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This study investigated the effects of contextualization on fluency in 12 school-age children who stutter (CWS), 11 children with language impairment (CLI), and 12 children with normally developing fluency skills (CNF). Participants in the study were between the ages of 8 and 12 years and were matched for age and sex. Four discourse samples were elicited by asking participants to (a) generate two scripts related to cooking and (b) retell two stories. Having objects or pictures immediately available contextualized a cooking task and a retelling task; another set of cooking and retelling tasks were decontextualized. Moments of disfluency were identified and coded for three primary categories of disfluency: stuttering-type, normal-type, and mazing. For CWS, a significant reduction in frequency of stuttering was noted in the contextualized script generation, and mazing occurred at a significantly higher frequency than did stuttering-type or normal-type disfluencies across the four tasks. For all three groups, both decontextualized conditions produced greater frequencies of normal-type disfluency and mazing. In addition, narrative retelling tasks yielded higher frequencies of disfluency than did the two cooking scripts.

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This study explored multiple effects of listener perceptions of different levels of simulated stuttering and fluency. A single stuttered speech sample was modified to create four additional samples of stuttering and fluency. A sixth sample of a nonstuttered signal served as a comparative baseline. Each of 60 independent listeners made quantitative and qualitative perceptual judgments upon hearing only one of the six randomly assigned samples. Results showed a broad spectrum of qualitative and quantitative listener perceptions of the various levels of stuttering and fluency studied. Likert scale data revealed that listeners gave lower ratings to samples with increased levels of stuttering. Listener commentaries revealed fewer positive comments with increased levels of stuttering and distinctive preferences between two 0% samples of stuttering where only prosodic features were modified. Additionally, specific perceptions of speaker competency, perceived ease in reading a passage, general comfort listening, and perceived effort in understanding the story appear to affect the global perceptions of a speaker's communication. Implications of these findings are discussed.

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This study tested for differences between children who stutter (CWS) and children with normally developing communication skills (CNC) on measures of narrative complexity and cohesion use in two narrative tasks. In addition, differences in stuttering frequency produced by CWS across tasks were measured. One story retelling and one story generation were elicited from eight CWS and eight age- and gender-matched CNC peers. Results revealed no significant differences between CWS and CNC for the measures of narrative complexity or cohesion use. However, significant differences were noted in stuttering frequency. Additionally, significant differences were found between the tasks for number of words, t-units, and episodes produced, as well as referents, conjunctions, and complete cohesive ties. Findings confirm that narrative abilities of CWS are similar to those of CNC, and that a retelling task produces longer and more elaborate narrative samples than does story generation. Directions for future research are discussed.

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Despite very successful treatments for social phobia, with many studies reporting as many as 75% of social phobics making clinically significant gains with 3 months of treatment or less, some social phobics fail to respond to treatment. This case presents a women with social phobia who received several trials of treatment for severe public-speaking fears but failed to improve, as demonstrated by persistent reports of fear and avoidance equal to those before treatment. With the assistance of a speech language pathologist, this client received combined therapy that included cognitive-behavioral therapy to treat her public-speaking fear and avoidance and voice therapy to treat excessive muscle contractions in the respiratory and phonatory systems. Overall, the combined treatment was successful, with the client's self-reported levels of fear and avoidance of public speaking decreasing dramatically. Specific improvements during voice therapy and implications for the treatment of social phobia are also discussed.

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The purpose of this study was to determine the amount of change in speakers' vocal intensity when a listener is located at various perceived versus actual physical distances from a speaker. Twelve men and 12 women with normal voices were asked to read a passage at three interspeaker distances in one of two conditions. In the perceived listener condition, participants were asked to "imagine" that the listener was located 3, 15, or 30 ft away. In the actual listener condition, one of the experimenters stood at each one of the three experimental distances. Conditions were counterbalanced. The results showed that men and women increased vocal intensity levels for all three interspeaker distances regardless of the type of condition. However, women showed larger increases than men at all interspeaker distances in both conditions. Data for both men and women combined showed that the amount of increase is < 6 dB, which indicates that speakers do not follow the inverse square law when raising vocal intensity. Clinical implications of the results are discussed.

