Stuttering-like Disfluencies Research Articles

Linguistic factors associated with stuttering-like disfluencies in Japanese preschool and school-aged children who stutter

IntroductionStuttering is influenced by different linguistic factors, such as sentence- and word-level factors. However, its developmental differences remain unclear. Thus, this study examined the developmental differences in the linguistic factors associated with stuttering-like disfluencies (SLD) among Japanese preschool and school-aged children who stutter. MethodsWe analyzed utterances from 30 Japanese-speaking children who stutter aged 5–10 years. Participants were divided into three groups according to their age (5–6, 7–8, and 9–10 years old). ResultsSignificant effects of sentence length, bunsetsu length, syllable weight, and bi-mora frequency on SLD frequency were observed across the age groups. In contrast, there was not a significant effect of mora frequency on SLD frequency. ConclusionsBoth sentence- and word-level factors affected SLD in children who stutter aged 5–10 years. Future research should be conducted with children below 5 years of age to observe detailed developmental differences in the linguistic factors that affect stuttering.

Speech Disfluencies in Bilingual Lebanese Children Who Do and Do Not Stutter.

Prior studies have shown that bilingual children who do not stutter (CWNS) exhibit a high number of disfluencies in both languages, increasing the risk of misidentification by speech-language pathologists as children who stutter (CWS). Conversely, there is a risk of misidentifying CWS with a relatively low incidence of disfluencies as CWNS. This study aims to explore the qualitative and quantitative distinctions in speech disfluency profiles between CWNS and CWS. The assessment covers both the dominant and nondominant language to examine the impact of language dominance on disfluency patterns. A total of 92 Lebanese bilinguals (70 CWNS and 22 CWS) from 4;06 to 7;06 (years;months) were included. Language dominance was determined based on parental assessments. Spontaneous and narrative speech samples were collected for each child in both languages and all stuttering-like disfluencies (SLD) and other disfluencies (OD) were coded. On average, CWNS showed a significantly lower percentage of total SLD, weighted SLD, SLD subtypes, and iterations compared to CWS. However, the number of disfluencies of CWNS exceeded monolingual clinical standards. Language dominance did not impact SLD and OD percentages, but some differences for SLD subtypes emerged. Binary logistic regression analyses showed that repetitions and dysrhythmic phonations are good predictors for correct CWS or CWNS classification, in contrast to OD. A combination of predictors from both languages led to better classification than using predictors from either language alone. The current study shows that speech disfluency percentages in bilingual CWNS typically surpass monolingual standards and can be at par with those of CWS. However, through careful consideration of disfluency characteristics, ideally in both languages, an accurate differential diagnosis of stuttering in bilingual children can be achieved.

Could linguistic and cognitive factors, degree of autistic traits and sex predict speech disfluencies in autistic young adults and controls?

ABSTRACT This study aimed to evaluate the effect of linguistic complexity and individual background variables (i.e. linguistic and cognitive abilities, degree of autistic traits, and sex) on speech disfluencies in autistic young adults and controls. Thirty-two 19- to 33-year-old autistic adults and 35 controls participated in this study. The frequency of disfluencies and stuttering severity were evaluated based on a narrative speech task. Linguistic complexity was assessed by evaluating the syntactic structures of the narratives. Cognitive and linguistic abilities were assessed using the General Ability Index (GAI), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) from the Wechsler Adult Intelligence Scale IV. Autistic traits were measured using the Autism Spectrum Quotient (AQ). Multiple-linear regression analyses (syntactic complexity, GAI, AQ, sex, and group status as predictors) showed that (a) syntactic complexity predicted total and stuttering-like disfluencies and stuttering severity, (b) GAI predicted typical disfluencies, and (c) sex predicted total, typical, and stuttering-like disfluencies. Additional correlation analyses revealed negative association between PRI and disfluencies in the control group but not in the autistic group. No connection was found between AQ and disfluencies. It seems that while some connections between disfluencies and individual cognitive features were found, some of the possible contributing factors for greater speech disfluency might differ between autistic and typical speakers.

