Adults Who Stutter Research Articles

Speech Timing Deficit of Stuttering: Evidence from Contingent Negative Variations.

The aim of the present study was to investigate the speech preparation processes of adults who stutter (AWS). Fifteen AWS and fifteen adults with fluent speech (AFS) participated in the experiment. The event-related potentials (ERPs) were recorded in a foreperiod paradigm. The warning signal (S1) was a color square, and the following imperative stimulus (S2) was either a white square (the Go signal that required participants to name the color of S1) or a white dot (the NoGo signal that prevents participants from speaking). Three differences were found between AWS and AFS. First, the mean amplitude of the ERP component parietal positivity elicited by S1 (S1-P3) was smaller in AWS than in AFS, which implies that AWS may have deficits in investing working memory on phonological programming. Second, the topographic shift from the early phase to the late phase of contingent negative variation occurred earlier for AWS than for AFS, thus suggesting that the motor preparation process is promoted in AWS. Third, the NoGo effect in the ERP component parietal positivity elicited by S2 (S2-P3) was larger for AFS than for AWS, indicating that AWS have difficulties in inhibiting a planned speech response. These results provide a full picture of the speech preparation and response inhibition processes of AWS. The relationship among these three findings is discussed. However, as stuttering was not manipulated in this study, it is still unclear whether the effects are the causes or the results of stuttering. Further studies are suggested to explore the relationship between stuttering and the effects found in the present study.

Me, My Stuttering, and Them! Effect of Self-Disclosure of Stuttering on Listener Perception

Purpose: A common question encountered by speech-language pathologists while dealing with adults who stutter (AWS) is whether their disclosure of stuttering to listeners would change their perception. The purpose of this study was to assess the impact of self-disclosure and speaker sex on adult listeners’ perceptions of simulated stuttering. Method: The study involved a group of 100 college students between the age range of 18 and 25 years, who judged the videotaped speech samples of 1 male and 1 female person, who simulated stuttering in disclosed and undisclosed state. The listener perception was evaluated through a questionnaire developed for the purpose. Results: The trends suggested that a female AWS possessed overall better listener perception as compared with male AWS in undisclosed condition and received better perception by listeners in more domains than male AWS in disclosed state. Conclusions: Listener perception seems to be a sex-specific phenomenon which gets affected by one’s disclosure about stuttering and the culture of the listeners.

The Impact of Social-Cognitive Stress on Speech Variability, Determinism, and Stability in Adults Who Do and Do Not Stutter.

This study examined the impact of social-cognitive stress on sentence-level speech variability, determinism, and stability in adults who stutter (AWS) and adults who do not stutter (AWNS). We demonstrated that complementing the spatiotemporal index (STI) with recurrence quantification analysis (RQA) provides a novel approach to both assessing and interpreting speech variability in stuttering. Twenty AWS and 21 AWNS repeated sentences in audience and nonaudience conditions while their lip movements were tracked. Across-sentence variability was assessed via the STI; within-sentence determinism and stability were assessed via RQA. Compared with the AWNS, the AWS produced speech that was more variable across sentences and more deterministic and stable within sentences. Audience presence contributed to greater within-sentence determinism and stability in the AWS. A subset of AWS who were more susceptible to experiencing anxiety exhibited reduced across-sentence variability in the audience condition compared with the nonaudience condition. This study extends the assessment of speech variability in AWS and AWNS into the social-cognitive domain and demonstrates that the characterization of speech within sentences using RQA is complementary to the across-sentence STI measure. AWS seem to adopt a more restrictive, less flexible speaking approach in response to social-cognitive stress, which is presumably a strategy for maintaining observably fluent speech.

