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

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.

Um, so, like, do speech disfluencies matter? A parametric evaluation of filler sounds and words.

This study evaluated how speech disfluencies affect perceived speaker effectiveness. Speeches with filler sounds and filler words at different rates of disfluencies (i.e., 0, 2, 5, and 12 per minute) were created and evaluated by a crowdsourcing service for survey-based research for the speaker's public speaking performance. Increased disfluencies, particularly filler sounds, significantly affected perceptions across most categories, notably at higher rates of filler sounds (i.e., 12 per minute). A low, but nonzero, rate of disfluencies (5 per minute) did not adversely affect perceived effectiveness. These findings suggest that although reducing filler sounds is crucial for optimizing perceived speaking effectiveness, a rate of five or fewer disfluencies per minute may be acceptable.

Linguistic disfluencies in Russian-speaking typically and atypically developing children: individual variability in different contexts.

Disfluency in children and adults seems to occur like errors of speech but, at the same time, is an essential feature of spontaneous (unprepared) speech. The present study aimed to evaluate linguistic disfluencies in typically and atypically developing Russian-speaking children from the perspective of the dynamic adaptive model of self-monitoring in speech production. The study collected four language samples from 10 six-year-old children with developmental language disorder and 14 typically developing peers: two storytelling tasks, structured conversation, and a play argument. After transcribing audio-recordings and marking linguistic disfluencies, the authors conducted structured distributional analysis. The distribution of several indexes of disfluency was estimated to assess the prevalence and profiles of different (sub)types of disfluencies. The disfluency rate statistics were similar between the typically developing children and children with developmental language disorder. The distributional indexes score showed that tasks significantly impacted the rate of different (sub)types of disfluencies. Task-related patterns in a set of the distributional indexes significantly distinguished the groups. Thus, changes in the disfluency profile related to different external factors, as a sign of a flexibility of an adaptive self-monitoring system, may be limited in children with developmental language disorder.

The efficacy of remote video-based behavioral skills training and awareness training on public speaking performance.

This study evaluated the efficacy of (a) remote video-based behavioral skills training (BST) with added speech outlines on teaching public speaking behaviors and (b) remote video-based awareness training (AT) on speech-disfluency rates. A multiple-baseline design across speech behaviors was used to evaluate the training. Remote video-based BST and AT were effective at teaching public speaking behaviors and reducing speech disfluencies, respectively, for both participants. In addition, performance generalized to increased audience size. Although expert ratings of perceived public speaking effectiveness improved following BST, the ratings did not improve and some worsened following AT. Both participants reported satisfaction with video-based BST and AT. One participant reported greater comfort, confidence, overall ability, and less anxiety as a public speaker following BST. Both participants reported greater improvements in those categories following AT. Our results suggest that public speaking behaviors can be taught using remote video-based BST and speech disfluencies can be reduced using remote video-based AT.

Pausing and fluency in speech of patients with relapsing-remitting multiple sclerosis.

Multiple Sclerosis (MS) causes a variety of symptoms in speech production, such as more frequent pauses and an increase in the duration of pauses in the speech. However, there is almost no data on whether the disease affects speech fluency in other ways, such as changes in the frequency of disfluencies in speech. The main question of this study is the following: if we examine speech fluency in speech tasks requiring different cognitive load, will there be a difference between patients and controls? Twenty people with relapsing-remitting MS (3 men and 17 women) and 20 age- and education-matched control speakers (4 men and 16 women) participated in the study. Speech samples were recorded with each participant in three speech tasks: 1) spontaneous narratives about their own lives, 2) narratives about their previous day, and 3) narrative recalls based on a heard text. In the speech samples, pauses and disfluencies were annotated and the duration of pauses was measured. Then, the frequency of pauses and disfluencies were calculated and the types of disfluencies were examined. The results show that there are differences in the frequency and duration of pauses between people with MS and controls. However, there were no significant differences in the frequency of disfluencies between the groups. The same types of disfluencies occurred in the same frequency in both groups. The results help to better understand the speech production processes in MS.

Disfluencies in the narratives of Russian-Hebrew bilingual children with and without Developmental Language Disorder (DLD).

