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Purpose: This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. Method: For this study, a taxonomy was developed--LBDL-C7--which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. Results: The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. Conclusion: Clinical and research applications of these findings are discussed.

Purpose: This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. Method: For this study, a taxonomy was developed--LBDL-C7--which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. Results: The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. Conclusion: Clinical and research applications of these findings are discussed., Stuttering The cause of stuttering is not yet fully understood, despite decades of research and theorizing (see Packman & Attanasio, 2017). However, much recent research indicates that it is a [...]

Background: Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts treatment prognosis. Aims: To investigate the predictors of treatment dropout and treatment outcome for children who were treated for early stuttering with the Lidcombe Program (N = 277). Methods & Procedures: A total of 32 variables were used as predictors in regression analyses of short- and medium-term Lidcombe Program outcome, and of treatment dropout. Outcomes & Results: Regression analyses associated children who have better language skills and easy temperament with better treatment outcome, although only a small portion of the variance of treatment outcome was accounted for by these variables. There was an association between treatment dropout and parental scores on a personality screening tool relating to their impulsivity. Conclusions & Implications: Variables identified as predictors of Lidcombe Program treatment outcome were statistically significant, but not clinically significant. They did not account for a clinically substantive portion of treatment outcomes. Findings about parental impulsivity and their relationship with intervention drop-out require replication with prospective methods and comprehensive assessment of parent psychological status. This is particularly important because parents are involved in conducting all early interventions.

Introduction: Attitudes of speech-language pathologists (SLPs) toward stuttering play an important role in managing stuttering cases. Yet, such studies had not been studied in Malaysia, a country that is still developing the profession of speech-language pathology. This study aimed to explore the attitudes of Malaysian SLPs and speech-language pathology students toward stuttering. Methods: A total of 50 SLPs and 67 speech-language pathology students completed the Clinician Attitudes Toward Stuttering (CATS) inventory. There were eight domains of attitudes toward stuttering: (a) etiology, (b) early intervention, (c) therapeutic efficacy, (d) personalities of people who stutter (PWS), (e) clinician expertise and roles, (f) teacher/counsellor roles and client/public reactions, (g) therapy strategies, and (h) parent attitudes. Descriptive data were presented, and multivariate analysis of variance was conducted to examine the effects of clinical certification on the eight domains of attitudes toward stuttering. Results: Participants who possessed a clinical certification were more accepting toward the personalities of PWS and therapy strategies. On the other hand, participants without a clinical certification were more accepting toward clinician expertise and roles. Conclusions: Current curriculum and professional training should be reevaluated to remediate less accepting stereotypes held by SLPs and students toward PWS and to enhance essential skills such as counseling. [ABSTRACT FROM AUTHOR]

Project Re-Vision uses disability arts to disrupt stereotypical understandings of disability and difference that create barriers to healthcare. In this paper, we examine how digital stories produced through Re-Vision disrupt biopedagogies by working as body-becoming pedagogies to create non-didactic possibilities for living in/with difference. We engage in meaning making about eight stories made by women and trans people living with disabilities and differences, with our interpretations guided by the following considerations: what these stories 'teach' about new ways of living with disability; how these stories resist neoliberalism through their production of new possibilities for living; how digital stories wrestle with representing disability in a culture in which disabled bodies are on display or hidden away; how vulnerability and receptivity become 'conditions of possibility' for the embodiments represented in digital stories; and how curatorial practice allows disability-identified artists to explore possibilities of 'looking back' at ableist gazes.

Purpose: Case-study methodology studying change is often used in the field of speech-language pathology, but it can be criticized for not being statistically robust. Yet with the heterogeneous nature of many communication disorders, case studies allow clinicians and researchers to closely observe and report on change. Such information is valuable and can further inform large-scale experimental designs. In this research note, a statistical analysis for case-study data is outlined that employs a modification to the Reliable Change Index (Jacobson & Truax, 1991). The relationship between reliable change and clinical significance is discussed. Example data are used to guide the reader through the use and application of this analysis. Method: A method of analysis is detailed that is suitable for assessing change in measures with binary categorical outcomes. The analysis is illustrated using data from one individual, measured before and after treatment for stuttering. Conclusions: The application of this approach to assess change in categorical, binary data has potential application in speech-language pathology. It enables clinicians and researchers to analyze results from case studies for their statistical and clinical significance. This new method addresses a gap in the research design literature, that is, the lack of analysis methods for noncontinuous data (such as counts, rates, proportions of events) that may be used in case-study designs.

