Conditioning of the speech activity in early stuttering: a case report

Stutter therapy in very young children does not always consist of direct treatment. If several factors indicate that a child can outgrow his stuttering, one could consider indirect treatment. This case report describes the outcome of a treatment situated between indirect and direct therapy. C. is a 2 year 9 month old boy who demonstrates a mild stuttering severity. A short intervention focused on the conditioning of the speech activity was recommended. Data collection took place before, during and up to 1 month after the intervention

Stutter-like dysfluencies in Flemish sign language users

Although stuttering is primarily considered to be a disorder of speech, stutter-like dysfluencies have been reported to occur during non-speech activities such as musical expression and sign language. Recently we conducted a questionnaire study aimed at documenting the possible occurrence and nature of stutter-like dysfluencies in Flemish Sign Language. A questionnaire was sent to 66 individuals who have knowledge of Flemish Sign Language and come regularly in contact with Flemish Sign Language users. They were 38 Flemish Sign Language interpreters and 28 employees of special needs schools adapted to deaf and partially deaf pupils. The questionnaire consisted of three parts. First, the participants were inquired about their occupational activities. The second part focused on the research questions. Namely, the interviewees were asked whether they had ever noticed dysfluencies in the manual communication of the deaf and partially deaf. If so, they had to indicate on a list which type of dysfluencies they had perceived and specify whether the dysfluencies generally occurred at the beginning, in the middle or at the end of a sign movement. Finally, the participants were asked to provide details (such as gender, age, nature of the fluency problems, awareness, secondary behaviour, and influencing factors) on each deaf and partially deaf person they consider to be dysfluent in the manual mode. Of the 66 individuals surveyed, 13 (i.e. 20%) responded. Of those 13 respondents, nine (i.e. 69%) reported to have observed dysfluencies in the manual communication of Flemish Sign Language users. Concerning the nature of these dysfluencies, participants mostly perceived ‘involuntary interjections’, ‘repetitions of sign movement’, ‘unusual body movements’ and ‘poor fluidity of the sign’. Looking at the distribution of the dysfluencies within the sign movement, fluency failures can occur at various loci but there seems to be a slight preponderance for the initial position. Individuals considered to be dysfluent in the manual mode are often males. They can be aware of their fluency problems and if so will often demonstrate secondary stuttering behaviour. Events accompanied by stress, fatigue or emotion will increase the manual dysfluencies at least in some cases. The current study revealed mainly features that are typical of stuttering, but also some features that are unlike those usually observed in stutterers. If dysfluencies in manual communication can be regarded as stuttering, this has implications for our perception of the stuttering phenomenon. One possibility is to hold on to the idea that stuttering is ‘first and foremost a disorder of speech’. On the other hand, instead of being a (speech) disorder on itself, stuttered speech and manual dysfluencies could be considered as symptoms of an underlying disturbance in motor functioning. In that case, one would expect to encounter stutter-like dysfluencies in all sorts of behaviour demanding extensive motor planning

Stutter-like dysfluencies in Flemish sign language users

The purpose of this communication is to report on the occurrence of stutter-like behaviour in Flemish Sign Language users. A questionnaire was sent to 38 Flemish Sign Language interpreters and 28 employees of special needs schools adapted to deaf and partially deaf pupils inquiring whether they had ever observed dysfluencies in the manual communication of the deaf and partially deaf. Of the 13 individuals who responded, nine indicated to have perceived such behaviour. The characteristics of the observed dysfluencies are summarized and implications are discussed

Voice characteristics in adults with neurofibromatosis type 1

Introduction and aims of the study: Change or loss of voice in patients with neurofibromatosis type 1 (NF1) has been associated with head and neck neurofibromas. However, laryngeal involvement in NF1 is rare and voice abnormalities have also been reported in absence of such a tumor. Authors mention the occurrence of deviations in voice quality (such as breathiness, hoarseness, harshness, presence of a creak) and problems in regulating pitch and loudness. These studies are mainly based on perceptual evaluations. Therefore, the purpose of this study was to examine the voice characteristics of adult NF1 patients without laryngeal manifestations using a multiparameter approach. Methods: A total of 22 NF1 patients (age range 17-64 years) and 22 controls (age range 18-67 years) participated in the study. The patient group consisted of 9 males (mean age 39,33 years) and 13 females (mean age 32,69 years). The control group consisted of 12 males (mean age 38,00 years) and 10 females (mean age 32,90 years). Voice characteristics were evaluated using aerodynamic, voice range and acoustic measurements. These measurements allowed us to determine the Dysphonia Severity Index (DSI). Additionally, participants were asked to complete the Voice Handicap Index (VHI), a questionnaire concerning voice-related quality of life. Results: Vital capacity was significantly reduced in NF1 patients compared with controls. Also, the frequency and intensity range were significantly narrower in the patient group compared with controls. The narrower frequency and intensity range were due to a significantly lower highest frequency and a significantly lower highest intensity respectively. Additionally, male NF1 patients showed a significantly higher lowest intensity compared with male controls. Further, during reading, female NF1 patients exhibited a significantly smaller standard deviation of the mean frequency compared with female controls. This trend was also observed in the male NF1 patients compared with male controls. However, a significant difference could not be demonstrated. Finally, DSI scores were significantly lower and VHI values were significantly higher in both sexes of the patient group compared with controls. Conclusion: NF1 patients appear to have a vocal quality that is worse compared with controls. In particular, it seems that NF1 patients have reduced laryngeal possibilities with respect to fundamental frequency and sound intensity compared with controls. They are also more likely to present a more marked psychosocial voice impact compared with controls