Anomaly in neural phase coherence accompanies reduced sensorimotor integration in adults who stutter

Despite advances in our understanding of the human speech system, the neurophysiological basis of stuttering remains largely unknown. Here, it is hypothesized that the speech of adults who stutter (AWS) is susceptible to disruptions in sensorimotor integration caused by neural miscommunication within the speech motor system. Human speech unfolds over rapid timescales and relies on a distributed system of brain regions working in a parallel and synchronized manner, and a breakdown in neural communication between the putative brain regions could increase susceptibility to dysfluency. Using a speech motor adaptation paradigm under altered auditory feedback with simultaneous recording of EEG, the oscillatory cortical dynamics was investigated in stuttering and fluent adults (FA). Auditory feedback perturbation involved the shifting of the formant frequencies of the target vowel sound. Reduced adaptation in response to the feedback error was observed in AWS and was accompanied by differences in EEG spectral powers and anomalies in phase coherence evolving over the course of speech motor training. It is understood that phase coherence possibly captures neural communication within speech motor networks. Thus, the phase coherence network of the two groups exhibited differences involving the EEG frequency bands. These findings in anomalous neural synchrony provide novel evidence for compromised neuronal communication at short time scales within the speech motor network of AWS.

Grey matter volume differences in the left caudate nucleus of people who stutter

The cause of stuttering has many theoretical explanations. A number of research groups have suggested changes in the volume and/or function of the striatum as a causal agent. Two recent studies in children and one in adults who stutter (AWS) report differences in striatal volume compared that seen in controls; however, the laterality and nature of this anatomical volume difference is not consistent across studies. The current study investigated whether a reduction in striatal grey matter volume, comparable to that seen in children who stutter (CWS), would be found in AWS. Such a finding would support claims that an anatomical striatal anomaly plays a causal role in stuttering. We used voxel-based morphometry to examine the structure of the striatum in a group of AWS and compared it to that in a group of matched adult control subjects. Results showed a statistically significant group difference for the left caudate nucleus, with smaller mean volume in the group of AWS. The caudate nucleus, one of three main structures within the striatum, is thought to be critical for the planning and modulation of movement sequencing. The difference in striatal volume found here aligns with theoretical accounts of stuttering, which suggest it is a motor control disorder that arises from deficient articulatory movement selection and sequencing. Whilst the current study provides further evidence of a striatal volume difference in stuttering at the group level compared to controls, the significant overlap between AWS and controls suggests this difference is unlikely to be diagnostic of stuttering.

Sensorimotor Oscillations Prior to Speech Onset Reflect Altered Motor Networks in Adults Who Stutter.

Adults who stutter (AWS) have demonstrated atypical coordination of motor and sensory regions during speech production. Yet little is known of the speech-motor network in AWS in the brief time window preceding audible speech onset. The purpose of the current study was to characterize neural oscillations in the speech-motor network during preparation for and execution of overt speech production in AWS using magnetoencephalography (MEG). Twelve AWS and 12 age-matched controls were presented with 220 words, each word embedded in a carrier phrase. Controls were presented with the same word list as their matched AWS participant. Neural oscillatory activity was localized using minimum-variance beamforming during two time periods of interest: speech preparation (prior to speech onset) and speech execution (following speech onset). Compared to controls, AWS showed stronger beta (15–25 Hz) suppression in the speech preparation stage, followed by stronger beta synchronization in the bilateral mouth motor cortex. AWS also recruited the right mouth motor cortex significantly earlier in the speech preparation stage compared to controls. Exaggerated motor preparation is discussed in the context of reduced coordination in the speech-motor network of AWS. It is further proposed that exaggerated beta synchronization may reflect a more strongly inhibited motor system that requires a stronger beta suppression to disengage prior to speech initiation. These novel findings highlight critical differences in the speech-motor network of AWS that occur prior to speech onset and emphasize the need to investigate further the speech-motor assembly in the stuttering population.

