Signs of developmental stuttering up to age eight and at 12 plus.
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Clinicians who are familiar with the general DSM-IV-TR scheme may want to know how to identify whether a child does, or (equally importantly) does not, stutter and what differences there are in the presenting signs for children of different ages. This article reviews and discusses topics in the research literature that have a bearing on these questions. The review compared language, social-environmental and host factors of children who stutter across two age groups (up to age eight and 12 plus). Dysfluency types mainly involved repetition of one or more whole function words up to age eight whereas at age 12 plus, dysfluency on parts of content words often occurred. Twin studies showed that environmental and host factors were split roughly 30/70 for both ages. Though the disorder is genetically transmitted, the mode of transmission is not known at present. At the earlier age, there were few clearcut socio-environmental influences. There were, however, some suggestions of sensory (high incidence of otitis media with effusion) and motor differences (high proportion of left-handed individuals in the stuttering group relative to norms) compared to control speakers. At age 12 plus, socio-environmental influences (like state anxiety) occurred in the children who persist, but were not evident in the children who recover from the disorder. Brain scans at the older age show some replicable abnormality in the areas connecting motor and sensory areas in speakers who stutter. The topics considered in the discussion return to the question of how to identify whether a child does or does not stutter. The review identifies extra details that might be considered to improve the classification of stuttering (e.g. sensory and motor assessments). Also, some age-dependent factors and processes are identified (such as change in dysfluency type with age). Knowing the distinguishing features of the disorder allows it to be contrasted with other disorders which show superficially similar features. Two or more disorders can co-occur for two reasons: comorbidity, where the child has two identifiable disorders (e.g. a child with Down Syndrome whose speech has been properly assessed and classed as stuttering). Ambiguous classifications, where an individual suffering from one disorder meets the criteria for one or more other disorders. One way DSM-IV-TR deals with the latter is by giving certain classification axes priority over others. The grounds for such superordinacy seem circular as the main role for allowing this appears to be to avoid such ambiguities. (+info)
Genetic studies of stuttering in a founder population.
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Genome-wide linkage and association analyses were conducted to identify genetic determinants of stuttering in a founder population in which 48 individuals affected with stuttering are connected in a single 232-person genealogy. A novel approach was devised to account for all necessary relationships to enable multipoint linkage analysis. Regions with nominal evidence for linkage were found on chromosomes 3 (P=0.013, 208.8 centiMorgans (cM)), 13 (P=0.012, 52.6 cM), and 15 (P=0.02, 100 cM). Regions with nominal evidence for association with stuttering that overlapped with a linkage signal are located on chromosomes 3 (P=0.0047, 195 cM), 9 (P=0.0067, 46.5 cM), and 13 (P=0.0055, 52.6 cM). We also conducted the first meta-analysis for stuttering using results from linkage studies in the Hutterites and The Illinois International Genetics of Stuttering Project and identified regions with nominal evidence for linkage on chromosomes 2 (P=0.013, 180-195 cM) and 5 (P=0.0051, 105-120 cM; P=0.015, 120-135 cM). None of the linkage signals detected in the Hutterite sample alone, or in the meta-analysis, meet genome-wide criteria for significance, although some of the stronger signals overlap linkage mapping signals previously reported for other speech and language disorders. EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (1) summarize information about the background of common disorders and methodology of genetic studies; (2) evaluate the role of genetics in stuttering; (3) discuss the value of using founder populations in genetic studies; (4) articulate the importance of combining several studies in a meta-analysis; (5) discuss the overlap of genetic signals identified in stuttering with other speech and language disorders. (+info)
Phonetic difficulty and stuttering in English.
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Previous work has shown that phonetic difficulty affects older, but not younger, speakers who stutter and that older speakers experience more difficulty on content words than function words. The relationship between stuttering rate and a recently-developed index of phonetic complexity (IPC, Jakielski) was examined in this study separately for function and content words for speakers in 6-11, 11 plus-18 and 18 plus age groups. The hypothesis that stuttering rate on the content words of older speakers, but not younger speakers, would be related to the IPC score was supported. It is argued that the similarity between results using the IPC scores with a previous analysis that looked at late emerging consonants, consonant strings and multiple syllables (also conducted on function and content words separately), validates the former instrument. In further analyses, the factors that are most likely to lead to stuttering in English and their order of importance were established. The order found was consonant by manner, consonant by place, word length and contiguous consonant clusters. As the effects of phonetic difficulty are evident in teenage and adulthood, at least some of the factors may have an acquired influence on stuttering (rather than an innate universal basis, as the theory behind Jakielski's work suggests). This may be established in future work by doing cross-linguistic comparisons to see which factors operate universally. Disfluency on function words in early childhood appears to be responsive to factors other than phonetic complexity. (+info)
Phonological neighborhood and word frequency effects in the stuttered disfluencies of children who stutter.