The present study examined disfluencies in the narratives of Russian-Hebrew bilingual children with Developmental Language Disorder (DLD) and Typical Language Development (TLD) in both Russian (home language) and Hebrew (societal language), with a focus on the independent and combined effects of language disorder and cross-linguistic differences on the rates and loci of disfluencies. Narratives were collected from 44 bilingual children (14 with DLD), ages 5;7-6;6, using a story retelling procedure. The narrative coding system targeted ratios of the following disfluencies (per C-unit): silent pauses, repetitions, self-corrections, and filled pauses. Silent pauses longer than 0.25 sec were identified using PRAAT software© and were classified according to the following durations: more than 0.5 sec, 1 sec, 1.5 sec, and 2 sec. In addition, the loci of pauses (utterance-initial or utterance-internal) and repetitions (content or function words) were coded. Overall, children with DLD and TLD had comparable rates of disfluencies but differed for pauses longer than 0.5 sec and repetition of content words in both languages. For the overall ratio of pauses (more than 0.25 sec), children with and without DLD had more pauses in Russian. Long pauses and repetition of content words reflect difficulties for bilingual children with DLD in dealing with the demands of storytelling, in particular planning processes. A higher ratio of pauses in Russian suggests that they reflect lower proficiency in that language.

Language sample analysis of conversation samples from school-age children who stutter: The role of syntactic factors in stuttering.

INTRODUCTION: The purpose of the study was to compare school-age children who stutter (CWS) and age-matched children who do not stutter (CWNS) in syntactic abilities and syntactic performance. METHODS: Computerized Language Sample Analysis (LSA) was conducted on the conversation samples obtained from 46 school-age CWS and CWNS between 7 and 16 years (CWS, n = 23). Syntactic abilities were assessed using the Index of Productive Syntax (the IPsyn) and Developmental Sentence Scores (DSS) and mixed effects logistic regression analyses with participants as random effects were conducted to determine if the scores were predictive of group membership. Additionally, the groups were compared in the IPsyn subcategories to assess the use of syntactic structures. Syntactic performance was assessed by: (a) Categorizing the sentences from each conversation sample into high vs. low syntactic complexity categories based on DSS scores and comparing the sentence categories in % stuttered sentences (% SS); and (b) Comparing the groups in the proportion of phrase-level disfluencies (phrase repetitions vs. revisions) that are associated with syntactic planning. RESULTS: In terms of syntactic abilities, the IPsyn scores interacted with the number of utterances (sample size) used to compute the scores in predicting group membership. In comparison to the CWNS, the CWS obtained higher scores in the IPsyn and the sentence structure subcategory of the IPsyn that were independent of sample size. In terms of syntactic performance: (a) Significantly more sentences were stuttered in the high compared to the low syntactic sentence category; (b) Compared to the CWNS who demonstrated significantly more phrase revisions, the CWS showed comparable and fewer phrase revisions and repetitions. Additionally, post-hoc analysis showed that the CWS used significantly elaborated noun phrases and a similar trend was evident for verb phrase elaborations. A significant association between verb phrase elaborations and%SS was also obtained. CONCLUSIONS: Findings from the IPsyn and the use of elaborate noun phrases, and to some extent verb phrases, suggested that the CWS used more complex syntax even in shorter conversational samples. More stuttered sentences in the high DSS sentence category, the use of fewer phrase revisions, and the association between stuttering and elaborated verb phrases in the CWS are interpreted to suggest the effects of syntactic planning and reformulation demands on fluency during ongoing articulation.

Speech disfluencies in bilingual Greek-English young adults.

PURPOSE: The purpose of this study was to investigate the frequency and types of disfluencies in Greek-English bilingual adults across naturalistic speech samples and compare frequency and types of disfluencies between the participants' L1 and L2. METHODS: Participants in the study included 26 Greek-English bilingual young adults. All participants were sequential bilinguals, whose first language was Greek and second language was English. Two speech samples were collected in each language, a conversational and a narrative sample, which were subsequently analyzed for the frequency and types of disfluencies. RESULTS: Results indicated that participants produced more typical disfluencies in English compared to Greek across speaking samples. The most frequent types of disfluencies were filled pauses and vowel prolongations (without tension or struggle) across speaking samples and languages. CONCLUSION: Our results revealed differences in the types and frequencies of disfluencies produced in participants' native compared to their second language. Results add to the growing body of literature addressing the manifestation of speech disfluencies in bilingual speakers.

