Purpose The purpose of this study was to investigate knowledge about stuttering in the Jordanian community and the public attitudes that the Jordanians might have toward people who stutter.Method:First, five non-stuttering speakers served as a focus group; they were interviewed in a qualitative, open-ended discussion to inform the design of a culturally appropriate questionnaire. Based on the participants’ responses in the focus group and similar items used in the literature, a questionnaire was designed for the current study. The survey was administered to 240 non-stuttering speakers to assess their knowledge and attitudes about people who stutter. Results No significant interaction effect was observed between gender and either knowledge or attitudes toward people who stutter. Education, religiosity, and contact status did not significantly predict knowledge about stuttering. The greatest perceived difference between fluent speakers and people who stutter was in speaking ability. Education and religiosity were significantly associated with attitudes, with higher levels of both linked to more positive attitude scores The association with religiosity may reflect the influence of non-discriminatory religious principles in Islamic teachings that emphasize equality and compassion. Contact status and knowledge were not significant predictors of attitudes. Conclusion Findings reveal specific areas of limited knowledge and persistent negative attitudes toward stuttering in Jordan, while also highlighting the potential positive roles of education and religiosity. The study underscores the need for culturally tailored public awareness campaigns to reduce stigma.

Background:Examining behavior, structure, and function of the brain of people with persistent developmental stuttering is necessary to unravel the suspected underlying neuronal mechanisms of stuttering.Aims and Objectives:The purpose of the present study is to investigate whether brain activation is related to the moment of stuttering can be identified using fMRI.Materials and Methods:This study is a case-control study, where seven adult males with persistent developmental stuttering (age range 18-28 years; M= 20.7; SD= 3.4) and seven normally fluent adults (age matched) were engaged.Results:Results indicated that adult people who stutter showed bilateral cortical activity in speech-related brain regions (middle temporal gyrus, inferior frontal gyrus, and superior temporal gyrus) during resting state posture. During the active state position, a bilateral cortical activity appeared in speech-related brain regions of precentral gyrus, inferior frontal gyrus and middle frontal gyrus.Conclusion:The findings of the current study propose that improvement in the coordination and connectivity between auditory and motor regions may enhance the fluency of speech.

PURPOSE:(1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components.METHODS:124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions.RESULTS:A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained).DISCUSSION:Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions.CONCLUSION:The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies.

Purpose: Fluency adaptation is characterised by a reduction in stuttering-like behaviours over successive readings of the same speech material and is an effect that is typically observed in developmental stuttering. Prominent theories suggest that short-term motor learning associated with practice explain, in part, fluency adaptation. The current investigation examined the fluency adaptation effect in a group of speakers with Parkinson disease (PD) who exhibited stuttering-like disfluencies. Method: Individuals with PD (n = 21) and neurologically healthy controls (n = 19) read a passage five times. Per cent syllables stuttered was measured and calculated for each reading passage. Result: Participants in the PD group exhibited significantly more stuttering-like disfluencies than control speakers. Twelve individuals in the PD group exhibited at least three per cent syllable stuttered on at least one reading. Statistical trends revealed that the subgroup of individuals with PD who stuttered exhibited a significant reduction in stuttering moments over the five successive readings. Conclusion: A significant fluency adaptation effect was observed for the group of speakers with PD who exhibited stuttering-like disfluencies. Results of the current study are discussed within the framework of the motor learning hypothesis of fluency adaptation.

