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Purpose: The purpose of this meta-analytic study was to identify clinical characteristics, defined as child factors that can be assessed by a speech-language pathologist as part of a routine speech-language evaluation that may differentiate children who persist in stuttering from children who eventually recover from stuttering. Clinical characteristics explored included sex, age at onset, family history of stuttering, stuttering frequency and severity, speech-language skills, and temperament. Method: Studies were identified through electronic databases, journals, and reference lists of relevant reports (e.g., research articles). Eligible studies followed young children who stutter (i.e., under 6 years old) for at least 24 months, assessed a potential clinical marker at study entry, and determined talker group classification (i.e., persistent or recovered) at study completion. Sex and family history differences were estimated using risk ratios; all other differences were estimated using Hedges's "g." Heterogeneity and methodological differences among studies were evaluated. Results: Eleven studies (41 reports) met eligibility criteria. Persistent children were older at stuttering onset and exhibited higher frequencies of stuttering-like disfluencies, lower speech sound accuracy, and lower expressive and receptive language skills than recovered children. Males and children with a family history of stuttering were also more likely to persist. Conclusions: Clinical characteristics were identified that are associated with increased risk for stuttering persistence. Future studies have the potential to translate these clinical characteristics into prognostic markers for stuttering persistence risk.

Purpose: This study reports the development, refinement, and exploration of the psychometric properties of the Vanderbilt Responses to Your Child's Speech (VRYCS) rating scale, a novel measure designed to assess parents' self-perceived responses to the speech of their children who stutter (CWS). Method: Parents of 214 young (ages 2;4[years;months]-5;11) CWS completed the original 40-item version of the VRYCS. Content analyses and an exploratory factor analysis determined the scale's factors and identified specific items corresponding to each. Items that did not load onto the factors were removed and internal consistency was assessed. Results: The final 18-item VRYCS rating scale includes five factors relating to parents' responses to the speech of their CWS including (a) Requesting Change, (b) Speaking for the Child, (c) Supporting Communication, (d) Slowing and Simplifying, and (e) Responding Emotionally. Reliability was demonstrated, responses by parents of CWS were described, and a revised scoring form developed. Conclusions: The VRYCS is a valid and reliable tool for assessing and exploring parents' perceptions of their own responses to the speech of their CWS for clinical and research purposes. Clinical applications of the VRYCS for assessment and treatment of childhood stuttering are discussed.

Purpose: The purpose of this study was to survey school speech-language practitioners' self-perceptions of their confidence, knowledge, and need for support for working with school-age students who stutter (SWS). Method: A total of 120 school-based speech-language practitioners from 27 Nashville, Tennessee, area counties completed an online, 35-item survey examining caseloads, coursework, continuing education, experience, and perceived levels of skill and confidence in service provision to SWS. They also rated their need for consultation from speech-language pathologists who specialize in stuttering to improve their skills with SWS. Results: Respondents were least confident in and needed most support for providing intervention to SWS. Those who needed most support for intervention rated themselves as less knowledgeable about stuttering theory, assessment, and intervention and were less confident about working with students who only stutter and with SWS who have concomitant communication concerns. Greater practitioner confidence in stuttering intervention skills was positively correlated with the number of SWS on caseloads; continuing education credits in stuttering; and knowledge of stuttering theory, assessment, and intervention. Respondents who completed a graduate course on stuttering had greater confidence in stuttering intervention and were less likely to identify a need for support from specialists. Conclusions: School speech-language practitioners continue to report needing additional education, practice opportunities, and support, especially with intervention, and desiring specialized guidance to serve SWS. Those with more experience, education, and knowledge about stuttering are more confident and skillful, reflecting the potential positive impact of increased opportunities to learn about and work with SWS. These needs may be addressed through increased availability of specialists in stuttering to consult with school practitioners; opportunities for school-based practitioners to become peer mentors; and provision of readily available, intervention-focused continuing education experiences and resources.

Background: It is already known that preschool-age children who stutter (CWS) tend to stutter on function words at the beginning of sentences. It is also known that phonological errors potentially resulting in part-word repetitions tend to occur on content words. However, the precise relation between word class and repetition type in preschool-age stuttering is unknown. Aims: To investigate repetitions associated with monosyllabic words in preschool-age CWS. Specifically, it was hypothesized that repetition type should vary according to word class in preschool-age CWS and children who do not stutter (CWNS). Methods & Procedures: Thirteen preschool-age CWS and 15 preschool-age CWNS produced age-appropriate narratives, which were transcribed and coded for part-word repetitions (PWR) and whole-word repetitions (WWR) occurring on monosyllabic words. Each repetition type was also coded for word class (i.e., function versus content). Outcomes & Results: Results indicated that although CWS and CWNS were significantly more likely to produce PWR on content words, this tendency did not differ between the two talker groups. Further, CWS and CWNS did not differ in their tendencies to produce PWR versus WWR overall, but the tendency to produce repetitions on function words was significantly greater for CWS versus CWNS. Conclusions & Implications: Findings are taken to suggest that repetitions of monosyllabic words in young children are not easily explained from the perspective of phonological errors, but may instead be considered from an incremental planning of speech perspective.

Cryptogenic stroke is associated with an increased prevalence of patent foramen ovale. The Paradoxical Emboli From Large Veins in Ischemic Stroke (PELVIS) study hypothesized that patients with cryptogenic stroke have an increased prevalence of pelvic deep venous thrombosis (DVT).At 5 sites, patients 18 to 60 years of age received an MRI venogram (MRV) of the pelvis within 72 hours of new symptom onset. Clinical data were then determined. Radiologists blinded to clinical data later read the scans.The 95 patients who met entry criteria were scanned. Their mean+/-SD age was 46+/-10 years, and time from stroke onset to pelvic MRV scan was 49+/-16 hours. Compared with those with stroke of determined origin (n=49), patients with cryptogenic stroke (n=46) were significantly younger, had a higher prevalence of patent foramen ovale (61% versus 19%), and had less atherosclerosis risk factors. Cryptogenic patients had more MRV scans with a high probability for pelvic DVT (20%) than patients with stroke of determined origin (4%, P

The purpose of this article is to discuss definitional and measurement issues as well as empirical evidence regarding temperament, especially with regard to children's (a)typical speech and language development. Although all ages are considered, there is a predominant focus on children. Evidence from considerable empirical research lends support to the association between temperament, childhood development and social competence. With regard to communication disorders, extant literature suggests that at least certain elements of temperament (e.g., attention regulation, inhibitory control) are associated with the presence of certain communication disorders. However, the precise nature of this association remains unclear. Three possible accounts of the association between temperament and speech-language disorder are presented. One, the disability model (i.e., certain disorders impact psychological processes leading to changes in these processes, personality, etc., Roy & Bless, 2000a) suggests speech-language disorders may lead to or cause changes in psychological or temperamental characteristics. The disability account cannot be categorically refuted based on currently available research findings. The (pre)dispositional or vulnerability model (i.e., certain psychological processes directly cause the disorder or indirectly modify the course or expression of the disorder, Roy & Bless, 2000a) suggests that psychological or temperamental characteristics may lead to or cause changes in speech-language disorders. The vulnerability account has received some empirical support with regard to stuttering and voice disorders but has not received widespread empirical testing for most speech-language disorders. A third, interaction account, suggests that "disability" and "vulnerability" may both impact communication disorders in a complex, dynamically changing manner, a possibility that must await further empirical study. Suggestions for future research directions are provided. Learning outcomes: After reading this article, the reader will be able to (1) define the concept of temperament as well as theories of and means to measure/study temperament, (2) describe the possible association of temperament to children's speech-language, in general, and children's speech-language disorders, in specific, and (3) be able to describe the disability, dispositional and interaction accounts of the association of temperament to speech-language disorders. (Contains 1 table and 2 figures.)

The purpose of this investigation was to assess the temperamental characteristics of children who do (CWS) and do not (CWNS) stutter using a norm-referenced parent-report questionnaire. Participants were 31 CWS and 31 CWNS between the ages of 3;0 (years;months) and 5;4 (CWS: mean age = 48.03 months; CWNS: mean age = 48.58 months). The CWS were matched by age (plus or minus 4 months), gender, and race to the CWNS. All participants had speech, language, and hearing development within normal limits, with the obvious exception of stuttering for CWS. Children's temperamental characteristics were determined using the Behavioral Style Questionnaire (BSQ; S. C. McDevitt & W. B. Carey, 1978), which was completed by each child's parents. Results, based on parent responses to the BSQ, indicated that CWS are more apt, when compared to CWNS, to exhibit temperamental profiles consistent with hypervigilance (i.e., less distractibility), nonadaptability to change, and irregular biological functions. Findings suggest that some temperamental characteristics differentiate CWS from CWNS and could conceivably contribute to the exacerbation, as well as maintenance, of their stuttering.

Indiana school speech-language pathologists (n=157) responded to a survey regarding their educational and clinical preparation and current clinical practices with people who stutter. Respondents reported receiving insufficient academic and clinical preparation to work with people who stutter. Nearly half reported that their clinical skills are inadequate for managing stuttering. (Author/CR)

Features of mothers' and fathers' interaction with children who stutter are reviewed, along with results of intervention studies that have included children who stutter and their parents. Similarities and differences in the roles played by fathers and mothers in children's communicative development are discussed, as are implications for clinical practice. (SW)

This preliminary investigation of stuttering development and maturation of speech motor processes recorded the electromyographic activity of the orofacial muscles of nine children who stuttered. Results suggest that the emergence of tremor-like instabilities in the speech motor processes of stuttering children may coincide with aspects of general neural maturation and with development of stuttering. (Author/DB)

Paralinguistic behaviors, including speech rates and turn-taking behaviors, of five-year-old boys who stutter (n=11) and boys who do not stutter (n=11) and their fathers were investigated. No significant differences were found in comparisons of the two groups of fathers or of the two groups of children for any of the paralinguistic behaviors. (Author/DB)

