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Purpose: This case study is presented to inform the reader of potential speech, language, cognitive, and emotional characteristics in preadolescent cluttering. Method: This case study describes a 10-year-old boy who started to clutter during preadolescence. The case illustrates that, in some adolescents, cluttering can co-occur with temporary stuttering-like behavior. In this case, signs of disturbances in speech-language production associated with behavioral impulsiveness as a young child were noted. Speech, language, cognitive, and emotional results of the case are reported in detail. Results: The changes in fluency development are reported and discussed within the context of changes in the adolescent brain as well as adolescent cognitive and emotional development. While being unaware of their speech condition before adolescence, during preadolescence, the changes in brain organization lead to an increase in rate and a decrease in speech control. Given that the client had limited understanding of what was occurring, they were at risk of developing negative communication attitudes. Speech-language therapists are strongly advised to monitor children with cluttering signals in the early years of their adolescence. Supplemental Material: https://doi.org/10.23641/asha.21318072

Purpose Among the best strategies to address inadequate speech monitoring skills and other parameters of communication in people with cluttering (PWC) is the relatively new but very promising auditory–visual feedback (AVF) training ( van Zaalen & Reichel, 2015 ). This study examines the effects of AVF training on articulatory accuracy, pause duration, frequency, and type of disfluencies of PWC, as well as on the emotional and cognitive aspects that may be present in clients with this communication disorder ( Reichel, 2010 ; van Zaalen & Reichel, 2015 ). Methods In this study, 12 male adolescents and adults—6 with phonological and 6 with syntactic cluttering—were provided with weekly AVF training for 12 weeks, with a 3-month follow-up. Data was gathered on baseline (T0), Week 6 (T1), Week 12 (T2), and after follow-up (T3). Spontaneous speech was recorded and analyzed by using digital audio-recording and speech analysis software known as Praat ( Boersma & Weenink, 2017 ). Results The results of this study indicated that PWC demonstrated significant improvements in articulatory rate measurements and in pause duration following the AVF training. In addition, the PWC in the study reported positive effects on their ability to retell a story and to speak in more complete sentences. PWC felt better about formulating their ideas and were more satisfied with their interactions with people around them. Conclusions The AVF training was found to be an effective approach for improving monitoring skills of PWC with both quantitative and qualitative benefits in the behavioral, cognitive, emotional, and social domains of communication.

Background: Owing to the improvement in acute care, there has been an increase in the number of people surviving stroke and living with its impairments. Frailty is common in people with stroke and has a significant impact on the prognosis after stroke. To reduce frailty progression, potentially modifiable factors should be identified. Increasing levels of self-efficacy influence both behaviour and physical functioning, and therefore it could be a potential target to prevent frailty. Methods: This is a prospective cohort study that involved the secondary analysis of the RISE data to examine the relationship between self-efficacy and frailty. The RISE study is a longitudinal study that consists of 200 adults aged 18+ years after their first stroke event. Data were collected from the respondents at 3 weeks, 6 months, 12 months, and 24 months after their discharge from the hospital. Frailty was assessed using the multidimensional frailty index with scores ranging from 0 to 1, and self-efficacy was assessed using the SESx scale, which was dichotomized as low/moderate or high. Frailty trajectories were examined using the repeated linear model. The generalized estimating equation was used to examine the relationship between self-efficacy and frailty at baseline and in the future (6–24 months). The B coefficients were reported at 95% CI before and after adjusting for potential confounders (age, gender, stroke severity, education, and social support). Results: A total of 200 responses were analysed, and the mean age of the respondents was 67.78 ± 11.53. Females made up 64% of the sample, and the mean frailty score at baseline was 0.17 ± 0.09. After adjusting for confounders, respondents with low self-efficacy had an approximately 5% increase in their frailty scores at baseline and in the 24-month follow-up period compared to those with high self-efficacy. Conclusion: The result from this study showed that self-efficacy was significantly associated with frailty after stroke. Our findings suggest that self-efficacy may play a role in frailty progression among stroke survivors.

