Although the past 50 years of research on early childhood stuttering and normal disfluency have produced vital information on the general features of disfluent speech behavior of young children, an adequate normative reference for early stuttering does not exist. The purpose of this report is to provide such reference and to provide a basis for clinical needs of differential diagnosis of stuttering from normal disfluency. Data are presented from 90 stuttering children ages 2 to 5 within 6 months of stuttering onset and from 54 age-matched normally fluent children. Means for disfluency types are presented. No significant differences were found for gender or for age. Stuttering-like disfluencies (SLD) did differ significantly for the stuttering and fluent groups, but other disfluencies (OD) did not. A weighted SLD is defined to further clarify differences between the groups. The pattern of disfluency types for normally fluent and for mild, moderate, and severe stuttering is presented. Stuttering is shown to be qualitatively as well as quantitatively different from normal disfluency even at the earliest stages of stuttering. Clinical and research implications are discussed.

Normative Disfluency Data for Early Childhood Stuttering

Objective To assess long-term results with consistent use of indwelling voice prostheses (Provox; Atos Medical AB, Horby, Sweden) for vocal rehabilitation after total laryngectomy. Design Retrospective clinical analysis. Setting Comprehensive national cancer center. Patients Three hundred eighteen patients (261 men and 57 women; mean age, 62 years) from November 1988, through May 1999. Intervention Standard wide-field total laryngectomy (287 patients) or total laryngectomy with circumferential pharyngeal resection (31 patients), and 2700 prosthesis replacements. Prostheses remained in situ during 364,339 days (1000 patient-years). Main Outcome Measures Device lifetime, indications for replacement (device or fistula related), adverse events, and voice quality. Results Median patient-device follow-up was 67 months. Mean actuarial device lifetime for all indications for replacement was 163 days (median, 89 days). Main indications for replacement were device-related, ie, leakage through the prosthesis (73%) and obstruction (4%), or fistula-related, ie, leakage around the prosthesis (13%), and hypertrophy and/or infection of the fistula (7%). Adverse events occurred in 11% of all replacements in one third of the patients, mostly solvable by a shrinkage period, or adequate sizing and/or antibiotic treatment. Definitive closure of the tracheoesophageal fistula tract occurred in 5% of the patients. Significant clinical factors for increased device lifetime were no radiotherapy ( P = .03), and age older than 70 years ( P P Conclusion The consistent use of indwelling voice prostheses shows a high success rate of prosthetic vocal rehabilitation, in terms of the percentage of long-term users (95%), and of a fair-to-excellent voice quality (88% of patients).

https://jamanetwork.com/journals/jamaotolaryngology/articlepdf/405482/ooa00012.pdf

A decade of postlaryngectomy vocal rehabilitation in 318 patients: a single Institution's experience with consistent application of provox indwelling voice prostheses.

A substantial research literature documents the effects of diverse item attributes, task conditions, and participant characteristics on the case of picture naming. The authors review what the research has revealed about 3 generally accepted stages of naming a pictured object: object identification, name activation, and response generation. They also show that dual coding theory gives a coherent and plausible account of these findings without positing amodal conceptual representations, and they identify issues and methods that may further advance the understanding of picture naming and related cognitive tasks.

Cognitive components of picture naming

A preliminary study (Onslow, Costa, & Rue, 1990) suggested that a parent-conducted program of verbal response-contingent stimulation would be an effective treatment for stuttering children younger ...

A Control/Experimental Trial of an Operant Treatment for Early Stuttering

A phonologically based treatment was implemented to train oral picture naming in four aphasic subjects with severe word-retrieval deficits. An initial assessment based on current cognitive neuropsychological models of naming indicated different levels of phonological and/or semantic deficits underlying naming failure across the subjects. Using a single-subject multiple baseline design across behaviours and subjects, the effects of treatment were evaluated by daily probing of both trained and untrained items across lexical tasks: oral naming, oral reading, and written naming. Results indicated successful acquisition of trained naming targets for the four subjects, and varied patterns of response generalization to naming of untrained phonologically and semantically related pictures, and to oral reading and written naming for the same words. Baseline levels of oral reading performance were noted to predict success in oral naming treatment. Differences in generalization patterns across tasks are disc...

Phonological treatment of naming deficits in aphasia: Model-based generalization analysis

Thirty-one naive listeners rated the intelligibility and acceptability of tracheoesophageal, esophageal, and normal laryngeal speech of 15 adult speakers. Intelligibility was measured using a multiple-choice word test while acceptability was rated on a seven-point equal-appearing interval scale. Judgments were made on the features of fluency, pitch/quality, speech rate, inflection, and overall acceptability. Tracheoesophageal speech was found not to differ significantly from normal speech in intelligibility, rate, and inflection, but was less acceptable for fluency, pitch/quality and overall acceptability. Tracheoesophageal speech was more acceptable than esophageal speech for all features measured.

Acceptability ratings of tracheoesophageal speech

Conversational samples were elicited from 3-, 4-, and 5-year-old normal-speaking children. Speech rates were measured per age group by the traditional overall method and by the articulatory rate me...

Speaking Rates of Young Children

Selected characteristics were compared in the speech of five tracheoesophageal, five esophageal, and 15 normal laryngeal adult speakers. Tape-recorded speech samples were measured for durational features with a stopwatch. Frequency features were analyzed with a Visi-Pitch/Apple IIE computer interface with statistical subroutines. Tracheoesophageal speech proved comparable to normal speech in maximum phonation time, speech rate, pitch pertubation (jitter), average fundamental frequency, and fundamental frequency range, but less efficient than normal speech in phrase grouping. Tracheoesophageal speech was superior to esophageal speech in maximum phonation time, speech rate, and phrase grouping, but not significantly different in pitch perturbation, average fundamental frequency, and fundamental frequency range. Explanations and clinical implications of these findings are discussed.

Duration and Frequency Characteristics of Tracheoesophageal Speech

Explicit identification procedures that can distinguish between beginning stutterers and normally disfluent children are needed. A Protocol for Differentiating the Incipient Stutterer is an apprais...

Rebekah H. Pindzola

Papers

Acceptability ratings of tracheoesophageal speech

Speaking Rates of Young Children

Duration and Frequency Characteristics of Tracheoesophageal Speech

A Protocol for Differentiating the Incipient Stutterer

Dysfluency characteristics of aged, normal-speaking black and white males