Associations between social anxiety, physiological reactivity, and speech disfluencies in autistic young adults and controls

IntroductionThe aim of this study was to examine possible associations of social anxiety (SA) and speaking-related physiological reactivity with the frequencies of a) total disfluencies, b) typical disfluencies, and c) stuttering-like disfluencies, as well as d) stuttering-severity in autistic young adults and controls. MethodsThirty-two autistic young adults and 35 controls participated in this study. Participants were presented with video clips (viewing condition) and were then asked to talk about the videos (narrating condition). SA was measured by the self-report Social Phobia and Anxiety Inventory (SPAI). Speaking-related physiological reactivity was measured by the electrodermal activity (EDA), an index of emotional arousal. The speech samples from the narrating condition were analyzed for type and frequency of speech disfluencies and used for determining the stuttering severity. SA and speaking-related physiological reactivity were compared between the groups. Correlation between SA, physiological reactivity, disfluency frequencies, and stuttering severity were tested separately for both groups. ResultsNo between-group differences were found in the overall SA, yet differences were found in SPAI subscales of social interaction, group interaction, and avoidance, as well as in agoraphobia. Both groups had higher physiological arousal in narrating condition in comparison to the video viewing condition, yet there was no between-group difference in the reactivity. No associations were found between SPAI measures, physiological reactivity, disfluency frequencies, and stuttering severity in the autistic group. In the control group, a negative association was found between physiological reactivity and total and typical disfluency frequencies. ConclusionsSA or speaking-related physiological reactivity were not associated with disfluency frequencies or stuttering severity in autistic persons. Negative association between physiological reactivity and disfluency frequencies found in the control group may indicate that the physiological arousal may impact the speech production process by reducing the overt disfluencies.

Inhibitory Control, Cognitive Flexibility, and the Production of Disfluencies in Children Who Do and Do Not Stutter.

Differences in inhibitory control and cognitive flexibility between children who stutter (CWS) and children who do not stutter (CWNS) have been previously demonstrated. The aim of the current study was to investigate whether the previously reported inhibitory control- and cognitive flexibility-related performance costs for CWS are associated with the number of speech disfluencies that they produce. Participants were 19 CWS (Mage = 7.58 years, range: 6.08-9.17) and 19 CWNS matched on age and gender (Mage = 7.58 years, range: 6.08-9.33). Gamma regression models were used to investigate possible associations between performance costs in speed and accuracy measured during a computer task evaluating inhibitory control and cognitive flexibility and the number of speech disfluencies during video-recorded speech samples (story retelling and casual conversation). Two significant interactions were observed. For both inhibitory control and cognitive flexibility, we identified a significant group and inhibitory control/cognitive flexibility performance-cost interaction in stuttering-like disfluencies (SLDs), indicating that the performance-cost effects on SLD production were significantly higher in the CWS group, compared to the CWNS group. CWS with reduced inhibitory control or cognitive flexibility produce more SLDs, but not other disfluencies. These results are partly in line with some previous findings in nonstuttering and stuttering populations linking inhibitory control and cognitive flexibility weaknesses to the production of speech disfluencies.

Manifestation of speech disfluencies in preschool Cantonese-English speaking bilingual children

ABSTRACT Stuttering is characterised by disruptions in speech fluency that normally emerges between the ages of 2 to 5 when children start to formulate sentences. Current stuttering identification in children is largely based on speech disfluency criteria (>3% stuttering-like disfluencies, SLDs) developed for monolingual English-speaking children. Research in a Western language context shows that application of the criteria for monolingual to bilingual children may result in false positive diagnosis of stuttering. The applicability of these criteria to children speaking languages typologically distinct from English remains unclear. This preliminary study focused on bilingual Cantonese-English-speaking children, aiming to explore the manifestations of the speech disfluencies in Cantonese (a syllable-timed language) and English (a stress-timed language) while accounting for language dominance/proficiency and speaking task. Nineteen typically fluent Cantonese-English bilingual preschoolers were recruited for this study and their speech samples were collected across different speaking tasks (i.e. conversation and narration), and languages (i.e. Cantonese and English). The types and frequency of speech disfluencies were compared across both languages and the speaking tasks. The results showed that between 21–68% of children showed higher than 3% SLDs across different languages and speaking tasks. Linear mixed-effect analysis revealed that the prevalence of SLDs is higher in English (less dominant language) than Cantonese (more dominant language), and the prevalence is also higher in narration than conversation. These findings suggest the need for tailored stuttering identification criteria for bilingual children speaking diverse languages and emphasise the importance of considering language dominance/proficiency and speaking task when assessing stuttering in bilingual populations.