This article explores how episodic disability (ED) is created and intensified by, present within, and pushed out of the neoliberalized academy in Canada. ED is an umbrella term for a range of physical, mental, and neurological conditions characterized by fluctuation and unpredictability. Over two million working‐age Canadians are affected by ED, with women more likely to be impacted. To consider how ED interacts with post‐secondary education, we put feminist disability theories of embodied precarity, crip time, and disability justice into conversation with multimedia stories created by post‐secondary women workers with EDs, with story‐makers contextualizing and theorizing their creations, and revealing their complex embodied and embedded experiences. We chose these from stories generated in two research projects focused on transforming negative concepts of disability to serve as an "archivy" of embodied precarity that challenges ED's erasure in the academy. We think with the stories to analyze power and resistance in and on gendered and raced academic bodies along three overlapping themes: debility and vulnerability in the neoliberal university; fault‐lines of neoliberal time and embodied time; and EDs as produced in, and pushed out of, the neoliberal academy. Considering interrelations between ED and post‐secondary education under neoliberalism, we argue that feminist disability theory and justice praxis challenge debilitating and exclusionary expectations that harm people with EDs in and outside of the academy. [ABSTRACT FROM AUTHOR]

While stuttering is known to be characterized by anomalous brain activations during speech, very little data is available describing brain activations during stuttering. To our knowledge there are no reports describing brain activations that precede blocking. In this case report we present magnetoencephalographic data from a person who stutters who had significant instances of blocking whilst performing a vowel production task. This unique data set has allowed us to compare the brain activations leading up to a block with those leading up to successful production. Surprisingly, the results are very consistent with data comparing fluent production in stutterers to controls. We show here that preceding a block there is significantly less activation of the left orbitofrontal and inferiorfrontal cortices. Furthermore, there is significant extra activation in the right orbitofrontal and inferiorfrontal cortices, and the sensorimotor and auditory areas bilaterally. This data adds weight to the argument forwarded by Kell et al. (2009) that the best functional sign of optimal repair in stuttering is activation of the left BA 47/12 in the orbitofrontal cortex. Educational objectives: At the end of this activity the reader will be able to (a) identify brain regions associated with blocked vocalization, (b) discuss the functions of the orbitofrontal and inferior frontal cortices in regard to speech production and (c) describe the usefulness and limitations of magnetoencephalography (MEG) in stuttering research. (Contains 2 figures.)

Purpose: This clinical trial determined the outcomes of a simple syllable-timed speech (STS) treatment for school-age children who stutter. Method: Participants were 10 children, ages 6-11 years, who stutter. Treatment involved training the children and their parents to use STS at near normal speech rates. The technique was practiced in the clinic and at home with the parents during everyday conversations. Results: Nine months after commencing treatment, stuttering had decreased by greater than 50% for half of the children, with 2 children attaining 81% and 87% reduction. Intention-to-treat analysis showed a clinically and statistically significant reduction in stuttering for the group even when a withdrawn participant was included. These results were mostly confirmed by self-reported stuttering severity ratings and were supported by improved situation avoidance and quality-of-life scores. There was considerable individual variation in response to the treatment. Conclusion: STS shows promise as a treatment for some school-age children who stutter. As a fluency technique, it is simple to learn and simple to teach, and the children in this study appeared to enjoy the treatment. The efficacy of the treatment could likely be improved with modifications.

Previous research has not explored the Five Factor Model of personality among adults who stutter. Therefore, the present study investigated the five personality domains of Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, as measured by the NEO Five Factor Inventory (NEO-FFI), in a sample of 93 adults seeking speech treatment for stuttering, and compared these scores with normative data from an Australian and a United States sample. Results revealed that NEO-FFI scores for the stuttering group were within the "average" range for all five personality domains. However, adults who stutter were characterized by significantly higher Neuroticism, and significantly lower Agreeableness and Conscientiousness, than normative samples. No significant differences were found between groups on the dimensions of Extraversion and Openness. These results are discussed with reference to the relationship between personality factors among adults who stutter, their directionality, and implications for predicting treatment outcome. Learning outcomes: The reader will be able to: (1) describe the Five Factor Model of personality, including the NEO-FFI personality domains of Extraversion, Neuroticism, Openness, Agreeableness, and Conscientiousness, and (2) discuss differences in NEO-FFI domain scores between adults who stutter and normative samples, and (3) understand the clinical implications of personality profiles in terms of treatment process and outcome for adults who stutter.