Premonitory Awareness in Stuttering Scale (PAiS)

Anticipation of stuttering events in persistent developmental stuttering is a frequent but inadequately measured phenomenon that is of both theoretical and clinical importance. Here, we describe the development and preliminary testing of a German version of the Premonitory Awareness in Stuttering Scale (PAiS): a 12-item questionnaire assessing immediate and prospective anticipation of stuttering that was translated and adapted from the Premonitory Urge for Tics Scale (PUTS) (Woods, Piacentini, Himle, & Chang, 2005). After refining the preliminary PAiS scale in a pilot study, we administered a revised version to 21 adults who stutter (AWS) and 21 age, gender and education-matched control participants. Results demonstrated that the PAiS had good internal consistency and discriminated the two speaker groups very effectively, with AWS reporting anticipation of speech disruptions significantly more often than adults with typical speech. Correlations between the PAiS total score and both the objective and subjective measures of stuttering severity revealed that AWS with high PAiS scores produced fewer stuttered syllables. This is possibly because these individuals are better able to adaptively use these anticipatory sensations to modulate their speech. These results suggest that, with continued refinement, the PAiS has the potential to provide clinicians and researchers with a practical and psychometrically sound tool that can quantify how a given AWS anticipates upcoming stuttering events.

Characteristics of Speech Mechanism and Motor Abilities in Adults Who Stutter

Purpose: The importance of oral motor abilities in stuttering occurrences has been continuously debated and discussed. The purpose of this study was to determine whether there would be a difference in speech mechanism and motor abilities between adults who stutter (AWS) and adults who do not stutter (AWNS). Methods: A total of 34 subjects participated in this study: 17 AWS (14 males and 3 females; mean age, 32 yrs 9 months) over 20 years old and 17 AWNS matched chronological age and sex with the former group. Each of the participants was directly examined on the basis of 13 items of structure and 17 items of function of speech mechanism. Results: There was no significant difference in speech structure and function between the two groups. Conclusion: In speech mechanism and motor ability assessment, a significant difference was not found in any areas, including structure and function, between AWS and AWNS. However, there may be individual variations, and for this reason, if there are any areas that might be problematic, even in the most fundamental areas, this should be taken into careful consideration. More considerable examination should be taken than direct observation of oral structure and function when it is doubtful.

The relationship between stuttering anticipation and verbal response time in adults who stutter

Objectives: The anticipation of stuttering is a common experience for many people who stutter. In this study, subjective ratings of stuttering anticipation were used to investigate the consistency of anticipation across time, beliefs about how anticipation affects the likelihood of stuttering, and the relationship between anticipation and verbal response time (VRT) in the perceptually fluent speech of 12 adults who stutter (AWS).Method: AWS used a visual analog scale to rate their beliefs about stuttering anticipation in general, and their degree of stuttering anticipation for 50 words at two separate visits that were separated by approximately 1 week. Participants performed a computer-prompted oral reading task with the same 50 words to obtain measures of VRT. Within-subject and group level correlations were used to explore relationships between stuttering anticipation, VRT, and stuttering severity.Results: Six of the participants had word-level stuttering anticipation ratings that were significantly correlated across the two testing visits. Two participants with the highest stuttering severity showed a positive correlation between word-level stuttering anticipation and VRT. Across the group, stuttering severity was positively correlated with the belief that the anticipation of stuttering increases the likelihood of stuttering, and the consistency of word level anticipation ratings across time.Conclusion: The results provide evidence for a relationship between stuttering severity, the consistency of anticipation, and the belief that anticipating stuttering increases the likelihood of stuttering. The relationship between anticipation and VRT in two of the most severe participants provides preliminary evidence that anticipation may be able to subtly influence the speech production system.

Cognitive Behavior Therapy and Mindfulness Training in the Treatment of Adults Who Stutter

Introduction: Stuttering is a developmental speech disorder with multiple etiological factors. Cognitive behavior therapy (CBT) has shown effectiveness in reducing anxiety symptoms and dysfluent speech in adults who stutter (AWS). So we planned to study the comparative efficacy of CBT and CBT combined with mindfulness training (MT) in AWS. Aim: The aim of this preliminary study was to examine and compare the efficacy of CBT and CBT combined with MT in reducing anxiety symptoms, and dysfluent speech and increasing communication attitude, quality of life, self-esteem and speech fluency in AWS. Method and Materials: A matched two group pretest and posttest interventional design was employed. The sample consisted of ten adults with the diagnosis of stuttering (ICD-10, 1992) who were randomly allotted to Group One (CBT; N=5) and Group Two (CBT+MT; N=5). The therapeutic program included 15-20 sessions of one hour each. Statistical Analysis: Obtained data were analyzed using the Wilcoxon Sign Rank Test for within the group, before and after intervention comparison and Mann Whitney U Test for between group comparisons. Results: Significant difference in both CBT group and CBT+MT group is observed in the area of communication attitude (U=1.00, p<0.05). Conclusion: The findings of the study show that CBT and CBT+MT are effective in the treatment of AWS, but CBT+MT is more effective than CBT alone.

