People Who Stutter Research Articles

Attitudes, knowledge, and beliefs of Arab speech-language pathologists about stuttering

ObjectivesThe current study assessed the attitudes, knowledge, and beliefs of Arab speech-language pathologists (SLPs) in the Middle East using the clinician's attitudes towards stuttering inventory (CATS). The aim was to determine whether the attitudes, knowledge, and perceptions of clinicians would potentially influence service provision, treatment efficacy, as well as the implementation of early intervention.Patients and methodsSixty-three Arab SLPs were surveyed using the CATS inventory. The survey consists of 50 attitudinal statements, assessing a broad range of beliefs related to the etiology of stuttering, people who stutter (PWS), the effectiveness of stuttering treatment, early intervention, and about their attitudes towards parents of children who stutter. A component in the survey also looked specifically at issues of awareness and knowledge about early intervention for stuttering.ResultsThe study found the presence of outdated concepts in the attitudes and beliefs of some SLPs towards stuttering and PWS. Although respondents seemed confident in treating PWS, they felt they required guidance from a stuttering specialist. Overall, SLPs believed that the treatment of stuttering is a complex and difficult area.ConclusionThe results highlight the need for education and training programs in the area of stuttering in the Middle East to improve knowledge about the disorder and its treatment.

Attitudes of Arab university students and general public towards people who stutter

Speech-language pathology is a burgeoning field in many Arab countries, including Kuwait. While a small number of studies have investigated Kuwaiti attitudes toward stuttering and people who stutter (PWS), no such studies have been conducted with a broad sampling of the general public. In this study, a modified version of Bebout and Arthur's (1992) questionnaire to measure attitudes toward communication disorders was adapted into Arabic and administered to 943 university students and adult members of the general population living in Kuwait. Results indicated that attitudes toward stuttering and PWS in Kuwait are generally positive, though negative trends were observed for some items related to the perceived causes and traits of stuttering as well as vocational/societal inclusion of PWS. The findings indicate that members of the general public in Kuwait and other Arab countries could benefit from increased knowledge of stuttering and how to interact with PWS. Speech-language pathologists and PWS who conduct public awareness campaigns in these countries may find it prudent to adopt educational strategies, which are specific to their target populations.

The impact of threat and cognitive stress on speech motor control in people who stutter

PurposeIn the present study, an Emotional Stroop and Classical Stroop task were used to separate the effect of threat content and cognitive stress from the phonetic features of words on motor preparation and execution processes. MethodA group of 10 people who stutter (PWS) and 10 matched people who do not stutter (PNS) repeated colour names for threat content words and neutral words, as well as for traditional Stroop stimuli. Data collection included speech acoustics and movement data from upper lip and lower lip using 3D EMA. ResultsPWS in both tasks were slower to respond and showed smaller upper lip movement ranges than PNS. For the Emotional Stroop task only, PWS were found to show larger inter-lip phase differences compared to PNS. General threat words were executed with faster lower lip movements (larger range and shorter duration) in both groups, but only PWS showed a change in upper lip movements. For stutter specific threat words, both groups showed a more variable lip coordination pattern, but only PWS showed a delay in reaction time compared to neutral words. Individual stuttered words showed no effects. Both groups showed a classical Stroop interference effect in reaction time but no changes in motor variables. ConclusionThis study shows differential motor responses in PWS compared to controls for specific threat words. Cognitive stress was not found to affect stuttering individuals differently than controls or that its impact spreads to motor execution processes.Educational objectives: After reading this article, the reader will be able to: (1) discuss the importance of understanding how threat content influences speech motor control in people who stutter and non-stuttering speakers; (2) discuss the need to use tasks like the Emotional Stroop and Regular Stroop to separate phonetic (word-bound) based impact on fluency from other factors in people who stutter; and (3) describe the role of anxiety and cognitive stress on speech motor processes.

Anxiety and speaking in people who stutter: An investigation using the emotional Stroop task