Developmental stuttering, physical concomitants associated with stuttering, and Tourette syndrome: A scoping review.

BACKGROUND AND PURPOSE: Developmental stuttering and Tourette syndrome (TS) are common neurodevelopmental disorders. Although disfluencies may co-occur in TS, their type and frequency do not always represent pure stuttering. Conversely, core symptoms of stuttering may be accompanied by physical concomitants (PCs) that can be confused for tics. This scoping review aimed to explore the similarities and differences between stuttering and tics in terms of epidemiology, comorbidities, phenomenology, evolution, physiopathology, and treatment. We also described the nature of PCs in stuttering and disfluencies in TS. METHODS: A literature search on Medline, Embase and PsycInfo was executed in March 2022. From 426 studies screened, 122 were included in the review (a majority being narrative reviews and case reports). RESULTS: TS and stuttering have several epidemiological, phenomenological, comorbidity, and management similarities suggesting shared risk factors and physiopathology (involving the basal ganglia and their connections with speech and motor control cortical regions). PCs in stuttering commonly involve the face (eyelids, jaw/mouth/lip movements) and sometimes the head, trunk and limbs. PCs can be present from early stages of stuttering and vary over time and within individuals. The function of PCs is unknown. Some individuals with TS have a distinct disfluency pattern, composed of a majority of typical disfluencies (mostly between-word disfluencies), and a mix of cluttering-like behaviors, complex phonic tics (e.g. speech-blocking tics, echolalia, palilalia), and rarely, atypical disfluencies. CONCLUSION: Future investigations are warranted to better understand the complex relationships between tics and stuttering and address the management of disfluencies in TS and PCs in stuttering.

Effects of task variations on language productivity, syntactic complexity, and stuttering in children who stutter.

PURPOSE: The aim of this preliminary study was to compare the effects of variations in task demands on: (a) language productivity in sentences categorised into stuttered vs. non-stuttered sentences; (b) syntactic complexity in stuttered vs. non-stuttered sentence categories, and (c) stuttering and typical disfluencies in school-age children who stutter (CWS). Language Sample Analysis (LSA) was conducted on samples from three tasks - Conversation, fable retell, and critical thinking based on the fables. METHODS: Participants were 14 CWS categorised into younger (9 to 12-year-olds, n = 8) and older age groups (13 to 15-year-olds, n = 6). The Computerized Language ANalysis program was used to conduct language and disfluency analyses. Repeated measures analysis of variance and nonparametric statistical analyses were used to investigate: (a) Language productivity in total number of words and sentences by task and sentence category; (b) Syntactic complexity at the word- (use of metacognitive verbs), phrase- (use of verb phrases), and utterance (Mean Length of Utterances in words, MLUw) levels by task and sentence category; and (c) Disfluencies measured using % stuttered syllables (%SS) and % typical disfluencies (%TD). RESULTS AND CONCLUSIONS: Task effects in language productivity did not differ by sentence category and suggested limited influences of propositionality and volubility in stuttering. In contrast, higher syntactic complexity was obtained in the stuttered compared to non-stuttered sentences at the word, phrase, and utterance levels and it was the same task - conversation, that elicited the effect. Additionally, variations in task demands did not result in significant differences in %SS. The findings inform assessment planning with the selection of tasks guided by task demands and assessment requirements.

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

PURPOSE: This study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children. METHOD: A 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. RESULTS: The 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. CONCLUSIONS: This 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.

Acquired Stuttering in Parkinson's Disease.