Turn-Taking Behaviors during Interaction with Adults-Who-Stutter

Stuttering is a disorder that affects not only the speaker, but also the conversational partner (CP). This study was designed to examine whether people communicate differently with adults-who-stutter (AWS), compared to adults-who-do-not-stutter (AWNS). Specifically, we examined the occurrence of three basic and common turn-taking behaviors (TTBs) used by CPs, during interactions with AWS compared to AWNS. Ten adults (age range 20–32), naive to the purposes of this study, were recorded during a conversation with four speakers: two AWS and two AWNS. Consequently, a total of 40 conversations were analyzed. Based on transcriptions of these interactions, the relative frequency of the three TTBs (Reinforcers, Interruptions and Completions) was calculated. The ten CPs exhibited a similar proportion of TTBs during their conversations with the AWS and AWNS (p > 0.05). However, during their conversations with the AWS, the CPs exhibited a higher proportion of Interruptions and Completions in response to stuttered turns, compared to fluent turns (p < 0.05). Additionally, the ten CPs exhibited a larger proportion of Reinforcers during their conversations with the AWS with moderate stuttering severity, compared to the AWS with mild severity (p = 0.04). Results provide a preliminary insight to CPs’ communication behavior in the presence of stuttering. Results are interpreted as demonstrating that, within this context, CPs do not exhibit different turn-taking behaviors when conversing with AWS and AWNS. However, CPs exhibit different TTBs in association with stuttered speech, compared to fluent speech of PWS.

Dorsal and ventral language pathways in persistent developmental stuttering

Persistent developmental stuttering is a speech disorder that affects an individual's ability to fluently produce speech. While the disorder mainly manifests in situations that require language production, it is still unclear whether persistent developmental stuttering is indeed a language impairment, and if so, which language stream is implicated in people who stutter. In this study, we take a neuroanatomical approach to this question by examining the structural properties of the dorsal and ventral language pathways in adults who stutter (AWS) and fluent controls. We use diffusion magnetic resonance imaging and individualized tract identification to extract white matter volumes and diffusion properties of these tracts in samples of adults who do and do not stutter. We further quantify diffusion properties at multiple points along the tract and examine group differences within these diffusivity profiles. Our results show differences in the dorsal, but not in the ventral, language-related tracts. Specifically, AWS show reduced volume of the left dorsal stream, as well as lower anisotropy in the right dorsal stream. These data provide neuroanatomical support for the view that stuttering involves an impairment in the bidirectional mapping between auditory and articulatory cortices supported by the dorsal pathways, not in lexical access and semantic aspects of language processing which are thought to rely more heavily on the left ventral pathways.

Attention demands of language production in adults who stutter

We investigated whether language production is atypically resource-demanding in adults who stutter (AWS) versus typically-fluent adults (TFA). Fifteen TFA and 15 AWS named pictures overlaid with printed Semantic, Phonological or Unrelated Distractor words while monitoring frequent low tones versus rare high tones. Tones were presented at a short or long Stimulus Onset Asynchrony (SOA) relative to picture onset. Group, Tone Type, Tone SOA and Distractor Type effects on P3 amplitudes were the main focus. P3 amplitude was also investigated separately in a simple tone oddball task. P3 morphology was similar between groups in the simple task. In the dual task, a P3 effect was detected in TFA in all three distractor conditions at each Tone SOA. In AWS, a P3 effect was attenuated or undetectable at the Short Tone SOA depending on Distractor Type. In TFA, attentional resources were available for P3-indexed processes in tone perception and categorization in all distractor conditions at both Tone SOAs. For AWS, availability of attentional resources for secondary task processing was reduced as competition in word retrieval was resolved. Results suggest that language production can be atypically resource-demanding in AWS. Theoretical and clinical implications of the findings are discussed.

