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Purpose: Very preterm (VPT) children are at risk for speech and language problems throughout school age. However, little is known about early speech sound production in these children. This study aims to present a detailed description of early speech sound production and its trajectories in VPT children from 2 to 4 years of age. In addition, this study aimed to determine if early speech sound production is associated with speech production and expressive language function at 4 years of age. Method: In 63 VPT children (< 32 weeks of gestation, 41 boys, mean gestational age = 28.8 weeks, mean birth weight = 1,135 g), speech sound production was assessed by naturalistic speech analysis at 2 years of corrected age and speech and language function by standardized tests at 4 years of age. Results: Speech sound production was found to be abnormal in 49% of the VPT children at 2 years of age and in 19% at 4 years of age. Four different speech production trajectories from 2 to 4 years of age could be identified: a normal trajectory, an abnormal trajectory, a catch-up trajectory, and a growing-into-deficit trajectory. Early speech production, defined by the number of acquired consonants at 2 years of age, significantly predicted the word production score at 4 years of age and the sentence production score at 4 years of age. Conclusions: Compared to the general population, an alarmingly high proportion of VPT children showed speech production problems at 2 years of age. About half of these children showed persistent speech problems at 4 years of age. Moreover, these problems were associated with expressive language problems at the age of 4 years. more...

Purpose: Behavior and temperament (e.g., emotional reactivity, self-regulation) have been considered relevant to stuttering and its developmental course, but the direction of this relation is still unknown. Knowledge of behavior difficulties and temperament in childhood stuttering can improve screening and intervention. The current study examined both directions of the relationship between stuttering and behavior difficulties and temperament and between persistent stuttering and behavior difficulties and temperament across childhood. Method: This study was embedded in the Generation R Study, a population-based cohort from fetal life onward in the Netherlands. We analyzed data from 145 children (4.2%) with a history of stuttering (118 recovered, 27 persistent) and 3,276 children without such a history. Behavior and temperament were repeatedly assessed using parental questionnaires (Child Behavior Checklist) and Infant/Child Behavior Questionnaire between 0.5 and 9 years of age. Multiple logistic and linear regression analyses were performed. Results: Six-month-old children who were less able to "recover from distress," indicating poor self-regulation, were more likely to develop persistent stuttering later in childhood (odds ratio = 2.05, 95% confidence interval (CI) [1.03, 4.05], p = 0.04). In the opposite direction, children with a history of stuttering showed more negative affectivity ([beta] = 0.19, 95% CI [0.02, 0.37], p = 0.03) at 6 years of age than children without such a history. Stuttering persistence was associated with increased internalizing behaviors ([beta] = 0.38, 95% CI [0.03, 0.74], p = 0.04) and higher emotional reactivity ([beta] = 0.53, 95% CI [0.09, 0.89], p = 0.02) at the age of 9 years. Conclusions: Behavior and temperament were associated with stuttering persistency--seemingly as both predictor and consequence--but did not predict a history of stuttering. We suggest that children who persist in stuttering should be carefully monitored, and if behavioral or temperamental problems appear, treatment for these problems should be offered. more...

Purpose: To understand factors contributing to therapy success, this study investigated the role of parents' temperament and the fit between parents' tem- perament and parent-reported child behavior problems in therapy outcomes across two therapy types. Method: A total of 177 children who stutter and their parents were included in this study. Data from 149 children were present at the follow-up. Children received either Lidcombe Program (LP) or Rotterdam Evaluation Study of Stuttering Therapy randomized trial--Demands and Capacities Model (RESTART-DCM) therapy. Parents' temperaments and children's behaviors were measured at baseline. At 18 months of therapy postonset (T4) and 5 years later (T5), the children's remittance or persistence in stuttering was assessed. Results: High parental novelty seeking and high harm avoidance were associated with transient stuttering at T4 in the entire sample. Looking across therapies, novelty seeking remained significant in the RESTART-DCM group at T4, whereas in the LP group, significant associations were observed for reward dependence (at T4 and T5) and persistence (at T4). Meanwhile, none of the parent--child fits were associated with therapy outcome. Conclusions: The results suggest that for preschoolers receiving treatment, parents who tend to seek novelty and exploration, as well as those with greater vigilance toward harm, have a positive impact on therapy success. In contrast, socially dependent parents might have a negative impact on therapy success in children receiving LP treatment, whereas diligent parents could serve as a protective factor in this therapy. These exploratory results should be interpreted with caution, and future research will be crucial to confirm and further interpret these results. [ABSTRACT FROM AUTHOR] more...

Purpose: To our knowledge, there are no data examining the agreement between self-reported and clinician-rated stuttering severity. In the era of big data, self-reported ratings have great potential utility for large-scale data collection, where cost and time preclude in-depth assessment by a clinician. Equally, there is increasing emphasis on the need to recognize an individual's experience of their own condition. Here, we examined the agreement between selfreported stuttering severity compared to clinician ratings during a speech assessment. As a secondary objective, we determined whether self-reported stuttering severity correlated with an individual's subjective impact of stuttering. Method: Speech-language pathologists conducted face-to-face speech assessments with 195 participants (137 males) aged 5-84 years, recruited from a cohort of people with self-reported stuttering. Stuttering severity was rated on a 10-point scale by the participant and by two speech-language pathologists. Participants also completed the Overall Assessment of the Subjective Experience of Stuttering (OASES). Clinician and participant ratings were compared. The association between stuttering severity and the OASES scores was examined. Results: There was a strong positive correlation between speech-language pathologist and participant-reported ratings of stuttering severity. Participantreported stuttering severity correlated weakly with the four OASES domains and with the OASES overall impact score. Conclusions: Participants were able to accurately rate their stuttering severity during a speech assessment using a simple one-item question. This finding indicates that self-report stuttering severity is a suitable method for large-scale data collection. Findings also support the collection of self-report subjective experience data using questionnaires, such as the OASES, which add vital information about the participants' experience of stuttering that is not captured by overt speech severity ratings alone. [ABSTRACT FROM AUTHOR] more...