A case study of bilingual neurogenic stuttering: Measures of fluency, emotion, and articulation rate

IntroductionThis study explores the features of bilingual neurogenic stuttering and the potential connection between emotion and articulation rate on speech disfluencies. MethodThe participant is a 59-year old, Yiddish-English bilingual male with a moderate non-fluent aphasia. Thirty-two narratives (16 in each language), elicited using cue words, were analyzed for frequency of disfluency, type of disfluency (stuttering vs. non-stuttering-like), word-type (content vs. function), within-word location of disfluency, and occurrence of accessory behaviors. Additionally, the percentage and type of emotion (positive vs. negative) expressed, and articulation rate (fluent syllables spoken/duration of fluent utterances) was assessed. ResultsDisfluency occurred in each language with approximately equal frequency. The most common stuttering-like disfluencies were repetitions (monosyllabic, sound, and syllable) and prolongations. The most common non-stuttering-like disfluencies were self-correction/revisions, phrase and multisyllabic word repetitions, and pauses (silent and filled). In both languages, disfluencies occurred on both content and function words, but primarily content words, and in any position of the word, although primarily initial position. No accessory behaviors were noted. There was a similar amount of emotion words used in each language although the first acquired language, L1/Yiddish, had an overall more positive tone, and his second acquired language, L2/English, had a more negative tone. Additionally, there was a negative relationship between emotion and the number of disfluencies in L1/Yiddish, and a positive relationship in L2/English. A faster articulation rate was found in his native and more proficient language, Yiddish, than English. There was a negative relationship between articulation rate and the number of disfluencies in L1/Yiddish, and a positive relationship in L2/English. ConclusionsCross-linguistics differences for emotion and articulation rate demonstrates that these aspects impact on fluency and contributes to the disfluencies in each language. Clinical implications of the study demonstrates the importance of assessment of bilingual (i.e., proficiency and dominance) and fluency features of each language in the diagnostic process and the significance of considering emotional processes and articulation rate as part of a comprehensive intervention plan for acquired stuttering.

Unique Patterns of Bilingual Speech: Factors Affecting Disfluency Rates in Russian-Hebrew Bilingual Children.

Bilingual children often demonstrate a high rate of disfluencies, which might impact the diagnostic evaluation of fluency disorders; however, research on the rates and types of disfluencies in bilinguals' two languages is limited. The purpose of this research is to profile disfluencies of two types, stuttering-like disfluencies (SLDs) and other disfluencies (ODs), in the speech of Russian-Hebrew bilingual typically developing children, focusing on cross-linguistic differences and the effect of language proficiency in both languages. Spontaneous narratives based on the Frog, Where Are You? (Mayer, 1969) picture book were collected in both languages from 40 bilingual Russian-Hebrew children aged 5;6-6;6 (years;months). The transcribed narratives were coded for SLD (sound, syllable, and monosyllabic word repetitions) and OD (multisyllabic word/phrase repetitions, interjections, and revisions), and their frequencies per 100 syllables were calculated. Overall, most children had a percentage of SLD and OD below the cutoff point and within the existing criteria for stuttering diagnosis established based on monolingual data, but several children exceeded this stuttering criterion. Monosyllabic word repetitions (part of SLD) and interjections (part of OD) were more frequent in Hebrew than in Russian. Lower proficiency was associated with a higher percentage of monosyllabic word repetitions and of interjections in both languages. Bilingual disfluency criteria are needed, since based on the existing monolingual criteria, some children might be erroneously assessed as children who stutter, thus leading to overdiagnosis. The results support the claim that proficiency is an important factor in the production of disfluencies.