Background: Parkinson's disease frequently causes communication impairments, but knowledge about the occurrence of new-onset stuttering is limited. Objectives: To determine the presence of acquired neurogenic stuttering and its relationship with cognitive and motor functioning in individuals with Parkinson's disease. Method: Conversation, picture description, and reading samples were collected from 100 people with Parkinson's disease and 25 controls to identify the presence of stuttered disfluencies (SD) and their association with neuropsychological test performance and motor function. Results: Participants with Parkinson's disease presented with twice as many stuttered disfluencies during conversation (2.2% ± 1.8%SD) compared to control participants (1.2% ± 1.2%SD; P < 0.01). 21% of people with Parkinson's disease (n = 20/94) met the diagnostic criterion for stuttering, compared with 1/25 controls. Stuttered disfluencies also differed significantly across speech tasks, with more disfluencies during conversation compared to reading (P < 0.01). Stuttered disfluencies in those with Parkinson's disease were associated with longer time since disease onset (P < 0.01), higher levodopa equivalent dosage (P < 0.01), and lower cognitive (P < 0.01) and motor scores (P < 0.01). Conclusion: One in five participants with Parkinson's disease presented with acquired neurogenic stuttering, suggesting that speech disfluency assessment, monitoring and intervention should be part of standard care. Conversation was the most informative task for identifying stuttered disfluencies. The frequency of stuttered disfluencies was higher in participants with worse motor functioning, and lower cognitive functioning. This challenges previous suggestions that the development of stuttered disfluencies in Parkinson's disease has purely a motoric basis.

Identification of stuttering in bilingual Lebanese children across two presentation modes.

The goals of this study were to investigate whether Lebanese speech-language pathologists (SLPs) are accurate at identifying stuttering in bilingual children, to examine whether the use of video-recordings instead of audio-recordings allows for better analyses, and to explore factors that may affect the SLPs' judgments. In phase 1, 32 SLPs listened to narrative samples in Lebanese Arabic of 6 children who do not stutter (CWNS) and 2 who stutter (CWS). They were instructed to label each child as stuttering or not, and to explain what motivated their decisions. Afterwards, they were asked to provide background information by means of a questionnaire. In phase 2, they were asked to judge the same speech samples on the basis of video-recordings, and to explain for each child which speech characteristics they relied on to make their decisions. The results showed that misidentification happens frequently, is significantly more likely to happen with CWNS than with CWS, but also varies within these categories. Moreover, the use of video-recordings does not provide more reliable analyses of speech disfluencies, and speech samples' characteristics and bilingual profile rather than SLPs' characteristics seem to influence the judgments. Qualitative analyses indicate that, in the current study, misidentification may be driven by neglecting or misinterpreting physical concomitants. In general, the findings indicate that identifying and analyzing speech fluency behaviors remain a challenging perceptual task, which underlies the need for developing consistent methods for training students and clinicians in identifying stuttering, especially in a bilingual context.

Speech error rates after a sports-related concussion.

Background: Alterations in speech have long been identified as indicators of various neurologic conditions including traumatic brain injury, neurodegenerative diseases, and stroke. The extent to which speech errors occur in milder brain injuries, such as sports-related concussions, is unknown. The present study examined speech error rates in student athletes after a sports-related concussion compared to pre-injury speech performance in order to determine the presence and relevant characteristics of changes in speech production in this less easily detected neurologic condition. Methods: A within-subjects pre/post-injury design was used. A total of 359 Division I student athletes participated in pre-season baseline speech testing. Of these, 27 athletes (18-22 years) who sustained a concussion also participated in speech testing in the days immediately following diagnosis of concussion. Picture description tasks were utilized to prompt connected speech samples. These samples were recorded and then transcribed for identification of errors and disfluencies. These were coded by two trained raters using a 6-category system that included 14 types of error metrics. Results: Repeated measures analysis of variance was used to compare the difference in error rates at baseline and post-concussion. Results revealed significant increases in the speech error categories of pauses and time fillers (interjections/fillers). Additionally, regression analysis showed that a different pattern of errors and disfluencies occur after a sports-related concussion (primarily time fillers) compared to pre-injury (primarily pauses). Conclusion: Results demonstrate that speech error rates increase following even mild head injuries, in particular, sports-related concussion. Furthermore, the speech error patterns driving this increase in speech errors, rate of pauses and interjections, are distinct features of this neurological injury, which is in contrast with more severe injuries that are marked by articulation errors and an overall reduction in verbal output. Future studies should consider speech as a diagnostic tool for concussion.

