Semin Speech Lang 2010; 31(4): 236-249
DOI: 10.1055/s-0030-1265757
© Thieme Medical Publishers

Translating Recent Research into Meaningful Clinical Practice

Nan Bernstein Ratner1
  • 1Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland
Further Information

Publication History

Publication Date:
15 November 2010 (online)

ABSTRACT

The goal of this article is to provide a synopsis of research, both basic and applied, that can improve the evaluation and treatment of stuttering in children and adults, as well as counseling of clients, families, and other professionals who interact with the person who stutters. Relevant basic research has informed genetic contributions to stuttering and possible neurological substrates of the disorder. Several treatment approaches to stuttering have recently been published, with varying degrees of apparent efficacy. There has also been increased attention to therapeutic outcomes that go beyond the components of the specific therapies themselves, which have the potential to improve therapy outcomes.

REFERENCES

  • 1 Bloodstein O, Bernstein Ratner N. A Handbook on Stuttering. Clifton Park, NY; Thomson/Delmar Learning 2008
  • 2 Fisher S E. Genetic susceptibility to stuttering.  N Engl J Med. 2010;  362(8) 750-752
  • 3 Kang C, Riazuddin S, Mundorff J et al.. Mutations in the lysosomal enzyme-targeting pathway and persistent stuttering.  N Engl J Med. 2010;  362(8) 677-685
  • 4 Riaz N, Steinberg S, Ahmad J et al.. Genomewide significant linkage to stuttering on chromosome 12.  Am J Hum Genet. 2005;  76(4) 647-651
  • 5 Suresh R, Ambrose N, Roe C et al.. New complexities in the genetics of stuttering: significant sex-specific linkage signals.  Am J Hum Genet. 2006;  78(4) 554-563
  • 6 Seppa N. Genes may explain some stuttering: defects on chromosome 12 found in small portion of cases.  Sci News. 2010;  177(6) 17
  • 7 Stuttering May Be Linked To Specific Genes . Child Health Alert. 2010;  28 4
  • 8 Bloodstein O, Bernstein Ratner N. A Handbook on Stuttering. 6th ed. Clifton Park, NY; Cengage 2008
  • 9 Beal D S, Gracco V L, Lafaille S J, De Nil L F. Voxel-based morphometry of auditory and speech-related cortex in stutterers.  Neuroreport. 2007;  18(12) 1257-1260
  • 10 Chang S-E, Erickson K I, Ambrose N G, Hasegawa-Johnson M A, Ludlow C L. Brain anatomy differences in childhood stuttering.  Neuroimage. 2008;  39(3) 1333-1344
  • 11 Cykowski M D, Kochunov P V, Ingham R J et al.. Perisylvian sulcal morphology and cerebral asymmetry patterns in adults who stutter.  Cereb Cortex. 2008;  18(3) 571-583
  • 12 Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers.  BMC Neurol. 2004;  4(1) 23
  • 13 Lu C, Peng D, Chen C et al.. Altered effective connectivity and anomalous anatomy in the basal ganglia-thalamocortical circuit of stuttering speakers.  Cortex. 2010;  46(1) 49-67
  • 14 Sommer M, Koch M A, Paulus W, Weiller C, Buchel C. Mechanisms of disease. Disconnection of speech-relevant brain areas in persistent developmental stuttering.  Lancet. 2002;  360(9330) 380-383
  • 15 Watkins K E, Smith S M, Davis S, Howell P. Structural and functional abnormalities of the motor system in developmental stuttering.  Brain. 2008;  131(Pt 1) 50-59
  • 16 Chang S-E, Kenney M K, Loucks T MJ, Ludlow C L. Brain activation abnormalities during speech and non-speech in stuttering speakers.  Neuroimage. 2009;  46(1) 201-212
  • 17 Giraud A-L, Neumann K, Bachoud-Levi A-C et al.. Severity of dysfluency correlates with basal ganglia activity in persistent developmental stuttering.  Brain Lang. 2008;  104(2) 190-199