People with anxiety disorders show an attentional bias towards threat or negative emotion words. This exploratory study examined whether people who stutter (PWS), who can be anxious when speaking, show similar bias and whether reactions to threat words also influence speech motor planning and execution. Comparisons were made between 31 PWS and 31 fluent controls in a modified emotional Stroop task where, depending on a visual cue, participants named the colour of threat and neutral words at either a normal or fast articulation rate. In a manual version of the same task participants pressed the corresponding colour button with either a long or short duration. PWS but not controls were slower to respond to threat words than neutral words, however, this emotionality effect was only evident for verbal responding. Emotionality did not interact with speech rate, but the size of the emotionality effect among PWS did correlate with frequency of stuttering. Results suggest PWS show an attentional bias to threat words similar to that found in people with anxiety disorder. In addition, this bias appears to be contingent on engaging the speech production system as a response modality. No evidence was found to indicate that emotional reactivity during the Stroop task constrains or destabilises, perhaps via arousal mechanisms, speech motor adjustment or execution for PWS.Educational objectives: The reader will be able to: (1) explain the importance of cognitive aspects of anxiety, such as attentional biases, in the possible cause and/or maintenance of anxiety in people who stutter, (2) explain how the emotional Stroop task can be used as a measure of attentional bias to threat information, and (3) evaluate the findings with respect to the relationship between attentional bias to threat information and speech production in people who stutter.

Validity and Reliability of Persian Version of WASSP Test for Adults with Stutter

Objectives: An essential need in Iran for the application of stuttering self-rating tools for the people who stutter (PWS) and its conversion into Persian language has encouraged this research to examine the validity and reliability of Wright and Ayre Stuttering Self-Rating Profile (WASSP) test to the benefits of adult Persianspeaking individuals who stutter. WASSP is an excellent tool for assessment and measuring outcomes and a beneficial tool for clinicians and clients as well. So, the purpose of this study is to examine the content validity by some speech and language pathologists in Iran, then to evaluate the reliability of the WASSP test for adult Persianspeaking people with stutter. Methods and Procedure: The participants were 24 (20 males and 4 females) stutterers who were Persian speaking, 1830 years old (mean 24 years) with no medical or behavioral problems. 20 skilled Speech Language pathologists (SLPs) who were independent of the research, participated in the study to evaluate translation and content validity of the test. Cronbach’s alpha coefficients were used to assess internal consistency of items and reliability assessed by estimating Intraclass Correlation Coefficients (ICC) in test-retest

COMPARING THE QUALITY OF LIFE IN ADULTS WHO STUTTER WITH THEIR NORMAL COUNTERPARTS

Introduction: Stuttering is a communication disorder that, in addition to speech fluency, can affect all aspects of personal life. Through numerous researches and also from the experiences of People Who Stutter (PWS), it is now evident that stuttering can cause an over all sense of life dissatisfaction. The aim of this study was to compare the quality of life in adults with stuttering versus their normal counterparts using the brief version of World Health Organization Quality Of Life Questionnaire. Materials and Methods: 25 adults with stuttering and 25 adults without stuttering, who were matched for age, sex and education level, participated in this cross-sectional analytic study. Tocollect data, World Health Organization Quality of Life Questionnaire was used. Independent sample t test was conducted for the statistical analysis of the data. Results: The results of data analysis showed that, except for social relationships domain, the difference between the two groups regarding total scores of quality of life, physical health, mental health and environmental health were statistically significant. Conclusion: The results of the present study showed that people who stutter have lower quality of life based on WHOQOL-BREF questionnaire. Thus, it is better to pay appropriate attention to in the quality of life of people who stutter during the evaluation and treatment processes rather than attending solely to speech fluency needs. Keywords: Quality of life, Stuttering, Adult persons

The SpeechEasy device in stuttering and nonstuttering adults: Fluency effects while speaking and reading

The SpeechEasy is an electronic device designed to alleviate stuttering by manipulating auditory feedback via time delays and frequency shifts. Device settings (control, default, custom), ear-placement (left, right), speaking task, and cognitive variables were examined in people who stutter (PWS) (n=14) compared to controls (n=10). Among the PWS there was a significantly greater reduction in stuttering (compared to baseline) with custom device settings compared to the non-altered feedback (control) condition. Stuttering was reduced the most during reading, followed by narrative and conversation. For the conversation task, stuttering was reduced more when the device was worn in the left ear. Those individuals with a more severe stuttering rate at baseline had a greater benefit from the use of the device compared to individuals with less severe stuttering. Our results support the view that overt stuttering is associated with defective speech-language monitoring that can be influenced by manipulating auditory feedback.

