Recent research has provided evidence that speech-related visual feedback presented to people who stutter may enhance fluency as effectively as well-established forms of altered auditory feedback. This study aimed to explore the effectiveness of visual feedback during speaking conditions that approximated naturalistic conversation. In order to determine what aspects of visual feedback may contribute to fluency enhancement, the feedback was manipulated in terms of synchronicity and linguistic congruence to the original signal. Participants included ten adults diagnosed with developmental stuttering with no concurring conditions. The study consisted of the following four conditions: synchronous visual feedback, asynchronous visual feedback, non-speech related visual feedback, and a control condition. Speech samples were analyzed for the percent of syllables stuttered per condition. Upon analysis of data, no statistically significant effect of visual feedback was found on stuttering frequency, although individual results varied greatly. / by Jamie Heidenreich. / Thesis (M.S.)--Florida Atlantic University, 2013. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

A gagueira é definida como um distúrbio de fluência que se caracteriza por interrupções anormais do fluxo da fala, geralmente experimentadas pelo indivíduo que gagueja como perda de controle, já que ocorrem de modo involuntário. É uma patologia de comunicação que atinge 5% da população em todo o mundo, dos quais 1% continua a gaguejar na idade adulta. Apresenta uma diversidade de sintomas que nem sempre são encontráveis em todos os indivíduos, o que dificulta diagnosticar as possíveis causas e defini-las com precisão. Medidas preventivas e, se necessário, tratamento precoce é o melhor que se pode fazer para impedir que uma criança se torne um adulto gago. A família, seio de desenvolvimento da criança, deve ser o ponto de partida para se entender o processo de aparecimento e desenvolvimento desta patologia e talvez seja dela que venham as respostas para um tratamento mais efetivo. Este trabalho tem por objetivo identificar as características significativas de comunicação às quais a criança está exposta em seu ambiente familiar, conhecer a rede de relações dentro do grupo familiar, o significado da comunicação para a família, seu padrão lingüístico, suas exigências socioculturais e suas práticas educativas. Participaram desta pesquisa quinze mães de crianças entre três e treze anos de idade, com diagnóstico de gagueira. Foram realizadas entrevistas utilizando-se roteiro semi-estruturado, cujos dados foram analisados quantitativa e qualitativamente por meio de análise temática de conteúdo. Os resultados mostram que as mães consideram a comunicação oral, o falar bem, como fundamental na vida das pessoas. Quando perceberam seus filhos gagos, ficaram preocupadas, pois julgam a gagueira um problema muito sério para o futuro deles. Corrigiam-nos, na tentativa de ajudá-los a parar de gaguejar. Todas procuraram ajuda de profissionais (fonoaudiólogos e psicólogos), quando sentiram a ineficiência de seus métodos corretivos. Pode-se constatar que algumas crianças do grupo recusaram-se a falar e tornaram-se tímidas, outras ao contrário eram falantes e extrovertidas, não se importando com a gagueira. O seu surgimento parece não depender do padrão lingüístico ou mesmo da estrutura e dinâmica familiares, não se encontrando neles um fator causal predominante para a gagueira. Conclui-se que a comunicação oral é extremamente valorizada pela sociedade e por isso a gagueira preocupa excessivamente as mães, cuja ansiedade pode interferir na manutenção deste distúrbio de comunicação. Palavras-chave: gagueira e família, distúrbio de comunicação. A gagueira é definida como um distúrbio de fluência que se caracteriza por interrupções anormais do fluxo da fala, geralmente experimentadas pelo indivíduo que gagueja como perda de controle, já que ocorrem de modo involuntário. É uma patologia de comunicação que atinge 5% da população em todo o mundo, dos quais 1% continua a gaguejar na idade adulta. Apresenta uma diversidade de sintomas que nem sempre são encontráveis em todos os indivíduos, o que dificulta diagnosticar as possíveis causas e defini-las com precisão. Medidas preventivas e, se necessário, tratamento precoce é o melhor que se pode fazer para impedir que uma criança se torne um adulto gago. A família, seio de