Italian normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter.

PURPOSE: This study aimed to assess the reliability and validity of the Italian translation of the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales for adults who stutter, as there are no assessment tools currently available in Italy. The UTBAS scales provide a comprehensive stuttering-specific measure of the unhelpful thoughts and beliefs that can be used to screen for indicators of social anxiety in adults who stutter. Additionally, the UTBAS scales also allow the identification of negative thoughts and beliefs that negatively impact speech treatment outcomes. METHOD: The translation of the UTBAS scales into Italian (UTBAS-ITA) was completed using the forward-backward translation process and it was administered to 98 adults who stutter (AWS) and 98 adults who do not stutter (AWNS). Both groups were matched for gender and age. We also administered the UTBAS-ITA to 76 AWS a second time within a two-week interval to assess test-retest reliability. Additionally, we administered the State-Trait Anxiety Inventory and the Fear of Negative Evaluation Scale to 20 AWS to assess concurrent validity. RESULTS: The UTBAS-ITA showed good power of discrimination between AWS and AWNS, high internal validity, high internal consistency, good construct validity, and good test-retest reliability. CONCLUSION: Since there is a scarcity of clinical assessment tools for adults who stutter in Italy, the UTBAS-ITA could serve as an assessment tool and outcome measure for clinical and research environments.

Communicative practices and perceptions towards stuttering people in South Africa.

BACKGROUND:  A few studies have explored the life experiences of people who stutter. Research has shown that stuttering affects a significant number of people in the population. OBJECTIVES:  The study was designed to explore the experiences of people who stutter and the perception of stuttering in South Africa. METHOD:  Four people who identified as South Africans who stutter participated in this study. The primary investigator conducted semi-structured interviews with each of the participants. In addition, a questionnaire was administered to 20 acquaintances of all the participants. Transcriptions of interviews and results of questionnaires were analysed for major and minor themes. RESULTS:  Results of this study suggest different perceptions by those who stutter and those acquainted with them. The findings of the study show that people who stutter experience communication barriers, so they adopt certain strategies to manage and cope with their speech disorder. The findings showed that stuttering has a pervasive impact on the lives of people who stutter and how they view themselves, considering negative societal views. CONCLUSION:  Evaluation of the results from the study reveals that although stuttering is a common speech disorder, many people who are less informed about it harbour various stereotypes and myths that stigmatise stuttering. This study concludes by outlining recommendations for creating awareness of stuttering. It suggests vigorous campaigns aiming at promoting a multilevel approach that extends beyond the mere social and professional understanding of stuttering but addresses the inherent perceptions, myths, and stereotypes around stuttering.Contribution: Experiences of people who stutter and perceptions towards stuttering can help to better understand the speech disorder and overcome myths and stereotyping of stuttering.

Risk of sleep problems in a clinical sample of children who stutter.

PURPOSE: Previous studies have shown increased prevalence of sleep problems among people who stutter. However, there is a lack of knowledge about what these sleep problems may specifically be. METHOD: Fifty children who stutter (CWS) from 6;0 to 12;9 years of age and 50 age- and gender-matched controls participated in this study. Parents did not report coexisting conditions, excepting stuttering and/or sleep problems. Sleep problems were investigated using a standardized questionnaire answered by parents. The questionnaire shows cut-off scores to identify the risk of sleep problems as a whole and on each one of the six subscales (i.e., disorders of initiating and maintaining sleep; sleep breathing disorders; disorders of arousal; sleep-wake transition disorders; disorders of excessive somnolence; and sleep hyperhidrosis). Scores above the cut-off are suggestive of sleep problems. RESULTS: Twenty-one CWS scored higher than the cut-off on the sleep questionnaire compared to only two controls (p < 0.00001). Specifically, CWS scored higher than controls in disorders of initiating and maintaining sleep, sleep-wake transition disorders (especially jerking, sleep talking, and bruxism), and disorders of excessive somnolence (p < 0.0083, corrected for multiple comparisons). DISCUSSION: Compared to controls, CWS are at greater risk for sleep problems, which are not consequences of coexisting disorders. Present findings confirm and expand current knowledge about sleep problems in CWS. Directionality possibilities and clinical implications are discussed.

Self-perceived outcomes of informative and apologetic self-disclosure: A mixed methods study.