Decontextualized Utterances Contain More Typical and Stuttering-Like Disfluencies in Preschoolers Who Do and Do Not Stutter.

Stuttering-like disfluencies (SLDs) and typical disfluencies (TDs) are both more likely to occur as utterance length increases. However, longer and shorter utterances differ by more than the number of morphemes: They may also serve different communicative functions or describe different ideas. Decontextualized language, or language that describes events and concepts outside of the "here and now," is associated with longer utterances. Prior work has shown that language samples taken in decontextualized contexts contain more disfluencies, but averaging across an entire language sample creates a confound between utterance length and decontextualization as contributors to stuttering. We coded individual utterances from naturalistic play samples to test the hypothesis that decontextualized language leads to increased disfluencies above and beyond the effects of utterance length. We used archival transcripts of language samples from 15 preschool children who stutter (CWS) and 15 age- and sex-matched children who do not stutter (CWNS). Utterances were coded as either contextualized or decontextualized, and we used mixed-effects logistic regression to investigate the impact of utterance length and decontextualization on SLDs and TDs. CWS were more likely to stutter when producing decontextualized utterances, even when controlling for utterance length. An interaction between decontextualization and utterance length indicated that the effect of decontextualization was greatest for shorter utterances. TDs increased in decontextualized utterances when controlling for utterance length for both CWS and CWNS. The effect of decontextualization on TDs did not differ statistically between the two groups. The increased working memory demands associated with decontextualized language contribute to increased language planning effort. This leads to increased TD in CWS and CWNS. Under a multifactorial dynamic model of stuttering, the increased language demands may also contribute to increased stuttering in CWS due to instabilities in their speech motor systems.

Personal Factors and the Overall Variability of Stuttering

Purpose: The initial diagnosis of stuttering is based on stuttering-like disfluencies. This approach fails to capture the variability in overt stuttering behaviors of persons who stutter across speaking tasks and over time. This preliminary study explored the relationships between day-to-day variability of stuttering and several commonly used self-report and behavioral outcomes used to diagnose and monitor stuttering in clinical and research settings. Method: Five adults who stutter participated in this study. All participants completed a demographic questionnaire; the Overall Assessment of the Experience of Stuttering, State, and Trait Anxiety Inventory; and the Brief Version of Unhelpful Thoughts and Beliefs About Stuttering (UTBAS), followed by six (i.e., twice weekly) online sessions where conversation and reading samples were video-recorded to determine stuttering frequency and severity. Participants also rated their stuttering severity, variability, stress, anxiety, and sleep on a 7-point Likert scale for each session. Results: No self-report measures correlated with stuttering frequency or severity measures determined at each twice-weekly online session. Positive correlations were observed between self-rated stuttering severity and stress, anxiety, and normal disfluencies. Stuttering variability across tasks and sessions was positively correlated with the one-time Overall Assessment of the Speaker's Experience of Stuttering (OASES) and UTBAS-6 scores. Conclusions: Stuttering frequency was found to vary to different degrees for individual participants, and preliminary data suggest that scores on standardized assessments such as the OASES and UTBAS-6 are predictive of stuttering variability. Objective data on stuttering frequency may not capture the entire experience of stuttering.

Reduced duration of stuttering-like disfluencies and consistent anticipatory slowing during an adaptation task.

