Inhibitory Control, Cognitive Flexibility, and the Production of Disfluencies in Children Who Do and Do Not Stutter.

PURPOSE: Differences in inhibitory control and cognitive flexibility between children who stutter (CWS) and children who do not stutter (CWNS) have been previously demonstrated. The aim of the current study was to investigate whether the previously reported inhibitory control- and cognitive flexibility-related performance costs for CWS are associated with the number of speech disfluencies that they produce. METHOD: Participants were 19 CWS (Mage = 7.58 years, range: 6.08-9.17) and 19 CWNS matched on age and gender (Mage = 7.58 years, range: 6.08-9.33). Gamma regression models were used to investigate possible associations between performance costs in speed and accuracy measured during a computer task evaluating inhibitory control and cognitive flexibility and the number of speech disfluencies during video-recorded speech samples (story retelling and casual conversation). RESULTS: Two significant interactions were observed. For both inhibitory control and cognitive flexibility, we identified a significant group and inhibitory control/cognitive flexibility performance-cost interaction in stuttering-like disfluencies (SLDs), indicating that the performance-cost effects on SLD production were significantly higher in the CWS group, compared to the CWNS group. CONCLUSIONS: CWS with reduced inhibitory control or cognitive flexibility produce more SLDs, but not other disfluencies. These results are partly in line with some previous findings in nonstuttering and stuttering populations linking inhibitory control and cognitive flexibility weaknesses to the production of speech disfluencies.

Designing a Module on Stuttering and Cluttering: A Guide for Speech-Language Pathology Educators.

PURPOSE: Due to the scope of practice of speech-language pathology (SLP) expanding considerably in recent times, there is reduced emphasis on certain communication conditions within the curricula of SLP university programs. Stuttering and cluttering are neglected components of such curricula, despite the complex clinical skill set required to work with these client groups. Evaluation of the content and quality of modules on stuttering and cluttering is warranted to ensure that SLP students are graduating with adequate competence and confidence for supporting people with these conditions. This tutorial, based on a review of the literature, aims to provide guidance to educators who are designing or revising such modules. METHOD: The All Ireland Society for Higher Education (AISHE) model for module design provides a practical and theoretically underpinned guide to educators in higher education on the design of a new module or the review of an existing one. The model's seven key components are discussed, and their application to a module on stuttering and cluttering is outlined. RESULTS: The AISHE model provides a systematic and user-friendly approach to module design in SLP university programs. It supports educators who are designing a new module or revising a module currently being taught on stuttering and cluttering. CONCLUSIONS: Educators are encouraged to familiarize themselves with the seven components of the AISHE model and to use it as a tool to design or revise modules on stuttering and cluttering. This will ensure that SLP students are graduating with increased competence and confidence in working with these client groups.

Source Localization and Spectrum Analyzing of EEG in Stuttering State upon Dysfluent Utterances.

Purpose: The present study which addressed adults who stutter (AWS) attempted to investigate power spectral dynamics in the stuttering state by answering the questions using quantitative electroencephalography (qEEG). Method: A 64-channel electroencephalography (EEG) setup was used for data acquisition at 20 AWS. Since the speech, especially stuttering, causes significant noise in the EEG, 2 conditions of speech preparation (SP) and imagined speech (IS) were considered. EEG signals were decomposed into 6 bands. The corresponding sources were localized using the standard low-resolution electromagnetic tomography (sLORETA) tool in both fluent and dysfluent states. Results: Significant differences were noted after analyzing the time-locked EEG signals in fluent and dysfluent utterances. Consistent with previous studies, poor alpha and beta suppression in SP and IS conditions were localized in the left frontotemporal areas in a dysfluent state. This was partly true for the right frontal regions. In the theta range, disfluency was concurrence with increased activation in the left and right motor areas. Increased delta power in the left and right motor areas as well as increased beta2 power over left parietal regions was notable EEG features upon fluent speech. Conclusion: Based on the present findings and those of earlier studies, explaining the neural circuitries involved in stuttering probably requires an examination of the entire frequency spectrum involved in speech.

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.

A preliminary comparison of fluent and non-fluent speech through Turkish predictive cluttering inventory-revised.