desenvolvimento da criança, deve ser o ponto de partida para se entender o processo de aparecimento e desenvolvimento desta patologia e talvez seja dela que venham as respostas para um tratamento mais efetivo. Este trabalho tem por objetivo identificar as características significativas de comunicação às quais a criança está exposta em seu ambiente familiar, conhecer a rede de relações dentro do grupo familiar, o significado da comunicação para a família, seu padrão lingüístico, suas exigências socioculturais e suas práticas educativas. Participaram desta pesquisa quinze mães de crianças entre três e treze anos de idade, com diagnóstico de gagueira. Foram realizadas entrevistas utilizando-se roteiro semi-estruturado, cujos dados foram analisados quantitativa e qualitativamente por meio de análise temática de conteúdo. Os resultados mostram que as mães consideram a comunicação oral, o falar bem, como fundamental na vida das pessoas. Quando perceberam seus filhos gagos, ficaram preocupadas, pois julgam a gagueira um problema muito sério para o futuro deles. Corrigiam-nos, na tentativa de ajudá-los a parar de gaguejar. Todas procuraram ajuda de profissionais (fonoaudiólogos e psicólogos), quando sentiram a ineficiência de seus métodos corretivos. Pode-se constatar que algumas crianças do grupo recusaram-se a falar e tornaram-se tímidas, outras ao contrário eram falantes e extrovertidas, não se importando com a gagueira. O seu surgimento parece não depender do padrão lingüístico ou mesmo da estrutura e dinâmica familiares, não se encontrando neles um fator causal predominante para a gagueira. Conclui-se que a comunicação oral é extremamente valorizada pela sociedade e por isso a gagueira preocupa excessivamente as mães, cuja ansiedade pode interferir na manutenção deste distúrbio de comunicação. Palavras-chave: gagueira e família, distúrbio de comunicação. / Stuttering is defined as a disturb of fluency which is characterized for uncommon interruptions in the speech flow, usually experienced for the individual that stutters as a lost of control, since they occur in an involuntary way. It is a pathology of communication that affects 5% of the population in the whole world, from which 1% keeps stuttering on adult age. It displays a variety of symptoms not always possible to be found in all individuals, what makes it difficult to diagnose the possible causes and precisely define them. Preventive measures and, if necessary, precocious treatment is the best to do in order to avoid a child to become a stuttering adult. The family, heart of the child’s development, must be the starting point for understanding the process of emersion and developing of this pathology and maybe it is the place where the answers for a more effective treatment come. This report has the objective of identifying the significative characteristics of communication to which a child is exposed in its family environment, understand the net of relations inside the family group, the meaning of communication to the family, its linguistic pattern, social-cultural demands and educational customs. The subjects were fifteen mothers of children amongst three and thirteen years old, with stuttering diagnosis. Interviews were made with a semi-structured script, which data were quantitative and qualitatively analyzed by means of a thematic contents analysis. The results show that mothers regard the oral communication, the well-speaking, as fundamental in people’s life. When they noticed their children stutter, they got worried, since they consider stuttering a very serious problem for their future. They corrected them, as an attempt to try to help them stop stuttering. All of them searched for professional help (phonoaudiologists and psychologists), when they felt the inefficiency of their corrective methods. It is possible to realize that some children from the group refused to speak and became timid, other children, on the contrary, talked a lot and behaved in an extroverted way, not caring about their stuttering. Its emergence seems not to depend on the linguistic pattern or even the familiar structure and dynamics, being not possible to find in them an outstanding causal factor for stuttering. It is concluded that oral communication is extremely valued by society and, this way, stuttering extremely worries mothers, whose anxiety might interfere in the persistence of this communication disturb.