PURPOSE: Self-disclosure statements that are informative, rather than apologetic, have been demonstrated to improve listener perceptions of adults who stutter (Byrd et al., 2017). The purpose of the present study is to investigate the benefits of self-disclosure from the perspective of the speaker and to determine whether self-disclosure statement type is associated with self-perceived outcomes of use. METHOD: A total of 156 adults who stutter completed a survey adapted from a previous study investigating affective, behavioral, and cognitive outcomes of voluntary stuttering. Survey responses were analyzed using descriptive and inferential statistics to determine if there was a significant relationship between self-disclosure statement type and self-reported outcomes. Additionally, responses to two open-ended questions relating to timing of self-disclosure and self-disclosure experiences in general were analyzed using reflexive thematic analysis. RESULTS: Self-disclosure was perceived as beneficial in at least one context by 96.8 % of respondents. Respondents who used an informative self-disclosure statement were more likely to agree that self-disclosure increased confidence and were less likely to report attempting to conceal or avoid stuttering than respondents who used an apologetic self-disclosure statement. Themes relating to additional aspects of self-disclosure experiences included personalized use, social connection, acceptance of stuttering, challenging cognitive distortions, communication is easier, self-empowerment, humor, voluntary stuttering, and vulnerability to prejudice. CONCLUSION: Similar to studies investigating the influence of self-disclosure on listener perceptions, informative self-disclosure is associated with greater self-perceived benefits than apologetic self-disclosure for adults who stutter.

Why do people who stutter attend stuttering support groups?

BACKGROUND:  Stuttering support groups (SSGs) have been a long-standing invaluable resource for people who stutter (PWS) but research into SSGs is only emerging. Speech-language therapists (SLTs) need further insight to successfully facilitate SSGs. OBJECTIVES:  To determine PWS' perspectives regarding why they attend SSGs in South Africa. METHOD:  Thirteen PWS who attend SSGs, between 20 and 58 years old, were a part of this qualitative study. Purposive sampling was utilised. Semi-structured telephonic interviews were used and data was analysed thematically. RESULTS:  Four themes, namely, 'altered perceptions', 'increased sense of community', 'support group reciprocity', and 'support group environment, participants and topics', were identified. The results yielded clinical implications which included SLTs encouraging: (1) improved perceptions of being a PWS through education and self-empowerment, (2) PWS' connections between meetings to increase the sense of community, (3) reciprocity in meetings, (4) sharing personal stories to promote learning and general self-management and (5) support, praise and education to empower and encourage PWS. This study's findings show that SSGs helped PWS accept their stutter and gain confidence. This study showcased how SSGs can help PWS manage their fluency and gain confidence. Additionally, this study supports current research which suggests that dysfluency and social-emotional well-being should be equally addressed. CONCLUSION:  Recommendations were generated from PWS' perspectives and included focusing discussions on fluency, emotions and sharing personal stories. Insights from PWS helped better inform SLTs of their role within SSGs including guiding and facilitating conversations.Contribution: People who stutters' perspectives can be used in clinical practice to help SLTs meet the needs of PWS and guide best practice when facilitating SSGs.

Perceptions and experiences of Australian speech-language pathologists who use the Lidcombe Program with children who stutter.

Purpose: Speech-language pathologists (SLPs) have varying levels of training and experience working with children who stutter (CWS). They often work in contexts and populations that require clinical management to take them beyond the borders of translating clinical trial protocols and evidence-based practice (EBP). This study sought to investigate the clinical experiences of Australian SLPs working with CWS, including their Lidcombe Program confidence and practices. Method: A cross-sectional online survey was completed by 215 Australian SLPs during 2017-2020. They were recruited prior to attending one of 14 workshops hosted by Speech Pathology Australia (SPA). Result: Participants worked in a range of contexts and were from all states and territories. The majority assessed and/or treated up to five CWS annually. Six predictor variables were considered for self-reported clinical confidence. The quantitative analysis identified that an SLP's previous training, reading the SPA stuttering management clinical guideline, and the annual number of CWS treated were found to significantly impact self-reported clinical confidence. Themes included: (1) client, family, service, and context factors that influence clinical decision-making; (2) SLP areas of clinical strength and aspects of paediatric stuttering management requiring further development; and (3) factors that impact Lidcombe Program success and modifications. Conclusion: This study has found that Australian SLPs working with CWS identify a range of important factors that impact their practice.

Functional Speech and Voice Disorders: Approaches to Diagnosis and Treatment.

Historically, formal training for speech-language therapists (SLTs) in the area of functional speech and voice disorders (FSVD) has been limited, as has the body of empirical research in this content area. Recent efforts in the field have codified expert opinions on best practices for diagnosing and treating FSVD and have begun to demonstrate positive treatment outcomes. To provide comprehensive interventions for these complex conditions at the intersection of neurology, psychiatry, and other medical specialties, the SLT must not only build knowledge of diagnostic strategies and components of symptomatic treatment in FSVD but also embrace behavior change techniques and counseling strategies.

