Interventions That Target or Affect Voice or Speech Production During Public Speaking: A Scoping Review.

OBJECTIVES: Public speaking (PS) is frequently necessary in many professional, educational, and personal settings. Mastering this communication skill is particularly important in today's society. Training techniques for PS have been described in the literature. Given that PS anxiety affects performance, especially voice characteristics and speech fluency, the purpose of this scoping review is to examine, map, and narratively summarize the available evidence on PS interventions that target or affect voice or speech. METHODS: An extensive literature search was conducted in three bibliographic databases: Medline ALL/Ovid, PsycINFO/Ovid, and Eric/Ovid. Of the 850 studies identified, 22 met the eligibility criteria, and one was added from the reference lists of the included studies. RESULTS: A total of 23 studies were included. The interventions identified aim to improve speaking skills either by explicitly targeting the voice or speech (direct intervention, n = 15) or by targeting the cognitive, behavioral, psychological, or physical environment impacting the speaker's production (indirect intervention, n = 8). CONCLUSIONS: This scoping review provides the first published methodological summary of the characteristics of existing PS interventions that target or affect voice and speech. Heterogeneous characteristics were observed. Further studies are needed to determine which interventions are most effective.

Real and virtual classrooms can trigger the same levels of stuttering severity ratings and anxiety in school-age children and adolescents who stutter.

PURPOSE: Many school-age children and adolescents who stutter experience the fear of public speaking. Treatment implications include the need to address this problem. However, it is not always possible to train repeatedly in front of a real audience. The present study aimed to assess the relevance of using a virtual classroom in clinical practice with school-age children and adolescents who stutter. METHODS: Ten children and adolescents who stutter (aged 9-17 years old) had to speak in three different situations: in front of a real audience, in front of a virtual class and in an empty virtual apartment using a head-mounted display. We aimed to assess whether the self-rated levels of anxiety while speaking in front of a virtual audience reflect the levels of anxiety reported while speaking in front of a live audience, and if the stuttering level while speaking to a virtual class reflects the stuttering level while speaking in real conditions. RESULTS: Results show that the real audience creates higher anticipatory anxiety than the virtual class. However, both the self-reported anxiety levels and the stuttering severity ratings when talking in front of a virtual class did not differ from those observed when talking to a real audience, and were significantly higher than when talking in an empty virtual apartment. CONCLUSION: Our results support the feasibility and relevance of using a virtual classroom to expose school-age children and adolescents who stutter to a feared situation during cognitive behavioral therapy targeting the fear of public speaking.

Beyond stuttering: Speech disfluencies in normally fluent French-speaking children at age 4.

The aim of this study was to establish normative data on the speech disfluencies of normally fluent French-speaking children at age 4, an age at which stuttering has begun in 95% of children who stutter (Yairi & Ambrose, 2013). Fifty monolingual French-speaking children who do not stutter participated in the study. Analyses of a conversational speech sample comprising 250-550 words revealed an average of 10% total disfluencies, 2% stuttering-like disfluencies and around 8% non-stuttered disfluencies. Possible explanations for these high speech disfluency frequencies are discussed, including explanations linked to French in particular. The results shed light on the importance of normative data specific to each language.

The impact of attentional allocation capacities on nonword repetition in children with specific language impairment.

This study aimed at directly assessing the hypothesis that attentional allocation capacity influences poor nonword repetition (NWR) performances in children with specific language impairment (SLI), using an attention demanding visual search task given concurrently with the NWR task. Twenty-one children with SLI, 21 typically developing children matched on age and 21 typically developing children matched on nonword span performed an immediate serial recall task of nonwords. The nonword lists were presented either alone or concurrently with the visual search task. Overall, results revealed a resource-sharing trade-off between the two tasks. Children with SLI were affected to the same extent as their span-matched controls by the necessity to allocate their attentional resources between the two tasks. Interestingly, nonword processing strategies seemed to differ among groups: age-matched controls allocated a larger part of their attentional resources to the encoding stage, whereas nonword recall was more attention demanding in children with SLI and younger controls.

Complexity markers in morphosyntactic productions in French-speaking children with specific language impairment (SLI).

The usage-based theory considers that the morphosyntactic productions of children with SLI are particularly dependent on input frequency. When producing complex syntax, the language of these children is, therefore, predicted to have a lower variability and to contain fewer infrequent morphosyntactic markers than that of younger children matched on morphosyntactic abilities. Using a spontaneous language task, the current study compared the complexity of the morphological and structural productions of 20 children with SLI and 20 language-matched peers (matched on both morphosyntactic comprehension and mean length of utterance). As expected, results showed that although basic structures were produced in the same way in both groups, several complex forms (i.e. tenses such as Imperfect, Future or Conditional and Conjunctions) were less frequent in the productions of children with SLI. Finally, we attempted to highlight complex linguistic forms that could be good clinical markers for these children.

The sentence repetition task: a powerful diagnostic tool for French children with specific language impairment.

This study assesses the diagnostic accuracy and construct validity of a sentence repetition task that is commonly used for the identification of French children with specific language impairment (SLI). Thirty-four school-aged children with a confirmed, diagnostically based diagnosis of SLI, and 34 control children matched on age and nonverbal abilities performed the sentence repetition task. Two general scoring measures took into account the verbatim repetition of the sentence and the number of words accurately repeated. Moreover, five other scoring measures were applied to their answers in order to separately take into account their respect of lexical items, functional items, syntax, verb morphology, and the general meaning of the sentence. Results show good to high levels of sensitivity and specificity at the three cut-off points for all scoring measures. A principal component analysis revealed two factors. Scoring measures for the respect of functional words, syntax and verb morphology provided the largest loadings to the first factor, while scoring measures for the respect of lexical words and general semantics provided the largest loadings to the second factor. Sentence repetition appears to be a valuable tool to identify SLI in French children, and the ability to repeat sentences correctly is supported by two factors: a morphosyntactic factor and a lexical factor.