The efficacy of cognitive behavior therapy in an adult who stutters

Byline: Sanjeev. Gupta Sir, Research studies show that speech therapy treatment for stuttering is available in early childhood,[sup][1] but stuttering in adults is much less responsive to speech therapy.[sup][2] Behavioral speech programs involving speech restructuring are the strongest evidence-based stuttering treatments for adults who stutter (AWS).[sup][3] Hence, cognitive behavior therapy (CBT) has been used in the present case to examine the efficacy in the reduction of anxiety, reduction of avoidance behavior, reduction of frequency of stuttering, and increasing the social interaction, increasing self-esteem, increasing the positive thoughts and attitudes about verbal communication. Index patient Mr. NN was a 24-year-old postgraduate student, belonging to middle socioeconomic family and the younger of two brothers with normal birth and developmental history. He came with the chief complaints of dysfluent speech and difficulty to speak with authority persons and strangers for the last 5 years which have increased in the last 8 months. Dysfluent speech significantly impacted his personal and social life. The onset was insidious, and course of the disorder was progressive. He had poor self-esteem and negative automatic thoughts (NATs) that “I will stutter and I am inferior” as well as autonomic arousal such as sweating and palpitation during communication and interaction with teachers and strangers. Premorbid personality was well adjusted. No significant family and treatment history were reported by him. The patient was diagnosed as a case of stuttering (ICD-10 DCR, F98.5)[sup][4] and was not having any concurrent diagnosis of psychiatric and medical illness or previous exposure to the cognitive behavioral intervention. The pre- and post-intervention assessments were done using Perceptions of Stuttering Inventory (PSI), Stuttering Severity Instrument (SSI), Modified Erickson Scale of Communication Attitudes (MESCA), Rosenberg Self-Esteem Scale (RSES), and Beck Anxiety Inventory (BAI). The CBT program consisted of 25 sessions and each session lasted for 45–50 min duration. CBT components included trust building, psychoeducation, deep breathing, relaxation techniques, cognitive restructuring, problem-solving, and prolongation technique. The prolongation is the speech production style used to facilitate fluency, where the person prolongs segments in spoken utterances. The client was asked to self-monitor and/or control the situations, where he stutters, and maintain a diary for the same. The cognitive-behavioral model of stuttering of Mr. NN is shown in [Figure 1].{Figure 1} The significant improvement was observed on both pre- and post-intervention scores on the following scales such as PSI (reduced from 42 to 19, 54. …

Beyond production: Brain responses during speech perception in adults who stutter.

Developmental stuttering is a speech disorder that disrupts the ability to produce speech fluently. While stuttering is typically diagnosed based on one's behavior during speech production, some models suggest that it involves more central representations of language, and thus may affect language perception as well. Here we tested the hypothesis that developmental stuttering implicates neural systems involved in language perception, in a task that manipulates comprehensibility without an overt speech production component. We used functional magnetic resonance imaging to measure blood oxygenation level dependent (BOLD) signals in adults who do and do not stutter, while they were engaged in an incidental speech perception task. We found that speech perception evokes stronger activation in adults who stutter (AWS) compared to controls, specifically in the right inferior frontal gyrus (RIFG) and in left Heschl's gyrus (LHG). Significant differences were additionally found in the lateralization of response in the inferior frontal cortex: AWS showed bilateral inferior frontal activity, while controls showed a left lateralized pattern of activation. These findings suggest that developmental stuttering is associated with an imbalanced neural network for speech processing, which is not limited to speech production, but also affects cortical responses during speech perception.