Primary muscle tension dysphonia (pMTD) is a voice disorder that occurs in the absence of laryngeal pathology. Dysregulated activity of the paralaryngcal muscles is considered the proximal cause; however, the central origin of this aberrant laryngeal muscle activation is unclear. The Trait Theory (Roy and Bless, 2000a,b) proposed that specific personality traits can predispose one to laryngeal motor inhibition and pMTD, and this inhibition is mediated by a hyperactive "behavioral inhibition system (BIS)" composed of limbic system structures (and associated prefrontal connections). This case study used functional magnetic resonance imaging to detect brain activation changes associated with successful management of pMTD, thereby evaluating possible neural correlates of this poorly understood disorder. Method. A 61-year-old woman with moderate-to-severe pMTD underwent functional magnetic resonance imaging scans before and immediately after successful treatment using manual circumlaryngeal techniques. Experimental stimuli were blocks of repeated vowel production and overt sentence reading. Results. Significantly greater activation was observed pre- versus posttreatment in all regions of interest during sentence production, that is, periaqueductal gray, amygdala, hypothalamus, anterior cingulate cortex, hippocampus, dorsolateral prefrontal cortex, Brodmann area 10, and premotor and inferior sensorimotor cortex. Conclusions. Our findings are compatible with overactivation of neural regions associated with the BIS (cingulate cortex, amygdala, hypothalamus, periaqueductal gray) and motor inhibition networks (eg, [pre-]supplementary motor area) along with the dorsolateral prefrontal cortex and medial prefrontal cortex. heightened input from limbic regions combined with dysfunctional prefrontal regulation may interfere with laryngeal motor preparation, initiation, and execution thereby contributing to disordered voice in pMTD.

PurposeThe purpose of this article is to quantify and describe stuttering-like disfluencies in speakers with acquired apraxia of speech (AOS), utilizing the Lidcombe Behavioural Data Language (LBDL). Additional purposes include measuring test-retest reliability and examining the effect of speech sample type on disfluency rates.MethodTwo types of speech samples were elicited from 20 persons with AOS and aphasia: repetition of mono- and multisyllabic words from a protocol for assessing AOS (Duffy, 2013), and connected speech tasks (Nicholas & Brookshire, 1993). Sampling was repeated at 1 and 4 weeks following initial sampling. Stuttering-like disfluencies were coded using the LBDL, which is a taxonomy that focuses on motoric aspects of stuttering.ResultsDisfluency rates ranged from 0% to 13.1% for the connected speech task and from 0% to 17% for the word repetition task. There was no significant effect of speech sampling time on disfluency rate in the connected speech task, but there was a significant effect of time for the word repetition task. There was no significant effect of speech sample type.ConclusionsSpeakers demonstrated both major types of stuttering-like disfluencies as categorized by the LBDL (fixed postures and repeated movements). Connected speech samples yielded more reliable tallies over repeated measurements. Suggestions are made for modifying the LBDL for use in AOS in order to further add to systematic descriptions of motoric disfluencies in this disorder.

This review provides a summary and appraisal commentary on the treatment review by Ingham, R., Ingham, J., Bothe, A., Wang, Y., & Kilgo, M. (2015). Efficacy of the Modifying Phonation Intervals (MPI) stuttering treatment program with adults who stutter. American Journal of Speech-Language Pathology, 24, 256–271.Sources of funding and declaration of interests: No conflicts of interest are reported by the authors.

Purpose: This study investigated the internalised feelings and discrimination experienced by people who stutter in Jordan.Method: Five adult speakers who stutter were interviewed as a focus group. The participants were asked about their feelings related to stuttering and discrimination. The participants' responses in the focus group and items adapted from the extant literature formed the basis of a 20-item questionnaire. The questionnaire was administered to 20 additional adults who stutter to assess their internalised feelings about stuttering and their perceived rejecting behaviours (discrimination) associated with their impairment.Result: Feeling "annoyed'' was the item that received the highest percentage of negative internalised feelings, followed by "embarrassed,'' "shame,'' "disappointed,'' "nervous, "sad,'' "pessimistic,'' "fearful,'' "worried'' and "lonely.'' The results of the discrimination experiences indicated that "getting a leadership position'' was the item that most people who stutter reported being worried about, followed by "participation in the classroom,'' "getting a job,'' "getting married,'' "being fully paid in their jobs,'' "teased,'' "promoted'' and "renting a house.''Conclusion: These findings provide further evidence of the universality that stuttering is more than the core surface features of speech, but also include aspects that exist below the surface such as negative internalised feelings and various discrimination experiences.