Comparison of quality of life in people who stutter and normal individuals

Background: Although recent findings suggest that stuttering as a chronic disorder has a substantial negative impact on quality of life (QOL), few systematic research has been conducted in this regard. The aim of this study was to compare the aspects of perceived QOL in people who stutter (PWS) and normal individuals. Methods: In this case-control pilot study, a comparative study was done on physical health, psychological health, social relationship and environmental aspects of QOL between 59 Kurdish-speaking PWS and 73 fluent speakers in Kermanshah, Iran. Standardized Persian versions of WHO QOL-BREF and a demographic questionnaire for data collection were employed. Stuttering Severity was measured using a 7-point self-rating questionnaire. Data was analysed using independent-samples T-test, U Mann Whitney and bivariate correlation. Results : In general, PWS had lower scores on physical health, psychological health and social relationship aspects of QOL compared to normal speakers. However except for physical health aspect of QOL, these differences were not statistically significant. According to the results of bivariate correlation in PWS, there was negatively significant correlation between severity of stuttering and three aspects of QOL including physical health, psychological healthand environment. Conclusion: PWS showed lower physical health compared to their normal peers. Perhaps, this outcome highlights this assumption that physical aspects of QOL are more vulnerable to stuttering compared to the other aspects of daily life.

Neural control of rising and falling tones in Mandarin speakers who stutter

Neural control of rising and falling tones in Mandarin people who stutter (PWS) was examined by comparing with that which occurs in fluent speakers [Howell, Jiang, Peng, and Lu (2012). Neural control of fundamental frequency rise and fall in Mandarin tones. Brain and Language, 121(1), 35–46]. Nine PWS and nine controls were scanned. Functional connectivity analysis showed that the connections between the insula and LMC and between the LMC and the putamen differed significantly between PWS and fluent speakers during both rising and falling tones. The connection between the insula and the brainstem differed between PWS and fluent speakers only during the falling tone. These results indicated the neural control for the rising tone and the falling tone are affected in PWS. Moreover, whilst both rising and falling tones were affected in PWS, falling-tone control appeared to be affected more.

Client Reports of Successful Treatment Approaches

Purpose: The purpose of this study was to obtain the perspectives of people who stutter (PWS) on the effectiveness of various stuttering treatment approaches based on their experiences with differe...

Long-term effectiveness of the SpeechEasy fluency-enhancement device

The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the SpeechEasy were maintained for longer periods, from 13 to 59 months. Results indicated no significant change for seven device users from post-fitting to the time of the study (t=−.074, p=.943); however, findings varied greatly on a case-by-case basis. Most notably, when stuttering frequency for eleven users and former users, prior to device fitting, was compared to current stuttering frequency while not wearing the device, the change over time was found to be statistically significant (t=2.851, p=.017), suggesting a carry-over effect of the device. There was no significant difference in stuttering frequency when users were wearing versus not wearing the device currently (t=1.949, p=0.92). Examinations of these results, as well as direction for future research, are described herein.Educational objectives: The reader will be able to: (a) identify and briefly describe two types of altered auditory feedback which the SpeechEasy incorporates in order to help reduce stuttering; (b) describe the carry-over effect found in this study, suggest effectiveness associated with the device over a longer period of time than previously reported, as well as its implications, and (c) list factors that might be assessed in future research involving this device in order to more narrowly determine which prospective users are most likely to benefit from employing the SpeechEasy.

Stuttering characteristics of German–English bilingual speakers

The purpose of this study was to examine stuttering behavior in German–English bilingual people who stutter (PWS), with particular reference to the frequency of stuttering on content and function words. Fifteen bilingual PWS were sampled who spoke German as the first language (L1) and English as a second language (L2). Conversational speech was sampled in each language and analyzed for the percentage of overall stuttering-like disfluencies and distribution of stuttering on content and function words. Significantly more stuttering was found to occur in L2 compared to L1. Stuttering occurred significantly more often on content words compared to function words in L1. No significant difference between stuttering on function and content words was observed in L2. Examination across L1 and L2 found a significantly greater percentage of stuttering on function words in L2 compared to L1, and a significantly lower percentage of stuttering on content words in L2 compared to L1. The characteristics of stuttering in L2 could not be differentiated on the basis of an L2 proficiency measure. The differences observed in the amount of stuttering between L1 and L2 suggest that stuttering in bilingual speakers is closely related to language dominance, with features of stuttering in L2 indicative of a less developed language system.

Fluent Speakers’ Management of Prospective Communication Breakdowns: The Case of Stuttering

Stuttering is a disorder of verbal fluency that is often associated with such negative stereotypes as shyness and anxiety. This study investigates typically fluent speakers’ advice to both people who stutter (PWS) and other fluent speakers as they interact with each other. A written, open-ended, qualitative survey was administered to 135 members of the general public and analyzed thematically. Results indicate that stuttering is a disorder which engenders cognitive and emotional reactions in fluent speakers as well as proscribed communication strategies designed to prevent and manage communicative breakdowns. Fluent speakers appear to engage in high-level metalinguistic and metacognitive strategies as they interact with someone who stutters and believe that PWS should do the same. Research implications for those who work with people who have communication disorders in educational and healthcare settings are discussed.