BACKGROUND Digital technologies (DTs) for older adults focus mainly on health care and are considered to have the potential to improve the well-being of older adults. However, adoption rates of these DTs are considered low. Although previous research has investigated possible reasons for adoption and acceptance of DT, age-based stereotypes (eg, those held by health care professionals) toward the abilities of older adults to use DTs have yet to be considered as possible barriers to adoption. OBJECTIVE The aim of this study was to investigate the influencing role of ageism in the context of health care professionals attitudes toward older adults’ abilities to use health care DT. A further goal was to examine if social comparison and stereotype activation affect and moderate this association. METHODS A new measurement to assess health care professionals’ attitudes toward older adults using technology (ATOAUT-10) was developed and used in 2 studies. Study 1 involved the development of the ATOAUT-10 scale using a principal component analysis and further examined health care professionals’ attitudes toward the use of health care DTs and correlations with ageism. Study 2 further explored the correlation between ageism and ATOAUT in an experimental design with health care professionals. RESULTS In study 1, physiotherapists (N=97) rated older adults as young as 50 years as less able to use health care DT compared to younger adults (Pt=3.73; PR2=0.19; F6,85=3.35; P=.005), such that higher levels of ageism correlated with more negative ATOAUT in the old age salient condition, but not the young condition. Stereotype activation accounted for health care professionals’ attitudes more than did the experience of working with older patients or the professionals’ age. CONCLUSIONS Negative and ageist attitudes of health care professionals can potentially affect how older adults are viewed in relation to DT and consequently might influence actual use and adoption of technology-based treatment. Future studies should broaden the validation of the ATOAUT-10 scale on more diverse samples and focus on the discriminatory aspect of ageism and self-ageism of older adults. This study calls for a focus on ageism as a determinant of adoption of DT.

Purpose Until now, little has been known about the prevalence of “pure” cluttering in a general population. This study sheds light on the prevalence of cluttering in populations of normally developing pre-adolescents in the Netherlands and Germany who do not stutter or have other communication disorders. Method 304 adolescents (Netherlands, n=219/393; Germany, n= 85) were screened with the Predictive Cluttering Inventory-Revised (PCI-r), and when cluttering characteristics were detected, tested for cluttering, using the Fluency Assessment Battery (FAB). Results In total, a group of 13 adolescents had a PCI-r score above 23, indicating the necessity for further fluency assessment. Four adolescents met all the diagnostic criteria for cluttering. The prevalence of pure cluttering in the Dutch study was computed to be 1.1%. The prevalence of pure cluttering in the German study was computed to be 1.2%. Conclusion The PCI-r can serve as an appropriate screening tool for further fluency assessment and should be administered by a speech-language pathologist (SLP). The prevalence of cluttering in a population of normally developing adolescents who do not stutter was found to be about 1.1%.

Item does not contain fulltext Purpose: There is a lack of longitudinal data on predictors of vocabulary development in children with Down syndrome (DS). In typically developing children, many internal and external predictors of vocabulary development have been determined before. The purpose of the present study was to investigate the role of these variables in the receptive and expressive vocabulary development of children with DS. Method: The present study used a longitudinal design in young children with DS to study the vocabulary development over a period of 1.6 years and investigated the possible predictive role of child-related and environmental variables. Result: Receptive vocabulary development was best predicted by the adaptive level of functioning and early receptive vocabulary skills. Expressive vocabulary development was best predicted by the adaptive level of functioning, receptive vocabulary, maternal educational level, level of communicative intent of the child, attention skills and phonological/phonemic awareness. Conclusion: A wide range of internal and external predictors for vocabulary development of children with DS was found. Predictors resemble those predicting vocabulary development in peers with typical development between 1 and 6 years of age, as identified in other studies. 13 p.

