue stuttering that may occur.
Van Borsel, J. (1997). Book review of The Neuropsychology of developmental stuttering. JOURNAL OF FLUENCY DISORDERS, 22, 69-70.
Hartman's (1994) book on the etiology of stuttering was "disappointing" to the author of this review. He feels that Hartman's presentation of his neuropsychological theory of stuttering is short on scientific data, and used inaccurate bibliographic listings. The author of this review feels that this book would not be useful in the classroom or to clinicians.
Van Borsel, J. (2006). Fluency in genetic syndromes. BULGARIAN JOURNAL OF COMMUNICATION DISORDERS, 1, 38-50.
Information regarding the association between certain syndromes and stuttering is limited. This article explored the association between several genetic syndromes and stuttering prevalence. The syndromes discussed were Down syndrome, Fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Turner syndrome, neurofibromatosis type I. The most current known information regarding each syndrome is included.
Van Borsel, J., & Eeckhout, H. (2008). The speech naturalness of people who stutter speaking under delayed auditory feedback as perceived by different groups of listeners. JOURNAL OF FLUENCY DISORDERS. 33(3), 241-251.
The purpose of this study was to determine how natural the speech of people who stutter using delayed auditory feedback (DAF) sounded to people who stutter, speech-language pathologists and the naïve listener. There is little past research on the issue of speech naturalness using the DAF, and the results from these studies don't seem to agree. This study used three different groups of judges to compare the way that each group would rate the naturalness of the participant's speech. Although there were differences in the severity of the judge's ratings, overall, the results revealed that the slower a person who stutter's rate of speech was, the less natural it was judged to sound.
Van Borsel, J., Maes, E., & Foulon, S. (2001). Stuttering and bilingualism: A review. JOURNAL OF FLUENCY DISORDERS, 26, 179-205.
This article reviewed the available literature on stuttering and bilingualism. According to the literature, there is some suggestion that stuttering is more prevalent in bilinguals than in monolinguals. In addition, stuttering can affect one or both languages of bilinguals. Studies have shown that when stuttering does occur in both languages, they may be equally affected, but it is more likely that one language is affected more than the other. The article also discussed the diagnostic and therapeutic considerations of bilingual clients who stutter.
Van Borsel, J., & Medeiros de Britto Pereia, M. (2005). Assessment of stuttering in a familiar versus an unfamiliar language. JOURNAL OF FLUENCY DISORDERS, 30, 109-124.
This article investigated how well undergraduate students in the field of communication disorders , who have completed a class in fluency disorders, were able to identify individuals who stuttered and individuals who did not stutter in their native language and in a foreign language. The students and subjects either spoke Dutch or Brazilian Portuguese. Results of the study indicate that the students correctly identified more subjects, and felt more confident in their decision in their native language. Students also gave more detail regarding why they felt a particular subject was a person who stuttered if that individual spoke their native language. Even though students did better in their native language, they were still able to correctly distinguish if a person stuttered or did not the majority of the time in the foreign language. The authors suggested that a clinician must rely on more than just the symptoms of a foreign speaking client. They must use their knowledge about stuttering, such as onset, family history, and emotional or cognitive components. The clinician may also want to include the assistance of a reliable native speaker.
Van Borsel, J., Sunaert, R., & Engelen, S. (2005). Speech disruption under delayed auditory feedback in multilingual speakers. JOURNAL OF FLUENCY DISORDERS, 30, 201-217.
This study compared the effect of delayed auditory feedback (DAF) in a group of normally fluent multilingual speakers to confirm the existence of the language familiarity effect, first hypothesized by Mackay (1970). Mackay stated that multilingual subjects are more likely to speak faster and stutter less under DAF when speaking their most familiar language. A second purpose of this study was to determine whether or not there are any gender differences in DAF effect. Thirty men and women participated in reading tasks with both meaningful and nonsense words in three different languages. Results indicated that subjects required more time per reading task and had significantly more speech disruptions under DAF while using later acquired languages. In addition, reading time and number of speech disruptions was significantly higher for the nonsense tasks for all three languages. These results confirm the existence of the familiarity effect. Significant gender differences in DAF effect were not discovered.
Van Borsel, J., & Tetnowski, J.A. (2007). Fluency disorders in genetic syndromes. JOURNAL OF FLUENCY DISORDERS, 32, 279-296.
Genetic syndromes such as Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome have a primary characteristic of stuttering (fluency disorders) associated with them. Many of these syndromes have other characteristics such as mental retardation, speech and language difficulties, and abnormal physical appearance. Research has closely linked fluency disorders with Down syndrome, fragile X syndrome, Prader-Willi syndrome and Tourette syndrome. For the other syndromes mentioned, the knowledge available is incomplete and unscientific. There is a small amount of data available on the frequency of occurrence and specific disposition of the related fluency disorders. It is often unclear as to how the data was collected, size of sample, type of speech task studied, and the criteria used to diagnose the fluency disorder during many research studies.
Van Borsel, J., Van Coster, R., & Van Lierde, K. (1996). Repetitions in final position in a nine year-old boy with focal brain damage. JOURNAL OF FLUENCY DISORDERS, 21(2), 137-146.
This study investigated a "Dutch-speaking" 9 year-old boy with a history of cerebral head trauma and the repetitions in his speech which occurred at the ends of words, and utterances. As a result of a fall at age 3:10, patient was possibly presented with palilalia. At age 8:11, it was determined that phonology, semantics, syntax, and pragmatics was affected. An unusual pattern of final repetitions of an entire syllable (on polysyllabic words) and the terminal words of utterances was present. However, no disfluencies occurred during repetition tasks or during singing tasks. Presumably, this form of stuttering is neurogenic stuttering.
Van Borsel, J., Van Lierde, K., Van Cauwenberge, P., Guldemont, I., Van Orshoven, M. (1998). Severe acquired stuttering following injury of the left supplementary motor region: a case report. JOURNAL OF FLUENCY DISORDERS, 23, 49-58.
This case study reports on a 69-year-old male who began experiencing "stutterlike speech" at approximately two months post CVA of the supplementary motor region. This client displayed different symptoms of neurogenic stuttering than other similar cases (each syllable of multisyllabic words was affected- including final position; dysfluencies were present during spontaneous speech, sentence repetition, and while reading aloud). The authors presented this case to prove acquired neurologic stuttering caused by damage to supplementary motor region doesn't result in a specific set of symptoms as previously thought.
VanLieshout, P.H.H.M., Peters H.F.M., Starkweather, C.W., Hulstyn, W. (1993). Physiological difluencies between stutterers and nonstutterers in perceptually fluency speech: EMG amplitude & duration. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 55-63.
The purpose of this study was to determine whether or not people who stutter had higher levels of EMG (electromyograph) signals of the orbicular oris and longer EMG durations in their perceptually fluent speech. They also hoped to compare the results of this study with previous similar studies. The study was based on the notion that stuttering has various speech motor aspects. The results replicated the results of many previous studies. The authors found significant differences between stutterers and nonstutterers for EMG amplitude at speech onset as well as for the mean EMG amplitude within a 1000 msec interval. Little differences between the two groups were noted in EMG amplitude before speech onset. The authors concluded that EMG response recording appears to have potential in the differential diagnosis and evaluation of stuttering.
Van Lieshout, P. H. H. M., Starkweather, C. W., Hulstijn, W., & Peters, H. F. M. (1995). Effects of linguistic correlates of stuttering on EMG activity in nonstuttering speakers. JOURNAL OF SPEECH AND HEARING RESEARCH, 38(2). 360-372.
Linguistic factors influencing stuttering, of twelve Dutch male nonstutterers is studied. The researchers look at changes in upper and lower lip integrated electromyographic (IEMG) amplitude and temporal measures, revealing that production of stress, vowel- rounding gestures of words in initial position, longer words, and words in longer sentences, produces IEMG results showing increased speech motor demands.
Van Lieshout, P., Hulstijn,W., & Peters, H. 1996. From Planning to Articulation in Speech Production: What Differentiates a Person Who Stutters From a Person Who Does Not Stutter? JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 3 546-564
The purpose of this study was to compare abilities to assemble, plan and execute muscle plans between people who stutter and people who do not stutter. Subjects were 12 adult male stutterers and 12 adult non-stutters. Results that electromyographic peak timing amplitudes differ in lower and upper lip measures between stutterers and non-stutterers refute claims that stutterers have deficits in abstract motor planning for speech.
Van Riper, C. (1992). Some ancient history. JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 25-28.
The article presents a historical summary of Charles Van Riper's 2- year investigation of the onset of stuttering, where 30 children were studied 2-to-3 times at varying intervals. Van Riper supports the view that children are not misdiagnosed. However, he does not agree with Hamre's assertions that stuttering does not emerge from normal disfluencies-or-that it does not grow in severity.
Van Riper, C. (1992). Stuttering? JOURNAL OF FLUENCY DISORDERS, 17 (1-2) 81-84.
The article presents a historical summary of Charles Van Riper's and Wendell Johnson's search for the cause of stuttering. The two of them acted as "experimental lab animals" during tests that investigated a variety of theories that range from cerebral dominance tests to taking pharmacological drugs. Van Riper relates how they both became disillusioned with the cerebral dominance theory and the primitive therapy that accompanied it then. In addition, Van Riper provides a summary of how each of them had differing attitudes, behaviors, and even ideas about what to call the event known as stuttering.
Vanryckeghem, M., (1995). The communication attitude test: A concordancy investigation of stuttering and nonstuttering children and their parents. JOURNAL OF FLUENCY DISORDERS, 20 (2), 191- 203.
This study challenges use of parents opinion in assessing a child's attitude towards his speech. Fifty five stutterers, ages 6-13, their parents and 55 nonstutterers and their parents estimated the child's attitude toward his/her communication ability. The results showed that the parents of the stutters viewed their child's speech to be worse than the stutterer reported. The parents of the nonstutterers saw their child's attitude more positively than the child themselves viewed it. Parent-child agreement was not achieved at neither the younger (6-9 yrs) nor the older (10-13) age. Based on these results, the author concludes that parents cannot be used to adequately predict the attitude of their child towards his/her speech. The author encourages developing a test that can assess a young child's attitude that does not rely on reading ability.
Vanryckeghem, M. & Brutten, G.J. (1997). The speech-associated attitude of children who do and do not stutter and the differential effect of age. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 6, 67-73.
This study was designed to determine if the attitudes of grade school children who stutter are more negative than their nonstuttering peers. The Communication Attitude Test (CAT) was administered to 55 Dutch-speaking Belgian grade schoolers who stuttered and 55 who did not stutter. The results are consistent with previous CAT studies, in which the attitudes of children who stuttered were more negative than children who did not stutter. It was also found that as children who stutter mature with age, their negative attitudes towards speech becomes increasingly more apparent.