Meningen van heteroseksuele mannen en vrouwen over de spraak van homoseksuele mannen en vrouwen

Achtergrond. Het is algemeen bekend dat de spraak van mannen en vrouwen onderling verschilt. Bovendien wordt gesuggereerd dat naargelang de seksuele voorkeur de spraak binnen deze groepen ook verschillen zou vertonen. Zo werden in de vroege literatuur populaire stereotypes beschreven over de spraakkenmerken van homoseksuele mannen en lesbische vrouwen, in die zin dat niet-heteroseksuelen de typische spraakpatronen zouden hanteren van het andere geslacht. Vooral over homoseksuelen bestaan een aantal vastgeroeste ideeën. Sinds deze publicaties is er zowel op sociaal als demografisch vlak veel veranderd. Mensen zijn opener over hun seksuele voorkeur, genieten vaker een hogere opleiding, zijn minder conservatief-religieus en leven vaker in een verstedelijkte omgeving. De huidige studie wou dan ook nagaan hoe wij tegenwoordig aankijken tegen homoseksualiteit en de spraak van homoseksuelen en lesbiennes in het bijzonder. Methode. Voor deze studie werden in 2009 door studenten 2de bachelor logopedie en audiologie (UGent) bij 1435 Vlamingen vragenlijsten afgenomen. Resultaten en besluit. Vlamingen staan tegenwoordig relatief tolerant ten opzichte van homoseksualiteit. Mannen, oudere personen en lager opgeleiden zijn echter iets gereserveerder in hun antwoord. Personen in contact met niet-heteroseksuelen stellen zich dan weer liberaler op. Hoewel beide aanvaard worden, wordt lesbisch zijn als meer “normaal en aanvaardbaar” bevonden dan homoseksualiteit. Verder denkt de meerderheid van de respondenten dat de seksuele voorkeur van homoseksuele mannen te horen is aan hun spraak. Homoseksuelen zouden op een hogere toonhoogte spreken en gebruik maken van een verfijnde articulatie en woordenschat en meer intonatie, emoties en lichaamstaal. Lesbiennes, daarentegen, zouden geen kenmerkend spraakpatroon vertonen

Het conditioneren van de spreekactiviteit als alternatief voor het geven van communicatieadviezen aan ouders van jonge stotterende kinderen

De behandeling van jonge kinderen die stotteren, hoeft niet altijd te bestaan uit directe therapie. Als een therapeut vermoedt dat er kans is op spontaan herstel, kan hij/zij opteren voor een therapie die op de omgeving van het kind gericht is. Deze indirecte therapie omvat veelal het geven van communicatieadviezen aan ouders. Een nadeel van deze aanpak is dat de therapeut weinig zicht heeft op de mate waarin de ouders deze adviezen opvolgen. Met de huidige studie wilden we dan ook nagaan of het conditioneren van de spreekactiviteit (Boey, 2010) een alternatief kan zijn voor het geven van communicatieadviezen. Daartoe werd een single subject ABA design opgezet bij een 2;8 jaar oude jongen die een viertal maanden eerder was beginnen stotteren. Na acht sessies van conditioneringsactiviteiten vertoonde de jongen een reductie van zijn stottergedrag

Speech in patients with neurofibromatosis type 1

Introduction. Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disorder, characterized by multiple café-au-lait macules and neurofibromas. With a prevalence of 2 to 3 individuals per 10,000, it is the most common single gene disorder to affect the human nervous system. NF1 is caused by mutations in the NF1 gene, which is localized on the long arm of chromosome 17 and encodes the protein neurofibromin. While the NF1-related medical issues and cognitive impairment, including language deficits, are well-described and a frequent subject of research, few studies investigated in depth the occurrence of speech disorders associated with this genetic disorder using objective measurement techniques. Goal of this doctoral thesis. This doctoral thesis aimed to further explore the speech of NF1 patients, preferably using objective measures. In a pilot study, key issues in the speech of NF1 patients as perceived by themselves were identified. Subsequently, a series of six studies were set up to document speech fluency, voice, nasal resonance, and articulation in NF1 patients. Results. The speech of NF1 patients as a group was characterized by dysprosody, including disfluencies not identical to stuttering, limitations in laryngeal possibilities, inconsistent hypernasality, and mild articulation disorders. Statistically significant gender differences were observed but not in every aspect of speech production. Adult men displayed more disfluencies and a narrower voice range profile than adult women. In children, girls tended to exhibit more severe articulation problems than boys. Further, children presented with significantly more articulation difficulties than adults. Conclusion. Speech abnormalities are a common finding in NF1 patients, reflecting difficulties with speech motor control. Mechanical factors alone cannot explain these near-constant findings from one patient to the next, and a neurological basis is proposed. It is hypothesized that subcortical dysfunction, a mechanism that has been linked to the occurrence of learning deficits in this population, might explain the speech abnormalities in NF1 patients

The year in review: voice and communication

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