Qualitative analysis of bibliotherapy as a tool for adults who stutter and graduate students

PurposeThe purpose of this study was to investigate the use of bibliotherapy as a therapeutic tool for adults who stutter (AWS) and as an educational tool for graduate students in speech-language pathology. Bibliotherapy refers to the process of reading, reflecting upon, and discussing literature, often first person illness or disability narratives, to promote cognitive shifts in the way clients and clinicians conceptualize the experience of disability. MethodFive AWS and six graduate students participated in supervised bibliotherapy using a stuttering memoir during therapy sessions. An inductive, qualitative analysis was utilized to analyze data collected from questionnaires and interviews. An additional deductive qualitative approach was utilized to explore how client data fit into an existing five-outcome model of bibliotherapy from the psychology literature. ResultsGraduate students reported developing essential clinical skills for working with clients who stutter, including an improved understanding of the experience of people who stutter and an increased ability to form and strengthen the therapeutic alliance. Clients reported experiencing shifts in the cognitive and affective components of the disorder. Imposing the five-outcome model on client data indicates that at least two clients in the current study experienced all five outcomes of bibliotherapy. These include client experiences of involvement, identification, catharsis, insight and universalism. ConclusionBoth graduate students and clients reported benefits from reading and discussing a memoir about stuttering. Bibliotherapy can be an effective tool in therapy and clinical education when used appropriately.

An event-related potential investigation of sentence processing in adults who stutter

The purpose of this study was to investigate characteristics of the semantic processing of sentences’ final verbs in stutterers using event-related potential (ERP). ERPs elicited from semantically violating and non-violating verbs in Japanese sentences were compared between 13 adults who stutter (AWS) and 13 adults who do not stutter (AWNS). The stimulus sentences elicited the N400 and the late positive component (LPC) in both groups. The amplitude of the N400, however, was attenuated in AWS. Regarding the LPC, the LPC in the 450–700ms time window (the early LPC) was evident in both groups, but the LPC in the 700–850 time window (the late LPC) was only apparent in AWS. Because AWS judged sentence congruency as accurately as AWNS did, it is assumed that AWS depended more on the LPC for semantic processing, resulting in the enhancement of the late LPC. We speculate that semantic processing of sentences for AWS is more time consuming than that for AWNS.

Linguistic Behaviours in Adults who Clutter and Adults who Stutter When Reading and Speaking

The breadth of behaviours that may be considered as cluttering continues to be contentious. The current lowest common denominator (LCD) definition of cluttering excludes the possibility of high level language deficits. However, recent studies suggest that those who clutter may have linguistic deficits alongside motor control difficulties. This paper reports behavioural findings from a larger data set collected during functional MRI scans with adults who clutter (AWC), adults who stutter (AWS) and controls (CTLs). Participants were asked to read short passages aloud and describe pictures. Speech data were analysed and coded for stuttering like dysfluencies (e.g. blocks) and normal dysfluencies (e.g. revisions and fillers) by two speech and language therapists. One-way ANOVAs showed that AWC use significantly more revisions than AWS and CTLs both when reading aloud and when describing pictures. AWC showed a trend toward increased co-articulation when describing a picture compared to AWS and CTL although this failed to meet significance level, AWC speaking rates was evaluated as similar to the two other groups. Results suggest that both spontaneous speech and oral reading outputs of AWC can be differentiated from AWS and CTL by the number of revisions used. We speculate that excessive co-articulation might differentiate AWC from AWS and CTLs in spontaneous speech but this does not appear to hold true for oral reading.

The Optical Examination of Cortical Activity Associated with Speech-motor Control in Children and Adults who Stutter