Vanryckeghem, M., & Brutten, G. J. (1996). The relationship between communication attitude and fluency failure of stuttering and nonstuttering children. JOURNAL OF FLUENCY DISORDERS, 21(2), 109-118.
This study investigated grade school stuttering and non stuttering populations to determine the relationship between speech beliefs (attitudes) and fluency failures. The C.A.T. (Communication Attitude Test) was given to 55 age matched Belgian students. Fluency was correlated between 3 oral reading categories and 3 conversation categories. Spearman Rank Order Correlation's indicated that stuttering children held a speech associated belief system that is significantly more negative than their nonstuttering peers. Methods in this study may be beneficial for differential diagnosis, behavior assessment, and therapy determination purposes.
Vanryckeghem, M. & Brutten, G. (2001). IFA news. JOURNAL OF FLUENCY DISORDERS, 26, 349-352.
This paper is a summary of a review by Vanryckeghem and Brutten of determining the reliability and validity of three self-report measures: Speech Situation Checklist (SSC), Behavior Checklist and the Communication Attitude Test (CAT). They found that for the SSC, while both stutterers and nonstutterers report concerns about their speech and fluency failures, the SSC scores for children and adults who stutter are significantly higher than for those who do not stutter. In reviewing the Behavior Checklist, they found that both children and adult stutterers use behaviors! with much greater frequency that help them speak better than those who do not stutter. Finally, in reviewing the CAT, they found a correlation of speech attitude and the severity of stuttering.
Vanryckeghem, M., Brutten, G.J., & Hernandez, L.M. (2005). A comparative investigation of the speech-associated attitude of preschool and kindergarten children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS, 30, 307-318.
This study focuses on the differences in self-perceptions in young children who stutter and young children who don't stutter. The study used 108 children between the ages of three and six, 45 were children who stuttered and 63 were children who did not stutter. The KiddyCAT was used to measure the children's self- reports on the way they perceive the way they talk and the way they think others perceive the way they talk. The purpose was to compare the two groups of children to see if very young children have an awareness of their stuttering and also if they hold any negative attitudes about their speech. The results show that young children who stutter are more likely to report a negative attitude about the way they talk. From the results it can be inferred that children who have negative beliefs about their speech are more aware of the way they talk.
Vanryckeghem, M., Brutten, G., Uddin, N, & Von Borsel, J., (2004). A comparative investigation of the speech-associated coping responses reported by adults who do and do not stutter. JOURNAL OF FLUENCY DISORDERS, 29, 237-250.
This is a comparative investigation looking at the number, frequency, and nature of responses that are employed to cope with the anticipation and/or presence of speech disruption made by those who stutter and those who do not. Stuttering moments are made up of combinations of involuntary speech disruptions (e.g., silent and oral repetitions and prolongations of simple) and voluntary coping responses of avoidance and escape that are secondary to stuttering (e.g., head turn, arm swing, interjection, and circumlocution) rather than part of it. The Behavior Checklist (BCL), a self-report test procedure, was administered to 42 adults who stutter and 76 adults who do not stutter, (all were ages 17 to 50 years old). The stuttering group reported a significantly greater number of speech-associated coping responses (3 SD above the mean) and a greater use of them than in the non- stuttering group. Between-group differences were reported in the type and nature of coping responses. The findings suggest that the difference between those who stutter and those who do not involves more than the number of coping responses, it involves the frequency, the type, and the under lying nature of the coping responses. These differences are potentially useful with respect to differential diagnostic and therapeutic decision making.
Vanryckeghem, M., Glessing, J., Brutten, G., and McAlinden, P. (1999). The Main and Interactive Effect of Oral Reading Rate on the Frequency of Stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY: A JOURNAL OF CLINICAL PRACTICE, 2, 164-170.
The study includes 24 adult participants all previously diagnosed by a speech, language pathologist as persons who stutter. The purpose of the study was to determine if, and to what extent, fluency was affected by speech rate during oral reading. Rate was controlled by "The Paced Reading Program", a computer program which presented the subjects with text at rates 30% slower and 30% faster than their predetermined, normal, reading rate.The results indicated the frequency of stuttering increased significantly in all the participants as the oral reading rate increased from slow to fast and from normal to fast.
Vanrychkeghem, M., Hylebos, C., Brutten, G.J., & Peleman, M. (2001). The Relationship Between Communication Attitude and Emotion of Children Who Stutter. JOURNAL OF FLUENCY DISORDERS, 26:1, 1-15.
This article addressed mal-attitude and negative emotion that stutterers may demonstrate during their act of speaking. The Behavior Assessment Battery (BAB), Communication Attitude Test (CAT) and the Speech Situation Checklist (SSC) are evaluations that assist the clinician in assessing the stutterers behavior, emotion, and interrelated attitude. It is believed that negative attitude of stuttering children increase with age while nonstuttering peers attitude decrease significantly. A study, using the updated CAT, was conducted on 143 young stutterers ages of 7-13 years old. This assessment consisted of 35 questions related to their speech associated attitude and emotional reaction to those responses that were indicative to negative attitude. Its therapist assessed each child individually. The findings point out: (1) There is a strong relationship between mal-attitude and negative emotion among children who stutter. (2) Mal-attitude and negative emotion tend to influence each other. (3) Speech associated mal- attitude of those children who stutter significantly increase with age. (4) There was an increase in both speech associated mal-attitude and negative emotion to a significant extent with age and stuttering severity. (6) There is a need to assess attitude early to avoid increased negative emotion later on. (7) The CAT may also provide as a useful tool in evaluating stuttering severity.
Venkatagiri, H.S. (1999). Clinical measurement of rate and discourse in young adults. JOURNAL OF FLUENCY DISORDERS, 24, 209-226.
Rate of speech has been found to correlate with stuttering because frequency and/or duration of stutters result in reduced speech output. Venkatagiri performed a study to determine the differences in rate during talking about a picture or describing a picture. It also looks at SPM vs. WPM when calculating rate. The study also compared males vs. females and whether or not they differ in rate of reading and discourse. Sixteen college students participated in the study. Each student performed three tasks: description of a picture, talking about themselves, and reading the rainbow passage. The study found that rates of children are much different than those of adults; rates of reading, conversation, and picture description were varied between all ages. Pauses were included when calculating the rates, however, there is some disagreement in this area. The study also found that routine utterances were spoken at a very fast rate.
Venkatagiri, H. S. (2005). Recent advantages in the treatment of stuttering: A theoretical perspective. JOURNAL OF COMMUNICATION DISORDERS, 38(5), 375-393.
This article discussed research performed at the Australian Stuttering Research Center pertaining to two behavioral treatment approaches. The Lidcombe program, meant for children, involves a home-based treatment approach where parents/caregivers are trained to administer verbal praise, request fluent speech after disfluencies, and rate stuttering severity through a ten-point scale upon each day. The Camperdown program, meant for adults, is a systematic approach to nearly stutter-free speech initiating with clinician-directed exercises including modeling slow speech, gentle voice onset, continuous vocalization, etc., and concluding with the ability to self-monitor without specific clinician instructions. Through clinician-directed and client-directed behavior modifications, a program that relies on self-monitoring (cognitively driven speech construction) rather than focusing directly on motorically driven speech construction will provide the client with faster and ongoing success.
Viswanath, N. S., (1989) Global - and Local - Temporal Effects of a Stuttering Event in the Context of a Clausal Utterance. JOURNAL OF FLUENCY DISORDERS, 14, 245-269.
This article had two main purposes. The 1st was to study the total articulation time (TAT), and the total pause time (TPT) and to compare it to the frequency of stuttering events during adaptation. The 2nd was to look at the duration of words near stuttering events in the context of clausal utterances. Four PWS were included in the study: the reduction of TAT and TPT was paralleled with the reduction of stuttering events. It was found that PWS decreased the TAT and TPT more when reading than normal speakers. The 2nd study results are: there are anticipatory and carry over effect near stuttering events and the anticipatory effects were more pronounced that the carry over effects.
Wagovich, S. A., & Ratner, N. B. (2007). Frequency of verb use in young children who stutter. JOURNAL OF FLUENCY DISORDERS, 32(2), 79-94.
This study was conducted to determine whether or not CWS tend to utilize general all-purpose verbs more often than CWNS and if CWS tend to produce a lower frequency of verbs than CWNS. GAP verbs are considered to be simpler to produce and are monosyllabic. 15 school-aged CWS and 15 school-aged CWNS participated in this study. A single conversational sample that occurred between the child and parent(s) was collected and analyzed to determine verb usage for the two groups of children. It was hypothesized that a CWS may have a lexicon of less diversity because GAP verbs are over- used to aid in maintaining fluency. The results of this study, however, indicated that GAP verbs were not produced to a greater extent by CWS than CWNS. CWS did, however, produce a fewer number of different verbs as well as a fewer number of total verbs.
Wahba, H. (2007). Effects of stuttering support groups on the perceived impact of stuttering on adults. JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 2, 20-25.
This exploratory pilot study focuses on determining the efficacy of stuttering support groups based on the total impact scores of 11 people who stutter. The Overall Assessment of the Speaker's Experience of Stuttering (OASES) is used in the assessment of 5 people who stutter who actively attend a stuttering support group and 6 people who stutter who do not attend stuttering support groups. Results proved significant in that PWS who attend SSGs know more about stuttering and the impact it has on their lives, but have a lower quality of life when compared to those PWS who do not attend stuttering support groups.
Wall, M. (1982). Language-based therapies for the young child stutterer. JOURNAL OF COMMUNICATION DISORDERS, 6, 40-48.
Reasons for using language-based therapy to facilitate fluency for young stutterers are given. Connections between language delay, language acquisition, disfluencies, and language complexities, disfluency and constituent structure, and the disfluencies of stutterers and nonstutterers are mentioned. Knowing how language is structured and in which sequences language is acquired as useful ways to facilitate fluency are discussed. Ryan and Van Kirk's therapy program, Gradual Increase in Length and Complexity of Utterance, a behavioral modification approach is discussed. Stocker's (1980) fluency-shaping program, The Stocker Probe Technique, is used to elicit increasing language creativity from the child, providing criterion levels to be reached. Gregory and Hill's more global approach to therapy is introduced. Finally, Wall and Myer's "three factor approach" where psychosocial, physiological, and psycholinguistic factors are remembered in therapy planning, is presented. All of these programs aim to increase the child's fluency by making them manipulate various linguistic variables.
