Fluency: Research Trends and Resources Self-efficacy, social support, and healthy social functioning may be the three most important factors for developing resilience among people who stutter, according to a recent article in the Journal of Speech, Language, and Hearing Research [doi:10.1044/1092-4388(2011/10-0304)]. Australian researchers examined factors that may protect people from the adversity of chronic ... Research in Brief
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Research in Brief  |   February 01, 2012
Fluency: Research Trends and Resources
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Speech, Voice & Prosodic Disorders / Fluency Disorders / Speech, Voice & Prosody / Research in Brief
Research in Brief   |   February 01, 2012
Fluency: Research Trends and Resources
The ASHA Leader, February 2012, Vol. 17, 18-19. doi:10.1044/leader.RIB.17022012.18
The ASHA Leader, February 2012, Vol. 17, 18-19. doi:10.1044/leader.RIB.17022012.18
Resilience and Stuttering
Self-efficacy, social support, and healthy social functioning may be the three most important factors for developing resilience among people who stutter, according to a recent article in the Journal of Speech, Language, and Hearing Research [doi:10.1044/1092-4388(2011/10-0304)].
Australian researchers examined factors that may protect people from the adversity of chronic stuttering. They studied 200 adults who have stuttered since childhood, divided into two groups—resilient and non-resilient—based on their Global Severity Index level of distress.
Factors that significantly distinguished between groups included level of health status, social support, vitality and social functioning, physical limitations, and sense of self-efficacy. Three unique contributors to adaptive outcomes were self-efficacy, social support, and healthy social functioning.
The researchers suggest that in addition to improving fluency, standard speech-language treatment should include an education component about the positive influence of protective factors such as the client’s self-efficacy, level of helpful social support, and amount of social activity and engagement.
Webcam Stuttering Treatment
Delivering a specific stuttering treatment via telepractice was efficacious and efficient and appealed to the adolescent participants and their parents in a recent Phase 1 clinical trial. In a study published in Language, Hearing, and Speech Services in Schools [doi:10.1044/0161-1461(2011/11-0010)], researchers examined outcomes of webcam delivery (with no clinic attendance) of the Camperdown Program to three adolescents ages 13, 15, and 16 with moderate–severe stuttering.
Primary outcomes were percentage of syllables stuttered and number of treatment sessions to maintenance; secondary outcomes were speech naturalness, situation avoidance, self-reported stuttering severity, and parent and adolescent satisfaction. Data were collected before treatment and at one day, six months, and 12 months post-treatment.
Mean treatment length was 18 sessions and 11 clinician hours. Group mean reduction of stuttering from pre- to immediately post-treatment was 83%; 93% from pre-treatment to six months post-treatment; and 74% from pre-treatment to 12 months post-treatment. Self-reported stuttering severity ratings confirmed these results. Post-treatment speech naturalness for participants fell within the range of three matched controls. However, avoidance of speech situations showed no corresponding improvements for two of the participants. Researchers suggest that study results justify a Phase II trial of the delivery model.
Genes Implicated in Stuttering
Some persistent stuttering may be associated with mutations in a gene governing a metabolic pathway involved in recycling old cell parts, according to Washington University School of Medicine researchers (doi: 10.1074/jbc.M111.295899). The study found that three mutations affecting cellular recycling centers called lysosomes are present in some people who stutter.
The study follows up on research published in 2010 that identified mutations in three genes in many unrelated individuals in Pakistan, North America, and Europe who stutter, but not in those with normal speech. The recent study entailed a biochemical investigation of those mutations, identifying which of the mutations of the NAGPA gene, which encodes an enzyme responsible for the last step in “addressing” proteins to the lysosome, may be associated with stuttering.
Two of the mutations prevent the protein from leaving the cell’s protein manufacturing center to go to the intracellular site where it acts to direct proteins to lysosomes. If a compound is found that helps the protein escape, it may function normally, offering a possible “gene therapy” treatment for stuttering.
Research is continuing on the biochemical analysis of the two other mutated genes associated with stuttering. Together, these three mutated genes account for only about 10% of people who stutter and have a family history of stuttering.
Anxiety and Stuttering: Improved Research Methods?
Research on the relationship between anxiety and stuttering has been plagued by methodological issues that preclude consistent findings. Researchers examined whether methodological improvements have taken place since the last review.
Literature published since 1999 was evaluated in terms of the five methodological issues identified in a 1999 review: the construct of anxiety, trait anxiety measures, participant numbers, treatment status of participants, and speaking tasks. Despite some remaining ambiguous findings, investigators conclude that research published since the review has provided far stronger evidence of a relationship between stuttering and anxiety, and has focused more on social anxiety, expectancies of social harm, and fear of negative evaluation. The investigators suggest that future studies should improve research design, increase statistical power, employ multidimensional measures of anxiety, and further develop anxiety-reducing treatment options for people who stutter. The study appears in the American Journal of Speech-Language Pathology [doi:10.1044/1058-0360(2011/10-0091)].
Language Abilities of Children Who Stutter
A Vanderbilt University study in the American Journal of Speech-Language Pathology adds to the literature suggesting that linguistic processes are influential variables associated with stuttering [doi:10.1044/1058-0360(2011/09-0102)]. Investigators conducted a literature review to identify, integrate, and summarize evidence from empirical studies of the language abilities of children who stutter and children who do not stutter to determine whether the linguistic system of people who stutter is more prone to encoding errors.
The 22 articles included in the review studied children ages 2–8 who did and did not stutter. Data were extracted using a coding manual and were assessed by application of general and specialized analytical software.
Findings indicated that children who stutter scored significantly lower than children who do not stutter on norm-referenced measures of overall language, receptive vocabulary, expressive vocabulary, and mean length of utterance. The findings suggest that language may be an influential variable associated with the difficulty of some children who stutter to establish normally fluent speech and that continued empirical study of this topic should contribute to a comprehensive understanding of those variables associated with childhood stuttering.
Fluency Resources
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February 2012
Volume 17, Issue 2