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PURPOSE: The purpose of this study was to examine (a) the role of neighborhood density (number of words that are phonologically similar to a target word) and frequency variables on the stuttering-like disfluencies of preschool children who stutter, and (b) whether these variables have an effect on the type of stuttering-like disfluency produced. METHOD: A 500+ word speech sample was obtained from each participant (N = 15). Each stuttered word was randomly paired with the firstly produced word that closely matched it in grammatical class, familiarity, and number of syllables/phonemes. Frequency, neighborhood density, and neighborhood frequency values were obtained for the stuttered and fluent words from an online database. RESULTS: Findings revealed that stuttered words were lower in frequency and neighborhood frequency than fluent words. Words containing part-word repetitions and sound prolongations were also lower in frequency and/or neighborhood frequency than fluent words, but these frequency variables did not have an effect on single-syllable word repetitions. Neighborhood density failed to influence the susceptibility of words to stuttering, as well as the type of stuttering-like disfluency produced. CONCLUSIONS: In general, findings suggest that neighborhood and frequency variables not only influence the fluency with which words are produced in speech, but also have an impact on the type of stuttering-like disfluency produced. (+info)
Phonetic complexity and stuttering in Spanish.
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The current study investigated whether phonetic complexity affected stuttering rate for Spanish speakers. The speakers were assigned to three age groups (6-11, 12-17 and 18-years plus) that were similar to those used in an earlier study on English. The analysis was performed using Jakielski's Index of Phonetic Complexity (IPC) scheme in which each word is given an IPC score based on the number of complex attributes it includes for each of eight factors. Stuttering on function words for Spanish did not correlate with IPC score for any age group. This mirrors the finding for English that stuttering on these words is not affected by phonetic complexity. The IPC scores of content words correlated positively with stuttering rate for 6-11-year-old and adult speakers. Comparison was made between the languages to establish whether or not experience with the factors determines the problem they pose for speakers (revealed by differences in stuttering rate). Evidence was obtained that four factors found to be important determinants of stuttering on content words in English for speakers aged 12 and above, also affected Spanish speakers. This occurred despite large differences in frequency of usage of these factors. It is concluded that phonetic factors affect stuttering rate irrespective of a speaker's experience with that factor. (+info)
Genetic etiology in cases of recovered and persistent stuttering in an unselected, longitudinal sample of young twins.
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PURPOSE: The contribution of genetic factors in the persistence of and early recovery from stuttering was assessed. METHOD: Data from the Twins Early Development Study were employed. Parental reports regarding stuttering were collected at ages 2, 3, 4, and 7 years, and were used to classify speakers into recovered and persistent groups. Of 12,892 children with at least 2 ratings, 950 children had recovered and 135 persisted in their stutter. RESULTS: Logistic regressions showed that the rating at age 2 was not predictive of later stuttering, whereas ratings at ages 3 and 4 were. Concordance rates were consistently higher for monozygotic than for dizygotic twin pairs (with the exception of girls at age 3). At 3, 4, and 7 years, the liability to stuttering was highly heritable (h2 estimates of between .58 and .66). Heritability for the recovered and persistent groups was also high but did not differ from each other. CONCLUSION: Stuttering appears to be a disorder that has high heritability and little shared environment effect in early childhood and for recovered and persistent groups of children, by age 7. The clinical implications of the findings are discussed. (+info)
Perisylvian sulcal morphology and cerebral asymmetry patterns in adults who stutter.
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Previous investigations of cerebral anatomy in persistent developmental stutterers have reported bilateral anomalies in the perisylvian region and atypical patterns of cerebral asymmetry. In this study, perisylvian sulcal patterns were analyzed to compare subjects with persistent developmental stuttering (PDS) and an age-, hand-, and gender-matched control group. This analysis was accomplished using software designed for 3-dimensional sulcal identification and extraction. Patterns of cerebral asymmetry were also investigated with standard planimetric measurements. PDS subjects showed a small but significant increase in both the number of sulci connecting with the second segment of the right Sylvian fissure and in the number of suprasylvian gyral banks (of sulci) along this segment. No differences were seen in the left perisylvian region for either sulcal number or gyral bank number. Measurements of asymmetry revealed typical patterns of cerebral asymmetry in both groups with no significant differences in frontal and occipital width asymmetry, frontal and occipital pole asymmetry, or planum temporale and Sylvian fissure asymmetries. The subtle difference in cortical folding of the right perisylvian region observed in PDS subjects may correlate with functional imaging studies that have reported increased right-hemisphere activity during stuttered speech. (+info)
Nonword repetition ability of children who do and do not stutter and covert repair hypothesis.
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CONTEXT: Stuttering has a life span incidence and it significantly impacts academic, social, emotional and vocational achievements of patients who stutter. AIMS: The purpose of the present study was to examine phonological encoding in young children who stutter (CWS) during a non word repetition task and to test the covert repair hypothesis (CRH) and phonological skills in Persian native children. SETTING AND DESIGN: The study was conducted among 12 CWS and 12 children who do not stutter (CWNS) between the ages of 5.1 and 7.10 at the rehabilitation clinics in Tehran. MATERIALS AND METHODS: A list of 40 bisyllabic and trisyllabic nonwords was used in a nonword repetition task to collect information about the following dependent variables: (a) reaction times (RTs), (b) the number of phonological errors (PEs) and (c) nonword length. DATA ANALYSIS: An independent sample T-test was performed to compare means of PEs and RTs between the two groups and a paired t-test for analysis of nonword length impacts. RESULTS: Results indicated that the CWS had a slightly poor performance than CWNS but there was no significant difference between the groups. Also, the differences between bisyllabic and trisyllabic nonwords were significant for phonological errors but not for reaction times. CONCLUSION: In general, it is concluded that CWS might not have a gross problem in phonological retrieval of the novel phonological context even with increase in syllable length. Also, some predictions of CRH were not supported by this research. However, further research into this possibility may shed light on the emergence and characteristics of childhood stuttering. (+info)