Ward, D. (1992). Outlining Semi-Intensive Fluency Therapy. JOURNAL OF FLUENCY DISORDERS, 17, 4, 243-256
This fluency program, SIFT, is designed to allow more time for the clinician to maintain a normal caseload and for clients to maintain a normal day-to-day life. Clients attend therapy 2 hours, 5 days a week for 3 weeks. Follow-up sessions continue 2 weeks, 4 weeks, 2 months, and then monthly for one year. Results of 4 stutters showed improved fluency across 4 tested speech areas, oral reading, monologue, conversation, and telephone conversation. It is important to remember that the results reflect preliminary information.
Ward, D. (2007) The etiology and treatment of developmental stammering in childhood. ARCH DIS CHILD, 93:68-71.
Past studies have shown stammering to effect 0.75% to 1% of the populations of Great Britain, Australia and the United States, although current research regarding Great Britain suggests stammering is prevalent in as many as 1% to 3% of individuals. This article provides an overview of the etiology of developmental stammering and briefly explains the results of early intervention and spontaneous recovery. The different theories proposed as the origin of stammering are discussed which include genetic components, the faulty auditory feedback processor, linguistic delays, and asymmetric hemispheric activity within the brain. Finally, the different forms of treatment are briefly described for both pre-school and school-aged children.
Watkins, K.E., Smith, S.M., Davis, S., & Howell, P. (2008). Structural and functional abnormalities of the motor system in developmental stuttering. BRAIN, 131, 50-59.
This study compared twelve subjects with developmental stuttering to ten age and sex-matched controls to determine if people who stutter have functional or structural abnormalities in either motor or language areas of the brain, or both when compared to people who do not stutter. The study also included eight more subjects (5 people who stutter and 3 controls) who were scanned with diffuse imaging. The study indicated that people who stuttered showed over activity in the anterior insula, cerebellum and midbrain bilaterally and under activity in the ventral premotor, Rolandic opercular and sensorimotor cortex bilaterally and Heschl's gyrus on the left during speech production, either during fluency or auditory feedback. Previous suggestions of how there is an abnormal function of the basal ganglia or excessive dopamine in people who stutter was supported by this study_ s findings of the over activity in the midbrain. The under activity that was found in this study of the cortical motor and premotor areas are associated with articulation and speech production. This data found in this study supports the conclusion that stuttering is a disorder related primarily to disruption in the cortical and subcortical neural systems supporting the selection, initiation and execution of motor sequences necessary for fluent speech production.
Watkins, R.V. & Johnson, B.W. (2004). Language abilities in children who stutter: Toward improved research and clinical applications. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35 (1), 82-89.
This article states that the differences in the research traditions and methods used in studying child language development and stuttering contributes to the uncertain nature of the literature on the status of language abilities in children who stutter (CWS). The author describes five principles to help gain a clearer picture of the relationship between language and fluency in young children. The five principles include 1) Control variables that are relevant for language development, 2) Use appropriate comparisons, 3) Evaluate language abilities in conjunction with fluency in a longitudinal time frame, 4) Integrate group and individual data in investigating language abilities in young CWS, and 5) Distinguish linguistic influences from language limitations.
Watkins, R., Yairi, E., & Ambrose, N. (1999). Early childhood stuttering III: Initial status of expressive language abilities. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 42, 1125-1135.
This study examined whether or not expressive language ability during preschool years differed for children whose stuttering would become persistent or would cease. Language samples of 1000 words were collected from 84 children, ages 2-5, who stuttered. The samples were analyzed to measure language proficiency. This study provided little information to differentiate those who will have persistent stuttering or will recover. All children were found at similar skill levels. Precocious language development was found to possibly be a risk factor for stuttering. The results from this study show a possibility of varied associations between language proficiency and stutterers over developmental time periods. This holds important implications for future investigating. The continued analysis of young children's language abilities may be informative. Areas that can be researched further include specific linguistic skills of children and the linguistic ability of children who's stuttering has stopped without intervention.
Watson, B. C., & Alfonso, P. J. (1987). Physiological bases of acoustic LRT in nonstutterers, mild stutterers, and severe stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 30, 434- 447.
The purpose of this research study was to investigate the hypothesis that differential physiological deficits underlie mild and severe stutterers' prolonged acoustic laryngeal reaction time (LRT). The study consisted of 2 adult male nonstutterers, 2 adult male mild stutterers, and 2 adult male severe stutterers. Procedures for the study included the collection of respiratory and laryngeal kinematic data during the production of isolated vowels. Results of the study revealed differences in the organization of respiratory and laryngeal events between the mild and severe stutterers. These results suggest that deficits in the respiratory and laryngeal functioning of mild and severe stutterers may be an underlying factor in their prolonged LRT values.
Watson, B.C., Pool, K.D., Devous, M.D., Freeman, F.J., & Finitzo, T. (1992). Brain blood flow related to acoustic laryngeal reaction time in adult developmental stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 555-561.
The investigators interpreted the metabolic (rCBF) measures of brain function findings by identifying patterns of impaired acoustic laryngeal reaction time (LRT) as a function of response complexity parallel to rCBF findings. The stutterer subgroups determined by clinical severity ratings were not differentiated by LRT values as a function of response complexity. Stutterers with relative blood flow asymmetry below and above the normal median relative flow values were compared and presented.
Watson, J.B. (1987). Profiles of stutterers' and nonstutterers' affective, cognitive, and behavioral communication attitudes. JOURNAL OF FLUENCY DISORDERS, 12, 389-405.
The purpose of this study was to profile the affective, cognitive, and behavioral attitudinal dimensions of stutterers' and nonstutterers' communication attitudes and to describe membership characteristics of each profile. The Inventory of Communication Attitudes was completed by 76 stutterers and 81 nonstutterers. Results indicated the existence of six profiles relating to how a person views his/her communication skills, how he/she thinks others view his/her communication skills, and how he/she views his/her own communication skills. Membership in each of these profiles had no specific pattern. Addressing attitudinal characteristics in therapy was addressed as a means to assist the adult stutterer in therapy. Additional longitudinal study into the area of attitude change affected by fluency enhancement and maintenance is recommended.
Watson, J.B. (1988). A comparison of stutterers' and nonstutterers' affective, cognitive, and behavioral self-reports. JOURNAL OF SPEECH AND HEARING RESEARCH, 31, 377-385.
This study compares stutterers to nonstutterers using the Inventory of Communication Attitudes-a new procedure used to examine adult stutterers. The Inventory of Communication Attitudes uses 4 response scale. The first is the affective scale, it rates feelings of enjoyment / hate about speaking in certain situations. The second scale rates speech skills in different situations. The third scale obtains ratings of the perceptions of how most people feel about speaking situations. The final scale, requests ratings of perceptions of most peoples speech skills in specific speaking situations. Results did show that stutterers attitudes of various speaking situations were multidimensional. Two situations differed between stutterers and nonstutterers they were telephone conversations, and unknown group conversations. Results of this study indicate that the attitudes of both groups are multidimensional and similarities and differences exist between stutterers and nonstutterers.
Watson, J.B., Gregory, H.H. & Kistler, D.J. (1987). Development and evaluation of an inventory to assess adult stutterers' communication attitudes. JOURNAL OF FLUENCY DISORDERS, 12, 429-450.
The goal of this study was to develop and evaluate a procedure to assess adult stutterers' communication attitudes. This was undertaken in two phases. Phase I involved the development and administration of an attitude assessment inventory. The inventory was refined following critiquing. This phase was administered to 107 adults who stutter. Phase II involved reassessing the reliability and validity of the inventory and examining the results gathered from the test subjects. This phase was administered to 26 stutterers and 56 non stutterers. Results indicated stutterers' communication attitudes to be more widely scattered over the inventory than nonstutterers' attitudes. This disparity was attributed to differences in severity of stuttering, attitude toward therapy, placement in therapy, perceived communication skills, and perceived effect therapy has on speech production. It was recommended that larger studies use this instrument to test the reliability and validity of this communication attitude inventory.
Watson, P., & Guitar, B. (1986). Respiratory Stuttering? JOURNAL OF FLUENCY DISORDERS, 11, 165- 173.
This article was a case history dealing with a disorder that two brothers encountered. They both were unable to breathe in speaking situations where they felt more stress and pressure was put on them. It is thought that the fear of having an anxiety attack was the cause of the apnea or inability to breathe. Treatment from different psychiatrists was unsuccessful, and no cure was found. It is suggested that this disorder may be a form of respiratory stuttering. These symptoms fit into Van Riper's track III, which is when the speaker has a history of fluent speech but in certain situations tight fixations occur in the area of the speech structures. This is also called "interiorized stuttering." Many treatment approaches are discussed and we are reminded that each person who stutters is different and that there may be many different approaches to treatment.
Weber, C. & Smith, A. (1990). Autonomic correlates of stuttering and speech assessed in a range of experimental tasks. JOURNAL OF SPEECH AND HEARING RESEARCH, 33, 690-706.
Two groups of 19 subjects - stutterers and normal speakers- were assessed for electrodermal activity, peripheral blood flow and heart rate while engaging in 2 speech tasks and 2 non-speech tasks. The authors were attempting to determine if stutterers exhibit abnormally high levels of autonomic arousal for speaking tasks. They were also attempting to determine how autonomic measures during speech compare to measures during other tasks and if extreme increases in sympathetic activity are related to the occurrence and severity of dysfluency in stutterers. Results indicate no difference between the 2 groups in the amount of autonomic activity associated with speech. However, within the stuttering group, more extreme increases in sympathetic arousal were associated with the occurrence and severity of dysflueny speech.
Weber-Fox, C. (2001). Neural systems for sentence processing in stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 44, 4, 814-825.
This article focused on the neurophysiological aspects of language processing in individuals who stutter. This study used an approach for studying language processing that combined recordings of event- related brain potentials with behavioral measures. This study was primarily trying to find out if people who stutter process visual linguistic stimuli for a sentence differently from their fluent peers, even when no speech production is required. The event-related brain potentials were recorded while 9 people who stutter and 9 normally fluent people read sentences silently. The stimuli consisted of 120 sentences: 60 contained final words that violated semantic expectations, and the remaining 60 were semantically correct. The results of the event-related brain potentials supported the notion that people who stutter display unusual neural functions for visual processing of linguistic material when speech production isn't required. Also, the processing differences between people who stutter and those who do not were similar across word classes and semantics.
Weber-Fox, C., & Hampton, A. (2008).Stuttering and natural speech processing of semantic and syntactic constraints on verbs. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH. 51, 1058-1071.
This article hypothesizes that neural processes differ in linguistic tasks for a person who stutters compared to a person with normal fluency. The study used a natural speech listening task and focused on verbs for syntactic and semantic processing constraints. The results indicated that a person who stutters performed similarly on the verb-agreement violations and semantic anomalies task. The syntactic and semantic processing constraints task showed that neural processing tasks for a person who stutters differ than a person with normal fluency.
Weber-Fox, C., Spencer, R.M.C., Spruill, J.E., & Smith, A. (2004). Phonologic processing in adults who stutter: Electrophysiological and behavioral evidence. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 47, 1244-1258.
The purpose of this study was to determine if there are differences in the neural functioning of adults who stutter in non- speech tasks by using a visual rhyming paradigm that combines event-related brain potentials and behavioral measures. The study involved 11 adults who stutter and 11 typically-fluent peers, who were matched on the basis of age (17-44 years), gender and education. The adults who stutter described themselves as very mild-very severe on the Stuttering Severity Instrument for Children and Adults, Third Edition (SSI). The participants were presented with 124 rhyming word pairs and 124 non-rhyming word pairs and instructed to make a judgment as to whether or not the words rhymed. The subjects wore an elastic cap with electrodes to measure brain activity. No significant differences were found between adults who stutter and their peers in event-related brain potentials, though the adults who stutter showed more difficulty when demands of the task were highest, as compared to their peers.
Webster, W. (1989). Sequence reproduction deficits in stutterers tested under nonspeeded response conditions. JOURNAL OF FLUENCY DISORDERS, 14, 79-86.
This study focuses on the ability of stutterers to motorically reproduce sequences with the same accuracy as nonstutterers, without the pressure of being timed. Previous research has produced evidence that the neural systems that help produce "serially ordered manual behavior," (p. 79) such as finger tapping, overlap with the neural systems that produce speech. This may be an indication that stuttering is the result of frontal cortex involvement. In this study participants were asked to tap telegraphic keys in the sequence indicated on a visual screen. Subjects were told that they could take as long as they wanted to respond. The results showed that the stutterers had fewer correct responses than the nonstutterers. These results suggest that time is not the underlying factor in the differences between the stutterers and the nonstutterers. These findings may be an indicator that sole use of rate control in therapy may not lead to significant improvement.
Webster, W.G., & Ryan, C.R.L., (1991). Task complexity and manual reaction times in people who stutter. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 708-714.
This study examined the manual reaction time of 24 people who stutter and compared the results to 24 nonstutterers. The study looked at decision complexity in terms of response time. One procedure involved increasing response choices. In the second procedure initiation and response completion times were compared. Results indicated that people who stutter have slower reaction time than nonstutterers. However, with increasing decision complexity, the two groups responses were parallel. This article concludes that whatever planning or response problem there may be in a stutterer, it is independent of decision complexity.
Weisel, A. & Spektor, G. (1998). Attitudes Toward Own Communication and Toward Stutterers. JOURNAL OF FLUENCY DISORDERS, 23, 3, 157-171
This research study involves investigating attitudes of stutterers of their own stuttering as well as attitudes of stuttering by non-stutterers in an adolescent age group. The study found boys more uncomfortable in attitudes towards stuttering as both stutterers and non-stutterers. Girls were found to be more comfortable in their attitudes toward stuttering, perhaps due to comfort in their own communication attitudes. Girls who stuttered, however, did fit more into the stereotypic view of stuttering, disregarding their own communication attitudes.
Weiss, AL. (1995). Conversational demands and their effects on fluency and stuttering. TOPICS IN LANGUAGE DISORDERS, 15 (3), 18-31.
In this article, the author discusses the demands placed on children while engaging in conversation. For children who stutter, these demands become more problematic when coupled with the maintenance of fluent speech. The connections between conversational demands and fluent speech are explored. Suggestions for the construction of therapy programs addressing these connections are also included.
Weiss, A. L. (2002). Recasts in parents' language to their school-age children who stutter: a preliminary study. JOURNAL OF FLUENCY DISORDERS, 27, 243-266.
The purpose of this study was to examine the recasts of parents whose children stutter and determine how/if it differs in frequency and type from recasts of parents whose children do not stutter. Comparisons of recasts of parents of children who stutter and parents of children who do not stutter did not reveal any remarkable findings of dissimilarity. The most noteworthy finding of the study was a low percentage of disfluencies that served as platform sentences for parents' recasts, suggesting a child's disfluency did not elicit regular attempts by parents to repair their children's disfluent utterances. The authors speculate that parents of children who stutter choose to recast utterances for reasons other than the presence of disfluency.
Weiss, Amy. (2004). Why we should consider pragmatics when planning treatment for children who stutter. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35, 34-45.
This article provides an in depth look at pragmatic language and its importance when considering overall speech and language development for children who speak fluently and especially for children who stutter. SLP's may find treatment in the area of pragmatic language to be a useful addition to fluency activities for children who stutter. The author presents suggestions for several pragmatic activities such as manipulation of conversations and other discourse in ways that can benefit children who stutter. These suggestions follow the traditional therapeutic procedure of gradually increasing the challenge of the tasks presented to the client as treatment progresses. A case description of a 10 year-old child who stutters is also included. The child's therapy program contained a conversational-based focus and included pragmatic language activities.
Weiss, Amy. (2004). What child language research may contribute to the understanding and treatment of stuttering. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, 35, 90-92.
In this clinical forum, the authors demonstrate that communication context, as well as aspects of language learning, are important when considering children who stutter. The authors agree that the development of fluent speech is tied to development in other areas of communication, such as the development of speech- language abilities involving vocabulary, syntax and morphology, phonology, and the ability of children who stutter to use these aspects successfully with a variety of people in many environments. The authors suggest that collection of evaluation and treatment data from children who stutter should be collected in naturalistic settings in addition to a therapeutic setting.
Weiss, A. & Zebrowski, P. (1992). Disfluencies in the conversation of young children who stutter: Some answers about questions. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 1230-1238.
The purposes of this study were to determine the amount that questions or request by parents in conversation elicited disfluencies in young stutterers and which utterances made by the children were especially vulnerable to disfluent production. The results showed that answers to questions were significantly less likely to produce 1 or more disfluencies and that the children were more disfluent on longer more complex structures.
Weiss, A. L., & Zebrowski, P. M. (1994). The narrative productions of children who stutter: A preliminary view. JOURNAL OF FLUENCY DISORDERS, 19 (1). 39-63.
Story retell tasks (once to naive listeners and once to familiar listeners) and story completion tasks were performed by 16 children involved in this study. Of the 16 subjects, 8 were diagnosed as stutterers, and 8 were nonstutterers. Findings of the study indicate insignificant distinctions between length and complexity of tasks by the stutterers and nonstutterers. Noted differences of stuttering subjects include shorter and slightly lower event recall as opposed to the nonstuttering subjects. It is encouraged to obtain and include discourse information in speech and language evaluations of young children who stutter.
Wenker, R. B., Wegener, J. G., & Hart, K. J. (1996). The impact of presentation mode and disfluency on judgments about speakers. JOURNAL OF FLUENCY DISORDERS, 21(2), 147-160.
This study investigated ratings on personality traits between fluent and disfluent speakers (i.e. actors) by 158 under-graduate students. Personality traits were rated on fluent and disfluent speakers when they presented "live" and on audiotape. Results found that disfluent speakers were rated more favorable than fluent speakers on traits including sincere, good sense of humor, friendly, and trustworthy. Disfluent speakers were rated less favorable on traits including fluent, understandable, communicates messages, and not impaired. It was determined that the presence of disfluent speakers did not negatively affect personality ratings. Research in various contexts, during job interviews, and in other socials situations is recommended.
Wertz, R.T. (1993). Adult onset disorders. AMERICAN SPEECH AND HEARING ASSOCIATION, 35, 38-39.
The purpose of this article was to discuss the efficacy of treating adults with aphasia, dysarthria, spasmodic dysphonia, and stuttering. The author suggests three areas that must be addressed when treating adult-onset disorders. The first is methodology: before any treatment is begun, the methods utilized must be researched thoroughly, including critical analysis of all studies. The second is the natural history of the problem; the clinician must know the normal progression of the disorder in order not to provide contradictory treatment. Lastly, the clinician must keep data on the efficacy of their own efforts in order to prevent the reoccurrence of flawed methods & to ensure the recurrence of appropriate methods.
Wieneke, G.H., Eijken, E., Jassen, P., & Brutten, G.J. (2001). Durational Variability in the Fluent Speech of Stutterers and Nonstutterers. JOURNAL OF FLUENCY DISORDERS. 26:1, 43-53.
This article discussed a study that focused on the relationship between timing variability and dysfluency levels. Two measures of dysfluency levels were used in this study (1) percentage of dysfluent words spoken in conversational speech (2) percentage of dysfluent utterances during physiologic testing as the subject repeated simple speech utterances. The results were inconsistent with the hypothesis that durational variability contributes to speech dysfluency, which led to this present study. This study was done to determine if durational variability is associated with dysfluent speech production. The study involved 3 groups, two consisted of adult stutterers and the third was a control group of 16 nonstutterers. Each group was asked to repeat a series of 2 test sentences which appeared on a computer monitor, a minimum of 10 times. A F-J Electronics EG 830 was used to determine the beginning and ending of the voiced segments in each sentence repetition. The speech signal was used to determine the phonemes in each voiced and voiceless segment. The findings indicated: (1) There was only one stuttering group who was able to produce 10 fluent productions, as well as the control group of nonstutterers. (2) This study does not coincide with the hypothesis that variability in speech motor systems is a source factor that contributes to speech dysfluency. (3) It is believed that there continues to be an undetermined mechanism that is responsible for the occurrence of stuttering. (4) It is believed that an increase in speech rate from beginning speech of children to adult speech may require automatization which would involve less sensory motor feedback and focus more on new control strategies that enhance fluency.
Wieneke, G., Janssen, P., Brutten, G. J. (1995). Variance of central timing of voiced and voiceless periods among stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 20(2), 191-203.
This study tested the hypothesis that speech production is dis- rupted when the variability in the speech motor system is relatively excessive. By using electroglottography (EGG), the speech of 24 adult stutterers was assessed in two conditions, at 20% faster and then 20% slower than their normal reading rate. Results indicate that the stutterers did not differ from nonstutterers on three measures of variability; rate, segment transition, and variance related to the timing of the segment. With the hypothesis unsupported, the authors conclude that a slower speech rate has a normalizing effect on the variability in speech production.
Wijnen, F., & Boers, I. (1994). Phonological primary effects in stutterers. JOURNAL OF FLUENCY DISORDERS, 19 (1), 1-20.
Nine stutterers and nine nonstutters were involved in this study. A phonological priming experiment was conducted involving subjects uttering one word from sets of 5 words as fast as possible once presented with a visual cue word. Homogeneous and heterogeneous conditions were applied to trials. Results denote reduction of speech onset in stuttering subjects.
Wilkenfeld, J.R. & Curlee, R.F. (1997). The relative effects of questions and comments on children's stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 6, 79-88.
There is a long standing belief, held by many, that parental interactions with their children contribute to stuttering. This study was designed to determine if adults questions, requests, and comments affect stuttering in children. Three preschool-age boys participated in the study and the results do not support the long standing belief. None of the children's stuttering varied across each condition.
Williams, D. (1982). Coping with attitudes and beliefs about stuttering. JOURNAL OF CHILDHOOD COMMUNICATION DISORDERS, 6, 60-66.
A child's view about his or her talking results not only because of the ways he or she talks, but also because of the reactions of listeners toward the child. Ways the clinician can deal with the classroom teachers, parents, and other key listeners in the child's environment are introduced. This article states that the major goal is to help the listeners see the problem of stuttering from a normal perspective, so that a child will not try to hide his flaws due to being told his speech is ''wrong". It suggests that teachers be calm and direct when working with stutterers. Reasons teachers do not feel comfortable talking with children who stutter are given. Also, means the clinician can use to help the child develop a realistic attitude toward stuttering is included. The importance of a child not "fighting" mistakes is discussed. This behavior should help place him in a more respected position in the verbal communication world.
Williams, D., F. (2006). Using essays in therapy. THE JOURNAL OF STUTTERING THERAPY, ADVOCACY AND RESEARCH, 1, 7-15 http://journalofstuttering.com/ListofArticles.html
This article lists five main ideas which are believed to be essential in the stuttering treatment process. These being: It's OK to feel bad about stuttering, it's OK to feel better about it, too, it's OK to speak (and to stutter), it's OK to modify your speech, and it's OK-no, it's a must-to go elsewhere with new skills. A brief overview of the main ideas is provided, along with a list of available essays to read. The essays included can provide readers with a starting point in the journey of stuttering therapy.
Williams, D. F., & Brutten, G. J. (1994). Physiologic and aerodynamic events prior to the speech of stutterers and nonstutterers. JOURNAL OF FLUENCY DISORDERS, 19(2), 83-111.
Fourteen male stutterers and nonstutterers participated in this study of respiratory-laryngeal-supralaryngeal behavior just prior to voice onset in fluent speech to see if there exists differences between the two groups. Respiratory bellows for abdominal and ribcage movement, EGG, and airflow signals were used to measure 5 dependent variables; respiratory onset locus, peak airflow, the area under the peak airflow curve, a latency period between respiratory onset and laryngeal initiation and a second latency period between peak airflow and the onset of a repetitive EGG wave. The speech task included six CVC and one VC words. The results suggest that stutterers present abnormal coordination among their respiratory structures. Various explanations for these findings and their significance and limitations are discussed.
Williams, D., & Dungan, P. (2002). Administering stuttering modification therapy in school settings. SEMINARS IN SPEECH AND LANGUAGE, 23, 187-194.
Stuttering modification is a treatment approach that is used to treat the speech, emotional, and behavioral aspects of stuttering. It includes the identification of stuttering, desensitization to emotions associated with stuttering, modification of speech, and stabilization of speech skills. This approach is appropriate for the school- aged population due to the disorders involvement in more than just observable speech breakdowns. Stuttering modification goals and techniques are outlined as well as how to implement the program to achieve the highest level of effectiveness through the use of a group setting, involvement of those individuals in the child's life, and measuring progress.
Williams, D.F., and Wener, D.L. (1996). Cluttering and stuttering exhibited in a young professional. JOURNAL OF FLUENCY DISORDERS 21, 261-269.
This purpose of this article demonstrates the effectiveness of techniques used by clutterers and how success may or may not occur with unstable motivation, changing of clinicians and lapses in therapy time. This article discusses the case of an 18-year old male. Assessment and treatment procedures are discussed about this individual.
Williams, HG., & Bishop, JH. (1992). Speech consistency of manual movements of stutterers, articulation-disordered children, and children with normal speech. JOURNAL OF FLUENCY DISORDERS, 17, 191-203.
This study examined the speech and consistency of manual movements of eighteen children from three groups; children who stutter, articulation-disordered children, and children with normal speech. An analysis of average movement time, variability of movement time, and ratios of movement time/total response time were conducted. Results indicated that children with speech disorders at all three ages were significantly slower at executing simple manual movements than children with normal speech. Furthermore, normal and articulatory-disordered children were less variable than children who stuttered in executing simple manual movements.
Wilson, L., Onslow, M., & Lincoln, M. (2004). Telehealth adaptation of the Lidcombe program of early stuttering intervention: five case studies. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 13, 81-93.
This therapy adapted the Lidcombe program to be used via telehealth. Five participants were involved in the case studies. Adaptations made to the Lidcombe program consisted of (1) replacing the clinic visits with scheduled telephone consultations, (2) Omitting real-time measures of percentage of syllables stuttered (%SS), (3) establishing an agreement on severity rating between parents and clinicians, (4) recording parent attempts at implementing verbal contingencies during structured speech, and (6) limited interaction between the clinician and the child. The age range of the participants was 3;5(years;months) to 5;7. All five participants completed stage one of the program. Data for four of the five children is available for stage two. Two of the children scored a mean %SS of less than 1.0 and two of the children scored a mean of below 2.0 at 12 months posttreatment. The number of consultations during this therapy was considerably more than is usually seen in the traditional Lidcombe program suggesting that it is less effective.
Wingate, ME. (1986). Adaptation, consistency and beyond: I. limitations and contradictions. JOURNAL OF FLUENCY DISORDERS, 11, 1-36.
This article attempts to identify and discuss issues with consistency and adaptation. Nine adult males with a mild to moderately-severe stutter were asked to read a 205-word passage five times in succession. Two judges recorded their frequency of stuttering and found that no individual consistencies were significant. The results also indicated that the participants manifested adaptation individually, which fails to support the learning theory of stuttering.
Wingate, ME. (1986). Adaptation, consistency and beyond: II. an integral account. JOURNAL OF FLUENCY DISORDERS, 11, 36-54.
This is the second article concerning adaptation and consistency. The focus is on the loci of stuttering occurrence and what influencing factors are present. Loci, for the purpose of this study, refer to stuttered words. The study further analyzed the previous 205-word reading for frequency of stuttered words in the initial reading of the passage, the relationship between frequency of stuttering and the grammatical complexity. The results discredit the longstanding belief that adaptation and consistency are in support of the learning theory of stuttering.
Wingate, ME. (1987). Fluency and Disfluency; Illusion and Identification. JOURNAL OF FLUENCY DISORDERS, 2, 79-101.
The focus of this article is the idea that the full understanding of the nature of stuttering depends upon the more fundamental understanding of the nature of fluency and the characteristics of disfluency in normal speech. This article identifies and discusses basic contributions of research in the areas of normal speech disfluencies and the disfluencies characteristic of disfluent speech and their relative significance for understanding stuttering, disfluency, and fluency.
Winslow, M., & Guitar, B. (1994). The effects of structured turn- taking on disfluencies: A case study. LANGUAGE, SPEECH AND HEARING SERVICES IN SCHOOLS, 25(4), 251-257.
This study examined the effects of structured conversational turn- taking on the amount and types of disfluencies as well as the speech rate of a 5 year old boy who stuttered. A single subject research design was used. The subject was seen in his home for 15 experimental sessions. Results indicate that the total number of disfluencies decreased during structured turn-taking conditions. The results also show that turn-taking during his family's dinner time resulted in a lower rate of dysfluency for the subject during conversation.
Wittke-Thompson, J.K., Ambrose, N., Yairi, E., Roe, C., Cook, E.H., Ober, C., & Cox, N.J. (2007). Genetic studies of stuttering in a founder population. JOURNAL OF FLUENCY DISORDERS, 32, 33-50.
Several genetic models have been suggested for the inheritance of stuttering within families. This study was conducted using genome-wide linkage and association analyses to determine if genetics played a role in the cause of stuttering. Forty-eight individuals who stuttered and were related to a 232-member pedigree comprised of nine generations were explored in the Hutterite communities of South Dakota. The results did not find a major locus contributing to stuttering and suggest that stuttering is a polygenic disorder, in which several genes of varying effect may increase susceptibility to stuttering.
Wolk, L., Edwards, M.L., & Conture, E.G. (1993). Coexistence of stuttering and disordered phonology in young children. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 906-917.
The purpose of this study was to compare the stuttering, phonological and diadochokinetic behaviors of children with both stuttering and disorders phonology and those children who displayed only one of the disorders. Twenty-one males participated in the study and fell into one of three groups: stuttering with normal phonology (S+NP), stuttering with disordered phonology (S+DP), and normal fluency with disordered phonology (NF+DP). The children were taped during a 30 minute conversation task and also given a 162 word picture naming task to detect phonological errors, and given a diadochokinetic task for sequencing the sounds. Results indicated that the S+DP group had more sound prolongation than the S+NP group. There were no significant differences between the two groups in the other stuttering areas, phonological behaviors or diadochokinetic rates. Implications of the study suggest two types of stuttering: one with and one without disordered phonology.
Wollock, J. (1990) Communication disorder in renaissance Italy: An unreported case analysis by Hieronymus Mercurialis (1530-1606). JOURNAL OF COMMUNICATION DISORDERS, 23, 1-30.
The author of this article contends that the science of speech and language (the physiology, psychology, and pathology) were comprehensively studied in the ancient past. A case report from the 1580's of a young nobleman who suffered from a speech impediment which in modern day would be termed a fluency disorder is discussed. The views, interpretations and general assessment, by the then renowned physician Hieronymus Mercurialis are discussed and an overview of the medical knowledge and beliefs of the times are given. Mercurialis' views on the etiology, prognosis, and treatment of this particular case are discussed and compared to modern day beliefs.
Woods, D., Fuqua, RW, & Waltz, TJ. (1997). Evaluation and elimination of an avoidance response in a child who stutters: a case study. JOURNAL OF FLUENCY DISORDERS, 22, 287-297.
This case study's focus is on a 6-year-old male with cerebral palsy. Efforts were undertaken to treat his stuttering by reducing the avoidance response "I don't know" he commonly used in response to conversational questions. Simplified Habit Reversal (SHR) techniques were added to the previous phase of reduction treatment. Expectations included seeing a decrease in stuttering and a low level of the avoidance response. Baseline conditions were implemented and then movement toward treatment progressed. Reliability was assessed with replication of these conditions. Extinguishing with differential reinforcement of alternative behavior (DRA) was followed. The result was that "I don't know" was decreased. Speech rate and stuttering both increased. Stuttering was reduced and low rates of avoidance were maintained when SHR techniques were implemented. Initially, when baseline was reversed, the 6-year-old avoided stuttering at high levels, thus stuttering less. Those occurrences reversed, however, as stuttering continued. When the SHR method was used once again, the boy stuttered less and used fewer avoidance measures. Concerns with the study are included as are future issues to address with research.
Yairi, E. (1993). Epidemiologic and other considerations in treatment efficacy research with preschool age children who stutter. JOURNAL OF FLUENCY DISORDERS, 18, 197-219.
This articles purpose is to highlight several factors to be considered in treatment efficacy research with preschool-aged children who stutter. The author reviews recent research findings that present the onset and characteristics of early childhood stuttering as more complex than has been previously thought. The article also focused on epidemiologic data with reference to recent genetic and longitudinal findings as well as possibilities for subgrouping. The authors conclusion is that the fast rate of recovery dictates rigid control of the recovery factor in studies of treatment efficacy and that all research of preschool-aged children who stutter should control age and post-onset interval.
Yairi, E. (1996). Letters to the editor: Applications of disfluencies in measurements of stuttering. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 402-403.
In Yairi's letter to the editor, he discusses an issue regarding the use of disfluency schemes in definitions and measures of stuttering. He reports that Cordes and Ingham's Research Note (1995) posed an important argument that not all within-word disfluencies are necessarily "stuttering" and that sometimes between-word utterances are perceived as stuttering. Yairi discusses the semantic implications of this as it pertains to normal speakers as well as his reservations regarding the "content" of this category. He states that if within-word disfluencies continue to be labeled as "stuttering", investigators may find themselves having to report the frequency of stuttering in the speech of their normally speaking subjects and that studies which do not specify monosyllabic word repetition patterns of its subjects may influence the credibility and generalizability of the outcomes. Yairi concludes by persuading the reader that not all disfluencies of persons who stutter are necessarily "stuttering" and that developing proper taxonomy for disfluent phenomena for both normal and disordered would be advantageous.
Yairi, E. (1998). Is the basis of stuttering genetic? ASHA, 29-32.
This article provides an overview of previous studies conducted to determine the relationship between stuttering, genetics, and the environment. Yairi concludes that at least a part of stuttering is genetic. By looking at genetics, Yairi hopes to find more specific data to establish criteria for early prognosis to determine if a child will become a chronic person who stutters or if the child will recover without intervention. The goal of current research is to find a specific gene which is linked to stuttering; however, Yairi points out that once a gene is discovered, the work is just beginning. The actual roles that a gene plays are still unknown. Yairi contends that once genetics are determined some of the questions concerning stuttering will be answered.
Yairi, E. (2004). The formative years of stuttering: A changing portrait. CONTEMPORARY ISSUES IN COMMUNICATION SCIENCES AND DISORDERS,31, 92-104.
This article discussed a longitudinal study that was done at the University of Illinois Stuttering Research Program, which focused on pre-school children. From their research they found out a lot about stuttering that contradicted previous beliefs. The study found that the age in which stuttering begins is younger than previously thought, with the average age being 33 months. The study also showed that onset was sudden, between a day or two, which also contradicted previous theory that stuttering is gradual. The condition in which stuttering begins was also addressed, and it was found that about 50% of the time it came after uneventful situations, but 50% started after stresses. This study also looked at awareness of dysfluency, secondary characteristics, language, cognitive abilities, phonology, motor speech, and genetics. The study found a lot of useful information in regards to childhood stuttering.
Yairi., E. (2007). Subtyping stuttering I: A review. JOURNAL OF FLUENCY DISORDERS, 32, 3, 165-196.
"The objectives of the current article are to (a) highlight the motivation for identifying sub-types of stuttering, (b) outline the issues involved in researching subtypes, and (c) address the question of whether or not subtyping is plausible for this disorder." To review past ideas of subtyping, the article concentrates on seven categories that reflect the author's theoretical or experimental approaches. These categories are: general etiology, prominent stuttering phenomena, reactions to drugs, biological characteristics, concomitant disorders, developmental course, and multiple variables. The seven categories also serve the purpose to present the research problems and challenges. This article concluded that there is a potential lead for distinguishing subtypes for early childhood stuttering, but research is still lacking evidence that is important to the nature of stuttering. It is recommended in the future studies to include multiple factors in the information collecting process, especially with young children.
Yairi, E., & Ambrose, N. (1992). A longitudinal study of stuttering in children: A preliminary report. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 755-760.
The purpose of this paper was to report preliminary information about general longitudinal trends and individual longitudinal information of disfuency for preschool children who stutter. Twenty-seven children who stutter were involved in the longitudinal study. The children were divided into treated and untreated groups. The results indicated that there were no differences between the two groups in the amount of disfluency. The untreated group had decrease of disfluencies. The data of individual's showed that stuttering is not uniform, 1/3 of the subjects continued to stutter after the first two years of the study.
Yairi, E. & Ambrose, N. (1992). Onset of stuttering in preschool children: Selected factors. JOURNAL OF SPEECH AND HEARING RESEARCH, 35, 782-788.
The purpose of this study was to examine the onset of stuttering in relation to gender, age, genetic background, stress, type of onset and stuttering severity. Eighty-seven children who stutter were the subjects of the study. The results showed a 2:1 male to female ratio and the greatest risk for beginning stuttering is under age 3 (75% of the risk is before 3 1/2 years old).
Yairi, E. Ambrose, N., & Niermann, R. (1993). The early months of stuttering: A developmental study. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 521-528.
This study was done in an attempt to follow the progression of stuttering in 16 preschoolers whose stuttering was discovered several weeks after onset. The authors considered the study quite valuable due to the relatively few studies available in the literature dealing with the early months of stuttering due to parent's tendency to postpone evaluation until later in the course of the disorder. Results indicated that early stuttering is much more severe than previously thought. The authors discovered secondary behaviors accompanying stuttering behaviors such as facial and head movements. The children were discovered to be in the moderate to severe severity rating, but the authors recognized that parents of these children may be more apt to have their child evaluated. In follow-up studies, it was determined that none of the children involved in early treatment were in need of therapy at any time after Tx, providing impetus for early identification.
Yairi, E., & N. Ambrose (1999). Spontaneous recovery and clinical trials research in early childhood stuttering: a response to Onslow and Packman. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 42, 402-409.
Yairi and Ambrose replied to a critique by Onslow and Packman (see under Onslow and Packman). They claim that Onslow and Packman failed to look at critical aspects of treatment. Instead the two focused on whether or not a complete cure has been obtained instead of whether or not it is their treatment that brought about the change rather than subject characteristics, spontaneous recovery, or other factors. Yairi and Ambrose defend their previous research and state that Onslow and Packman jump to some incorrect conclusions. The authors agree that many environmental factors may play a role in recovery without treatment, however they have yet to be identified. They claim that Onslow and Packman made an unfair comparison between two different research methods, misread previous findings, applied double standards in evaluation of research, and set up their own rules as to what constitutes appropriate research.
Yairi, E., and Hall, K.D. (1993). Temporal relations within repetitions of preschool children near the onset of stuttering: A preliminary report. JOURNAL OF COMMUNICATION DISORDERS 26, 231-244.
This study involved 15 children who stutter and 18 children who do not stutter. All subjects were under the age of five. This study was done to compare duration characteristics of single repetitions of single-syllable words. The results showed that very early stutterers have an inclination for faster repetitions than the repetitions in nonstuttering children.
Yaruss, S. (1997). Utterance timing and childhood stuttering, JOURNAL OF FLUENCY DISORDERS, 22, 263-286.
In this article, speaking rate and response time latency were discussed at length as they are believed to be crucial components to determine whether stuttering will occur in an utterance. Little empirical evidence is available at the time to suggest that these methods of timing are correlated to stuttering. Twelve boys who stutter (mean = 55.2 months) were considered in this study based on their conversational speech. The relationship between articulatory speaking rate and response time latency was examined in the 30- minute conversational interactions these boys had with their mothers. Seventy-five utterances were selected from each child's speech sample and discriminant function analyses were completed on them. From this information, it was determined if the articulatory speaking rate or response time latency of a certain utterance made it more likely for the child to stutter on that utterance. Findings for each of the subjects showed no significant relationships between these utterance timings and stuttering. Also, no significant difference between both means of utterance timing was discovered. Thus, these findings do not support the speculation that articulatory speaking rate and response time latency help determine if stuttering will happen in a certain statement. Future such studies should be done taking into account linguistic complexity and its relationship to utterance timing and childhood stuttering.
Yaruss, J.S. (1997). Clinical implications of situational variability in preschool children who stutter. JOURNAL OF FLUENCY DISORDERS, 22(3): p187-203.
This is a study that examines variability in the number of disfluencies produced by 45 preschool children who stutter. Five different speaking situations were used. The situations used were; parent-child interaction, play with clinician, play with pressures imposed, story retell, and picture description. The results of the study indicated that significant differences were found between the five different speaking situations. Variability was greater between the speaking situations then with in a single speaking situation. The play with pressure situation yielded the highest number of disfluencies though subjects patterns of variability were highly individualized. Children who had a higher number of "less typical" disfluencies also had a significantly higher degree of variability. This study shows the importance of evaluating a child's speech in different speaking situations. In doing this the clinician can gain a better understanding of the child's stuttering and the true extent of the stuttering will not be overlooked.
Yaruss, J.S. (1998). Describing the consequence of disorders: Stuttering and the international classification of impairments, disabilities, and handicap. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 41, 249-257.
The International Classification of Impairments, Disorders, and Handicaps (ICIDH) could be used effectively to describe stuttering; however, the current definitions of impairment, disorders, and handicaps do not accurately apply to stuttering. This article presented three definitions which apply specifically to stuttering and are more consistent with ICIDH. The new definitions presented could improve understanding about stuttering, help evaluate treatment outcomes, and help other clinicians, researchers, and professionals communicate more effectively. If the ICIDH would adopt these definitions as proposed in this article, the author argues that stuttering would benefit from the improved clarity of terms and consistency across professions.
Yaruss, J.S., (1998). Real-Time Analysis of Speech Fluency: Procedures and Reliability Training. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 7, 2, 25-37.
This article explained the procedures for using real-time analysis (collecting data about clients actual speech in real time) for assessing a client's progress. Two items that it measures are the frequency of dysfluencies and the types of dysfluencies. The reliability and consistency of such measures are of great concern to clinicians and researchers. It reviews important issues to remember while conducting real-time analysis such as ensuring that the speech sample obtained is representative of the client's speech and also that it is acceptable for the clinician to "miss" some words. There are two primary dysfluency count sheets discussed: the Vanderbuilt Form and the Northwestern Form. Specific issues and concerns are presented such as how to code: dysfluencies containing multiple iterations, dysfluencies that may include several words, multiple types of dysfluencies on a single word or phrase, lexicalizes phrases (two words produced as a single unit), repeated utterances that may not be dysfluent, "toy noises", nonrepresentative utterances, and how to use other symbols. Also discussed were the topics of intrajudge and interjudge reliability.
Yaruss, J. Scott (1999). Current Status of Academic and Clinical Education in Fluency Disorders at ASHA-Accredited Training Programs. JOURNAL OF FLUENCY DISORDERS, 24, 3, 169-183
This article addresses concerns regarding graduate training programs and the limited or lacking requirements of coursework in fluency disorders (i.e. stuttering). Previous research has indicated the attitude by many speech pathologists that they feel unprepared in treating fluency disorders. This study provides information further supporting the attitude that graduate students may not be adequately prepared, which is reflected both academically and professionally, suggesting this as an area of coursework that needs more, not less, attention.
Yaruss, S. (1999). Utterance Length, Syntactic Complexity, and Childhood Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH, 2. 329-344.
The purpose of the study was to determine whether utterance length and syntactic complexity are related to the likelihood of stuttering in the conversational speech of children who stutter. Twelve male subjects who stuttered, ranging in age from 40 to 66 months, served as subjects. The subjects and their mothers were video and audio taped during free play and a 75- utterance conversational speech sample was extracted for assessment of fluency, utterance length, and syntactic complexity. Utterances that were disfluent but not stuttered, nonsensical, elliptical, formulatic, or fragmented were not used. Results concluded stuttered utterances are likely to be longer and more syntactically complicated than fluent utterances. The study also sought to determine which factor (utterance length or syntactic complexity) had the greatest influence on stuttering. Results showed utterance length was the more important factor in determining whether an utterance would be stuttered.
Yaruss, J.S. (2000). Converting between word and syllable counts in children's conversational speech samples. JOURNAL OF FLUENCY DISORDERS, 25, 305-316.
Discussion among researchers and clinicians has been raised regarding whether clinical measurements, such as frequency of disfluencies, should be made in terms of words or syllables. It can be difficult to compare results when different measures are implemented. As a child's language becomes more complex and vocabulary expands, a reliable means of converting between word and syllable measures may be increasingly difficult. The subjects in the study engaged in a thirty-minute conversational speech task. A ratio for converting between length of utterance in syllables and words was established. Results indicate a ratio of 1.15 syllables per word can yield a more accurate conversion between length of utterance in words and syllables of young children.
Yaruss, J. (2002). Facing the challenge of treating stuttering in the schools. SEMINARS IN SPEECH AND LANGUAGE, 23, 153-157.
The fears and incompetencies felt by school-based clinicians are addressed in this article. It offers the school-based clinician advice on identifying some of the challenges of treating a child who stutters and how to address these challenges effectively. Stuttering treatment can be provided to a child in a school setting with complete confidence. This article offers information to ease the clinicians fears and tips to help her get started in assessing and treating the child who stutters.
Yaruss, Scott J. (2003). One size does not fit all: special topics in stuttering therapy. SEMINARS IN SPEECH AND LANGUAGE, 24, 3-6.
One of the most apparent challenges clinicians confront when working with a child who stutters in the schools are the many differences the child displays in regards to behaviors and reactions to the stuttering. Individuals stutter in their own ways. Because of this, different treatment strategies work for different people. The purpose of this article is to provide adequate information regarding topics about locating resources directed toward meeting the needs of children, especially those with special needs. It also provides beneficial information for clinicians for developing plans for working with parents and teachers.
Yaruss, JS. (2004). Documenting individual treatment outcomes in stuttering therapy.CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS, 31, 49-57.
This article is about the measurement and evaluation of treatment outcomes. In recent research on stuttering, this has been one of the most talked about aspects. Recently, more people, including clients and clinicians, have begun to question whether or not stuttering therapy is valuable. Yaruss lists some factors to take into consideration when trying to determine whether or not treatment is effective, some factors that complicate the process of determining whether or not treatment is working and some less tangible factors to consider when looking at the effectiveness of therapy with people who stutter. Yaruss concludes the article with some suggestions to help clinicians and researchers remember that it is important to take into consideration individual differences when developing and evaluating treatment outcomes for people who stutter.
Yaruss, J.S., Coleman, C., & Hammer, D. (2006). Treating preschool children who stutter: Description and preliminary evaluation of a family-focused treatment approach. LANGUAGE, SPEECH & HEARING SERVICES IN SCHOOLS, 37, 118-136.
This article focuses on family-centered treatment for preschoolers who stutter and discusses attitudes and reactions that both children and parents have in response to stuttering. Seventeen children who stutter and their families attended six to eight sessions, 45 minutes in length either once per week or every other week. The program can be divided into three sections: education and counseling, communication modification training, and review and re-assessment. Education and counseling consisted of 2 to 4 sessions and encouraged and prepared parents to be active participants in the therapy process. Communication modification consisted of 3 sessions with the purpose of helping parents learn how to facilitate fluent speech from their child. Review and re-assessment consisted of the clinician reviewing treatment strategies so that parents appropriately use their newly learned techniques. Assessments were achieved through direct speech fluency evaluations, a parent questionnaire, and long-term follow-up. Results indicate that the program enabled families to learn more about fluency facilitating strategies and that all participants achieved measurable success during the long-term follow-up. The conclusion of this study is that this treatment approach promoted improved fluency, more effective communication abilities, and more positive communication attitudes.
Yaruss, J.S., & Conture, E.G. (1993). F2 transitions during sound syllable repetitions of children who stutter and predictions of stuttering chronicity. JOURNAL OF SPEECH AND HEARING RESEARCH, 36, 883-896.
The purpose of this study was to assess whether there are acoustic differences in F2 transitions that are associated with the speech disfluencies of children who stutter and are at a low risk of continuing to stutter vs. those children at a high risk of continuing to stutter into adulthood without intervention. Thirteen children participated in the study and were placed in either at low risk / high risk groups. Each child was audio/video taped for 30 minutes in conversation. Ten of the sound/syllable repetitions (SSR) were acoustically analyzed to determine if differences of F2 transitions were present. The results found that children who stutter produce F2 transitions that are absent or unmeasurable. In the low risk children, stuttered F2's were shorter than fluency transitions.
Yaruss, J S., & Conture, E.G. (1995). Mother and child speaking rates and utterance lengths in adjacent fluent utterances: Preliminary observations. JOURNAL OF FLUENCY DISORDERS, 3, 257-278
The purpose of this study was to examine the relationships between naturally occurring variations in parent and child speaking rates and utterance lengths in adjacent fluent utterances. The authors wanted to determine if changes in parents' speech characteristics were followed immediately by similar changes in the children's speech characteristics. One of the most interesting findings in this study was that the greater the difference between mother and child speaking rates in adjacent fluent utterances, the greater the child's stuttering severity. The authors suggest that helping parents Improve the "synchrony" between their child's and their own speaking rates may help reduce the severity of their child's stuttering. Furthermore, they suggest that examiners may take into consideration the speaking rate of a child's conversational partner when measuring the child's stuttering severity and, perhaps, base stuttering severity judgments on samples of children speaking with conversational partners using various speaking rates.
Yaruss, J. S. & Conture, E.G. (1996). Stuttering and phonological disorders in children: Examination of the Covert Repair Hypothesis. JOURNAL OF SPEECH AND HEARING RESEARCH, 39, 349-364.
The purpose of this study was to evaluate if the Covert Repair Hypothesis, a theory designed to account for the occurrence of speech disfluencies in adults who stutter, can also account for selected speech characteristics of children who stutter who also demonstrate disordered phonology. The Covert Repair Hypothesis is reported to be based on the assumption that disfluencies occur as a by-product of the speakers internal detection and repair process of thoughts prior to being spoken. Disfluencies occur when these covertly repaired errors are overtly produced. It is thought that this theory can be applied to children and it is suggested that children who stutter may demonstrate an impairment in their phonological encoding mechanism that, when combined with a tendency to use rapid articulatory rates or short response time latencies, might not permit sufficient time for their phonological encoding mechanisms to make appropriate selections of target phonemes. Children's speech production during picture naming and conversational speech was evaluated and it was determined that, although speech disfluencies may not represent by-products of self-repairs or systematic speech errors produced during conversational speech, self-repairs of nonsystematic speech errors may be related to children's production of speech disfluencies.
Yaruss, JS.; LaSalle, LR.; Conture, EG. (1998). Evaluating Stuttering in Young Children: Diagnostic Data. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, 7: 4, 62-73.
This is a study of 100 children, ranging in age from 2 years old to 6 years old looking at relationships between speech, language, and related behaviors that are exhibited during an initial evaluation. The children were referred by their parents who were concerned that their child was at risk for stuttering. Results showed that the children recommended for treatment had significantly higher scores on all fluency diagnostic measures, than the children recommended for reevaluation or for neither treatment or reevaluation. It was also noted that a proportion of the children evaluated had other difficulties with language, phonology, and/or oral motor skills. The authors also provide some benchmarks from their study to provide clinicians with something to compare their own treatment recommendations to.
Yaruss, S., Max, M., Newman, R., and Campbell, J., (1998). Comparing Real-Time and Transcription Techniques for Measuring Stuttering. JOURNAL OF FLUENCY DISORDERS, 2, 137-151.
The purpose of this study was to compare the results from two different speech disfluency counting techniques. The first involved a transcript based technique called "Systematic Disfluency Analysis" (SDA), in which the clinician prepares a detailed orthographic transcription and notes the occurrence of all speech disfluencies. The second method was a real-time technique in which the clinician marks all fluent words spoken with a dash or dot and all disfluent words with an abbreviation indicating the type of disfluency. For this study, fifty audio/video taped recorded speech samples were analyzed. The results suggested the frequency of more typical and less typical disfluencies obtained during the transcript-based method were very similar, but not identical, to those obtained from the real-time analysis. Substantially different severity ratings were evident in 2 of the fifty speech sample analyses.
Yaruss, J.S., Newman, R., & Flora, T. (1999). Language and disfluency in nonstuttering children's conversational speech. JOURNAL OF FLUENCY DISORDERS, 24, 185-207.
This study examined the relationship between syntactic complexity, utterance length, and disfluency in spontaneous speech. The purpose of the study was to determine if there was a relationship between language formulation and the production of speech disfluencies. The study consisted of 12 normally fluent children. The children were videotaped during 30 minutes of spontaneous speech, which consisted of 50 consecutive, completely intelligible utterances. The utterances were evaluated for speech fluency, utterance length, and syntactic complexity. It was found that disfluent utterances were longer and more complex than fluent utterances. There are current theories of stuttering that correlated with the findings of this study. It can be hypothesized from this study that utterance timing or other aspects such as pragmatics may influence whether or not an utterance will contain a disfluency.