PURPOSE:Second formant (F2) transitions can be used to infer attributes of articulatory transitions. This study compared formant transitions during fluent speech segments of Farsi (Persian) speaking people who stutter and normally fluent Farsi speakers. METHODS:Ten Iranian males who stutter and 10 normally fluent Iranian males participated. Sixteen different "CVt" tokens were embedded within the phrase "Begu CVt an". Measures included overall F2 transition frequency extents, durations, and derived overall slopes, initial F2 transition slopes at 30ms and 60ms, and speaking rate. RESULTS:(1) Mean overall formant frequency extent was significantly greater in 14 of the 16 CVt tokens for the group of stuttering speakers. (2) Stuttering speakers exhibited significantly longer overall F2 transitions for all 16 tokens compared to the nonstuttering speakers. (3) The overall F2 slopes were similar between the two groups. (4) The stuttering speakers exhibited significantly greater initial F2 transition slopes (positive or negative) for five of the 16 tokens at 30ms and six of the 16 tokens at 60ms. (5) The stuttering group produced a slower syllable rate than the non-stuttering group. CONCLUSIONS:During perceptually fluent utterances, the stuttering speakers had greater F2 frequency extents during transitions, took longer to reach vowel steady state, exhibited some evidence of steeper slopes at the beginning of transitions, had overall similar F2 formant slopes, and had slower speaking rates compared to nonstuttering speakers. Findings support the notion of different speech motor timing strategies in stuttering speakers. Findings are likely to be independent of the language spoken. Educational objectives This study compares aspects of F2 formant transitions between 10 stuttering and 10 nonstuttering speakers. Readers will be able to describe: (a) characteristics of formant frequency as a specific acoustic feature used to infer speech movements in stuttering and nonstuttering speakers, (b) two methods of measuring second formant (F2) transitions: the visual criteria method and fixed time criteria method, (c) characteristics of F2 transitions in the fluent speech of stuttering speakers and how those characteristics appear to differ from normally fluent speakers, and (d) possible cross-linguistic effects on acoustic analyses of stuttering.

Background/Aims: Many speech-language pathologists (SLPs) are working in linguistically diverse communities and have to identify and measure stuttering in a language other than their own. The aim of the present study was to extend our understanding of how well SLPs can measure stuttering in other languages and to encourage collaboration between SLPs across cultures. Methods: Speech samples consisted of seven preschool-aged children each speaking one of the following languages: Danish, English, French, German, Greek, Italian, and Persian (Farsi). The judges were classified in seven groups of SLPs (n = 170) each speaking one of the seven languages of the children and two more English-speaking groups. Each judge rated the severity of stuttering in each child using a 10-point scale. The study was conducted over the Internet. Results: Overall, the judges' proficiency in a child's language was not systematically related to the variability and agreement of the severity ratings, accounting for maximally 4.6% of the variance. Conclusion: SLPs should not be overly concerned about the appropriateness of their severity ratings if they feel less proficient in the native language of the stuttering children. It may also be encouraging for beginning clinicians that the severity ratings were not systematically related to professional experience.

The aim of this study was to evaluate the ability of English-speaking speech-language pathologists (SLPs) to evaluate stuttering behaviour in two Spanish-English bilingual adults who stutter (AWS1 and AWS2). The English-speaking SLPs were asked to judge the frequency, severity, type, duration, and physical concomitants of stuttering in both languages of the two AWS. The combined results from the English-speaking SLPs were then compared to the judgements of three Spanish-English bilingual SLPs. Results indicated that English-speaking SLPs (1) judged stuttering frequency to be greater in Spanish than English for AWS1, and equal in Spanish and English for AWS2, (2) were more accurate at evaluating individual moments of stuttering for the English samples compared to the Spanish samples, (3) identified fewer and less severe stuttering behaviours than the bilingual SLPs in both languages, and (4) were accurate judges of overall stuttering severity in both languages. The results correspond to past research examining the accuracy of stuttering evaluations in unfamiliar languages. Possible explanations for the findings, clinical implications, and future research directions are discussed.