Made available in DSpace on 2016-04-27T18:11:46Z (GMT). No. of bitstreams: 1 nos limites da fluencia.pdf: 371976 bytes, checksum: 839d3536b0e16186b8c770eaf762bf4d (MD5) Previous issue date: 2005-08-23 / Objective: To investigate how cases of dysfluency, especially those within the limits between normal and pathological, have been diagnosed and the assessment criteria and therapeutic approaches used by speech therapists. Methods: Using a semi-guided interview, speech therapists talked about their conceptions and procedures with stuttering. The interview was recorded and literally transcribed to analyze data, which were organized in topics for discussion. Results: We could observe that stuttering had different approaches and, therefore, assessment and treatment procedures were equally different. Concerning the limits between normal and pathological dysfluent behavior, we noticed that not all interviewed therapists considered its existence. Conclusion: Considering that there are different types of clinical practice in speech therapy, subjects and complaints may be seen, assessed and treated differently. This clearly applies to speech fluency problems, given that there are professionals that focus on symptoms and not on the subject that presents them. Conversely, there are professionals that take into account the subject as a whole, without disregarding the context. Within such aspect, they value individual singularity, which does not comply with standardization of human behaviors into normal and deviant from normal. It was also concluded that the purpose of speech is to allow interpersonal communication, which takes place in different moments, and interruptions are accepted because speech fluency is not absolute in anyone / Objetivo: Pesquisar como os casos de disfluência, em especial aquelas que se encontram no limite entre o normal e o patológico, têm sido diagnosticado, quais os critérios de avaliação e qual a conduta terapêutica utilizada pelos fonoaudiólogos. Métodos: Através da entrevista semi-dirigida os fonoaudiólogos falaram sobre suas concepções e procedimentos sobre a gagueira. A entrevista, foi gravada e transcrita literalmente para análise dos dados, os quais foram organizados em temas para serem discutidos. Resultados: Pôde-se observar que a gagueira apresenta diferentes vertentes e portanto, procedimentos de avaliação e tratamento também distintos. Em relação a disfluência no limite entre o normal e o patológico, verificou-se que não são todos os entrevistados que consideram sua existência. Conclusões: Os tipos de clínica existentes na fonoaudiologia, permite que o sujeito e sua queixa seja visto, avaliado e tratado de maneiras diferentes. Nos casos da fluência de fala e seus problemas, isso pôde ser notado claramente, pois, há profissionais que focam o olhar no sintoma e não no sujeito que o apresenta. Por outro lado, existem profissionais que consideram o sujeito e sua totalidade, sem desconsiderar o seu contexto. Neste aspecto, valoriza-se a singularidade de cada um, o que não comporta padronizações dos comportamentos humanos, convencionando a normalidade e seus desvios. Conclui-se, ainda que o sentido da fala é permitir a comunicação com o outro, a qual se dá em momentos diversos, onde interrupções podem ocorrer, pois a fluência de fala não é absoluta em ninguém

Made available in DSpace on 2016-04-27T18:11:56Z (GMT). No. of bitstreams: 1 Wladimir Alberti Pascoal de Lima Damasceno.pdf: 755356 bytes, checksum: 5df780b760530121b8115fdecff96f09 (MD5) Previous issue date: 2012-07-06 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This paper starts from the assumption that there is a disharmony between speech (meaning) and language (form) in the stuttered discursive functioning. Based on discursive linguistics we understand that in a fluent in position, the speaker slides along the meaning of speech without any attention to the form of language; yet in a stuttered position he reminds occupied in trying to avoid stuttering and by acting like that he remains subdued to the form of language and looses the discursive position that would guarantee his fluency. Objective: To develop the understanding about disharmony between speech and language via the speech of adult stutterers. Method: Prospective qualitative research conducted through semi-structured interviews with six adults, following the key questions: what comes to mind when I say - speech ; to speak with fluency ; public speaking ; talking to myself ; what helps fluency ; what do you makes to not stutter or what helps you not to stutter ; do you know if you will stutter?, and what makes you know that you will stutter . After the speech transcription, the notion of discursive practices and production of meaning (Spink and Medrado, 2004) allowed us to define three categories that organized the results and guided the discussion: Sense Speech composed by the sub-categories: Positive and Negative; Context of Speech, composed by the sub-categories The Effect of Others and The Effect of Being Alone; and Anticipation of Stuttering. Results and Discussion: In Sense Speech-Positive respondents reported how they feel when they flow better in speech