The adaptation effect in stuttering, traditionally described as the reduction of stuttering moments over repeated readings, provides a context to investigate fluency facilitation as well as a relatively controlled means of comparing fluent speech in the immediate vicinity of words that were stuttered versus fluently produced. Acoustic studies have documented decreased duration of fluent speech during adaptation but rarely address changes in disfluencies or the speech preceding or following the disfluencies. This study addresses this gap in the research by documenting frequency and duration changes in both fluent and stuttered syllables. Fifteen people who stutter read passages aloud five times in succession. Frequency and duration of fluent syllables, pauses, stuttering-like disfluencies (SLDs) and other disfluencies (ODs) were compared across the five readings. In addition, durations for syllables before and after pauses and SLDs were compared to determine if there were anticipation or carryover effects of SLDs on surrounding syllables. Durations measured for more than 22000 fluent syllables, 1531 pauses, 128 ODs and 1752 SLDs. For most of the 15 participants, significant decreases in both frequency and duration of SLDs over the five readings were observed. In addition, lengthening of fluent syllables immediately preceding the disfluent syllables was observed: this pre-SLD lengthening did not change over the five readings. Decreased duration of SLDs across readings supports the motor practice hypothesis, which assumes that successive reading of the same text increases the efficiency of the speech motor plans resulting in less stuttering and decreased durations of the stuttering that persists. Pre-SLD lengthening merits further study, because it informs our knowledge of the time course of stuttered events and may be associated with conscious or unconscious anticipation of upcoming SLDs that does not decrease with motor practice. What is already known on this subject The frequency of stuttering-like disfluencies (SLDs) can be reduced using a variety of fluency-enhancing strategies. For example, the adaptation effect, in which a reduction of stuttered events occurs over repeated readings of the same material, has been widely studied. Previous studies have shown that durations of fluent syllables decrease during adaptation, supporting the hypothesis that repeated practice of the motor plan leads to increased fluency. However, temporal changes in disfluent syllables and syllables preceding and following SLDs have rarely been studied, so our understanding of the effect of motor practice on stuttering reduction is incomplete. What this study adds This study has two significant findings. First, stuttered disfluencies that persisted after the initial reading of the adaptation task tended to become shorter in duration. Fluently produced syllables and those that were stuttered, both of which are speech events related to motor control of articulators, were affected in a similar manner by the motor practice associated with adaptation. Second, lengthening of fluent syllables immediately preceding stuttered syllables was observed. This pre-stuttering lengthening, however, did not decrease in duration over the five readings: the mechanism that drives this anticipatory behaviour is not affected by repeated practice. What are the clinical implications of this work? People who stutter have neural differences that lead to speech motor planning and/or execution that is less efficient than that of typical speakers. The finding that stuttering is reduced and that persisting SLDs become shorter in duration over repeated readings provides evidence that motor practice can influence the manifestation of stuttering by temporarily making those specific motor plans more efficient. This may inform treatments for stuttering. The observation that fluent syllables immediately before SLDs were lengthened, and that this lengthening was not influenced by repeated practice, extends our understanding of the time course of stuttering events and may be useful in understanding anticipation and listener reactions to stuttering.

A cross-sectional investigation of disfluencies in typically developing Spanish-English bilingual children

PurposeThis study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children. MethodA cross-sectional sample of 106 bilingual children (50 boys; 56 girls) enrolled in kindergarten through Grade 4, produced a total of 212 narrative retell language samples in English and Spanish. A specialized fluency coding system was implemented to index the percentage of total (%TD) and stuttering-like disfluencies (%SLD) in each language. Large-scale reference databases were used to classify children’s dual language proficiency profiles (balanced, English dominant, Spanish dominant) based on language sample analysis measures of morphosyntax and lexical diversity. ResultsThe bilingual Spanish-English children in this study did not demonstrate significant cross-linguistic differences for mean %TD or %SLD. However, the mean %TD and %SLD in both languages exceeded the risk threshold based on monolingual English-speaking norms. English dominant bilingual children demonstrated significantly lower %TD in English than Spanish. Spanish dominant children demonstrated significantly lower %SLD in Spanish than English. ConclusionsThis study included the largest sample size of bilingual Spanish-English children investigated to date from a fluency perspective. The frequency of disfluencies was found to be variable across participants and change dynamically as a function of grade and dual language proficiency profiles, indicating the need for studies that employ larger sample sizes and longitudinal designs.

