Frequency Of Disfluencies Research Articles

Differential diagnostic characteristics between cluttering and stuttering—Part one

Speech-language pathologists generally agree that cluttering and stuttering represent two different fluency disorders. Differential diagnostics between cluttering and stuttering is difficult because these disorders have similar characteristics and often occur in conjunction with each other. This paper presents an analysis of the differential diagnostic characteristics of the two disorders, and a proposal for distinguishing between the two in clinical settings. The main goal of this two-part article is to set objective norms for differential diagnostic assessment of cluttering and stuttering symptoms, based on the three main characteristics of cluttering indicated/identified by St. Louis, Raphael, Myers & Bakker [St. Louis, K. O., Raphael, L. J., Myers, F. L., & Bakker, K. (2003). Cluttering updated. The ASHA leader. ASHA, 4–5, 20–22]: a fast and/or irregular articulatory rate together with errors in syllable, word or sentence structure and or a high frequency of normal disfluencies (not being stuttering). In the first half of the article objective measures are compared to the subjective clinical judgement made by fluency experts. In other words, which characteristics can be found in the speech profiles of persons who were diagnosed as people who clutter or stutter? In the second part of the article results on the Predictive Cluttering Inventory [Daly, D. A., & Cantrell, R. P. (2006). Cluttering characteristics identified as diagnostically significant by 60 fluency experts. Proceedings of second world congress on fluency disorders] are discussed in relationship to the subjective and objective measurements studied in the first half of the article. Educational objectives: The reader will learn about and be able to (1) describe obligatory characteristics of cluttering, (2) plan cluttering assessment on speech characteristics and (3) use and interpret a checklist on possible cluttering characteristics.

Caracterização dos indivíduos com distúrbios da fluência, atendidos na clínica-escola do curso de fonoaudiologia da USP-Bauru

OBJETIVO: caracterizar a população de indivíduos atendidos na Clínica de Distúrbios da Fluência do Curso de Fonoaudiologia da USP (Bauru), de 1992 a 2005, quanto à idade, gênero, queixa inicial, diagnóstico fonoaudiológico, antecedentes familiares, manifestações, gravidade e frequência, além de possíveis alterações associadas, comparando tais dados com a literatura estudada. MÉTODOS: análise de 194 prontuários da população acima referida por meio do preenchimento de protocolo com questões referentes às variáveis propostas no objetivo. RESULTADOS: dos 194 prontuários, 140 pertenciam a pacientes do sexo masculino (72% da amostra) e 54 (28%), do feminino. Entre as queixas relatadas, 68% (n=132) eram de gagueira, 23% (n=45) referiam-se a outros distúrbios da fluência (taquifemia, distúrbio motor da fala) e outras 9% (n=17) estavam associadas a alterações vocais, linguagem oral e/ou escrita e fala. Quanto a antecedentes familiares, 57% (n=110) tinham na família mais de um parente com alterações na fala e/ou linguagem. As manifestações das disfluências, citadas em 54% dos prontuários (n=105) dos indivíduos diagnosticados com gagueira, foram bloqueios, repetições e prolongamentos. Constatou-se histórico de atraso de linguagem nos casos de gagueira em 31% dos casos (n=60). CONCLUSÃO: com base nos dados encontrados, conclui-se que a população estudada caracteriza-se por apresentar: início dos primeiros sintomas entre 1 e 5 anos, maior acometimento no gênero masculino, histórico familiar e de atraso de fala e linguagem positivo, manifestações predominantes de repetição de sílabas, bloqueios, bloqueios acompanhados de prolongamentos e hesitações.