This paper provides a brief overview of stuttering followed by a synopsis of current approaches to treat stuttering in children and adults. Treatment is discussed in terms of multifactorial, operant, speech restructuring, and anxiolytic approaches. Multifactorial and operant treatments are designed for young children who stutter. Both of these approaches involve parent training and differ primarily in their focus on reducing demands on the child (multifactorial) or in their use of response contingent stimulation (operant conditioning). Speech restructuring and anxiolytic approaches are used with adults who stutter. Speech restructuring approaches focus on the mechanics of speech production, and anxiolytic treatments tend to focus on the symptoms and social and vocational challenges of stuttering. The evidence base for these different approaches is outlined. Response contingent therapy (for children) and speech restructuring therapy (for adults) have the most robust empirical evidence base. Multifactorial treatments for children and stuttering management approaches for adults are popular but are based on theoretical models of stuttering; the evidence base is not robust and tends to be inferred from work in areas such as cognitive behavior therapy and desensitization. Comprehensive, or holistic, approaches to treating stuttering are also discussed. Comprehensive approaches for treating stuttering in adults address both improved speech fluency and stuttering management.

This study examined stimuli classification skills in stuttering and nonstuttering speakers using a group study design across two measurement times. Auditory P300 event-related potentials were assessed in 10 stuttering speakers and 12 nonstuttering speakers. Study participants were recorded twice: stuttering speakers before and after a 3-week stuttering modification treatment program and controls three weeks apart. Right and left hemispheric P300 responses to tonal and speechlike stimuli were measured

This study investigated the relationship between a cepstral/spectral index of dysphonia severity (i.e., the CSID) and listener severity ratings of disordered voices. To assess the value of the CSID as a potential objective treatment outcomes tool, preand posttreatment samples of continuous speech and sustained vowel /a/ productions were elicited from 112 patients (with varying degrees of dysphonia) from six diagnostic categories: (1) unilateral vocal fold paralysis (UVFP), (2) adductor spasmodic dysphonia (ADSD), (3) primary muscle tension dysphonia (PMTD), (4) benign vocal fold lesions (BVFL), (5) presbylaryngis, and (6) mutational falsetto. Perceptual ratings of dysphonia severity in continuous speech were compared to acoustically-derived severity estimates using a three factor CSID model consisting of the cepstral peak prominence (CPP), the ratio of low-to-high spectral energy, and its standard deviation. A five factor CSID model incorporating all acoustic variables as well as gender and the CPP standard deviation was used to estimate severity in sustained vowel samples. Results showed strong relationships between perceptual and acoustic estimates in dysphonia severity in connected speech (r = 0.72, p < 0.0001) and sustained vowels (r = 0.836, p < 0.0001). A strong relationship between the perceived and predicted change in dysphonia severity from preto posttreatment was also observed for connected speech (r = 0.77, p < 0.001) and sustained vowels (r = 0.81, p < 0.0001). Spectrum effects were also examined, and overall severity (mild, moderate, or severe) did not influence the relationship between perceived and estimated severity ratings in connected speech (F[1, 2] = 0.58, p = 0.56); however, dysphonia severity did influence the relationship in sustained vowels (F[1, 2] = 6.22, p = 0.002). In general, the results confirm a robust relationship between listener perceived and acoustically-derived estimates of severity within the contexts of connected speech and sustained vowels across diverse diagnostic categories and varying degrees of dysphonia severity. As such, the CSID shows considerable promise an objective treatment outcomes measure.

The purpose of this study was to describe speech disfluency characteristics in a group of 32 individuals with Parkinson disease (PD). Individuals with PD read a standard passage, and percentages of within-word and between-word disfluencies were calculated. The disfluency percentages exhibited by the individuals with PD were significantly greater than age-matched control speakers. Similarity was found between PD-related disfluencies and disfluencies seen in developmental stuttering, as the PD participants produced primarily motoric-based within-word disfluencies, including both repeated movements and fixed postures. A relationship was also found between self-ratings of medication effectiveness and disfluency levels, and this relationship is interpreted relative to the dopamine hypothesis of stuttering. Finally, significant reductions in within-word disfluencies were seen during a clear-speech task, along with an increase in disfluency levels during a monologue compared to a reading task.