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.

Gestures and pauses to help thought: hands, voice, and silence in the tourist guide's speech.

In the body of research on the relationship between gesture and speech, some models propose they form an integrated system while others attribute gestures a compensatory role in communication. This study addresses the gesture-speech relationship by taking disfluency phenomena as a case study. Since it is part of a project aimed at designing virtual agents to be employed in museums, an analysis was performed on the communicative behavior of tourist guides. Results reveal that gesturing is more frequent during speech than pauses. Moreover, when comparing the types of gestures and types of pauses they co-occur with, non-communicative gestures (idles and manipulators) turn out to be more frequent than communicatively-meaningful gestures, which instead more often co-occur with speech. We discuss these findings as relevant for a theoretical model viewing speech and gesture as an integrated system.

The efficacy of remote video-based training on public speaking.

This study evaluated the efficacy of remote video-based behavioral skills training (BST) on teaching public speaking behaviors to 4 participants. A multiple-baseline design across speech behaviors was used to evaluate the effects of the training. Remote video-based BST was effective at increasing public speaking behaviors for all participants. In addition, performance generalized to an increased audience size. An external expert in communications rated the participants as more effective public speakers following training. All participants reported satisfaction with the training and expressed greater comfort, confidence, overall ability, and less anxiety as a public speaker following training. We also measured potential collateral effects of teaching public speaking behaviors on speech disfluencies. Although remote video-based BST was effective for all participants, it did not produce a change in the rate of speech disfluencies. Our findings indicate that public speaking behaviors can be taught using a remote video-based BST package.

Public speaking disfluencies: A review of habit reversal training and research.

From 2016 to 2022, the Journal of Applied Behavior Analysis published 7 studies that evaluated the effects of habit reversal training on speech disfluencies (filled pauses) during public speaking. This review summarizes the participants, dependent variables, procedures, experimental design, and outcomes from this research including practice implications and suggested areas of inquiry.

Disfluency clusters in typical and atypical finnish adult speech. A pilot study.

This study first aimed to investigate disfluency clusters in typical and atypical Finnish adult speakers. Secondly, it aimed to observe possible fluency strategies in speakers representing different fluency levels. In addition to individual disfluency types, we examined different characteristics of disfluency clusters produced by 23 speakers in a fluency continuum. Three adult speaker groups participated in this study: typical speakers with high disfluency frequencies (GA), typical and atypical speakers with very high disfluency frequencies (GB) and atypical speakers with the highest disfluency frequencies (GC). Data were based on a narrative speech task, and disfluency clusters were analysed with both traditional methods and alternative methods. Two statistically significant differences between the speaker groups were found: 1) the length of the clusters was highest in GC compared to other groups, and 2) speakers in GC formulated their utterances more than other groups. Other results, although nonsignificant, were that 3) speakers in GA revised utterances more often than interrupted them compared to GB and GC speakers, and 4) clusters using repetitive words and phrases to maintain fluency were found in GA and GB only. In this study, different fluency levels revealed different strategies in both the production of single disfluencies and in disfluency clusters. It seems that more fluent speakers formulate their messages differently than less fluent speakers, and repetitions can be used to maintain fluency and possibly prevent difficult clusters, as noted with more fluent speakers.

Comparison of Disfluent and Ungrammatical Speech of Preadolescents with and without ASD.

This paper analyses disfluencies and ungrammatical expressions in the speech of 11-13-year-old Finnish-speaking boys with ASD (N = 5) and with neurotypical development (N = 6). The ASD data were from authentic group therapy sessions and neurotypical data from teacher-led group discussions. The proportion of disfluencies and ungrammatical expressions was greater in the speech of participants with ASD (26.4%) than in the control group (15.5%). Furthermore, a qualitative difference was noted: The ASD group produced long, complex disfluent turns with word searches, self-repairs, false starts, fillers, prolongations, inconsistent syntactic structures and grammatical errors, whereas in the control group, the disfluencies were mainly fillers and sound prolongations. The disfluencies and ungrammatical expressions occurring in the ASD participants' interactions also caused comprehension problems.