Comparative Analysis of the Temporal Aspects of Word-Final Disfluencies, Stuttering-Like Disfluencies, and Nonstuttering-Like Disfluencies

Purpose: Repetitions at the end of words, known as word-final disfluencies (WFDs), have long been documented in the speech of individuals with and without other communication disorders. Although these disfluencies are often compared to repetitions at the beginning of words observed in stuttering, it has been suggested that WFDs differ from stuttering in their salient features. WFDs have been observed to present more as nonstuttering-like disfluencies (NSLDs; interjections, phrase repetitions, revisions) than as stuttering-like disfluencies (SLDs) in terms of tension and the individual's awareness of their disfluencies. An acoustic comparison of the different types of disfluency has not yet been explored. The purpose of this study was to compare the durational characteristics of repetitions in individuals with WFDs to those in individuals who exhibit SLDs and NSLDs. Method: Speech samples from three school-age boys who presented with WFDs, three school-age boys who stutter, and three preschool-age boys who presented with NSLDs often seen in normal language development were recorded and analyzed. The silent duration between the parent word and the repetition unit of each participant's disfluencies were measured using acoustic analysis software and compared across groups. Results: Results indicated that the silent duration between the word and the repeated segment of the disfluencies produced by each group was significantly different from each other. Conclusion: Descriptively, the silent duration of WFDs was closer to that of NSLDs than to that of SLDs, suggesting that WFDs may be more closely related to the disfluencies of developing language than to those of stuttering.

Stalling for Time: Stall, Revision, and Stuttering-Like Disfluencies Reflect Language Factors in the Speech of Young Children.

Disfluencies can be classified as stuttering-like disfluencies (SLDs) or typical disfluencies (TDs). Dividing TDs further, stalls (fillers and repetitions) are thought to be prospective, occurring due to planning glitches, and revisions (word and phrase revisions, word fragments) are thought to be retrospective, occurring when a speaker corrects language produced in error. In the first study assessing stalls, revisions, and SLDs in matched groups of children who stutter (CWS) and children who do not stutter (CWNS), we hypothesized that SLDs and stalls would increase with utterance length and grammaticality but not with a child's expressive language level. We expected revisions to be associated with a child having more advanced language but not with utterance length or grammaticality. We hypothesized that SLDs and stalls (thought to be planning-related) would tend to precede grammatical errors. We analyzed 15,782 utterances from 32 preschool-age CWS and 32 matched CWNS to assess these predictions. Stalls and revisions increased in ungrammatical and longer utterances and with the child's language level. SLDs increased in ungrammatical and longer utterances, but not with overall language level. SLDs and stalls tended to occur before grammatical errors. Results suggest that both stalls and revisions are more likely to occur in utterances that are harder to plan (those that are ungrammatical and/or longer) and that, as children's language develops, so do the skills they need to produce both stalls and revisions. We discuss clinical implications of the finding that ungrammatical utterances are more likely to be stuttered.

Syllable- and word-based measures of stuttering in speech samples of Turkish-speaking school-aged children

ABSTRACT Linguistic factors influence the likelihood of occurrence of stuttering instances on a certain word within an utterance. However, studies on the relationship between stuttering instances and linguistic factors of Turkish-speaking individuals are scarce. This study aimed to determine the syllable- and word-based measures of stuttering speech samples of Turkish-speaking school-aged children who stutter. Stuttering-like disfluencies (SLDs) and lexical categories were identified after transcription of 61 children’s spontaneous speech samples (age range = 6–16). Syllable-, word- and utterance-level measures were employed. Syllable-based and word-based stuttering frequency findings were significantly different (p < .001); SLDs were more likely to occur at the utterance-initial (p < .001) and word-initial (p < .001) positions; content words were more likely to be stuttered and, there was a relation between the occurrence of SLDs and utterance length (p = .001). Since there is great variability between word-based and syllable-based measures, and SLDs tend to occur at word onsets, using word-based measures in Turkish would provide a measure of stuttering frequency that is comparable to the literature. Moreover, findings support that phrases requiring greater demands on utterance planning increase the possibility of occurrence of stuttering instances.