PURPOSE: The aim of this study is to compare the speech fluency performance of non-fluent participants namely people with stuttering (PWS), people with cluttering (PWC) and people with cluttering and stuttering (PWCS) with a fluent control group using the Turkish version of Predictive Cluttering Inventory-revised (TR-PCI-r). METHODS: The study recruited non-fluent individuals (n = 60) and fluent controls (n = 60) between the ages of 6 and 55. The non-fluent group was perceptually evaluated by two speech and language pathologists (SLP). The speaking, reading and retelling samples were collected from 18 PWC, 17 PWCS, 25 PWS and 60 controls. The scores of each factor were compared. Age and gender differences were analyzed. Validity and reliability were calculated. RESULTS: The agreement between two SLPs was found to be at the barely acceptable level (κ = 0.378). PWC and PWCS produced parallel outcomes in the speech motor area. In every other domain and in total scores, PWC were different from PWCS, PWS, and the controls. There was a variation in the total scores obtained by the children and adolescents in the PWS and between males and females in the controls. Except for three items (namely items 8, 22, 27), TR-PCI-r met the content validity criterion. Furthermore, TR-PCI-r was found to be a reliable tool as shown by ɑ> 0.70 and ICC values of between 0.75 and 0.90. CONCLUSION: The scores from TR-PCI-r indicated that, speech motor characteristics of PWC and PWCS were similar. Other features assessed by the tool seemed to distinguish PWC from PWCS, PWS and controls.

Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K).

INTRODUCTION: Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter. METHOD: The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment. RESULTS: The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K. CONCLUSION: The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.

Unique Patterns of Bilingual Speech: Factors Affecting Disfluency Rates in Russian-Hebrew Bilingual Children.

PURPOSE: Bilingual children often demonstrate a high rate of disfluencies, which might impact the diagnostic evaluation of fluency disorders; however, research on the rates and types of disfluencies in bilinguals' two languages is limited. The purpose of this research is to profile disfluencies of two types, stuttering-like disfluencies (SLDs) and other disfluencies (ODs), in the speech of Russian-Hebrew bilingual typically developing children, focusing on cross-linguistic differences and the effect of language proficiency in both languages. METHOD: Spontaneous narratives based on the Frog, Where Are You? (Mayer, 1969) picture book were collected in both languages from 40 bilingual Russian-Hebrew children aged 5;6-6;6 (years;months). The transcribed narratives were coded for SLD (sound, syllable, and monosyllabic word repetitions) and OD (multisyllabic word/phrase repetitions, interjections, and revisions), and their frequencies per 100 syllables were calculated. RESULTS: Overall, most children had a percentage of SLD and OD below the cutoff point and within the existing criteria for stuttering diagnosis established based on monolingual data, but several children exceeded this stuttering criterion. Monosyllabic word repetitions (part of SLD) and interjections (part of OD) were more frequent in Hebrew than in Russian. Lower proficiency was associated with a higher percentage of monosyllabic word repetitions and of interjections in both languages. CONCLUSIONS: Bilingual disfluency criteria are needed, since based on the existing monolingual criteria, some children might be erroneously assessed as children who stutter, thus leading to overdiagnosis. The results support the claim that proficiency is an important factor in the production of disfluencies.

Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions. / Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala.

PURPOSE: To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions. METHODS: Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering. RESULTS: For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions. CONCLUSION: The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

OBJETIVO: Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala. MÉTODO: Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira. RESULTADOS: Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala. CONCLUSÃO: O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.

Turkish adaptation of the self-stigma of stuttering scale (4S): Study of validity and reliability (4S-TR).

PURPOSE: This study aimed to adapt the Self-Stigma of Stuttering Scale (4S) into Turkish and evaluate its factor structure, reliability, and validity in Turkish culture. METHODS: The original 4S scale was translated into Turkish (4S-TR) using a forward-backward translation technique and was administered to 350 adults who stutter (AWS). To discover latent variables evaluated on the scale, two-factor analyses were performed. Internal consistency and temporal stability were calculated to ensure reliability. Test-retest reliability correlation scores were calculated with multiple applications of the scale within about two weeks. To verify construct validity, participants also completed the Turkish versions of the Self-Esteem Rating Scale-Short Form (BSDÖ-KF) and the Satisfaction with Life Scale(YDÖ). RESULTS: The explanatory factor analysis showed three factors explaining 74.76 % of the total variance. The findings were also validated by confirmatory factor analysis. High levels of internal consistency (r = .89) and test-retest reliability (r = .96) were obtained. In terms of construct validity, our findings revealed that self-stigma has a significant negative correlation with self-esteem (r = -.41) and life satisfaction (r = -.38) as was predicted. CONCLUSIONS: The findings demonstrate preliminary evidence that the 4S-TR is a viable and valid instrument for self-stigma evaluation in three domains (stigma awareness, stereotype agreement, and self-concurrence). The 4S-TR can be applied for research and clinical purposes in Turkish.

Eye movement as a simple, cost-effective tool for people who stutter: A case study.