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The purpose of this article is to provide clinicians information on some of the key issues in making decisions about the treatment process for children who stutter. Ten decisions that should be considered prior to, during, and at the time of dismissal are discussed. These decisions relate to a number of issues regarding treatment such as: increasing clinicians' confidence in treating stuttering in children, setting long- and short-term goals, selecting an approach to treatment, documenting progress, involving parents and teachers in the treatment process, and determining when the child is ready to be dismissed from treatment. Additionally, questions clinicians should ask themselves are presented with each of the ten decisions. The intent of this article is to show how an analysis of clinical information systematically collected over a period of time will help a clinician make accurate decisions about the treatment of children who stutter.

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The purpose of this article is to describe the treatment of a 45-year-old male with a hyperfunctional voice disorder by a biofeedback therapist and a speech-language pathologist. The interdisciplinary approach to the treatment of this voice disorder involved the combined use of traditional voice therapy techniques and EMG biofeedback procedures together with cognitive behavioral therapy. Voice therapy was facilitated through the use of a computer-based, speech-monitoring system. The remediation of this voice disorder was attributed to the collaborative efforts of two professionals representing diverse professional training and treatment protocols. The results showed reductions in muscle activity in the infrahyoid and laryngeal areas as well as improved use of proper breathing and voicing onset behaviors. Follow-up at 10 and 15 months posttreatment intervals indicated that the client had retained all target voice skills and the tension reduction/biofeedback skills. Results suggest that interdisciplinary, collaborative efforts using biofeedback and voice therapy can prove beneficial in the treatment of hyperfunctional voice disorders.

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The purpose of this study was to investigate the relationship between stuttering severity and treatment length to temporal measures of stutterers' perceptually fluent speech. Seventeen adult stutterers (4 mild, 8 moderate, and 5 severe) were divided into two treatment categories. One group with limited exposure to treatment (n = 7) consisted of stutterers who had completed 0-10 hr of treatment. Another group with an extensive period of treatment (n = 10) consisted of stutterers who had completed 47-212 hr of treatment. All subjects were asked to repeat a simple phrase and read a prose passage. Spectrographic measures of the stutterers' voice onset times, vowel, consonant, and phrase durations were obtained from perceptibly fluent productions of the isolated phrase and from a phrase extracted from the oral reading. Results showed that there were no significant differences among stuttering severity groups or the two groups with different lengths of treatment. These results suggest that changes in temporal measures of stutterers' fluency might occur through the process of treatment, but those changes are not related to stuttering severity or length of treatment.

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The purpose of this study was to compare adult stutterers' and adult nonstutterers' fluent speech patterns produced during one nonshadowed reading and two speech shadowing conditions. Subjects' speech error rates, shadowing strategies, and fluent speech segment durations were obtained during baseline, diotic speech shadowing, and dichotic speech shadowing conditions. Results indicated that stutterers produced fewer speech production errors (i.e., omissions, substitutions, and insertions) than nonstutterers during each shadowing condition. Stutterers also favored the use of a word-by-word speech shadowing strategy, while nonstutterers utilized both word-by-word and small phrase shadowing strategies. Finally, stutterers exhibited significantly longer vowel and phrase durations than nonstutterers during the shadowing conditions.

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The purpose of this study was to determine the amount of variation for several vocal parameters across three times of the day (morning, noon, and afternoon). Connected speech samples from normal adult males (N = 10) and females (N = 10) were recorded during morning, early afternoon, and late afternoon. Results showed that males produced a statistically significant increase in speaking fundamental frequency (SFF) from morning to afternoon. Females did not demonstrate a statistically significant change in SFF across the three time periods. Vocal amplitude did not change significantly for either group. The SFF variability was higher for the females than for the males. Analysis of individual data revealed that the patterns of vocal change across the three times of day were not consistent among the subjects.