A Comprehensive Analysis of Speech Disfluencies in Autistic Young Adults and Control Young Adults: Group Differences in Typical, Stuttering-Like, and Atypical Disfluencies.

The purpose of this study was to examine the nature of speech disfluencies in autistic young adults and controls by using a wide-range disfluency classification of typical disfluencies (TD; i.e., filled pauses, revisions, abandoned utterances, and multisyllable word and phrase repetitions), stuttering-like disfluencies (SLD; i.e., sound and syllable repetitions, monosyllable word repetitions, prolongations, blocks, and broken words), and atypical disfluencies (AD; i.e., word-final prolongations and repetitions and atypical insertions). Thirty-two autistic young adults and 35 controls completed a narrative telling task based on socially complex events. Frequencies of total disfluencies, TD, SLD, AD and stuttering severity were compared between groups. The overall frequency of disfluencies was significantly higher in the autistic group and significant between-group differences were found for all disfluency categories. The autistic group produced significantly more revisions, filled pauses, and abandoned utterances, and each subtype of SLD and AD than the control group. In total, approximately every fourth autistic participants scored at least a very mild severity of stuttering, and every fifth produced more than three SLD per 100 syllables. Disfluent speech can be challenging for effective communication. This study revealed that the speech of autistic young adults was highly more disfluent than that of the controls. The findings provide information on speech disfluency characteristics in autistic young adults and highlight the importance of evaluating speech disfluency with a wide-range disfluency classification in autistic persons in order to understand their role in overall communication. The results of this study offer tools for SLPs to evaluate and understand the nature of disfluencies in autistic persons.

Prolongamentos no final de palavras: características acústicas e influência na percepção da fluência de fala

ABSTRACT The aim of this study was to characterize word final prolongations in individuals with and without stuttering as well as to investigate the influence of end of words prolongations on speech fluency perception. In Experiment 1, 14 subjects were submitted to speech fluency evaluation for analysis of duration and average frequency of extended phones at the end of words. In Experiment 2, twenty lay judges were asked to judge the fluency degree of utterances without disfluency, utterances containing prolongations and utterances containing filled pauses. In experiment 1 the groups differed only in the duration’s variation; in both groups the prolongations in monosyllabic words prevailed; 80% of the prolonged phones in both groups were vowels. In experiment 2 no significant difference was found in the comparison between the judgements of prolongations and filled pauses. The utterances without disfluency differentiated themselves significantly from the others. We suggest that characteristics such as position in the word, duration and physical concomitants should be considered before deeming prolongations as a stuttering-like disfluency.

Stuttering Severity Judgments by Speech-Language Pathologists of Bilingual Children Who Do and Do Not Stutter

Introduction: Recent studies conducted with bilingual populations have shown that bilingual children who do not stutter (CWNS) are often less fluent than their monolingual counterparts, which seems to affect the accuracy with which speech-language pathologists (SLPs) identify stuttering in bilinguals. That is, misdiagnosis appears frequently in bilingual children and is more likely to occur with bilingual CWNS (false positives) than with bilingual CWS (false negatives). Methods: The goal of the current study was to gain insight in the extent of this misdiagnosis. Speech samples of 6 Lebanese bilingual CWNS and 2 CWS were rated by Lebanese SLPs in an audio-only and audiovisual presentation mode. SLPs had to identify each child as stuttering or not and subsequently rate on a 6-point scale the stuttering severity for each child. SLPs also provided background information by means of a questionnaire. Results: The results showed that stuttering severity ratings (1) were on average significantly higher for CWS than for CWNS, (2) were for each CWS higher than for all but one of the CWNS, (3) varied significantly among the CWNS but not the CWS, (4) were not affected by the presentation mode, and (5) correlated positively with the percentage of stuttering-like disfluencies (SLD) and the mean number of iterations, but not with the percentage of other disfluencies (OD). Conclusion: Misdiagnosed bilingual CWNS are perceived by the SLPs as having a mild stutter, primarily based on the frequency of their disfluencies, but can be occasionally rated at par with CWS. Further research differentiating the disfluent speech of bilingual children who do and do not stutter is needed to reach a more adequate diagnosis of stuttering.