Adults who stutter (AWS) show robust over-activation of right hemisphere structures during speech production relative to adults who do not stutter (AWNS). This is well documented in the fMRI literature in stuttering. These differences are often interpreted as risk factors for the development of stuttering, however, it remains unclear whether differences in brain activity reflect neural substrates related to the cause of stuttering or plastic changes resulting from a lifetime of stuttering. Few investigations of neural activity underlying speech-motor production in stuttering have distinguished speech motor planning from execution, nevertheless, there is evidence indicating altered planning and execution in AWS relative to AWNS (Chang et al., 2009; Lu et al., 2010). The neural activity of speech motor control in children who stutter (CWS) relative to children who do not stutter (CWNS) is not well documented. Near-Infrared spectroscopy (NIRS) allows the non-invasive acquisition of cortical activity using paradigms that are appropriate for use with children. Using NIRS the cortical activity related to speech motor planning and execution will be examined during two production tasks: a Go/noGo picture identification task and a nonword repetition task in pre-school CWS, school-aged CWS, AWS and age matched peers. The go/noGo task is designed to elucidate speech motor execution. The participants view a picture for 1500ms after which the colour of the picture's border changes to indicate whether or not the child should produce the object's label. This is a covert/overt naming task whereby the participant is unaware whether he will be required to produce speech. The planning of speech motor events is similar across covert and overt conditions. Therefore, by subtracting the cortical activity associated with covert naming from that required for overt naming the remaining cortical activity will be related to execution of speech motor events. The nonword repetition task is designed to elucidate speech motor planning. Participants hear nonwords of various lengths including one syllable (1SYL), three syllables (3SYL) and one syllable nonwords thrice repeated (1SYLx3). Participants are instructed to immediately repeat the nonword. The contrast between the cortical activities generated by 1SYL and 1SYLx3 indexes an increase in motor execution but not motor planning. Whereas the contrast between the cortical activity generated by the SYL3 relative to 1SYLx3 indexes an increase in motor planning but not execution. Comparing the indices of motor planning and motor execution will provide information describing differences in cortical activity that distinguish fluent from stuttering groups. This abstract is developed from ongoing research as part of the first author's dissertation. Results will be presented (at the time of writing we have unanalysed results from three participants).Regarding feedback from the panellists, I am specifically interested in hearing the following:1 – General feedback regarding the paradigm for examining speech motor control.2 – Alternative ways to explore the cortical activity underlying speech motor control.3 – Potential ways to capture the cortical activity for language processing along with indices of speech motor control.4 – The use of NIRS in the acquisition of non-speech motor control data in AWS and CWS.

Intensive Non-avoidance Group Therapy with Adults Stutterers: Follow Up Data

MethodThe outcomes measurement of an intensive non-avoidance group therapy for adult clients with stuttering was presented. The adults who stutter (AWS) in this study included 15 persons (average age 25.2 years) who were enrolled in the First, Second and Third Stage of the study. The male female ratio was 4:1. According to the initial SSI score (percentile) six of the clients were diagnosed as moderate stutterers, four with severe stuttering, and five with very severe stuttering (Riley, 1994). Inclusion criteria for the intensive therapy were: (i) adults older than age 21; (ii) having participated previously in therapy, and (iii) exhibiting a range of stuttering severities to ensure a representative sample.The follow up study includes measurement of: changes in speech fluency in follow up period (1, 2, and 3 years after the intensive therapy); mean duration of three longest disfluencies in seconds (DDs); and, Index of disfluencies (ID) – the number of stuttering events by the number of syllables was divided. Each speaking sample contained at least between 300 - 400 syllables. The Stuttering Severity Instrument for Adults, Third Edition [SSI–3] (Riley, 1994) was used to determine stuttering severity. The data were analysed using (i) the Wilcoxon signed rank test for hypotheses testing, and (ii) the Mann-Withney rank-sum test. For the statistical analysis, the 15 subjects were divided intotwo main groups: severe (very severe and severe), and moderate. Data collectionA review of the client's files (assessment reports and progress reports). Three types of files were recorded during the initial diagnostic evaluation, at the onset of treatment, and at the end of the 5-day intensive program. The follow up study (after the 9-month complete stabilization period) includes results evaluation after one, two and three years post treatment period. Therapy approachVan Riper's (1973) stuttering modification therapy approach, a non-avoidance approach. ConclusionsThe changes in speech fluency before and after the intensive therapy and in the follow up period (one, two and three years after the intensive therapy) were obtained regarding the duration of disfluencies and the index of disfluency. The improvement in stuttering duration was observed immediately upon completing the intensive therapy. This was reflected in a statistically significant reduction in the number of stuttered utterances per minute. These positive changes were maintained for the period of the nine months stabilization phase, then one year, two years and three years after the therapy.