Effect existence of aging on stutter ratio evaluated via Bayesian inference.

The stochastic behavior of the stutter ratio (SR) in capillary electrophoresis-based DNA typing is currently described and predicted using statistical models in forensic genetics. Clarifying this behavior can help obtain more objective and robust evidence to the court in terms of mixture interpretation. This study aimed to investigate the effect existence of aging on SR via a Bayesian framework. Nail scrapings and clippings were collected from 68 healthy individuals with informed consent. Samples were classified by age-class: young group (0-16 years; n = 36) and older-adult group (>61 years; n = 32). Then, they were compared in terms of their SRs for each simple repeat locus included in GlobalFiler Kit. Bayesian modeling was performed with lognormal distribution model, which implemented multiple linear regression, allele and age-class as explanatory variables. For all simple repeat loci, the median of the posterior distribution of the age-class parameter was a positive value. For CSF1PO and D7S820, the 95% credible interval of the posterior distribution did not include 0. Our data suggested that aging slightly increases the SR. These findings might help elucidate the stochastic behavior of SR.

A pilot study of an online self-compassion intervention for adults who stutter.

PURPOSE: The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction. METHOD: Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports. RESULT: Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains. CONCLUSION: The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.

Bibliometric mapping of non-invasive brain stimulation techniques (NIBS) for fluent speech production.

Introduction: Language production is a finely regulated process, with many aspects which still elude comprehension. From a motor perspective, speech involves over a hundred different muscles functioning in coordination. As science and technology evolve, new approaches are used to study speech production and treat its disorders, and there is growing interest in the use of non-invasive modulation by means of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Methods: Here we analyzed data obtained from Scopus (Elsevier) using VOSViewer to provide an overview of bibliographic mapping of citation, co-occurrence of keywords, co-citation and bibliographic coupling of non-invasive brain stimulation (NIBS) use in speech research. Results: In total, 253 documents were found, being 55% from only three countries (USA, Germany and Italy), with emerging economies such as Brazil and China becoming relevant in this topic recently. Most documents were published in this last decade, with 2022 being the most productive yet, showing brain stimulation has untapped potential for the speech research field. Discussion: Keyword analysis indicates a move away from basic research on the motor control in healthy speech, toward clinical applications such as stuttering and aphasia treatment. We also observe a recent trend in cerebellar modulation for clinical treatment. Finally, we discuss how NIBS have established over the years and gained prominence as tools in speech therapy and research, and highlight potential methodological possibilities for future research.

Episodic stuttering as the presenting manifestation of acute ischemic stroke: A case report and systematic literature review.

BACKGROUND: Acquired episodic stuttering in adulthood represents a rare condition, which has been infrequently described in the literature. CASE PRESENTATION: We describe the case of a 62-year-old male who presented to the emergency room with three episodes of new-onset brief isolated stuttering with no other speech impairment or associated focal neurologic deficits. His brain magnetic resonance imaging was notable for the presence of a small acute ischemic stroke involving the left precuneus cortex. SYSTEMATIC LITERATURE REVIEW: We performed a systematic literature review to evaluate the association between stroke and acquired neurogenic stuttering. The evidence published to this date suggests that the underlying pathophysiology of acquired stutter does not localize to an isolated or focal region. The development of stuttering secondary to strokes may be the result of a disruption at any level in a cortico-striato-cortical integrative pathway mediating speech execution. CONCLUSION: Here we aimed to emphasize the importance of carefully evaluating new-onset recurrent episodic stuttering to rule out an underlying stroke or another neurogenic etiology. We provide a comprehensive review of acquired stuttering, its differential diagnosis, and its evaluation.

The effects of attentional focus on speech motor control in adults who stutter with and without social evaluative threat.

PURPOSE: We sought to investigate the effects of cued attentional shifts on speechmotor control in adults who stutter (AWS) and adults who do not stutter (ANS) when speaking under low and high social stress conditions. METHOD: Thirteen AWS' and 10 ANS' lip aperture (LA) and posterior tongue (PT) movements were assessed under a Cued-Internal and Cued-External attentional focus condition with and without social stress induction (i.e. speaking to an audience). Skin conductance levels were used to measure a stress response. Speech motor control was assessed by measuring movement duration and variability of movement for LA and PT using the spatial temporal index (STI). RESULTS: A significant Group x Condition interaction was found for LA STI. Post-hoc comparisons indicated AWS' LA STI significantly decreased under Cued External Focus conditions during both low and high social stress. No significant Group x Condition interaction was found for PT STI. AWS showed significantly slower tongue movements (PT) across all low and high social stress conditions; however, there was no significant Group x Condition interaction for PT or LA. DISCUSSION: Findings yield preliminary insights into the role of attentional focus on speech motor control when speaking during high social stress. Theoretical and clinical implications are discussed.