Purpose: Case-study methodology studying change is often used in the field of speech-language pathology, but it can be criticized for not being statistically robust. Yet with the heterogeneous nature of many communication disorders, case studies allow clinicians and researchers to closely observe and report on change. Such information is valuable and can further inform large-scale experimental designs. In this research note, a statistical analysis for case-study data is outlined that employs a modification to the Reliable Change Index (Jacobson & Truax, 1991). The relationship between reliable change and clinical significance is discussed. Example data are used to guide the reader through the use and application of this analysis. Method: A method of analysis is detailed that is suitable for assessing change in measures with binary categorical outcomes. The analysis is illustrated using data from one individual, measured before and after treatment for stuttering. Conclusions: The application of this approach to assess change in categorical, binary data has potential application in speech-language pathology. It enables clinicians and researchers to analyze results from case studies for their statistical and clinical significance. This new method addresses a gap in the research design literature, that is, the lack of analysis methods for noncontinuous data (such as counts, rates, proportions of events) that may be used in case-study designs., Case-study methodology is 'an empirical enquiry that investigates a contemporary phenomenon in-depth and within its real-life context' (Yin, 2009, p. 18). With historical foundations in behavioral science, single-case-study research dates [...]

Drawing on the growing field of critical access studies, this article positions critical access as a research methodology that aligns with feminist praxis and disability politics. We begin by mapping our central concept in relation to literature on feminist disability studies, crip methodology, feminist methodology, and critical access. We then demonstrate critical access methodology in practice drawing on our collective research programs. Our first example comes from a workshop exploring citizen photojournalism as part of Stretching Our Stories and takes up non-linear and unverifiable journalistic accounts by disabled people. We follow this with an example from Practicing the Social, a three-day online artistic research and knowledge mobilisation event, which foregrounds the complexity of structuring pace and time. We conclude by suggesting that approaching critical access as methodology makes it possible to embrace moments of friction. Throughout this article, we argue that access, when taken up critically, becomes a transformative process that can contribute to the development of a feminist research methodology that supports research directed towards crip-feminist futurities. [ABSTRACT FROM AUTHOR]

Background: Data have accumulated to show that the Lidcombe Program of early stuttering intervention is a safe treatment with positive outcomes for preschoolers who stutter, and a randomized controlled trial is under way at the time of writing. Program components have not been investigated experimentally so the functionality of each component is unknown. Aims: The aim of this preliminary study was to establish the viability of a programme of research that would assess the clinical value of two program components. These components were parental verbal contingencies for stuttering and severity ratings. Methods & Procedures: In the present preliminary experiment, 38 preschool children were randomized to an experiment involving a 4-week 'dose' of treatment followed by 4 weeks without treatment. The dependent variable was the percentage of syllables stuttered (%SS) obtained from the mean %SS score from recordings on three recording occasions. Outcomes & Results: Some preliminary indications were found that parental verbal contingencies for stuttering contributed to treatment outcomes. No preliminary evidence was found for the contribution of parent severity ratings to treatment outcomes. Conclusions: It was concluded that a robust, statistical demonstration of these result would be desirable, but effect size estimates from the present data show that access to more than 650 families of stuttering preschool children would be required for such a study. Such a project would be beyond the resources of any one research group to complete in a timely manner, and a method to address this problem is proposed.