Perceptions About Occupational Experiences by People Who Stutter

We explored the perceptions about work experiences and discrimination that people who stutter (PWS) report. A total of 184 PWS responded to a paper and pencil or an online version of a questionnaire that included 13 Likert-type scale and demographics questions. Of the respondents, 68 completed a pencil and paper version of the questionnaire and 116 completed an online version. Participants reported that their stuttering affected some aspects of occupational experiences and that their employers had made negative judgments during job interviews and promotional opportunities due to stuttering. Conversely, participants reported that stuttering did not affect whether they were asked to perform supervisory activities, that their coworkers appeared to accept their stuttering, and that stuttering did not affect their choice of careers. Stuttering severity, gender, treatment experiences, type of employment, and differences in salary did not affect participants’ reports related to occupational experiences. Finally, there were no differences between the responses provided by participants responding to the paper and pencil or electronic versions of the survey. In this paper, we discuss relationships between these findings and past research studies exploring occupational experiences of people who stutter.

Hand Preference in Developmental Stuttering: A Test of the Geschwind-Galaburda Hypothesis of Hemispheric Specialization (P07.178)

Objective: Our hypothesis was that people who stutter (PWS) are more likely to have atypical hand preference; to test this we measured the association of stuttering with gender and hand and foot preference. Background Geschwind and Galaburda postulated that functional inter-hemispheric differences reflect the extent of anatomical differences. From this idea they postulated that atypical cerebral lateralization underlies stuttering and thus stuttering would be associated with both left-handedness and gender. Design/Methods: Individuals on the Stuttering Foundation of America9s mailing list were asked to complete a mail survey and to distribute it to acquaintances. The survey included questions about gender, demographics and stuttering as well as 42-item hand-preference and 12-item foot-preference inventories (HPI and FPI, respectively). Results were analyzed using logistic regression. Results: Four-hundred-eighty-six subjects currently stuttered out of 863 responders. Handedness and gender were significant predictors of stuttering. Males were more likely to stutter than females [OR=7.7 95%CI(5,10) p Conclusions: Our results confirm our hypothesis that atypical laterality, as reflected on scores from a handedness survey, is a predictor of stuttering. This relationship is complex due to its interaction with sex-linked factors. Handedness and sex-linked factors may influence cortical development in PWS. From our results we postulate that how females respond to higher estrogen or lower testosterone exposure in utero can lead to both atypical language organization and hand preference. The process leading to stuttering in males may be different affecting only language organization. Supported by: Stuttering Foundation of America. Disclosure: Dr. Lovera has received personal compensation for activities with EMD Serono, Teva Neuroscience, and Biogen Idec as a consultant. Dr. Corey has nothing to disclose. Dr. Foundas has nothing to disclose.

The validity and reliability of the Farsi version of "the overall assessment of the speaker's experience of stuttering– adult" (OASES-A) Questionnaire

Introduction: To apply a comprehensive evidence-based approach to stuttering, there is a need for an instrument examining the totality of this disorder. Yaruss and Quesal (2006) published the “Overall Assessment of the Speaker’s Experience of Stuttering” (OASES) questionnaire to achieve this aim. OASES-A can be used for documenting multiple treatment outcomes of individuals with stuttering who are older than 18 years. The aim of this study was to determine the validity and reliability of Farsi version of OASES-A questionnaire. Materials and Methods: Face validity, internal consistency and reliability of OASES-A were evaluated thorough conducting a pilot study in which a semi-structural interview arranged for 10 people who stutter (PWS). 50 PWS were then asked to complete modified OASES-A and S-24 scale to determine concurrent validity. Finally, in order to determine test-retest reliability of Farsi version of OASES-A questionnaire, 5 stuttering people completed the form 2 times within a 7-to-10-day interval. Results: Cronbach's alpha coefficient, which was calculated for entire 4 parts of the Farsi version of OASES, was 82 to 97, implying that the Farsi version of OASES-A questionnaire had a good concurrent validity, internal consistency and reliability. Finally it was shown that all the items of the questionnaire have an appropriate validity and reliability. Conclusion: Results of the present study indicate that the validity and reliability of Farsi version of OASES are compatible with the original English version. Keywords: OASES-A, Stuttering, Validity, Reliability, Outcome measurement, Adulthood stuttering

Arab and American Teachers' Attitudes Toward People Who Stutter: A Comparative Study