Short tandem repeats of human genome are intrinsically unstable in cultured cells in vivo.

Short tandem repeats (STRs) are a class of abundant structural or functional elements in the human genome and exhibit a polymorphic nature of repeat length and genetic variation within human populations. Interestingly, STR expansions underlie about 60 neurological disorders. However, "stutter" artifacts or noises render it difficult to investigate the pathogenesis of STR expansions. Here, we systematically investigated STR instability in cultured human cells using GC-rich CAG and AT-rich ATTCT tandem repeats as examples. We found that triplicate bidirectional Sanger sequencing with PCR amplification under proper conditions can reliably assess STR length. In addition, we found that next-generation sequencing with paired-end reads bidirectionally covering STR regions can accurately and reliably assay STR length. Finally, we found that STRs are intrinsically unstable in cultured human cell populations and during single-cell cloning. Our data suggest a general method for accurately and reliably assessing STR length and have important implications in investigating pathogenesis of STR expansion diseases.

LT-RPA: An Isothermal DNA Amplification Approach for Improved Microsatellite Genotyping and Microsatellite Instability Detection.

Microsatellites are short tandem repeats of one to six nucleotides that are highly polymorphic and extensively used as genetic markers in numerous biomedical applications, including the detection of microsatellite instability (MSI) in cancer. The standard analytical method for microsatellite analysis relies on PCR amplification followed by capillary electrophoresis or, more recently, next-generation sequencing (NGS). However, their amplification during PCR generates undesirable frameshift products known as stutter peaks caused by polymerase slippage, complicating data analysis and interpretation, while very few alternative methods for microsatellite amplification have been developed to reduce the formation of these artifacts. In this context, the recently developed low-temperature recombinase polymerase amplification (LT-RPA) is an isothermal DNA amplification method at low temperature (32 °C) that drastically reduces and sometimes completely abolishes the formation of stutter peaks. LT-RPA greatly simplifies the genotyping of microsatellites and improves the detection of MSI in cancer. In this chapter, we describe in detail all the experimental steps necessary for the development of LT-RPA simplex and multiplex assays for microsatellite genotyping and MSI detection, including the design, optimization, and validation of the assays combined with capillary electrophoresis or NGS.

Enfin, a podcast in French on stuttering! - "Je je je suis un podcast": Impacts of accessing stuttering-related information in one's mother tongue.

PURPOSE: English-language podcasts on stuttering are numerous. However, stuttering-related podcasts in French are far more rare. In order to create a space to explore stuttering for a French-speaking population, the Association bégaiement communication (ABC), a French-Canadian stuttering organization, produced "Je je je suis un podcast". This study seeks to understand 1) how French, as the language of the podcast, has impacted accessibility to stuttering-related information in the Francophone stuttering community, and 2) how this information impacted listeners' experience with stuttering. METHOD: An anonymous online survey which included multiple choice, Likert scale and open-ended questions was conducted to better understand the impact, among listeners, of having access to a stuttering-related podcast in French. Answers were analyzed quantitatively and qualitatively. RESULTS: Eighty-seven people (40 people who stutter [PWS], 39 speech-language pathologists [SLP]/SLP students, eight parents/close persons to a person who stutters), who had listened to "Je je je suis un podcast" participated in the survey. All three populations reported a greater accessibility, and a sense of identification and connection facilitated because of French. SLPs reported seeing the podcast as a way to support their practice, to gain perspective from PWS, and as a lever for change in the SLP field. PWS reported that the podcast gives them a sense of belonging that encourages involvement, as well as knowledge that empowers and supports them in managing their stuttering. CONCLUSION: "Je je je suis un podcast" is a podcast about stuttering produced in French that increases accessibility to stuttering-related information and empowers PWS and SLPs.

Adult recasts as fluency-facilitators in preschoolers who stutter: Evidence from FluencyBank.