This article presents a variety of treatment approaches based on an understanding of four components of communication, and describes cluttering intervention focusing on problem identification, speech rate reduction, appropriate pausing, appropriate monitoring, and addressing story narrating skills. Therapeutic considerations, taking into account the specific characteristics of cluttering, will also be presented. Finally, building clients' confidence, emotional skills, and sense of accomplishment will turn the therapeutic process into awareness of realistic expectations and motivation to pursue challenging goals.

This article presents the highlights of an International Cluttering Association (ICA) international initiative featuring ten experts in fluency disorders from various countries, describing the historical and current state of awareness, research, diagnosis, and treatment of cluttering across countries and continents. In addition, authors discuss the challenges facing people with cluttering and ways of overcoming them in developed and developing countries.

Item does not contain fulltext The aim of this study was to develop a core vocabulary list for young children with intellectual disabilities between 2 and 7 years of age because data from this population are lacking in core vocabulary literature. Children with Down syndrome are considered one of the most valid reference groups for researching developmental patterns in children with intellectual disabilities; therefore, spontaneous language samples of 30 Dutch children with Down syndrome were collected during three different activities with multiple communication partners (free play with parents, lunch- or snack-time at home or at school, and speech therapy sessions). Of these children, 19 used multimodal communication, primarily manual signs and speech. Functional word use in both modalities was transcribed. The 50 most frequently used core words accounted for 67.2% of total word use; 16 words comprised core vocabulary, based on commonality. These data are consistent with similar studies related to the core vocabularies of preschoolers and toddlers with typical development, although the number of nouns present on the core vocabulary list was higher for the children in the present study. This finding can be explained by manual sign use of the children with Down syndrome and is reflective of their expressive vocabulary ages. 10 p.

The primary objective of this article is to study whether an assessment instrument specifically designed to assess speech motor control on word level productions would be able to add differential diagnostic speech characteristics between people who clutter and people who stutter. It was hypothesized that cluttering is a fluency disorder in which speech motor control on word level is disturbed in high speech rate, resulting in errors in flow of speech and sequencing. An assessment instrument on speech motor coordination on word level was developed and validated. In an elicitation procedure, repetitions of complex multi-syllabic words at a fast speech rate were obtained from 47 dysfluent participants (mean age 24.3; SD 10.25, range 14.2–47.4 yrs) and 327 controls (mean age 25.56 yrs; SD 8.49; age range 14.3–50.1). Speech production was judged on articulatory accuracy, smooth-flow (coarticulation, flow and sequencing) and articulatory rate. Results from people who clutter (PWC) and people who stutter (PWS) were compared to normative data based on control group data. PWC produced significantly more flow and sequencing errors compared to PWS. Further research is needed in order to study speech motor control in spontaneous speech of people who clutter.

Item does not contain fulltext Enhancing communication performance skills may help children with Down Syndrome (DS) to expand their opportunities for participation in daily life. It is a clinical challenge for speech-language pathologists (SLP) to disentangle various mechanisms that contribute to the language and communication problems that children with DS encounter. Without clarity of different levels of functioning, appropriate interventions may be poorly conceived or improperly implemented. In the present study, the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY) framework was used to classify contributing factors to communication performance in a multiple case study of six young children with DS. Within a comprehensive assessment, we identified individual and environmental facilitators and barriers, leading to an integrative profile of communication performance (IPCP) for each child. Whereas these six children shared a developmental, and/or expressive vocabulary age and/or level of communicative intent, the children faced similar but also unique personal and environmental factors that play an important role in their communication performance. Our data reveal that a combination of different factors may lead to the same language outcomes and vice versa, based on a unique pattern of interdependency of ICF-CY domains. Planning SLP interventions for enhancing communication performance in children with DS should therefore be based on a comprehensive view on the competences and limitations of every individual child and its significant communication partners. This evaluation should address facilitators and barriers in body functions, structures, activities, participation and environment, with a specific focus on individual strengths. The ICF-CY provides a useful framework for constructing an IPCP that serves this purpose. 19 p.