and when they allow themselves to stutter. Theirs vision of speech is the one that circulates in common sense. The respondents had an idealized view of fluency as absolute. In Sense of Speech-Negative respondents reported feeling dissimilar and marginalized by his manner of speaking, also reported emotions and feelings related to stuttering. We emphasize the importance of understanding the relationship between the production of stuttering and the subjective position of a stigmatized speaker, to build up therapeutic approaches to overcome this position. In Context of Speech-The Effect of Others, respondents discriminated types of speakers and of discursive contexts that favored fluency or stuttering. They showed negative marks on subjectivity, because when they feel like stutterers they imagine the others monitoring their speech and able to reject or disapprove them. In Context of Speech-The Effect Alone respondents reported that when they are alone they can flow freely, which reiterates the stuttering as a manifestation strongly linked to the presence of others. In Anticipation of Stuttering respondents reveal the ways in which stuttering is expected subjectively before it is materialized in their speech: thoughts or views; emotions or feelings; actions of the body or linguistic strategies. Conclusion: The reports of the respondents indicates that the disharmony between speech and language, in stuttered speech, is related to a speaker who feels stigmatized in his subjectivity in face of certain conditions of discursive production; also indicates the different ways in which this disharmony is materialized in order to avoid the provided stuttering. These characteristics indicate some elements that seem important to the targeting of a therapeutic approach of stutter speech wishing to overcome the subjective/discursive functioning that sustains it / Este trabalho parte da hipótese de que no funcionamento discursivo gaguejante há uma desarmonia entre fala (sentido do dizer) e língua (forma do dizer). Com base na linguística discursiva temos que, na posição fluente, o falante desliza pelo sentido do dizer esquecido da forma; na posição gaguejante, ocupado em evitar essa forma de falar, permanece submetido à forma e perde a posição discursiva que lhe garantiria a fluência. Objetivo: Desenvolver a compreensão sobre a desarmonia entre fala e língua a partir do discurso de pessoas adultas com gagueira. Método: Pesquisa qualitativa prospectiva realizadas por meio de entrevistas semi-estruturadas com 6 adultos, a partir das perguntas-chave: o que vem à sua cabeça quando eu digo - falar ; falar com fluência ; falar em público ; falar sozinho ; o que o ajuda a fluir ; o que faz para não gaguejar ou o que o ajuda a não gaguejar ; se sabe que vai gaguejar ; e o que o faz saber que vai gaguejar . Após a transcrição do discurso a noção de práticas discursivas e produção de sentidos (Spink e Medrado, 2004) permitiu que se definissem três categorias analíticas que organizaram os resultados e guiaram a discussão: Sentido da Fala composta pelas sub-categorias Positivo e Negativo; Contexto de Fala, composta pelas sub-categorias Efeito Outro e Efeito Sozinho e Antecipação da Gagueira. Resultados e Discussão: Em Sentido da Fala Positivo os entrevistados relataram os modos de se sentir relacionados a fluir melhor na fala e a permitir-se gaguejar. Sua visão de fala é a que circula no senso comum e corresponde a uma visão idealizada da fluência como absoluta. Em Sentido da Fala Negativo os entrevistados relataram sentir-se dessemelhantes e marginalizados por seu modo de falar, relataram também emoções e sentimentos relacionados à gagueira. Destaca-se a importância de compreender a relação entre a produção da gagueira e a posição subjetiva de falante estigmatizado, para construir os caminhos terapêuticos de sua superação. Em Contexto de Fala Efeito Outro, os entrevistados discriminaram os tipos de interlocutores e de contextos discursivos que lhes favorecem a fluência ou a gagueira. Revelam marcas negativas na subjetividade, porque ao ocuparem a posição de falantes gagos imaginam o outro na posição daquele que fiscalizará seu dizer e poderá rejeitá-los ou reprová-los. Em Contexto de Fala Efeito Sozinho relataram que na condição sozinhos podem fluir livremente, o que reitera a gagueira como uma manifestação fortemente atrelada à presença do outro. Em Antecipação da Gagueira os entrevistados revelam os modos como a gagueira é prevista subjetivamente antes de materializar-se na fala: pensamentos ou visualizações; emoções ou sentimentos; ações do corpo ou estratégias linguísticas. Conclusão: Os relatos dos entrevistados indicam que a desarmonia entre fala e língua, no discurso gaguejante, relaciona-se a um falante que, na subjetividade, se sente estigmatizado diante de certas condições de produção discursiva; indicam ainda os diferentes modos pelos quais essa desarmonia se materializa com a finalidade de evitar a gagueira prevista. Tais características assinalam alguns elementos que parecem importantes ao direcionamento de uma abordagem terapêutica fonoaudiológica da gagueira que pretenda superar o modo de funcionamento subjetivo/discursivo que a sustenta