BACKGROUND:  Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online. OBJECTIVES:  This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions. METHOD:  On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment). RESULTS:  The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences. CONCLUSION:  This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial.Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.

TranStutter: A Convolution-Free Transformer-Based Deep Learning Method to Classify Stuttered Speech Using 2D Mel-Spectrogram Visualization and Attention-Based Feature Representation.

Stuttering, a prevalent neurodevelopmental disorder, profoundly affects fluent speech, causing involuntary interruptions and recurrent sound patterns. This study addresses the critical need for the accurate classification of stuttering types. The researchers introduce "TranStutter", a pioneering Convolution-free Transformer-based DL model, designed to excel in speech disfluency classification. Unlike conventional methods, TranStutter leverages Multi-Head Self-Attention and Positional Encoding to capture intricate temporal patterns, yielding superior accuracy. In this study, the researchers employed two benchmark datasets: the Stuttering Events in Podcasts Dataset (SEP-28k) and the FluencyBank Interview Subset. SEP-28k comprises 28,177 audio clips from podcasts, meticulously annotated into distinct dysfluent and non-dysfluent labels, including Block (BL), Prolongation (PR), Sound Repetition (SR), Word Repetition (WR), and Interjection (IJ). The FluencyBank subset encompasses 4144 audio clips from 32 People Who Stutter (PWS), providing a diverse set of speech samples. TranStutter's performance was assessed rigorously. On SEP-28k, the model achieved an impressive accuracy of 88.1%. Furthermore, on the FluencyBank dataset, TranStutter demonstrated its efficacy with an accuracy of 80.6%. These results highlight TranStutter's significant potential in revolutionizing the diagnosis and treatment of stuttering, thereby contributing to the evolving landscape of speech pathology and neurodevelopmental research. The innovative integration of Multi-Head Self-Attention and Positional Encoding distinguishes TranStutter, enabling it to discern nuanced disfluencies with unparalleled precision. This novel approach represents a substantial leap forward in the field of speech pathology, promising more accurate diagnostics and targeted interventions for individuals with stuttering disorders.

Linguistic features of stuttering during spontaneous speech.

PURPOSE: Previous work shows that linguistic features (e.g., word length, word frequency) impact the predictability of stuttering events. Most of this work has been conducted using reading tasks. Our study examined how linguistic features impact the predictability of stuttering events during spontaneous speech. METHODS: The data were sourced from the FluencyBank database and consisted of interviews with 35 adult stutterers (27,009 words). Three logistic regression mixed models were fit as the primary analyses: one model with four features (i.e., initial phoneme, grammatical function, word length, and word position within a sentence), a second model with six features (i.e., the features from the previous model plus word frequency and neighborhood density), and a third model with nine features (i.e., the features from the previous model plus bigram frequency, word concreteness, and typical age of word acquisition). We compared our models using the Area Under the Curve statistic. RESULTS: The four-feature model revealed that initial phoneme, grammatical function, and word length were predictive of stuttering events. The six-feature model revealed that initial phoneme, word length, word frequency, and neighborhood density were predictive of stuttering events. The nine-feature model was not more predictive than the six-feature model. CONCLUSION: Linguistic features that were previously found to be predictive of stuttering during reading were predictive of stuttering during spontaneous speech. The results indicate the influence of linguistic processes on the predictability of stuttering events such that words associated with increased planning demands (e.g., longer words, low frequency words) were more likely to be stuttered.

The relation between long latency cortical auditory evoked potentials and stuttering severity in stuttering school-age children.

BACKGROUND: Disturbances in auditory processing and feedback have been suggested to play a role in the pathogenesis of developmental stuttering. Long latency cortical auditory evoked potentials in response to non-linguistic and linguistic stimuli can be used to investigate these disturbances. There were differences between developmental stuttering patients. However, there is no solid evidence of these differences to date. OBJECTIVE: This study aims to determine whether there is a statistically significant difference in component P1-N1-P2 of long latency cortical auditory evoked potentials between stuttering school-aged children and non-stuttering children. In addition, the study aims to investigate the relationship between these potentials and objective quantitative measures of stuttering. METHOD: The study included two groups, patients and controls, consisting of 40 subjects aged 6-12 years. For the cases group, the severity of stuttering symptoms and P1-N1-P2 responses to a non-linguistic stimulus were evaluated. In addition, the P1-N1-P2 responses of the matched control group were evaluated. RESULTS: The P1-N1 responses were similar in both study groups, while P2 response was shorter in the patient group, but the difference was not statistically significant compared to the control group. N1 latency has the only statistically significant correlation with the percentage of repetitions, prolongation, and blocks. The female cases had a decreased, not statistically significant, latency than the male cases group. CONCLUSION: In contrast to the previous finding, the study revealed a non-statistically significant different P1-N1, a non-statistically significant reduced P2 response to a non-linguistic stimulus, in CWS, in as evidence for basic auditory processing. The study also revealed a significant correlation between N1 latency and proportion of the repetition symptoms.