The impact of lexical frequency on sentence comprehension in children with specific language impairment.

Children with SLI generally exhibit poor sentence comprehension skills. We examined the specific impact of grammatical complexity and lexical frequency on comprehension performance, yielding contrasting results. The present study sheds new light on sentence comprehension in children with SLI by investigating a linguistic factor which has attracted little research interest: the impact of the lexical frequency of known words on sentence comprehension. We also examined the impact of grammatical complexity and sentence length by independently varying these two factors. Fifteen children with SLI, 15 age- and IQ-matched controls, and 15 controls matched on lexical and grammatical skills, performed sentence comprehension tasks in which three linguistic factors were manipulated: lexical frequency (sentences containing words of either low or high lexical frequency), grammatical complexity (sentence containing either a subject relative clause or an object relative clause) and sentence length (either short or long sentences). Results indicated that children with SLI performed more poorly overall compared to age- and IQ-matched children and to lexical and morphosyntactic age-matched children. However, their performance was not more affected by either sentence length or clause type than that of control children. Only lexical frequency affected sentence comprehension to a greater extent in children with SLI relative to the control groups, revealing that SLI children's sentence comprehension abilities are particularly affected by the presence of low-frequency but familiar words.

The impact of dual tasking on sentence comprehension in children with specific language impairment.

PURPOSE: In this study, the authors assessed the hypothesis of a limitation in attentional allocation capacity as underlying poor sentence comprehension in children with specific language impairment (SLI). METHOD: Fifteen children with SLI, 15 age-matched controls, and 15 grammar-matched controls participated in the study. Sixty sentences were presented in isolation, and 60 sentences were presented with a concurrent choice reaction time task in which colored stimuli randomly appeared at the center of the computer screen. RESULTS: Sentence comprehension was affected by the dual-task condition to a greater extent in children with SLI relative to age controls but not relative to grammatical controls. CONCLUSION: This study does not support limitations in attentional allocation capacity as representing a core deficit in SLI. Rather, the data show that these children show attentional allocation capacity comparable to that of younger children having similar language level, suggesting that SLI is characterized by a slowed development of both attentional and language domains.

The impact of visual complexity on visual short-term memory in children with specific language impairment.

Many studies have assessed visual short-term memory (VSTM) abilities in children with specific language impairment (SLI), with contrasting results: some studies observed preserved VSTM capacities, while others reported impaired VSTM. The present study explores the hypothesis that the complexity of the visual information to be encoded and stored might underlie these discrepancies. Four VSTM conditions were administered to a group of 15 children with SLI, as well as to two groups of typically developing children, matched for chronological age and for VSTM capacity for visually simple stimuli, respectively. The stimuli to be remembered varied in their visual similarity and in the number of their visual features. Across the four VSTM conditions, children with SLI showed significantly reduced performance relative to an age-matched control group, and they were more strongly affected by visual similarity and number of features when compared to a control group matched for VSTM capacity for visually simple stimuli. The present results support the hypothesis that stimulus complexity is a determining factor of the poor VSTM performances in children with SLI.

Serial-order short-term memory predicts vocabulary development: evidence from a longitudinal study.

Serial-order short-term memory (STM), as opposed to item STM, has been shown to be very consistently associated with lexical learning abilities in cross-sectional study designs. This study investigated longitudinal predictions between serial-order STM and vocabulary development. Tasks maximizing the temporary retention of either serial-order or item information were administered to kindergarten children aged 4 and 5. At age 4, age 5, and from age 4 to age 5, serial-order STM capacities, but not item STM capacities, were specifically associated with vocabulary development. Moreover, the increase of serial-order STM capacity from age 4 to age 5 predicted the increase of vocabulary knowledge over the same time period. These results support a theoretical position that assumes an important role for serial-order STM capacities in vocabulary acquisition.

Serial order short-term memory capacities and specific language impairment: no evidence for a causal association.

This study re-explored the nature of verbal short-term memory (STM) deficits in children with specific language impairment (SLI), by distinguishing item and serial order STM processes. Recent studies have shown serial order STM capacity to be a critical determinant of language development, relative to item STM. In Experiment 1, 12 children with SLI, 12 age-matched children and 12 language-matched children were administered serial order recognition and reconstruction tasks. Experiment 2 assessed implicit serial learning abilities via a Hebb learning task. The SLI group showed impaired performance for the serial order reconstruction and recognition tasks, relative to language-matched and/or age-matched control groups. However, normal serial position effects were observed in all SLI children in the serial order reconstruction task, suggesting normal coding of serial position information. Similarly, performance on the Hebb serial learning task was at chronological age appropriate levels. Experiment 3 showed that the group differences observed for the serial order STM tasks in Experiment 1 disappeared when the SLI group was compared to a mental age-matched control group. Experiment 4 showed similar performance levels in the SLI group and the mental age-matched control group for a nonword recognition task assessing item STM capacities. This study shows that children with SLI have no specific impairments for serial order and item STM components but that poorer general cognitive efficiency is related to functional limitations in verbal STM tasks. The data are in line with limited information processing accounts of SLI.