Purpose: As a group, adults who stutter (AWS) are vulnerable to experiencing distress and other negative psychological health outcomes. However, not all AWS experience elevated levels of distress, and little is known about why some people are resilient while others struggle to cope. In the current study, stuttering was conceptualized as a type of concealable stigmatized identity (CSI). The purpose of this study was to determine if stigma-identity constructs that contribute to variability in distress among groups of people with other types of CSIs also contribute to psychological health outcomes among AWS. The specific stigma-identity constructs that were examined include salience (the extent that a person thinks about stuttering), centrality (how much a person defines themselves by stuttering), concealment (the extent that a person attempts to keep stuttering a secret from others), and disclosure (the frequency in which a person tells others about stuttering). Methods: A sample of 505 AWS completed an online survey that included measures of salience, centrality, concealment, disclosure, demographics, self-rated stuttering severity, psychological distress, and adverse impact of stuttering on quality of life. Correlational and hierarchical regression analyses were performed to (1) determine the extent that stigma-identity constructs explain variability in psychological health outcomes among AWS and (2) identify unique relationships between each of the stigma-identity constructs and psychological health outcomes. Additionally, self-rated stuttering severity was investigated as a potential moderator of the relationships between stigma-identity constructs and psychological health outcomes. Results: Together, the stigma-identity constructs accounted for a significant proportion of the variability in distress (~25%) and adverse impact of stuttering on quality of life (~30%) among AWS. Salience, centrality, and concealment were positively associated with and predictive of distress and adverse impact of stuttering on quality of life after controlling for demographics and neuroticism. Further, self-rated stuttering severity moderated the relationship between centrality and adverse impact of stuttering on quality of life. Specifically, high centrality was only associated with more adverse impact of stuttering on quality of life among people with moderate and high self-rated stuttering severity. Disclosure did not have a consistent reliable relationship with either psychological health outcome. Conclusions: The results from this study provide evidence that it is both appropriate and useful to conceptualize stuttering as a type of CSI. That is, variability in psychological health outcomes among AWS can be explained to a large extent by individual differences in the ways people think about and behave in relation to their stuttering identity. Speech-language pathologists should be aware of the relationships that salience, centrality, and concealment have with psychological health outcomes among AWS and should consider the implications for stuttering intervention.

Stuttering is a developmental disorder which may adversely affect the individual on many functional and emotional levels. Common sequelae of speech disfluency include powerful emotions such as anxiety, shame, and anger, as well as speech-avoidant behaviors. For males, the influence of gender role socialization may present an additional burden. From a traditional perspective of masculinity, emotional expression and exposing one's flaws are strongly discouraged in most forms and contexts and may be seen as signs of weakness. While expression of emotions is a common developmental milestone for many who stutter, it is unclear what impact awareness, repression, and avoidance of emotions have on the well-being of people who stutter. This study explored the effects of disruptions in emotional expression and the influence of masculinity on the impact of disfluency for adult males who stutter (n=65). It was hypothesized that masculine-type emotional restriction would mediate the relationship between disruptions in emotional expression and the perceived impact of stuttering. Regression analysis revealed disruptions in emotional expression accounted for 25% of the variance in self-reported perceptions of stuttering, and self-regulation of emotion was negatively correlated with perceived impact of stuttering. Contrary to hypothesis, masculine-type emotional restriction was not significantly correlated with perceived impact of stuttering and thus invalidated impetus for mediation analysis. Implications and suggestions for further exploration are discussed.

This study investigated the advisability of utilizing parents to provide treatment for their dysfluent preschoolers. It involved the development, implementation and evaluation of a specific treatment program involving indirect language stimulation techniques. The primary question asked was whether or not parents can be successful in significantly reducing or eliminating dysfluent speech in their children. The secondary question was whether or not parents can be trained successfully to provide treatment.