Purpose: This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children. Method: Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland-Altman plots, analysis of covariance, and Spearman rho correlations. Results: Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results. Conclusion: There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment. more...

Purpose: The purpose of this research note was to validate a simplified version of the Dutch nonword repetition task (NWR; Rispens & Baker, 2012). The NWR was shortened and scoring was transformed to correct/incorrect nonwords, resulting in the shortened NWR (NWR-S). Method: NWR-S and NWR performance were compared in the previously published data set of Rispens and Baker (2012; N = 88), who compared NWR performance in 5 participant groups: specific language impairment (SLI), reading impairment (RI), both SLI and RI, one control group matched on chronological age, and one control group matched on language age. Results: Analyses of variance showed that children with SLI + RI performed significantly worse than other participant groups in NWR-S, just as in NWR. Logistic regression analyses showed that both tasks can predict an SLI + RI outcome. NWR-S holds a sensitivity of 82.6% and a specificity of 95.4% in identifying children with SLI + RI. The sensitivity of the original NWR is 87.0% with a specificity of 87.7%. Conclusions: As the original NWR, the NWR-S comprising a subset of 22 nonwords scored with a simplified scoring system can identify children with combined SLI and RI while saving a significant amount of the needed assessment time. more...

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from 0.91 (for mild stuttering) to 0.73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual's "speech", "emotion", "cognition" and "pain" as measured by the HUI3 and "daily activities" and "anxiety/depression" as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual's coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants. Learning outcomes: Readers will be able to: (1) Understand how the Wilson and Cleary (1995) model of quality of life could be applied to comprehensively assess the quality of life in adults who stutter, (2) describe how health related quality of life is impaired in adults who stutter, (3) mention affected domains of functioning that are related to health related quality of life impairment in adults who stutter, (4) describe the relationship between stuttering severity, functioning, coping and health related quality of life in adults who stutter, (5) describe differences in stuttering severity, coping style, functioning and health related quality of life between adults who stutter who have registered for therapy and adults who stutter who have not. (Contains 7 tables and 1 figure.) more...

Aim: Very-low-birthweight (VLBW; birthweight less than 1500g and/or gestational age less than 32wks) children are at risk for speech problems. However, there are few studies on speech development in VLBW children at an early age. The aim of this study was to investigate phonological development in 2-year-old VLBW children. Method: Twenty VLBW children without major neurosensory impairment (7 males, 13 females; mean birthweight 971g, SD 315; mean gestational age 28wks, SD 1.81) and 20 term children (7 males, 13 females; mean birthweight 3503g, SD 416; mean gestational age 40wks, SD 1.26) were compared on measures of phonological development derived from 20-minute spontaneous speech samples of standardized mother-child play interaction as well as on standardized tests of cognitive and psychomotor development, language, and behaviour. Results: VLBW children had significantly fewer acquired consonants (median 9, p = 0.02) and a significantly lower phonological mean length of utterance (pMLU; median 4.1, p less than 0.01) than term children (median acquired consonants 10, median pMLU 5.0). Interpretation: This study provides evidence for poor phonological development in even healthy VLBW children, compared with term-matched children, independent of their cognitive, psychomotor, and language development, and their behavioural functioning. more...

This pilot study compared two treatments for stuttering in preschool-age children. Thirty children were randomly assigned to either a Lidcombe Program (LP) treatment or a Demands and Capacities Model (DCM) treatment. Stuttering frequencies and severity ratings were obtained immediately before and after treatment (12 weeks). The stuttering frequencies and severity ratings significantly decreased for both treatment groups. No differences between groups were found. Parents of children in both groups were cooperative in many respects, and there were no differences between them on scales that measured their satisfaction with the two treatments. The findings suggest that randomized controlled trials of LP versus DCM treatments are feasible, and they underline the need for experimental analyses of the two treatments. Educational objectives: The reader will be able to: (1) describe the principles and methods of Lidcombe treatment for early stuttering; (2) delineate principles and methods of Demands and Capacities Model treatment; and (3) summarize results of an investigation that compared these programs' relative effects in a pilot study. (Contains 3 tables and 1 figure.) more...

Listeners compared 10 individuals' suitability of speech at three stages of treatment for stuttering (before, immediately after, and six months after) with 10 non-stutterers. Ten speaking situations with different demands were rated using a newly developed instrument. Results indicated the instrument can be scored reliably and the factor "situation" had a significant effect on suitability ratings. (Author/DB) more...

A rating instrument is described that can be used to assess the results of stuttering treatments. The instrument yields a comprehensive and detailed description of speech quality in terms of articulation, phonation, pitch, and loudness, as well as naturalness. Psychometric characteristics of the instrument are analyzed, and methodological problems with evaluating stuttering instruments are discussed. (Author/PB) more...