Purpose: A limited number of studies have ex- plored attitudes toward people who stutter (PWS) in different cultures. Recent studies have looked at the attitudes of Arab parents toward PWS. The current study explores attitudes reported by Arab teachers from Kuwait and provides a pre- liminary comparison with attitudes reported by teachers from the United States. Method: This study used an English version and an Arabic translation of a 14-item semantic differential (SD) scale (Bur- ley & Rinaldi, 1986) to assess differences in American and Arab teachers' attitudes toward PWS. Results: A majority of Arab teachers from Kuwait reported neutral to positive attitudes toward PWS on the SD scale. However, ~ 1

Immediate effects of AAF devices on the characteristics of stuttering: A clinical analysis

The present study investigated the immediate effects of altered auditory feedback (AAF) and one Inactive Condition (AAF parameters set to 0) on clinical attributes of stuttering during scripted and spontaneous speech. Two commercially available, portable AAF devices were used to create the combined delayed auditory feedback (DAF) and frequency altered feedback (FAF) effects. Thirty adults, who stutter, aged 18–68 years (M=36.5; SD=15.2), participated in this investigation. Each subject produced four sets of 5-min of oral reading, three sets of 5-min monologs as well as 10-min dialogs. These speech samples were analyzed to detect changes in descriptive features of stuttering (frequency, duration, speech/articulatory rate, core behaviors) across the various speech samples and within two SSI-4 (Riley, 2009) based severity ratings. A statistically significant difference was found in the frequency of stuttered syllables (%SS) during both Active Device conditions (p=.000) for all speech samples. The most sizable reductions in %SS occurred within scripted speech. In the analysis of stuttering type, it was found that blocks were reduced significantly (Device A: p=.017; Device B: p=.049). To evaluate the impact on severe and mild stuttering, participants were grouped into two SSI-4 based categories; mild and moderate–severe. During the Inactive Condition those participants within the moderate–severe group (p=.024) showed a statistically significant reduction in overall disfluencies. This result indicates, that active AAF parameters alone may not be the sole cause of a fluency-enhancement when using a technical speech aid.Educational objectives: The reader will learn and be able to describe: (1) currently available scientific evidence on the use of altered auditory feedback (AAF) during scripted and spontaneous speech, (2) which characteristics of stuttering are impacted by an AAF device (frequency, duration, core behaviors, speech & articulatory rate, stuttering severity), (3) the effects of an Inactive Condition on people who stutter (PWS) falling into two severity groups, and (4) how the examined participants perceived the use of AAF devices.

Stuttering behavior in Kurdish-Persian bilingual speakers

The present study was conducted to investigate the dissociation between some linguistic variables including the Mean Length of Utterance (MLU) and Type Token Ratio (TTR) and stuttering severity in both languages of Kurdish-Persian bilingual people who stutter (PWS). The connected speech of 31 PWS (age ranges: 9 to 13 years old) speaking in their first (Kurdish) and second (Persian) languages were collected. The results indicate that there is a significant correlation between stuttering severities in both languages. Moreover, it seems that MLU in Kurdish could predict the stuttering occurrence in the Persian language.

Arab school teachers’ knowledge, beliefs and reactions regarding stuttering

PurposeStereotypes toward stuttering and people who stutter (PWS) are widespread in the general public irrespective of age, level of education, culture, geographic location and profession. Negative attitudes held by persons of authority like teachers can lead to social, economic and educational obstacles in the lives of PWS. MethodThe current study used an Arabic translation of an adapted version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to explore Arab teachers’ knowledge and attitudes toward stuttering as well as strategies they adopt to cope with the problem in class. The participants were 262 in-service and 209 pre-service public school teachers in Kuwait. The results are contrasted to those of Arab parents in Kuwait reported earlier. ResultsAlthough many of the teachers knew a person who stutters well and were sensitive in their interactions with PWS, major findings of this study suggest that many were misinformed about the causes of stuttering and held stereotypical views about PWS, comparable to those reported in the literature. Very few differences were noted between opinions of teachers who were still in training and those who were practicing for an average of 11 years. ConclusionThe study underscores the need for awareness campaigns that target not only teachers who are currently working but also those still in training to dispel misconceptions about stuttering and ensure a better educational environment for PWS.Educational objectives: At the end of this activity the reader will be able to: (1) describe knowledge of stuttering and attitudes toward students who stutter and classroom strategies perceived to be helpful by pre-service and in-service teachers in Kuwait; (2) identify stereotypes toward stuttering across cultures, professions and geographic locations; and (3) list similarities and differences in attitude and knowledge of stuttering between parents and teachers.