Adult conversational recasts are based on child platform utterances that contain errors (e.g., Child: "Me going." Adult: "Yes, you are going"), and recasts are effective in the child language literature. For many years, adult recasts of preschoolers' stuttered utterances were surmised as fluency-facilitating, but to date, no evidence has been reported to support their efficacy. The purpose was to investigate the natural occurrence of, and the fluency-facilitating potential of, recasts produced by caregivers and clinicians/examiners in free-play interactions transcribed from audio or video recordings on FluencyBank. Forty-three participants with a median age of 38 mo (3;2) (Range=28-73 mo), including 32 boys and 11 girls were selected from five databases, and recasts which were near-imitations and simple recasts as per Weiss (2002) were identified. One database chosen was the Illinois project, to include a subgroup of persistent (n = 9) and recovered children (n = 9). In the 43 participants, significantly (p < 0.0001) fewer stutters and lower percent syllables stuttered (%SS) were observed in post-recast utterances (4%SS) as compared to post-nonrecast utterances (12.5%SS). The CWS-persistent subgroup (n = 9) did not fit the group trend of the 34 others who significantly differed in stuttering frequency post-nonrecast versus postrecast. Findings are taken to mean that adult conversational recasts of preschoolers' stuttered utterances are fluency-facilitating, and interpretations are addressed.

Effect of linguistic factors on the occurrence of stuttering-like disfluency among Japanese-speaking preschool children who stutter.

This study aimed to investigate the linguistic factors involved in stuttering among Japanese-speaking preschool children. The participants included 10 Japanese children who stutter, with a mean age of 5 years and 9 months. Speech samples comprised spontaneous conversations of the participants with their parents for about 20 minutes. We compared the percentages of the occurrence of stuttering-like disfluencies (SLDs) at the word and sentence levels, using the Wilcoxon signed-rank test. The results showed no significant differences in SLDs based on syllable structure when comparing light and heavy syllables and comparing consonants and vowels in the initial position of each content word. SLDs occurred more frequently in the initial than non-initial position of words and in longer rather than shorter words. Additionally, SLDs occurred more frequently in sentences that contained more 'bunsetsu' (a kind of linguistic unit in Japanese). Our study is the first to show that both word and sentence-level factors could contribute to SLDs in preschool children who stutter in agglutinating languages, such as Japanese. This aspect is rarely reported in psycholinguistic studies based on stuttering occurrence in inflecting languages, such as English.

Internet searches conducted by people who stutter: association with speech-language therapy and severity of stuttering.

Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves.

Linguistic factors and stuttering in Nepali speaking adults who stutter.

This study aimed to determine the effect of phonological and morphological factors on the dysfluencies of Nepali-speaking adults who stutter. Eighteen Nepali-speaking adult speakers with mild to very severe developmental stuttering were recruited. The spontaneous speech sample was audio-video recorded and transcribed through orthographic transcription. A total of 350 syllables were analysed to calculate stuttering frequency. Phoneme position, phoneme category, and word length were considered as the phonological factors and word-class as morphological factors. The percentage of stuttering for each of these variables was computed. The study's outcome displayed a significant effect of phoneme position and word length but no effect of phoneme category. Significantly greater stuttering was noticed in the word-initial position and longer words compared to word-medial and shorter words, respectively. In morphological factors, content words and content-function words had a greater stuttering rate than function words. This study showed a significant effect of phoneme position, word length, and grammatical class on the frequency of dysfluency in Nepali-speaking adults who stutter but no effect of phoneme category. The phonetic complexity of these variables may lead to an increase in motor planning demand resulting in more stuttering.

Using unique molecular identifiers to improve allele calling in low-template mixtures.

PCR artifacts are an ever-present challenge in sequencing applications. These artifacts can seriously limit the analysis and interpretation of low-template samples and mixtures, especially with respect to a minor contributor. In medicine, molecular barcoding techniques have been employed to decrease the impact of PCR error and to allow the examination of low-abundance somatic variation. In principle, it should be possible to apply the same techniques to the forensic analysis of mixtures. To that end, several short tandem repeat loci were selected for targeted sequencing, and a bioinformatic pipeline for analyzing the sequence data was developed. The pipeline notes the relevant unique molecular identifiers (UMIs) attached to each read and, using machine learning, filters the noise products out of the set of potential alleles. To evaluate this pipeline, DNA from pairs of individuals were mixed at different ratios (1-1, 1-9) and sequenced with different starting amounts of DNA (10, 1 and 0.1 ng). Naïvely using the information in the molecular barcodes led to increased performance, with the machine learning resulting in an additional benefit. In concrete terms, using the UMI data results in less noise for a given amount of drop out. For instance, if thresholds are selected that filter out a quarter of the true alleles, using read counts accepts 2381 noise alleles and using raw UMI counts accepts 1726 noise alleles, while the machine learning approach only accepts 307.