A study investigated whether age, gender, period from onset to treatment, and stuttering severity related to the required treatment time of 250 preschoolers who completed the Lidcombe Program. Data indicate that, for a short period after stuttering onset, a short delay in treatment did not appear to increase treatment time. (Contains references.) (Author/CR)

Objectives: Stuttering has been associated with a range of anxiety disorders, including social phobia. In the general community, anxiety disorders are frequently associated with increased rates of mood and substance use disorders. Therefore, in the present study, the authors sought to determine the rate of mood and substance use disorders among adults who stutter. Method: The study employed a matched case--control design. Participants included 92 adults seeking treatment for stuttering and 920 age--and gender-matched controls. Mental health assessments were conducted via a computerized psychiatric diagnostic interview. Conditional logistic regression models were used to estimate odds ratios for the prevalence of mood and substance use disorders in both groups. Results: When compared with matched controls, adults seeking treatment for stuttering had twofold increased odds of meeting criteria for a 12-month diagnosis of any mood disorder but were not found to report significantly higher lifetime prevalence rates for any substance use disorder. Conclusions: Although adults who stutter in the present study were characterized by significantly higher rates of mood disorders than matched controls, they do not appear to self-medicate with substances such as alcohol. Results are discussed in terms of treatment implications and possible reasons why adults who stutter may avoid alcohol. KEY WORDS: stuttering, mood disorders, substance use, alcohol use, anxiety, Anxiety, mood, and substance use disorders are among the most common and disabling psychiatric disorders in the general community (Kessler et al., 1994; Ormel et al., 1994; Wells et al., [...]

Purpose: In this study, the authors investigated the efficacy of video self-modeling (VSM) following speech restructuring treatment to improve the maintenance of treatment effects. Method: The design was an open-plan, parallel-group, randomized controlled trial. Participants were 89 adults and adolescents who undertook intensive speech restructuring treatment. Post treatment, participants were randomly assigned to 2 trial arms: standard maintenance and standard maintenance plus VSM. Participants in the latter arm viewed stutter-free videos of themselves each day for 1 month. Results: The addition of VSM did not improve speech outcomes, as measured by percent syllables stuttered, at either 1 or 6 months postrandomization. However, at the latter assessment, self-rating of worst stuttering severity by the VSM group was 10% better than that of the control group, and satisfaction with speech fluency was 20% better. Quality of life was also better for the VSM group, which was mildly to moderately impaired compared with moderate impairment in the control group. Conclusions: VSM intervention after treatment was associated with improvements in self-reported outcomes. The clinical implications of this finding are discussed., Behavioral control of stuttering is a core component of the clinical management of many who stutter (Onslow, 1996). To that end, there is compelling evidence in favor of treatments based [...]

(1) Background: There is clear evidence supporting the need for individualized early intervention in children with hearing loss. However, relying on hearing thresholds and speech and language test results to guide intervention alone is problematic, particularly in infants and young children. This study aimed to establish the feasibility of a tool to monitor the development of functional listening skills to inform early and ongoing decisions by parents and professionals. (2) Methods: The FLI-P® is a 64-item checklist completed by parents and/or a child's team. The listening development of 543 children with hearing loss enrolled in an early intervention and cochlear implant program was tracked with the FLI-P over a 6-year period. The scores for individual children were grouped according to hearing loss, device, additional needs, and age at device fitting. (3) Results: Results indicate that the FLI-P is a feasible and viable clinical measure that can be used to identify and track a child's developing listening skills. Its use across a wide range of children supports its broad application. Children's individual scores and aggregated group data were consistent with indicated expected differences and variations. Children's individual scores and aggregated group data indicated expected differences and variations. (4) Conclusions: Information provided by children's listening scores on the FLI-P can guide and support discussions and intervention decisions and bridge the gap between information from audiological assessments and language measures. [ABSTRACT FROM AUTHOR]

It has been shown that people who stutter can speak with greatly reduced stuttering after treatments that use variations of Goldiamond's (1965) prolonged-speech (PS). However, outcome research to date has not taken account of several important issues. In particular, speech outcome measures in that research have been insufficient to show that lasting relief from stuttering has been achieved by clients outside the clinic for meaningful periods. The present study used extensive speech outcome measures across a variety of situations in evaluating the outcome of an intensive PS treatment (Ingham, 1987). The speech of 12 clients in this treatment was assessed on three occasions prior to treatment and frequently - on eight occasions - after discharge from the residential setting. For 7 clients, a further assessment occurred at 3 years posttreatment. Concurrent dependent measures were percent syllables stuttered, syllables per minute, and speech naturalness. The dependent measures were collected in many speaking situations within and beyond the clinic. Dependent measures were based on speech samples of substantive duration, and covert assessments were included in the study. Detailed data were presented for individual subjects. Results showed that 12 subjects who remained with the entire 2-3-year program achieved zero or near-zero stuttering. The majority of subjects did not show a regression trend in %SS or speech naturalness scores during the posttreatment period, either within or beyond the clinic. Some subjects showed higher posttreatment %SS scores during covert assessment than during overt assessment. Results also showed that stuttering was eliminated without using unusually slow and unnatural speech patterns. This treatment program does not specify a target speech rate range, and many clients maintained stutter-free speech using speech rates that were higher than the range typically specified in intensive PS programs. A significant correlation was found between speech rate and perceived posttreatment speech naturalness. KEY WORDS: stuttering, treatment, adult

