Preschool Stutterers Research Articles

Comparing a Demands and Capacities Model Approach and the Lidcombe Program for Pre-school Stuttering Children: The Restart Randomised trail

In the Netherlands, the Demands and Capacities Model based treatment (DCM) has been the standard treatment for pre-school stuttering children since the late 1980s. The Lidcombe Program (LP) is a behavioural treatment program for stuttering pre-schoolers that was developed in Australia in the 1990s. Since 2000, this treatment program is also practised by a minority of Dutch clinicians. In 2007, a randomised trial in which both treatments were compared on effectiveness and costs was started. This study was named RESTART: the Rotterdam Evaluation study of Stuttering Therapy in preschool children- a Randomised Trial.In total, 199 stuttering children aged 3-6 years old and their parents participated in this study. They presented for treatment to one of the 24 participating clinicians who were qualified for both treatment methods (DCM and LP) and whose clinics were scattered over the Netherlands. To be admitted to the study, the children had to stutter at least mildly according the parent and the clinician, and children and parents had to be proficient in Dutch. Children stuttering less than six months before recruitment were excluded. Assessments were scheduled pre-treatment, 3, 6, 12 and 18 months post treatment, including audio speech samples outside the clinic, video recording inside the clinic, and questionnaires.Randomisation over treatment was stratified by age, gender, time since onset, severity of stuttering, family history of recovery/persistence from stuttering, and clinician. Every three months, meetings between the research group and all participating clinicians were held, enabling deliberation.At the conference, the results of the RESTART study regarding recovery of stuttering and cost effectiveness will be presented.

REMOVED: Webcam Preschool Stuttering Treatment: Outcomes and Experiences from a Clinical Trial

REMOVED: Webcam Preschool Stuttering Treatment: Outcomes and Experiences from a Clinical Trial

Involve Parents in Preschool Stuttering Therapy? Yes!

Involve Parents in Preschool Stuttering Therapy? Yes!

The Preschool Stuttering Screen for Health Care Professionals

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

Treatment Decisions for Young Children Who Stutter

Treatment Decisions for Young Children Who Stutter

Measurable Outcomes of Instructions to Modify Normal Parent-Child Verbal Interactions

This study was a preliminary analysis of the differential effects of instructions to slow maternal speech rate, or to slow and simplify maternal speech when conversing with normally fluent children. Twenty mothers and their normally fluent children participated. Instructions to slow maternal rate resulted in maternal speech simplification as a by-product. No significant differences were found between the effects of the two sets of instructions. Furthermore, children's speech rate and language complexity did not parallel maternal adjustments. These last findings are problematic for some of the premises that underlie the use of parental counseling as a component of indirect therapy for stuttering.

Verbal Behaviors of Preschool Stutterers and Conversational Partners

Standard counseling practices with the families of young stutterers include recommendations that listeners' negative verbal behaviors be modified in order to reduce the likelihood of stuttering. This study tested the hypothesis that stuttering and normal disfluencies in preschool stutterers are related to selected verbal behaviors in conversational partners. Twelve 2- to 6-year-old stutterers were video recorded while playing with their mother, father, and a familiar peer. The resulting videotapes were transcribed and two types of social communicative analyses (total number of words and utterances, verbal intent of the speaker) were undertaken. Results suggested that fathers used more words and utterances than mothers and peers. Parents provided more positive interactions with their stutterer offspring than did peers. Parents also asked significantly more negative and routine questions when talking to their stuttering child. Peer playmates were significantly more negative and generally commented more frequently when interacting with stutterers than did the parents. Stutterers were involved in significantly more positive interactions with their fathers. The frequency of fluency failures did not differ significantly when stutterers communicated with their mother, father, or peer partners. Implications regarding verbal styles of partners in relationship to the stuttering of preschool children are discussed.

Verbal behaviors of preschool stutterers and conversational partners: Observing reciprocal relationships : Meyers, S.C., California State University, Northridge, California. Journal of Speech and Hearing Disorders, (1990) 55, 706–712

Verbal behaviors of preschool stutterers and conversational partners: Observing reciprocal relationships : Meyers, S.C., California State University, Northridge, California. Journal of Speech and Hearing Disorders, (1990) 55, 706–712

Verbal behaviors of preschool stutterers and conversational partners: Observing reciprocal relationships : Mayers, S.C., California State University, Northridge. Journal of speech and hearing disorders, (1990) 55, 706–712.

Verbal behaviors of preschool stutterers and conversational partners: Observing reciprocal relationships : Mayers, S.C., California State University, Northridge. Journal of speech and hearing disorders, (1990) 55, 706–712.

Clinical Implications From Meyers (1989) on Preschool Stutterers and Their Conversational Partners

Clinical Implications From Meyers (1989) on Preschool Stutterers and Their Conversational Partners

Impact of microcomputer simulation training on student-clinicians' ability to effectively intervene with preschool stutterers

A computer-based simulation was developed to train student-clinicians to use effective verbal techniques while intervening with preschool stutterers. This training vehicle allowed student-clinicians to maintain a verbal dialogue in real-time with a preschool stutterer whose voice-synthesized level of disfluency was directly tied to the participant's intervention effectiveness. Ten experimental and 10 control subjects completed a pre- and posttest therapy session with a computer-defined stutterer. The experimental subjects completed additional simulated therapy sessions, while control subjects coded and analyzed audiotaped segments of children's disfluency. All subjects then administered therapy to real preschool stutterers during a 10-min session. Results from the pre- and posttest simulation sessions revealed no significant differences between the groups on the pretest simulation and significant differences in the use of slow talk, positive feedback, interruptions, fast talk, negative feedback, and inappropriate questions during the posttest simulation. During intervention with real stutterers, the experimental subjects used significantly more effective intervention techniques (explain/describe, slow talk, positive feedback, model) and significantly fewer ineffective techniques (interrupt, fast talk, negative feedback, inappropriate questions, social interaction) than the control subjects.

Nonfluencies of preschool stutterers and conversational partners: observing reciprocal relationships.

Nonfluencies produced by 12 stutterers (2-6 years old) interacting in three dyadic sessions were analyzed. A stutterer played with his own mother, own father, and a familiar peer for 10 min. Results indicated that the total frequencies and types of nonfluency observed were very similar in each of the play situations. Although stutterers exhibited more part-word repetitions and prolongations than any other type of nonfluency, they did not differ in the amount and type of nonfluency when talking to their three conversational partners. Because children have more breakdowns in fluency than adults, it was not surprising that peers were more nonfluent when talking to the stutterer than were the parents. Peers used significantly more part- and whole-word repetitions, tense pauses, and interjections than the parents did. The nonfluency levels of the parent partners were quite similar when talking to the stutterers.

A microcomputer simulation to evaluate and train effective intervention techniques in listening partners of preschool stutterers

A microcomputer-based simulation is being developed to assist parents and speech clinicians-in-training in intervening effectively with a stuttering child. The experience centers on the participant's maintenance of an active verbal dialogue with a computer-generated preschool stutterer whose speech-synthesized fluency level can be directly linked to the participant's verbal behavior. In an initial test of the system's evaluation efficacy, the intervention behaviors exhibited by a group of eight experienced speech pathologists were compared with those exhibited by a group of eight entry-level speech pathology students. The experienced group showed superior intervention particularly on rate-of-speech variables. Efforts are also focusing on increasing the system's coding sensitivity and on assessing its potential as a vehicle for the direct training of effective intervention skills.

Voice onsets and segment durations of normal speakers and beginning stutterers

Longer VOT and segment durations apparently characterize the contrived responses of school-age stutterers examined under laboratory conditions. Thus, these variables may reflect basic disparities between the speech production abilities of stutterers and normal speakers. To better explore this possibility, VOT and segment durations were assessed in five nonstutterers who were closely matched with five preschool stutterers who had been diagnosed and tested in the experiment within six months of parental concern about fluency development. Target words were measured in isolation, in elicited sentences, and conversation. Results revealed significantly slower VOT and longer segment durations in the young stuttering members of the pairs of speakers. The stutterers were also more variable in their management of these same two aspects of motor speech timing control.