Social anxiety disorder in adolescents who stutter: A risk for school refusal.

BACKGROUND: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. METHODS: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. RESULTS: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. CONCLUSIONS: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.

Contemporary clinical conversations about stuttering: Neurodiversity and ableism.

PURPOSE: To discuss issues about neurodiversity and ableism, and how they pertain to clinical management of stuttering, with particular reference to early childhood stuttering. METHODS: During a webinar this year, the issue emerged of how concepts of neurodiversity and ableism apply to early childhood stuttering during the pre-school years. It became apparent that this topic elicited disparate views and would be of particular interest to students of speech-language pathology. Consequently, the leaders of that webinar continued the conversation by written dialogue for the purpose of placing it on record. RESULTS: The discussants reached agreement on many points, but there was some diversity of viewpoint about how neurodiversity and ableism should apply to clinical practice with children who have recently begun to stutter.

"I Just Want People to Think I'm Normal": An Interview Study of Young Swedish Women With Covert Stuttering.

PURPOSE: Research indicates that there is a tendency for females who stutter, more often than males, to use coping strategies that involve covering their stutter, for example, by avoiding situations that require verbal participation. The aim of the study is to increase knowledge about how covert stuttering develops and its impact on self-image and quality of life for women who stutter. METHOD: Eleven young women who stutter covertly were interviewed, and data were subjected to qualitative content analysis. Background information was obtained from the self-report instruments measuring the impact of stuttering on different aspects of life (Overall Assessment of the Speaker's Experiences of Stuttering) and degree of perceived social anxiety (Liebowitz Social Anxiety Scale, Self-Report). RESULTS: Three main themes were identified: (a) managing stuttering, (b) personal aspects, and (c) stuttering as a phenomenon. Shame and a desire to fit in emerged as distinct motives for covering stuttering. The women described that stuttering controlled both life choices and everyday life. Development of self-image had been strongly negatively affected, resulting in social anxiety. The women expressed a particular vulnerability of being a woman who stutters, due to societal norms of female behavior and a lack of female role models who stutter. CONCLUSIONS: The choice of coping strategy was motivated by a desire to "be normal." As a result, stuttering had come to dominate life and affect self-image and life choices. The study highlights the importance for clinicians to be alert to and aware of the fact that the experiences of women who stutter can lead them to develop coping strategies that have far-reaching negative consequences.

The Fifth Croatia Stuttering Symposium: Part III. Mental health and early stuttering.

PURPOSE: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules. METHODS: The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters. RESULTS: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

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.

Understanding the Broader Impact of Stuttering: Suicidal Ideation.

PURPOSE: Suicide and suicidal ideation are topics that have a long but limited history in stuttering research. Clinicians and clinical researchers have discussed personal and therapeutic experiences with clients who have attempted suicide, died by suicide, or struggled with suicidal thoughts. This study sought to (a) explore the occurrence of suicidal ideation in a sample of adults who stutter; (b) evaluate the relationship between adverse impact related to stuttering and suicidal ideation; and (c) document respondents' thoughts related to suicide, stuttering, and their intersection. METHOD: One hundred forty adults who stutter completed the Suicide Behavior Questionnaire-Revised (SBQ-R). Of these, 70 participants completed the Perseverative Thinking Questionnaire (PTQ), and 67 completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Participants who indicated at least some tendency for suicidal thoughts on the SBQ-R (n = 95) were then asked a set of follow-up questions to explore their experiences of suicidal ideation related to stuttering. RESULTS: Quantitative data indicated that the majority of adults who reported experiencing suicidal ideation associated these experiences with stuttering (61.2%, n = 59). Individuals with higher Total Scores on the PTQ and OASES were predicted to experience significantly higher rates of suicidal ideation and, in particular, a higher likelihood of having more frequent suicidal ideation in the past year. Qualitative analyses revealed that suicidal ideation intersects meaningfully with the experience of stuttering. CONCLUSIONS: Data from this study highlight the importance of considering broader life consequences of stuttering that some adults may experience, including suicidal ideation. By being cognizant that clients may develop such thoughts, speech-language pathologists can play a valuable role in identifying and providing necessary support for at-risk individuals. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23699688.

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.