Similarities in speech and white matter characteristics in idiopathic developmental stuttering and adult-onset stuttering

Adult-onset stuttering (AS) typically occurs following neurological and/or psychological trauma, considered different from developmental stuttering (DS), which starts during early childhood with few if any new cases reported after adolescence. Here we report four cases of AS, two with apparent psychological trigger and two without, none with evidence of neurological injury, and none conforming to previously reported characteristics of psychogenic stuttering. We asked whether this group of AS would have similar speech and neuroanatomical characteristics to those with DS. We conducted blinded analyses of speech samples in four AS cases and 14 cases of DS on type, frequency, and loci of disfluencies. Diffusion tensor imaging (DTI) was conducted to compare white matter tracts using fractional anisotropy (FA). We found that AS did not differ significantly from DS in any of the speech characteristics measured. On DTI, DS had significantly increased FA relative to controls in the right superior longitudinal tract. AS cases showed a similar trend for increases in these regions when compared to controls. The results of this study suggest that symptoms of idiopathic stuttering can begin during adulthood, and that similar neuroanatomical differences from controls may be associated with both developmental and adult-onset idiopathic stuttering.

Influence of stuttering variation on talker group classification in preschool children: Preliminary findings

The purpose of this study was to investigate whether variations in disfluencies of young children who do (CWS) and do not stutter (CWNS) significantly change their talker group classification or diagnosis from stutterer to nonstutterer, and vice versa. Participants consisted of seventeen 3- to 5-year-old CWS and nine 3- to 5-year-old CWNS, with no statistically significant between-group difference in chronological age (CWS: M = 45.53 months, S.D. = 8.32; CWNS: M = 47.67 months, S.D. = 6.69). All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a series of speaking samples that varied by: (a) conversational partner [parent and clinician], (b) location [home and clinic], and (c) context [conversation and narrative]. The primary dependent measures for this study were the number of stuttering-like disfluencies (SLD) per total number of spoken words [%SLD] and the ratio of SLD to total disfluencies (TD) [SLD/TD]. The results indicated that significant variability of stuttering did not exist as a result of conversational partner or location. Changes in context, however, did impact the CWS, who demonstrated higher SLD/TD in the conversation sample versus a narrative sample. Consistent with hypotheses, CWS and CWNS were accurately identified as stutterers and nonstutterers, respectively, regardless of changes to conversational partner, location or context for the overall participant sample. Present findings were taken to suggest that during assessment, variations in stuttering frequency resulting from changes in conversational partner, location or context do not significantly influence the diagnosis of stuttering, especially for children not on the talker group classification borderline between CWS and CWNS. Learning outcomes: Readers will be able to: (1) Describe the role of variability in stuttering frequency for young children who stutter; (2) Identify three fundamental measurements of the frequency of stuttering-like and nonstuttering-like disfluencies; (3) Describe the effects of stuttering variation on talker group classification of stuttering or nonstuttering.

Perfil comunicativo de indivíduos com a síndrome de Williams-Beuren

OBJETIVO: Descrever o perfil comunicativo de indivíduos com a síndrome de Williams-Beuren. MÉTODOS: A casuística foi composta por 12 indivíduos com a síndrome com idade cronológica entre 6;6 a 23;6 (Grupo 1) que foram comparados a outros 12 sem a síndrome e com idade mental semelhante e sem dificuldades de linguagem/aprendizagem (Grupo 2). Os indivíduos foram avaliados em situação de conversação para classificação dos comportamentos verbais e não-verbais, segundo critérios pragmáticos, levantamento do número de turnos por minuto, enunciados por turno, Extensão Média de Enunciados, levantamento quanto à freqüência e tipologia de disfluências da fala e classificação quanto ao tipo de pausas plenas do discurso. RESULTADOS: O perfil comunicativo do Grupo 1 mostrou facilidade para interagirem em situação de comunicação com a presença de limitações lingüísticas estruturais e funcionais variáveis, quando comparados aos indivíduos do Grupo 2. Os indivíduos do Grupo 1 freqüentemente utilizaram estratégias comunicativas, na tentativa de preencherem o espaço comunicativo, como o uso de clichês, efeitos sonoros, recursos entonacionais e as pausas plenas que mostraram ser favoráveis do ponto de vista sócio-comunicativo, enquanto que os comportamentos verbais ecolálicos e perseverativos prejudicam o desempenho comunicativo desses indivíduos. CONCLUSÃO: O desempenho comunicativo mais prejudicado do Grupo 1 permitiu especular que comprometimentos lingüísticos nesta condição podem estar presentes, independente da diferença entre idade cronológica e mental. Estudos mais abrangentes poderão responder ao questionamento da dissociação de habilidades cognitivas e lingüísticas nesta síndrome e também no que diz respeito à complexa esta correlação em meio aos distúrbios da comunicação humana.

Speech disfluencies in individuals with Tourette syndrome

Objective The purpose of the present study was to analyze the frequency and type of speech disfluencies in a relatively large group of individuals with Tourette's syndrome (TS) and to compare their results with similar speech data from a control group of unselected individuals. Method Self-report data, as well as conversation and reading samples, were obtained from 69 children diagnosed with TS (mean age=12.49) and 27 control participants (mean age=10.9). Results Self-report data on fluency difficulties did not reveal significant group differences; however, detailed analysis of fluency during reading and spontaneous speech revealed an overall higher level of more typical (normal) disfluencies in the TS group. No overall differences in less typical (stuttering) disfluencies were observed between the two groups of children. Conclusion Results are discussed in light of previous studies proposing a common aetiology and neuropathological link between TS and developmental stuttering.

Childhood stuttering and speech disfluencies in relation to children’s mean length of utterance: a preliminary study

The purpose of this study was to examine the influence of utterance length and complexity relative to the children’s mean length of utterance (MLU) on stuttering-like disfluencies (SLDs) for children who stutter (CWS) and nonstuttering-like disfluencies (nonSLDs) for children who do not stutter (CWNS). Participants were 12 (3;1–5;11, years;months) children: 6 CWS and 6 age-matched (±5 months) CWNS, with equal numbers in each talker group (CWS and CWNS) exhibiting MLU from the lower to the upper end of normal limits. Data were based on audio–video recordings of each child in two separate settings (i.e., home and laboratory) during loosely structured, 30-min parent–child conversational interactions and analyzed in terms of each participant’s utterance length, MLU, frequency and type of speech disfluency. Results indicate that utterances above children’s MLU are more apt to be stuttered or disfluent and that both stuttering-like as well as nonstuttering-like disfluencies are most apt to occur on utterances that are both long and complex. Findings were taken to support the hypothesis that the relative “match” or “mismatch” between linguistic components of an utterance (i.e., utterance length and complexity) and a child’s language proficiency (i.e., MLU) influences the frequency of the child’s stuttering/speech disfluency. Educational objectives: The reader will learn about and be able to: (1) compare different procedures for assessing the relationship among stuttering, length and complexity of utterance, (2) describe the difference between relative and absolute measures of utterance length, (3) discuss the measurement and value of mean length of utterance and its possible contributions to childhood stuttering, and (4) describe how length and complexity influence nonstuttering-like disfluencies of children who stutter as well as the stuttering-like disfluencies of children who do not stutter.

Perspectives on Speech Fluency Issues in African Americans

No AccessPerspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) PopulationsArticle1 Jul 2002Perspectives on Speech Fluency Issues in African Americans Tommie L. Robinson Tommie L. Robinson Scottish Rite Center for Childhood Language Disorders Children's Hearing and Speech Center Children's Hospital Google Scholar More articles by this author https://doi.org/10.1044/cds8.2.15 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In "Perspectives on Speech Fluency Issues in African Americans." Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations, 8(2), pp. 15–16 References Anderson, B. (1981). An analysis of the relationship of age and sex to type and frequency of disfluencies in lower socioeconomic preschool Black children. Unpublished doctoral dissertation, Northwestern University, Evanston, IL. Google Scholar Brutten, G. & Miller, R. (1988). The disfluencies of normally fluent Black first graders.Journal of Fluency Disorders, 13, 291–299. Google Scholar Conrad, C. (1985). A conversational act analysis of Black mother-child dyads including stuttering and nonstuttering children. Unpublished doctoral dissertation, Northwestern University, Evanston, IL. Google Scholar Conrad, C. (1987). Fluency in multicultural populations.In L. C. & V. Deal (Eds.), Communication disorders in multicultural populations. Unpublished manuscript. Rockville, MD: ASHA. Google Scholar Ford, S. (1986). Pragmatic abilities in Black disfluent preschoolers. Unpublished master’s thesis, Howard University, Washington, DC. Google Scholar Goldman, R. (1967). Cultural influences on the sex ratio in the incidence of stuttering.American Anthropology, 69, 78–81. Google Scholar Leith, W. R., & Mims, H. A. (1975). Cultural influences in the development and treatment of stuttering: A preliminary report on the Black stutterer.Journal of Speech and Hearing Disorders, 40, 459–466. Google Scholar Nathanson, S. (1969). A study of the influence of race, socioeconomic status and sex on the speech fluency of 200 nonstuttering fifth graders, Unpublished dissertation, Northwestern University, Evanston, IL. Google Scholar Robinson, T. L.Jr. & Crowe, T. A. (1987). A comparative study of speech disfluencies in nonstuttering Black and White college male athletes.Journal of Fluency Disorders, 12, 147–156. Google Scholar Robinson, T. L.Jr. & Crowe, T. A. (1998). Culture-based considerations in programming for stuttering intervention with African American clients and their families.Language, Speech and Hearing Services in the Schools, 29, 172–179. AbstractGoogle Scholar Robinson, T. L.Jr., Davis, J. G., & Crowe, T. A. (2000). Disfluency in nonstuttering African American preschoolers during conversation and narrative discourse.Contemporary Issues in Communication Science and Disorders, 27, 164–171. Google Scholar Additional Resources FiguresReferencesRelatedDetails Volume 8Issue 2July 2002Pages: 15-16 Get Permissions Add to your Mendeley library History Published in issue: Jul 1, 2002 Metrics Downloaded 22 times Topicsasha-topicsleader-topicsasha-article-typesasha-sigsCopyright & Permissions© 2002 American Speech-Language-Hearing AssociationLoading ...

Speech disfluency in centenarians

Other than a single case presentation of a 105-year-old female, no other studies have addressed the speech fluency characteristics of centenarians. The purpose of this study was to provide descriptive information on the fluency characteristics of speakers between the ages of 100–103 years. Conversational speech samples from seven speakers were evaluated for the frequency and types of disfluencies and speech rate. The centenarian speakers had a disfluency rate similar to that reported for 70-, 80-, and early 90-year-olds. The types of disfluencies observed also were similar to those reported for younger elderly speakers (primarily whole word/phrase, or formulative fluency breaks). Finally, the speech rate data for the current group of speakers supports prior literature reports of a slower rate with advancing age, but extends the finding to centenarians. Learning outcomes As a result of this activity, participants will be able to: (1) describe the frequency of disfluency breaks and the types of disfluencies exhibited by centenarian speakers, (2) describe the mean and range of speaking rates in centenarians, and (3) compare the present findings for centenarians to the fluency and speaking rate characteristics reported in the literature.

The Tudor Study

Recent exposure of an experiment (the Tudor Study) conducted in 1939 at the University of Iowa with the aim of studying the effect of verbal labeling on the frequency of disfluency in children who stutter and in normally fluent children has raised strong reactions both from the general public and the scientific community. Allegedly, the investigator and her mentor, a past leader in the field of speech pathology, were successful in their attempts to induce stuttering in normally speaking children; hence, serious accusations of breech of ethics in science have been made. The potential clinical implications of such conclusions for the treatment of early childhood stuttering are far reaching and negate recent developments that employ direct therapies with preschool children who show signs of stuttering. The purpose of this article is to re-examine the data reported in the Tudor Study and its ethical ramifications. We conclude that none of the experimental questions posed by Tudor and Johnson received empirical support. A broad range of relevant ethical issues is discussed.

Fluency of School-Aged Children With a History of Specific Expressive Language Impairment

A large volume of literature now links language demand and fluency behaviors in children. Although it might be reasonable to assume that children with relatively weak language skills might demonstrate higher levels of disfluency, the sparse literature on this topic is characterized by conflicting findings on the relationship between language impairment and disfluency. However, in studies finding elevated disfluency in children with specific language impairment, a higher frequency of disfluencies more characteristic of stuttering has been noted. This study asks whether children with long-standing histories of language delay and impairment are more disfluent, and display different types of disfluencies than their typically developing, age-matched peers. Elicited narratives from 22 pairs of 9-year-old children were analyzed for fluency characteristics. Half of the children had histories of specific expressive language impairment (HSLI-E), whereas the others had typical developmental histories. The children with HSLI-E were significantly more disfluent than their peers and produced more stutter-like disfluencies, although these behaviors were relatively infrequent in both groups. Implications for clinical intervention and future research are discussed.

Evaluating rate, accuracy, and fluency of young children’s diadochokinetic productions: a preliminary investigation

Diadochokinetic (DDK) rates are commonly assessed in children with speech–language disorders, even though the implications of fast or slow DDK rates are not clear. This study explored the possibility that the accuracy and fluency of DDK productions may provide a meaningful supplement to traditional measures of DDK rate. Participants were 15 boys, age 3–7, with normal speech–language development, who were asked to produce “puh-tuh-kuh” or “pattycake” in a standard DDK task. Analyses revealed that normally developing children produce frequent articulation errors but few disfluencies during DDK tasks. Errors and disfluencies did not affect DDK rate, suggesting that the rate of DDKs may be a relatively insensitive measure of children’s speaking abilities. Although an expected correlation was found between age and overall DDK rate, no correlations were found between age and the frequency of articulation errors or speech disfluencies. Findings suggest that measures of DDK accuracy and fluency may provide information about children’s speech development that is independent of age and may be more closely related to oral motor development than rate. Overall, results underscore concerns with the interpretation of DDK rate and highlight ways that rate measures might be supplemented with measurement of accuracy and fluency in the evaluation of children’s speaking abilities. Educational objectives: The reader will learn about a technique that may facilitate the evaluation of young children’s oral DDK abilities. The reader will learn about the frequency and type of errors children produce on DDKs and how this information can be used in the assessment of children’s oral motor abilities.

Durational, proportionate, and absolute frequency characteristic of disfluencies: a longitudinal study regarding persistence and recovery.

The main objective of this study was to investigate developmental aspects of disfluencies over time as stuttering persists or ameliorates for 2 groups of preschool age children who stutter. Results indicated that the frequency, type, and duration of disfluencies remained relatively constant instead of increasing as expected in the persistent group over a 3-year period. In contrast, the recovered group's initially higher frequency of disfluency decreased over time, as did their number of repetition units and proportion of disrhythmic phonations, while the duration of silent intervals between repetition units and proportion of monosyllabic word repetitions increased.

The frequency of simultaneous disfluency and phonological errors in children: A preliminary investigation

The frequency of simultaneous disfluency and phonological errors was examined in seven young English-speaking children exhibiting coexisting stuttering and phonological disorders. Data were gathered during 30 minutes of mother-child conversation and analyzed in three parts: (1) stuttering, (2) phonological errors, and (3) stuttering and phonological error co-occurrence. Results indicated that stuttering did not occur more frequently on syllables with phonological errors than on syllables without phonological errors. However, the frequency of disfluency on word-initial consonant clusters with phonological errors was significantly higher than on word-initial consonant clusters without phonological errors. Theoretical and clinical implications are discussed.

Converting between word and syllable counts in children's conversational speech samples

Several authors have suggested that it is possible to convert between word and syllable counts for basic clinical measurements such as the frequency of speech disfluencies or speaking rate in conversational speech samples. Based primarily on results from adults' speech samples, proposed conversion factors have averaged approximately 1.5 syllables per word. Because children produce fewer multisyllabic words than adults, this conversion factor is probably not appropriate for children's speech samples. This study sought to develop a more accurate conversion factor for children's speech by comparing syllable and word counts in spontaneous speech samples produced by 50 children, age 3 to 5. Analyses revealed an average ratio of 1.15 syllables per word, which was consistent across different subjects, across subject groups (children who stutter and children who do not stutter) and also, somewhat surprisingly, across age groups (3-year olds, 4-year olds, and 5-year olds). Results suggest that this constant conversion factor of 1.15 can be used to convert between word and syllable with sufficient precision to allow clinicians to compare their data to published guidelines and benchmarks about childhood stuttering.

Language abilities of children who stutter: A preliminary study

The purpose of this study was to examine differences between children who do (CWS) and children who do not stutter (CWNS) on standardized tests of receptive/expressive language and receptive vocabulary. Subjects were 16 boys and 4 girls who stutter (mean age = 46.80 months) and 16 boys and 4 girls who do not stutter (mean age = 47.55 months). Each child was audio recorded during a loosely structured, 30-minute conversation with an adult. This conversational interaction was subsequently assessed to provide information pertinent to the child's frequency and type of speech disfluency. After completion of the adult-child conversational interaction, each child was administered and responded to standardized tests of syntactic, semantic, and phonological abilities and development. Results indicated that the difference between measures of receptive/expressive language and receptive vocabulary is significantly greater for CWS than CWNS; however, this difference between receptive/expressive language and receptive vocabulary scores was not significantly correlated with the overall stuttering frequency of CWS. Findings were taken to suggest that the semantic development of CWS may lag behind their syntactic development, a possible imbalance among components of the speech-language systems of CWS that may contribute to the difficulties they have establishing normal speech fluency. Research supported by an NIH grant (DC00523) to Vanderbilt University.

Real-Time Analysis of Speech Fluency

Many authors have suggested that it is possible for clinicians to collect basic data regarding their client's speech fluency on-line, or in real time, while the client is speaking. Unfortunately, the literature contains relatively little in the way of detailed instructions on exactly how such data should be collected. This article provides specific instructions for real-time collection of information about the frequency and types of speech disfluencies produced by individuals who stutter. The paper also outlines procedures for training students and clinicians to use this technique reliably and accurately and proposes tolerance limits for determining whether frequency counts are sufficiently reliable for clinical use.

Clinical implications of situational variability in preschool children who stutter

Variability is one of the hallmarks of stuttering. Nevertheless, differences in children's frequency of stuttering in different speaking situations have not been thoroughly investigated. This study examined variability in the frequency of disfluencies produced by 45 preschool children who stutter (mean age = 42.3 months) in five different speaking situations (parent-child interaction, play with clinician, play with pressures imposed, story retell, and picture description). Significant differences were found in the frequency of disfluencies between these situations, and the variability between situations was significantly greater than the variability seen within a single speaking situation. In general, the “play with pressure” situation elicited the highest frequency of disfluencies from many subjects, though subjects exhibited highly individualized patterns of variability. Finally, children with a higher average frequency of “less typical” disfluency types exhibited a significantly higher degree of variability. Results highlight the importance of evaluating more than one speaking situation when diagnosing a child who stutters both to obtain a better understanding of the nature of the child's stuttering disorder and to ensure that the true extent of the child's stuttering is not overlooked.

The interaction of bilingualism and stuttering in an adult

The relation between bilingualism and stuttering was examined in a bilingual adult who stutters. Language ability in English and Afrikaans was assessed through the use of cloze and language proficiency tests. Anticipation, adaptation and consistency of stuttering were investigated. Frequency, distribution and nature of disfluencies on narrative and procedural tasks were analyzed according to a modified version of the Systematic Disfluency Analysis (SDA) (Campbell & Hill, 1987). Results indicated that language ability influenced frequency, distribution and nature of disfluencies. The subject was more proficient and stuttered less in his predominant language. Implications for the interaction of language and stuttering were discussed. Clinical strategies for dealing with bilingual stutterers were considered.

Predictive factors of persistence and recovery: Pathways of childhood stuttering

This article presents broad preliminary findings from a longitudinal study of stuttering pertaining to differentiation of developmental paths of childhood stuttering, as well as possible early prediction of High Risk, Low Risk, and No Risk for chronic stuttering. More than 100 preschool children who stutter have been closely followed for several years from near the onset of stuttering using a multiple data collection system, with 45 nonstuttering children serving as controls. Thirty-two stuttering and 32 control subjects who have progressed through several stages of the investigation were identified for the present indepth analyses. They represent four subgroups: I. Persistent Stuttering; II. Late Recovery; III. Early Recovery; IV. Control. Comparative data for the groups with special reference to differences in frequency of disfluency, acoustic features, phonologic skills, language development, nonverbal skills, and genetics are presented. The results suggest several promising predictors of recovery and chronicity.