A Comparison of Speech Dysfluencies Before and After Sports-Related Concussion

<h3>Research Objectives</h3> The purpose of this study is to compare the number and type of speech disfluencies that occur in college-aged athletes at baseline compared to after a sports-related concussion. <h3>Design</h3> Pre-post (repeated measures). <h3>Setting</h3> University. <h3>Participants</h3> A total of 230 Division I student athletes participated in pre-season speech testing. Twelve students (18-22 years) who sustained a concussion participated in speech testing in the days following concussion. Picture description speech samples were independently coded by three trained raters for 17 error types in the traditional categories of errors defined in fluency analysis. <h3>Interventions</h3> Not Applicable. <h3>Main Outcome Measures</h3> Error types were sorted into three categories: stuttering-like dysfluencies (part-word repetition, single-syllable whole-word repetition, prolongation, block), articulation errors (substitution, distortion, addition, omission), and other dysfluencies (multisyllable whole-word repetition, revision, abandoned or incomplete segment, interjection, filler, phrase repetition, pauses). <h3>Results</h3> Within-subjects analysis comparing the difference in percent error scores at baseline and post-concussion revealed significant differences for interjections (t(11)=-2.678, p< .05). The Other Disfluency category was also significantly different (t(11)= -2.735, p< .05), with more errors occurring after a concussion. No change in the Stuttering-Like Disfluency (t(11)= -0.799, p>.05) or Articulation Error category (t(11)=-0.045, p>.05) was found. <h3>Conclusions</h3> As predicted, pre-post comparisons demonstrated an overall increase in total number of speech errors after a concussion (Mean Baseline = 11.5 errors; Mean Concussion = 15.9 errors). Results demonstrate that specific speech fluency changes occur following mild sports-related concussions. Future studies should consider speech as a diagnostic tool for concussion. <h3>Author(s) Disclosures</h3> Funding for this work is through an internal grant by Seton Hall University. No other relevant disclosures.

Examining the Relationship Between Task-Switching and Speech Errors in Parkinson's Disease

<h3>Research Objectives</h3> To establish the link between cognitive flexibility deficits and errors in speech production in Parkinson's disease (PD). A secondary goal is to show that this relationship exists despite the presentation of "normal" overall cognitive functioning on a standard screening test (Montreal Cognitive Battery; MoCA). <h3>Design</h3> Regression (between-subjects). <h3>Setting</h3> University. <h3>Participants</h3> Fifteen people with PD and 15 adult controls participated in this study. All were native speakers of American English, had no upper respiratory tract infections, and passed depression and hearing screenings. People with PD varied on a continuum of overall disease and speech severity. Controls had no history of hearing, speech-language, or neurological disorders. All study procedures were approved by the Institutional Review Board. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> 1) Metrics of cognitive flexibility (reaction times, error rates) 2) MoCA scores, speech errors (articulation errors, stuttering-like disfluencies, and other disfluencies) and 3) Speech rate. <h3>Results</h3> Results show that people with PD would present with impaired cognitive flexibility (slower reaction times to switch demands compared to controls) despite falling within normal range on standard clinical screenings of cognition (MoCA) and that people with PD and controls show an inverse relationship between cognitive flexibility and the number of errors during speech production with group differences in both flexibility and speech error rates occurring. <h3>Conclusions</h3> Our findings suggest that impairments in cognition in PD may occur earlier than previously thought and may only be apparent on more sensitive tests of cognitive flexibility that are typically not performed as standard-of-care. A relationship between cognitive flexibility and speech errors suggests a role of cognitive flexibility during speech-motor control. These deficits should be considered when recommending therapy and designing interventions. <h3>Author(s) Disclosures</h3> Funding for this work is through an internal grant by Seton Hall University. No other relevant disclosures.