Transcript Slide 1

Defining speech and language
fluency profiles before and after the
onset of stuttering: Preliminary
findings
Charn Nang
School of Psychology and Social Science
ECU Research Week
19th September 2012
Research Supervisors: Professor Kim Kirsner, Professor Kathryn Hird
Contact Info: www.ecu.edu.au/research/week
Stuttering: What is it?
• Know exactly what they want to say
• Surface features:
– Repetitions, prolongations, blocks
– Secondary non-verbal behaviours
• Below the surface:
– Covert strategies to postpone, avoid stutters
– Fear, embarrassment, anxiety
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• King George VI: If I'm King, where's my
power? Can I form a government? Can I levy
a tax, declare a war? No! And yet I am the
seat of all authority. Why? Because the
nation believes that when I speak, I speak
for them. But I can't speak.
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The problem of stuttering
• 1% prevalence
• 5% incidence
• Approximately 75%-80% of children who start to stutter
spontaneously recover
• Approximately 20% continue stuttering into adulthood
• Debilitating condition that can affect all aspects of life:
– Education
– Personal relationships
– Employment
• Cannot tell for sure if a child will continue to stutter
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The problem of stuttering
• Queen Elizabeth: [Using the name "Mrs.
Johnson"] My husband's work involves a
great deal of public speaking.
Lionel Logue: Then he should change
jobs.
Queen Elizabeth: He can't.
Lionel Logue: What is he, an indentured
servant?
Queen Elizabeth: Something like that.
Contact Info: www.ecu.edu.au/research/week
What is the cause?
• The past:
Linguistic-symbolic
– Psychological
– Parents
Motor plan
• The present:
– Speech motor control
– Neurological
– Genetics
Motor programs
Motor execution
• Complex interaction of a
range of factors
Van Der Merwe, 2009
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Rationale
• Problems with determining cause or consequence:
– Adult participants
– Data after the onset of stuttering
• Predictor variables for the onset of stutter?
– What is the contribution of language-based skills
– Speech and language examined in unnatural speaking
contexts
• Better predict those who will continue to stutter
• Increased understanding of how stuttering develops
to inform treatment
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This study
• Eighteen children aged 21 to 48 months (Session 1)
• Either have a positive family history of stuttering or
not
• Four data selection sessions (three- months apart for
nine months in total)
• Data collection was prior to the onset of any
stuttering
• Speech and language fluency profiles determined
through natural speaking contexts
– Conversational/play sessions with mum and the
examiner
Contact Info: www.ecu.edu.au/research/week
Research questions
• Are there any speech and language fluency
predictor variables for the onset of
stuttering?
• Are the speech and language fluency
profiles of children who start to stutter
different to that of children who continued to
develop typically?
Contact Info: www.ecu.edu.au/research/week
This Study
• Major findings:
– Did NOT predict the onset of stuttering
• Differences in speech and fluency profiles
– After the onset of stuttering changes to speech
and language fluency profiles were observed
• Hypothesised to be changes children make to deal
with stuttering
Contact Info: www.ecu.edu.au/research/week
Method
• Language-based and speech motor control
measures gathered
– Language-based measures
– Articulation rate
– Pause measures
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Mean Length
Utterance
Morphemes
Number of
different word
roots
Percent
mazes
Speech and
Language Fluency
Profiles
Syllables
spoken per
second
Percent
intelligibility
Pause
measures
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Method
• Pause measures
– Short pause
mean duration
– Long pause
mean duration
– Proportion of
pause time
Kirsner et al., 2003
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Results: Preliminary
• Five children started to stutter, thirteen continued to typically
develop
• Speech and language fluency profiles before the onset of
stuttering
– Syllables spoken per second was a significant predictor (logistic
regression)
– Inconclusive result as children who started to stutter were also older
• Speech and language fluency profiles after the onset of stuttering
– Group interaction for Percent intelligibility (repeated measures) for
Session 3 to 4
– Subtle changes in how speech and language measure relate
(Analysis of Covariance)
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Differences in speech and language fluency
profiles after the onset of stuttering
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Differences in speech and language fluency
profiles after the onset of stuttering
• Analysis of Covariance: group interactions found – difference in
the pattern of performance for how speech and language fluency
measures relate between the groups
• There were NO significant group interactions for Session 1 (no
stuttering)
• Group interactions generally involved measures: Long Pause
Mean and Proportion of Pause Time
– Children who started to stutter were taking more time
– Hypothesised to be due to effects of stuttering
– Children who started to stutter compensated by taking longer for
speech production
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Session 2
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Session 3
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Session 4
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Major Findings
• Are there any speech and language fluency
predictor variables for the onset of stuttering?
– NO, the pre-liminary results do not support that
stuttering stems from deficits in speech motor
control or deficits in language-based skills
• Are the speech and language fluency profiles of
children who start to stutter different to that of
children who continued to develop typically?
– YES, but only after stuttering started
Contact Info: www.ecu.edu.au/research/week
References
• Guitar, B. . (2006). Stuttering: An integrated approach to its nature and
treatment. Baltimore, MD: Lippincott Williams & Wilkins.
• Kirsner, K., Dunn, J., Hird, K., & Hennessey, N. (2003). Temporal coordination: Lynch-pin of language production. Paper presented at the
6th International Seminar on Speech Production, Sydney, Australia.
• Klein, J., & Hood, S. (2004). The impact of stuttering on employment
opportunities and job performance. Journal of Fluency Disorders, 29,
255-273.
• Miller, J. (2008). Systematic Analysis of Language Transcripts (SALT),
English Version 2008: SALT Software, LLC.
• van der Merwe, A. (2009). A theoretical framework for the
characterization of pathological speech sensorimotor control. In M
McNeil, R. (Ed.), Clinical management of sensorimotor speech
disorders (2nd ed., pp. 3-18). New York, NY: Thieme.
Contact Info: www.ecu.edu.au/research/week