This thesis introduces a new theoretical framework from which to view the factors that contribute to stuttering variability. The speech and monitoring interaction (SAMI) framework proposes that there are two systems that account for stuttering variability: the speech production system and the monitoring system. Each system has unique factors that modulate them. Within SAMI, the interaction of these two categories of factors is formalized in a mathematical equation. What is particularly novel about SAMI is the use of a mathematical equation to formalize the interaction between these systems and the specific proposal of the biological substrates of the monitoring system and its interaction with the speech system. The focus of this thesis is on the anticipation of stuttering, which is one of the factors from SAMI that modulates the monitoring system. The goals of the studies were to 1) characterize the degree to which people who stutter (PWS) anticipate stuttering and how accurately they can predict actual stuttering, 2) investigate the correlation between stuttering expectancy on words and the verbal response time to say those word in word naming tasks, and 3) make a qualitative comparison of the behavioral results and the results from a neural network model. Utilizing the SAMI framework it was hypothesized that stuttering expectancy would be positively correlated with the response time and the results from the simulations would qualitatively match the behavioral results. The key finding was that across the group of PWS, there was positive correlation between stuttering expectancy scores and relative reaction times on those words. The degree to which stuttering expectancy was correlated with reaction time within subjects was positively correlated with stuttering severity. A qualitative comparison showed a good fit in between results of the simulations and the behavioral study. This is the first study to show that the expectation of stuttering has an effect on fluent speech production, providing evidence that the anticipation of stuttering is not only correlated with moments of stuttering but may also be a contributing factor to stuttering. The model provides a means of hypothesizing and testing specific neural substrates associated with anticipation of stuttering and its effects on the speech production process.

Purpose: Research has shown that children who stutter (CWS) demonstrate poor adaptive functioning, or poor functional, social, and psychological skills, when compared to children who do not stutter (CWNS). Previous work has also shown that preschool CWS demonstrate significantly lower effortful control than CWNS. High effortful control, or the ability to inhibit a dominant response, is predictive of high adaptive functioning in children who are exposed to a range of adversities. The purposes of this study were fourfold: (a) to investigate if the differences between preschool CWS and CWNS in effortful control extended to school-aged children; (b) to determine if effortful control could uniquely explain adaptive functioning after controlling for a diagnosis of stuttering; (c) to investigate whether effortful control was more influential to CWS than to CWNS; and (d) to investigate whether effortful control uniquely explained adaptive functioning in CWS after controlling for stuttering frequency. Methods: Effortful control and seven core areas of adaptive functioning were investigated in 46 school-age CWS and 46 CWNS. Eight independent two tailed t-tests were used to assess whether CWS demonstrated lower effortful control than CWNS and lower adaptive functioning than CWNS in seven adaptive functioning areas: communication competence, peer competence, internalizing behaviors, externalizing behaviors, general anxiety, social anxiety, and depression. Correlation and hierarchical regression analyses were used to examine the extent to which each component of adaptive functioning was related to effortful control when controlling for age, intelligence, parent-child relationship, and stuttering group membership. Hierarchical regression analyses were used to assess the extent to which each separate component of adaptive functioning was related to effortful control in CWS only. Results: CWS demonstrated significantly lower effortful control when measured by the Early Adolescent Temperament Questionnaire (a parent report measure of hot effortful control) than CWNS. CWS also performed more poorly in all aspects of adaptive functioning; however statistical significance was only reached for internalizing behaviors and general anxiety. The hierarchical linear regressions indicated that effortful control predicted the majority of the variance in five areas of adaptive functioning: peer competence, externalizing behaviors, internalizing behaviors, general anxiety, and depression. In the group of CWS, stuttering frequency predicted internalizing behaviors, general anxiety, and social anxiety. However, stuttering was the most important contributor to only one of the seven components of adaptive functioning, social anxiety. Conclusions: This study with school-aged CWS extends previous work indicating that preschool CWS exhibit lower effortful control than their normally fluent peers. The fact that emotional aspects of effortful control were a stronger predictor of social functioning, internalizing behaviors, and externalizing behaviors than either a stuttering diagnosis or the quantity of stuttering, may explain the adaptive functioning deficits often observed in CWS. Because effortful control is both a powerful contributor to adaptive functioning, and is reduced in CWS, clinical therapy approaches, which boost effortful control skills, have the potential to greatly lessen the impact of stuttering for CWS.

Children afflicted with speech disorders represent the largest single group of exceptional children. The numbers of speech defectives reach between 2 and 2 1/2 million or about 5% of the population (Johnson et a l., 1956). Newman (1961) has disputed this claim and has stressed the difference to be made between speech differences and handicapping conditions: