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.
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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.
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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.
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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.
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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.
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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!
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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 speakerº_s results were similar for the spontaneous and controlled speaking tasks.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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).
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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.
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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 ‡ 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.
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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.
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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.
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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.
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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.
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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.
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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).
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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."
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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".
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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.
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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.
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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.
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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.
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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."
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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 .
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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 individual¹s 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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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."
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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).
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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).
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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last modified November 28, 2008