Yaruss, J., S., Quesal, R., W. (2004). Partnership between clinicians, researchers, and people who stutter in the evaluation of stuttering treatment outcomes. STAMMERING RESEARCH, 1, 1- 15. Retrieved from http://www.stamres.psychol.ucl.ac.uk
It has been emphasized that there is a need to better understand the results of stuttering treatment by numerous authors. This paper includes key questions about stuttering treatment outcomes and research and attempts to explain each. There is need for more research and collaboration between people who stutter, scientists, and clinicians working together to share their ideas and opinions of stuttering therapy. This paper serves as a starting point for others to begin a discussion about the future of treatment outcomes.
Yaruss, J. Scott, & Quesal, Robert W. (2006). Overall Assessment of the Speaker's Experience of Stuttering (OASES): Documenting Multiple Outcomes in stuttering Treatment. JOURNAL OF FLUENCY DISORDERS, Volume 31, issue 2, 90-115
The purpose of this article was to develop a new assessment tool that would look at the intrinsic factions of the stuttering disorder. It gives the rationale behind the assessment design and the validity and reliability of the assessment tool. The OASES is to assess the overall impact of stuttering as it relates to the speaker's self perception of fluency, stuttering, and speech naturalness as well as the speakers knowledge and overall attitude of stuttering. The assessment has four parts: Section 1: Overall Information, Section II: Your Reactions to Stuttering, Section III: Communication in Daily Situations and Section IV: Quality of Life. It is hoped that this tool will help continue the data collection of the affective component of stuttering and outcomes of the therapy process.
Yaruss, J. S., Quesal, R. W., Murphy B. (2002) National Stuttering Association members' opinions about stuttering treatment. JOURNAL OF FLUENCY DISORDERS, 27, 227-242.
Two-hundred members of the National Stuttering Association completed a brief questionnaire covering topics such as self-referral practices, resources for people who stutter, early intervention, and opinions about treatment for children and adults. Survey results are useful for SLPs, physicians, employers, and anyone else wanting to gain a better understanding of people who stutter.
Yaruss, J.S., Quesal, R.W., Reeves, L., Molt, L.F., Klutz, B., Caruso, A.J., McClure, J.A., & Lewis, F. (2002) Speech treatment and support group experiences of people who participate in the National Stuttering Association. Journal of Fluency Disorders, 27, 115-134
This study surveyed 71 people who are members of the National Stuttering Association (NSA). The survey questions included therapy experiences as well as participation in group activities.
Yaruss, Scott J., Reardon, Nina A., (2003). Fostering generalization and maintenance in school settings. SEMINARS IN SPEECH AND LANGUAGE, 24, 33-40.
Speech language pathologists in school systems encounter challenges in helping children generalize skills learned in the therapy room to other settings. The article summarizes four areas: goals of therapy, treatment strategies that insist upon generalization, scheduling/implementing of generalized activities within the overall therapy process and the child's understanding of the treatment goals and strategies that should be used. This article focuses on the broad based viewpoint of stuttering to help children improve their communication skills in a variety of settings and over time.
Yaruss, J. & Reardon, N. (2002). Successful communication for children who stutter: finding the balance. SEMINARS IN SPEECH AND LANGUAGE, 23, 195-203.
The ultimate goal of speech therapy is communication, or the process of conveying a speaker's intent to the listener. This paper's purpose is to present an approach to stuttering therapy that is based on the view that the foremost purpose of therapeutic intervention with children who stutter is not just to improve fluency or change stuttering, but to support and enhance a child's ability to communicate by achieving a balance between a variety of approaches and goals. It aids the clinician in forming an approach uniquely balanced for each individual child to increase fluency, reduce negative consequences of stuttering, and improve pragmatic skills for the child to communicate with complete confidence.
Yeakle, M.K. & Cooper, E.B. (1986). Teacher perceptions of stuttering. JOURNAL OF FLUENCY DISORDERS, 11, 345-359.
Children who stutter are greatly affected by the attitudes of significant people in their lives, including their teachers. The Teachers' Perceptions of Stuttering Inventory (TPSI) was given to public school teachers to assess their attitudes toward stuttering. 521 teachers responded to ten different statements by expressing how strongly they agreed with each statement. A significant amount of the teachers demonstrated inaccurate beliefs concerning the etiology of stuttering and also the personality characteristics of people who stutter. These beliefs are seen less often in teachers who have either had classroom experience with people who stutter or have completed coursework in the area of communication disorders. The results illustrate the need for teachers to receive education and information regarding stuttering.
Yovetich, W., Leschied, A., & Flicht J. (2000). Self-esteem of school- age children who stutter. JOURNAL OF FLUENCY DISORDERS, 25, 143-153.
The researchers assessed the self-esteem (SE) of 25 elementary school children who stuttered (CWS). 5 dimensions of SE were measured to include: total SE, general SE, social SE, academic SE and parent-related SE. As compared to normative data, from Battle's 2nd edition of the 1992 Culture Free Self-Esteem Inventory, this study showed no differences on these five SE dimensions.
Young, M.A. (1994). Evaluating differences between stuttering and nonstuttering speakers: The group difference design. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 522-534.
The author of this paper describes the limitations of group difference studies and details alternate measures that can be used as a supplement. The main limitation of group difference design's include: 1) difficulty matching subjects, 2) emphasis on differences rather than strengths, and 3) a lack of random sampling. The alternative measures described by the author are variation accounted for, confidence interval for the difference between groups means, and proportion misclassified.
Zackheim, C. T., & Conture, E. G. (2003). Childhood stuttering and speech disfluencies in relation to children's mean length of utterance: a preliminary study. JOURNAL OF FLUENCY DISORDERS, 2, 116-142.
The purpose of this study was to examine the influence of utterance length and complexity relative to children's mean length of utterance (MLU) on stuttering-like disfluencies for children who stutter (CWS) and nonstuttering-like disfluencies for children who do not stutter (CWNS). Participants were 12 children 6 CWS and 6 age- matched CWNS, with equal numbers in each talker group exhibiting MLU from the lower to the upper end of normal limits. Data were based on audio-video recordings of each child conversational interactions and analyzed in terms of each participant's utterance length, MLU, frequency and type of speech disfluency. Results indicated that utterances above children's MLU are more apt to be stuttered of disfluent and that both stuttering-like as well as nonstuttering-like disfluencies are most apt to occur on utterances that are both long and complex. These findings were taken to support the hypothesis that the relative "match" or "mismatch" between linguistic components of an utterance and a child's language proficiency influences the frequency of the child's stuttering/speech disfluency.
Zebrowski, P. (1991). Duration of the speech disfluencies of beginning stutterers. JOURNAL OF SPEECH AND HEARING RESEARCH, 34, 483-491.
The subjects consisted of 10 children who stuttered, and 10 controls, matched for age and sex. There were 9 boys and 1 girl in each group, with a mean age of 4.1 years. The children were both audio and video taped during an informal 45 minute interaction with their mothers. Similarities between the two groups within 12 months of stuttering onset included: average duration of sound/syllable repetitions, and sound prolongation. In addition, the average number of repeated units of sound/ syllable and whole- word repetitions were not significantly different between the two groups. Differences included: overall frequency, and proportion of disfluency types.
Zebrowski, P.M. (1994). Duration of sound prolongation and sound/ syllable repetition in children who stutter: Preliminary observations. JOURNAL OF SPEECH AND HEARING RESEARCH, 37, 254-263.
The purpose of this study was to measure the duration of sound prolongations and sound/syllable repetitions produced in the conversational speech of school-aged children who stutter. Also of interest was the number of repeated units per repetition and the rate of each repetition. Fourteen children with a mean age of 8:2 were included in the study. A 300 word conversational speech sample was recorded and analyzed for each subject. The average rate of speech was 107 wpm and the average duration of prolongations was .75 seconds. Forty-six percent of all disfluencies were sound prolongations with a 4:1 ratio of prolongations to repetitions. The author concluded that the duration of sound prolongation and the duration and rate of repetitions can provide important diagnostic information.
Zebrowski, P. M. (1995). The topography of beginning stuttering. JOURNAL OF COMMUNICATION DISORDERS, 28, 75-91.
The need for tools to assist in early identification of stutters is increasing as clinicians work to prevent the development of long term stuttering. This paper reviews research that investigates the salient features of early stuttering. Recommendations and cautions are provided. The seven features discussed include: 1) frequency, 2) type and proportion of speech disfluencies, 3) changes in frequency and distribution of disfluencies over time, 4) the absolute duration of instances of stuttering, 5) the number of repeated units, 6) temporal aspects of repetitions, 7) and associated nonspeech behaviors. Findings suggest that there is considerable overlap of features in young stutters and nonstutters, but careful analysis of frequency, proportion and duration, and associated behaviors can reveal between group and within group differences.
Zebrowski, PM. (1995). Temporal aspects of the conversations between children who stutter and their parents. TOPICS IN LANGUAGE DISORDERS, 15 (3), 1-17.
This article looks at several different studies which focus on either turn taking or timing in conversations between children who stutter and their parents. The research revealed that parents of children who stutter do not differ from parents of non-stuttering children in the temporal aspects of communication. However, for some children who stutter, slowed speech rate and/or an increased response latency time (RTL) from parents may help the child develop fluent speech. When considering whether to use therapeutic strategies addressing response latency time and/or the speech rate of parents it is important to consider other factors. These factors include the age of the child, the most common type of disfluencies, severity of stuttering, overall speech and language abilities of the child, and the differences between parent and child speech rate, RTL, and turn taking.
Zebrowski, P.M. (1997). Assisting young children who stutter and their families: Defining the role of the speech-language pathologist. AMERICAN SPEECH-LANGUAGE PATHOLOGY, 6, 19-28.
This report further investigates the controversy surrounding early intervention for all children who begin to stutter. The author provides a preliminary structure for clinical decision-making when dealing with early childhood stuttering. The framework of decision making is based on a collection of a variety of information from the child and his/her parents. This information then places the child in 1 of 4 "streams". These "streams" are categories to aid SLP's in defining their relationship and plans of treatment with the young child who stutters.
Zimmerman, S., Kalinowski, J., Stuart, A., and Rastatter, M., (1997). Effect of altered auditory feedback on people who stutter during scripted telephone conversations. JOURNAL OF SPEECH, LANGUAGE AND HEARING RESEARCH 40, 1130-1135.
The purpose of this study was to determine whether or not altered auditory feedback (AAF) conditions decreased the amount of stuttering during scripted telephone conversations. Subjects used in this study included six men and three women that were randomly picked from the files of the Total Immersion Fluency Training Program in New York and were asked to participate. Each subject made five phone calls to randomly selected businesses under each experimental condition and were given scripts to follow. The conditions included NAF, DAF (50 msec. delay), and FAF (shift in fequency 1/2 an octave down). Results indicated that by using AAF devices, the subjects demonstrated a reduced frequency of stuttering.
