Showing papers by "Harald A. Euler published in 2017"

The Pathogenesis, Assessment and Treatment of Speech Fluency Disorders.

Abstract: Background Approximately 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering, and lesser numbers from cluttering. Persistent speech fluency disorders often cause lifelong problems in communication and social participation. Methods In an interdisciplinary, evidence and consensus based clinical practice guideline, the current understanding of the nature, identification, diagnosis, and treatment of stuttering and cluttering was summarized. A systematic review of the literature was carried out to assess the efficacy and effectiveness of treatments for stuttering. Evidence is lacking on the etiology, pathogenesis, evaluation, and treatment of cluttering. Results In view of the fact that common (developmental, idiopathic) stuttering is associated with structural and functional changes of the brain, the guideline recommends that it should be called "originary neurogenic non-syndromic stuttering." Heritability estimates for this disorder range from 70% to over 80%. For preschool children, the Lidcombe therapy has the best evidence of efficacy (Cohen's d = 0.72-1.00). There is also strong evidence for an indirect treatment approach. For children aged 6 to 12, there is no solid evidence for the efficacy of any treatment. For adolescents and adults, there is good evidence with high effect sizes (Cohen's d = 0.75-1.63) for speech restructuring methods such as fluency shaping; weak evidence with intermediate effect sizes for stuttering modification (Cohen's d = 0.56-0.65); and weak evidence for combined speech restructuring and stuttering modification. The evidence does not support the efficacy of pharmacotherapy, rhythmic speaking, or breathing regulation as the sole or main form of treatment, or that of hypnosis or eclectic, unspecified stuttering therapies. Conclusion Stuttering is often treated in Germany with therapies for which there is inadequate evidence, and the initiation of treatment is often unnecessarily delayed. The guideline presents treatment methods whose efficacy is supported by the current evidence.

Pre-schoolers who stutter score lower in verbal skills than their non-stuttering peers

Abstract: Purpose: The study aimed at the examination of a link between stuttering and verbal skills (speech comprehension, articulation, grammar, vocabulary, and phonological short-term memory) in three- to five-year-old children. Method: Two samples with a total of 7,217 unselected German children were tested with the validated speech and language test Marburger Sprachscreening – revised version ( MSSrev ) . Linguistic domains were compared for pre-school children who stuttered (CWS; n =110) and those who did not (CWNS; n =7,107) by means of Mann-Whitney U tests, general linear models, Spearman correlations, and cross-tables. Results: In both samples, CWS scored lower in grammar, articulation, and overall performance on the MSSrev . Statistically significant associations between stuttering and (a) sex of the child, and (b) language disorders in the family were identified. Conclusions: Taking into account the effect sizes, there appears to be a weak, but statistically significant link between stuttering and verbal skills.