Qualitative and quantitative differences and patterns of variability in disfluencies emitted by preschool stutterers and nonstutterers during dyadic conversations

Disfluencies produced by 24 young stuttering and nonstuttering boys (4 to 5 years old) interacting in three dyadic sessions were analyzed. Each child interacted with his own mother, an unfamiliar mother of a stutterer, and an unfamiliar mother of a nonstutterer. Significant quantitative and qualitative differences were found in the number and types of disfluencies emitted by the two groups of children. Stuttering children with more severe disfluency problems differed quantitatively from those with less severe problems. Total frequency of disfluency was highly consistent for both groups of children. Only two disfluency types (tense pauses and whole-word repetitions) showed significant variability across sessions. This research demonstrates the feasibility of differential diagnosis of young stuttering children.

Interruptions as a variable in stuttering and disfluency.

Parental verbal behavior is often cited as a major precipitating and maintaining factor in the onset and development of stuttering. Parents are frequently counseled to avoid interrupting their stuttering child. The purpose of the present study was to determine (a) whether mothers of preschool stutterers interrupt children's speech more frequently than mothers of nonstutterers, (b) whether stutterers interrupt the speech of mothers more frequently than nonstutterers, and (c) whether there is relationship between interruptive behavior and the occurrence of children's disfluencies. Twenty-four preschool boys (12 stutterers and 12 nonstutterers) and their mothers participated in the study. Ten-min, conversational speech samples of mothers interacting with their own children, unfamiliar stutterers, and unfamiliar nonstutterers were analyzed. Results indicated that mothers of nonstutterers interrupted the disfluent speech of stutterers significantly more often than did mothers of stutterers. Most importantly, all mothers interrupted children's disfluent speech significantly more than they interrupted children's fluent speech. Further, all children demonstrated a tendency to be disfluent when they interrupted a mother.

An experimental treatment using verbal punishment with two preschool stutterers

A multiple base-line experimental treatment was conducted with two preschool stuttering children. Each child conversed 20 min with the experimenter for 20 sessions. Treatment consisted of the presentation of the verbal stimulus “slow down” contingent upon a stuttering response. The percentage of words stuttered by both children decreased during the treatment sessions. Probe tape recordings conducted in each child's home revealed a decrease in stuttering frequency.

Early syllable dysfluency in stutterers and nonstutterers: A preliminary report

Four preschool stutterers and 20 nonstutterers were compared to determine if children who develop stuttering differ from nonstutters in frequency of syllable dysfluency. This preliminary report points to the possibility that children who develop stuttering are less able from the outset to manage the fluent flow of syllables in their speech; the mean percent syllables dysfluent for the stutterers was 9.88, whereas for the nonstutterers it was only 1.24.

The grammatical factor in childhood disfluency in relation to the continuity hypothesis.

The relationship between grammatical function and disfluency was investigated in 15 normal-speaking children aged three years 11 months to four years 10 months. Pronouns and conjunctions appeared in significantly greater proportion among the subjects' disfluent words than among their total words. On the other hand, nouns, verbs, and prepositions had a significantly low frequency of disfluency. In many respects, the results were similar to those previously found for preschool stutterers, though a notable difference occurred in the case of verbs. The findings were interpreted to be in general accord with the hypothesis that a continuity exists between early stuttering and certain forms of normal childhood disfluency.

An experimental treatment with two preschool stuttering children.

An experimental treatment was conducted with two stuttering children. Each child conversed with a “talking” puppet for a number of 20-minute sessions. Baserates of stuttering frequency were established. Treatment consisted of a “time-out” procedure during which the puppet was not visible and did not talk with the child for 10 seconds contingent on each stuttering. Generalization, carry-over, and follow-up sessions were conducted. The stuttering frequencies of both children reduced essentially to zero during the treatment sessions, and remained at that low frequency throughout generalization, carry-over, and follow-up sessions.