This study assessed the nonspeech behaviors associated with young stutterers (n=30, mean age 54 months) and normally fluent children's comparable fluent utterances. Findings suggested that children can be classified as stutterers on the basis of their nonspeech behaviors, which may reflect cognitive, emotional, linguistic, and physical events associated with stuttering. (Author/DB)

The goal of the present experiment was to determine if stuttering is associated with unusually high levels of activity in laryngeal muscles. Qualitative and quantitative analyses of thyroary-tenoid and cricothyroid recordings from 4 stuttering and 3 nonstuttering adults revealed the following: Compared to periods of fluent speech, intervals of disfluent speech are not typically characterized by higher levels of activity in these muscles; and when EMG levels during conversational speech are compared to maximal activation levels for these muscles (e.g., those observed during singing and the Valsalva maneuver), normally fluent adults show robust and sometimes near maximal recruitment during conversational speech. The adults who stutter had a lower operating range for these muscles during conversational speech, and their disfluencies did not produce relatively high activation levels. In summary, the present data require us to reject the claim that adults with a history of chronic stuttering routinely produce excessive levels of intrinsic laryngeal muscle activity. These results suggest that the use of botulinum toxin injections into the vocal folds to treat stuttering should be questioned. KEY WORDS: stuttering, laryngeal muscles, speech motor control, electromyography, voice

The purpose of this study was to investigate the speaking rates, interrupting behaviors, and response time latencies (RTL) produced by stuttering and nonstuttering children and their mothers, and the relationship these three paralinguistic behaviors have to children's speech disfluencies. Subjects were 13 boys who stutter (mean age = 4:0) and their mothers and 13 nonstuttering boys (mean age = 4:0) and their mothers. No significant differences were found between the two groups of children or between the two groups of mothers for any of the three paralinguistic behaviors with the exception that the mothers of nonstuttering children exhibited significantly (p < 0.01) faster rates of speech than either group of children. A strong positive correlation (r = .84) was found between stuttering children's scores on the Stuttering Severity Instrument (Riley, 1980) and the durations of the overlapping portions of their mothers' interruptions (i.e., their simultalk). Findings of this study are taken to support a facilitative demands-capacities model of conversational interaction in which mothers adjust the demands of their speaking models in response to their children's demonstrated capacities for fluent speech production.

Purpose: The purpose of the current investigation was to examine speech-language pathologists' (SLPs') knowledge and perceptions of bullying, with an emphasis on autism spectrum disorder (ASD). Method: A 46-item, web-based survey was used to address the purposes of this investigation. Participants were recruited through e-mail and electronic mailing lists for American Speech-Language-Hearing Association (ASHA) special interest divisions 1 (Language, Learning, and Education) and 16 (School-Based Issues). Also, an embedded link to the survey was posted on the ASHA Community website and ASHA Facebook page. Results: Participants demonstrated knowledge of many aspects of bullying research; however, they demonstrated weaknesses in others. All respondents agreed that SLPs should intervene in moments of bullying, but not all indicated that they feel comfortable intervening. Few participants indicated that their school district implemented antibullying campaigns specific to children with special needs, such as ASD. Conclusions: As recognized experts in working with children with communication deficits, including individuals with ASD, SLPs have the opportunity to play a key role in antibullying efforts. Results revealed, however, that school-based SLPs may benefit from more information on bullying in order to understand the nature, context, and extent of this issue, as well as ways in which to respond to bullying when it is observed. [ABSTRACT FROM AUTHOR]

Purpose: This Phase II clinical trial examined stuttering adolescents’ responsiveness to the Webcam-delivered Camperdown Program. Method: Sixteen adolescents were treated by Webcam with no clinic attendance. Primary outcome was percentage of syllables stuttered (%SS). Secondary outcomes were number of sessions, weeks and hours to maintenance, self-reported stuttering severity, speech satisfaction, speech naturalness, self-reported anxiety, self-reported situation avoidance, self-reported impact of stuttering, and satisfaction with Webcam treatment delivery. Data were collected before treatment and up to 12 months after entry into maintenance. Results: Fourteen participants completed the treatment. Group mean stuttering frequency was 6.1 %SS (range, 0.7–14.7) pretreatment and 2.8 %SS (range, 0–12.2) 12 months after entry into maintenance, with half the participants stuttering at 1.2 %SS or lower at this time. Treatment was completed in a mean of 25 sessions (15.5 hr). Self-reported stuttering severity ratings, self-reported stuttering impact, and speech satisfaction scores supported %SS outcomes. Minimal anxiety was evident either pre- or post-treatment. Individual responsiveness to the treatment varied, with half the participants showing little reduction in avoidance of speech situations. Conclusions: The Webcam service delivery model was appealing to participants, although it was efficacious and efficient for only half. Suggestions for future stuttering treatment development for adolescents are discussed. [ABSTRACT FROM AUTHOR]