Background: Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts treatment prognosis. Aims: To investigate the predictors of treatment dropout and treatment outcome for children who were treated for early stuttering with the Lidcombe Program (N = 277). Methods & Procedures: A total of 32 variables were used as predictors in regression analyses of short‐ and medium‐term Lidcombe Program outcome, and of treatment dropout. Outcomes & Results: Regression analyses associated children who have better language skills and easy temperament with better treatment outcome, although only a small portion of the variance of treatment outcome was accounted for by these variables. There was an association between treatment dropout and parental scores on a personality screening tool relating to their impulsivity. Conclusions & Implications: Variables identified as predictors of Lidcombe Program treatment outcome were statistically significant, but not clinically significant. They did not account for a clinically substantive portion of treatment outcomes. Findings about parental impulsivity and their relationship with intervention drop‐out require replication with prospective methods and comprehensive assessment of parent psychological status. This is particularly important because parents are involved in conducting all early interventions. What this paper addsWhat is already known on the subjectInformation is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts Lidcombe Program treatment outcome.What this paper adds to existing knowledgeThere are predictors of Lidcombe Program treatment outcome that are statistically significant, but none are clinically significant.What are the potential or actual clinical implications of this work?Clinicians can tell parents that nothing has been found that can assist with making prognostic indications about treatment outcome for their children. [ABSTRACT FROM AUTHOR]

It is known that children may recover from stuttering without formal treatment during the first years after onset. Consequently, the timing of professional, early stuttering intervention is a pressing issue in speech-language pathology. This report presents data pertinent to this issue for 261 preschool-age children who received the Lidcombe Program of early stuttering intervention. Of these children, 250 completed the program and were considered by their clinicians to have been treated successfully. For the children who were treated successfully, logistical regression analyses were used to determine whether age, gender, period from onset to treatment, and stuttering severity related systematically to the time required for treatment. The present data confirmed previous reports that a median of 11 clinic visits was required to achieve zero or near-zero stuttering with the Lidcombe Program. Results were also consistent with a preliminary report of 14 children (C. W. Starkweather & S. R. Gottwald, 1993) showing a significant relation between stuttering severity and the time needed for treatment, with children with more severe stuttering requiring longer treatment times than children with less severe stuttering. However, results did not associate either increasing age or increased onset-to-treatment intervals with longer treatment times. This finding is not consistent with the Starkweather and Gottwald report, which linked advancing age with longer treatment time. In fact, the present data suggest that, for a short period after stuttering onset in the preschool years, a short delay in treatment does not appear to increase treatment time. An important caveat to these data is that they cannot be generalized to late childhood or early adolescence. The present findings are discussed in relation to natural recovery from stuttering. KEY WORDS: stuttering, preschool, treatment, regression, duration, During the past 2 decades the merits of treating stuttering soon after onset have become obvious (see Onslow, 1996, for a review). Clinicians and researchers have been considering the practicalities [...]

Project Re·Vision uses disability arts to disrupt stereotypical understandings of disability and difference that create barriers to healthcare. In this paper, we examine how digital stories produced through Re·Vision disrupt biopedagogies by working as body-becoming pedagogies to create non-didactic possibilities for living in/with difference. We engage in meaning making about eight stories made by women and trans people living with disabilities and differences, with our interpretations guided by the following considerations: what these stories 'teach' about new ways of living with disability; how these stories resist neoliberalism through their production of new possibilities for living; how digital stories wrestle with representing disability in a culture in which disabled bodies are on display or hidden away; how vulnerability and receptivity become 'conditions of possibility' for the embodiments represented in digital stories; and how curatorial practice allows disability-identified artists to explore possibilities of 'looking back' at ableist gazes. [ABSTRACT FROM AUTHOR]