1. Contact Info: www.ecu.edu.au/research/week Defining speech and language fluency profiles before and after the onset of stuttering: Preliminary findings Charn Nang School of Psychology and Social Science ECU Research Week 19 th September 2012 Research Supervisors: Professor Kim Kirsner, Professor Kathryn Hird

2. Contact Info: www.ecu.edu.au/research/week Stuttering: What is it? Know exactly what they want to say Surface features: –Repetitions, prolongations, blocks –Secondary non-verbal behaviours Below the surface: –Covert strategies to postpone, avoid stutters –Fear, embarrassment, anxiety

3. Contact Info: www.ecu.edu.au/research/week King George VI: If I'm King, where's my power? Can I form a government? Can I levy a tax, declare a war? No! And yet I am the seat of all authority. Why? Because the nation believes that when I speak, I speak for them. But I can't speak.King George VI

4. Contact Info: www.ecu.edu.au/research/week The problem of stuttering 1% prevalence 5% incidence Approximately 75%-80% of children who start to stutter spontaneously recover Approximately 20% continue stuttering into adulthood Debilitating condition that can affect all aspects of life: –Education –Personal relationships –Employment Cannot tell for sure if a child will continue to stutter

5. Contact Info: www.ecu.edu.au/research/week The problem of stuttering Queen Elizabeth: [Using the name "Mrs. Johnson"] My husband's work involves a great deal of public speaking. Lionel Logue: Then he should change jobs. Queen Elizabeth: He can't. Lionel Logue: What is he, an indentured servant? Queen Elizabeth: Something like that.Queen Elizabeth Lionel Logue Queen Elizabeth Lionel Logue Queen Elizabeth

6. Contact Info: www.ecu.edu.au/research/week What is the cause? The past: –Psychological –Parents The present: –Speech motor control –Neurological –Genetics Complex interaction of a range of factors Linguistic-symbolic Motor plan Motor programs Motor execution Van Der Merwe, 2009

7. Contact Info: www.ecu.edu.au/research/week Rationale Problems with determining cause or consequence: –Adult participants –Data after the onset of stuttering Predictor variables for the onset of stutter? –What is the contribution of language-based skills –Speech and language examined in unnatural speaking contexts Better predict those who will continue to stutter Increased understanding of how stuttering develops to inform treatment

8. Contact Info: www.ecu.edu.au/research/week This study Eighteen children aged 21 to 48 months (Session 1) Either have a positive family history of stuttering or not Four data selection sessions (three- months apart for nine months in total) Data collection was prior to the onset of any stuttering Speech and language fluency profiles determined through natural speaking contexts –Conversational/play sessions with mum and the examiner

9. Contact Info: www.ecu.edu.au/research/week Research questions Are there any speech and language fluency predictor variables for the onset of stuttering? Are the speech and language fluency profiles of children who start to stutter different to that of children who continued to develop typically?

10. Contact Info: www.ecu.edu.au/research/week This Study Major findings: –Did NOT predict the onset of stuttering Differences in speech and fluency profiles –After the onset of stuttering changes to speech and language fluency profiles were observed Hypothesised to be changes children make to deal with stuttering

11. Contact Info: www.ecu.edu.au/research/week Method Language-based and speech motor control measures gathered –Language-based measures –Articulation rate –Pause measures

12. Contact Info: www.ecu.edu.au/research/week Mean Length Utterance Morphemes Number of different word roots Percent intelligibility Pause measures Syllables spoken per second Percent mazes Speech and Language Fluency Profiles

13. Contact Info: www.ecu.edu.au/research/week Method Pause measures –Short pause mean duration –Long pause mean duration –Proportion of pause time Kirsner et al., 2003

14. Contact Info: www.ecu.edu.au/research/week Results: Preliminary Five children started to stutter, thirteen continued to typically develop Speech and language fluency profiles before the onset of stuttering –Syllables spoken per second was a significant predictor (logistic regression) –Inconclusive result as children who started to stutter were also older Speech and language fluency profiles after the onset of stuttering –Group interaction for Percent intelligibility (repeated measures) for Session 3 to 4 –Subtle changes in how speech and language measure relate (Analysis of Covariance)

15. Contact Info: www.ecu.edu.au/research/week Differences in speech and language fluency profiles after the onset of stuttering

16. Contact Info: www.ecu.edu.au/research/week Differences in speech and language fluency profiles after the onset of stuttering Analysis of Covariance: group interactions found – difference in the pattern of performance for how speech and language fluency measures relate between the groups There were NO significant group interactions for Session 1 (no stuttering) Group interactions generally involved measures: Long Pause Mean and Proportion of Pause Time –Children who started to stutter were taking more time –Hypothesised to be due to effects of stuttering –Children who started to stutter compensated by taking longer for speech production

17. Contact Info: www.ecu.edu.au/research/week Session 2

18. Contact Info: www.ecu.edu.au/research/week Session 3

19. Contact Info: www.ecu.edu.au/research/week Session 4

20. Contact Info: www.ecu.edu.au/research/week Major Findings Are there any speech and language fluency predictor variables for the onset of stuttering? –NO, the pre-liminary results do not support that stuttering stems from deficits in speech motor control or deficits in language-based skills Are the speech and language fluency profiles of children who start to stutter different to that of children who continued to develop typically? –YES, but only after stuttering started

21. Contact Info: www.ecu.edu.au/research/week References Guitar, B.. (2006). Stuttering: An integrated approach to its nature and treatment. Baltimore, MD: Lippincott Williams & Wilkins. Kirsner, K., Dunn, J., Hird, K., & Hennessey, N. (2003). Temporal co- ordination: Lynch-pin of language production. Paper presented at the 6th International Seminar on Speech Production, Sydney, Australia. Klein, J., & Hood, S. (2004). The impact of stuttering on employment opportunities and job performance. Journal of Fluency Disorders, 29, 255-273. Miller, J. (2008). Systematic Analysis of Language Transcripts (SALT), English Version 2008: SALT Software, LLC. van der Merwe, A. (2009). A theoretical framework for the characterization of pathological speech sensorimotor control. In M McNeil, R. (Ed.), Clinical management of sensorimotor speech disorders (2nd ed., pp. 3-18). New York, NY: Thieme.