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As a consequence of recent inquiries into the brainstem activity of stutterers, saccades and pursuit were evaluated in stutterers and their matched normals while silent and talking. No ocular motor instabilities or aberrations caused by speech were found. Saccadic latencies and gains for the stutterers were normal, but peak velocities were higher and durations were shorter. This finding is consistent with hypotheses of speech dysfluency proposed by others. The gains of these fast saccades were kept normal by an adaptive decrease in the duration of the neural pulse producing the saccade. It is proposed that these fast saccades are a result of increased excitatory input to the burst cells in the brainstem.

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The purpose of this study was to compare stutterers' and nonstutterers' fluency during multiple productions of two dissimilar speech contexts. Twenty-two adult stutterers were matched within 1 year of age to 22 nonstutterers. Spectrographic analyses were performed on subjects' five consecutively fluent productions of a simple isolated phrase and a phrase extracted from an oral reading passage. Measures of fluent voice onset time (VOT), and vowel, consonant, and total phrase durations were calculated from the five repetitions of each phrase. From the isolated phrase, there were a total of five fluent durational measures (i.e., one VOT, two vowel, one consonant, & one phrase duration). For the phrase taken from the oral reading passage, six fluent measures were obtained (i.e., one VOT, three vowel, one consonant, & one phrase duration). Results demonstrated that only one of the five measurements taken during the isolated phrase condition was significantly different between the groups. Three of the six measures obtained from the phrase taken from the oral reading condition revealed significant between-group differences. No group differences were associated with the repetitions of either phrase for any of the dependent measures for both groups. These findings suggest that the length and complexity of the speech tasks used to obtain acoustic measures of stutterers' fluency play an important role in the discovery of differences between the fluency of the two groups.

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The purpose of this study was to examine stutterers' and nonstutterers' fluent voice onset time (VOT) and fundamental frequency (Fo) contour measures from target syllables located at the beginning of a carrier phrase. Ten adult male stutterers were matched within one year of age with 10 adult male nonstutterers. Oscillographic and spectrographic analyses of subjects' VOT and Fo at vowel onset, average vowel Fo, and speed and range of Fo change were obtained from fluent productions of 18 stop consonant-vowel syllables. Results showed that VOTs for voiced stops and the range of Fo change for voiceless stops were associated with significant between-group differences. All other dependent measures were not significantly different between the two groups. When compared with past research, these findings indicate that greater differences emerge between stutterers and nonstutterers when measures of fluency are taken at the beginning than in the middle of a carrier phrase. Implications for future research are discussed.

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This study examined certain parameters of speaking fundamental frequency (SFF) associated with stutterers' and nonstutterers' fluent production of a declarative and an interrogative utterance. Ten adult male stutterers were matched according to age and average SFF with 10 adult male nonstutterers. Analysis of the waveform data from the experimental utterances showed that the nonstutterers produced a significantly greater range of frequencies than did the stutterers across both utterances. The parameters of mean SFF, mean rate of frequency change, and mean number of frequency shifts were not significantly different between the groups. The findings of this study are in general agreement with the results of previous investigations in this area. The consistency of the findings across several studies seems to indicate that reductions in stutterers' SFF variability may be one vocal tract behavior that could serve to distinguish between stutterers' and non stutterers' fluency.

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This study was conducted to determine if the reduction of stuttering typically observed during singing is associated with altered vocalization or the familiarity of the melody and lyrics of the song sung by the stutterer, or both. Subjects were eight adult male stutterers. Prior to testing, each of these individuals demonstrated that he knew the melody and lyrics of a well-known song from memory. Subsequently, subjects were asked to read these lyrics aloud and then sing them. Next, subjects had to read aloud and then sing a set of unfamiliar lyrics to the conventional melody of the same song. The stutterers' reading and singing performances were audiotaped. The dependent measures of utterance duration and stuttering frequency were extracted from the tapes. Results showed that subjects' utterance durations were significantly longer during singing than reading. The main effects of singing and familiarity were both associated with significant reductions in stuttering frequency. The greatest decrement in stuttering occurred in the condition where subjects sang the familiar melody and lyrics. These findings were interpreted to mean that changes in vocalization cannot account for all of the decrease in stuttering that occurs during singing. During song, the familiarity of the melody and lyrics being produced may also affect stuttering frequency.

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