  • 18 Lu C, Chen C, Ning N et al.. The neural substrates for atypical planning and execution of word production in stuttering.  Exp Neurol. 2010;  221(1) 146-156
  • 19 Lu C, Ning N, Peng D et al.. The role of large-scale neural interactions for developmental stuttering.  Neuroscience. 2009;  161(4) 1008-1026
  • 20 Foundas A L, Bollich A M, Feldman J et al.. Aberrant auditory processing and atypical planum temporale in developmental stuttering.  Neurology. 2004;  63(9) 1640-1646
  • 21 De Nil L F, Kroll R M, Lafaille S J, Houle S. A positron emission tomography study of short- and long-term treatment effects on functional brain activation in adults who stutter.  J Fluency Disord. 2003;  28(4) 357-379 quiz 379-380
  • 22 Kell C A, Neumann K, von Kriegstein K et al.. How the brain repairs stuttering.  Brain. 2009;  132(Pt 10) 2747-2760
  • 23 Neumann K, Preibisch C, Euler H A et al.. Cortical plasticity associated with stuttering therapy.  J Fluency Disord. 2005;  30(1) 23-39
  • 24 Angrisani R MG, Matas C G, Neves I F, Sassi F C, Andrade C RF. Eletrophysiological auditory evaluation in stutterers pre and post treatment.  Pro Fono. 2009;  21(2) 95-100
  • 25 Büchel C, Sommer M. What causes stuttering?.  PLoS Biol. 2004;  2(2) E46
  • 26 Smits-Bandstra S, De Nil L. Speech skill learning of persons who stutter and fluent speakers under single and dual task conditions.  Clin Linguist Phon. 2009;  23(1) 38-57
  • 27 Smits-Bandstra S, De Nil L F. Sequence skill learning in persons who stutter: implications for cortico-striato-thalamo-cortical dysfunction.  J Fluency Disord. 2007;  32(4) 251-278
  • 28 Hampton A, Weber-Fox C. Non-linguistic auditory processing in stuttering: evidence from behavior and event-related brain potentials.  J Fluency Disord. 2008;  33(4) 253-273
  • 29 Weber-Fox C, Hampton A. Stuttering and natural speech processing of semantic and syntactic constraints on verbs.  J Speech Lang Hear Res. 2008;  51(5) 1058-1071
  • 30 Weber-Fox C, Spruill III J E, Spencer R, Smith A. Atypical neural functions underlying phonological processing and silent rehearsal in children who stutter.  Dev Sci. 2008;  11(2) 321-337
  • 31 Bloodstein O. Some empirical observations about early stuttering: a possible link to language development.  J Commun Disord. 2006;  39(3) 185-191
  • 32 Kleinow J, Smith A. Influences of length and syntactic complexity on the speech motor stability of the fluent speech of adults who stutter.  J Speech Lang Hear Res. 2000;  43(2) 548-559
  • 33 Smith A, Kleinow J. Kinematic correlates of speaking rate changes in stuttering and normally fluent adults.  J Speech Lang Hear Res. 2000;  43(2) 521-536
  • 34 Smith A, Sadagopan N, Walsh B, Weber-Fox C. Increasing phonological complexity reveals heightened instability in inter-articulatory coordination in adults who stutter.  J Fluency Disord. 2010;  35(1) 1-18
  • 35 Tsiamtsiouris J, Cairns H S. Effects of syntactic complexity and sentence-structure priming on speech initiation time in adults who stutter.  J Speech Lang Hear Res. 2009;  52(6) 1623-1639
  • 36 Arndt J, Healey E C. Concomitant disorders in school-age children who stutter.  Lang Speech Hear Serv Sch. 2001;  32(2) 68-78
  • 37 Yairi E, Ambrose N G. Early Childhood Stuttering. Austin, TX; Pro-Ed 2004
  • 38 Reilly S, Onslow M, Packman A et al.. Predicting stuttering onset by the age of 3 years: a prospective, community cohort study.  Pediatrics. 2009;  123(1) 270-277
  • 39 Overall Assessment of the Speaker's Experience of Stuttering .Available at: http://www.pearsonassessments.com Accessed June 15, 2010
  • 40 Yaruss J S, Quesal R W. Overall Assessment of the Speaker's Experience of Stuttering (OASES): documenting multiple outcomes in stuttering treatment.  J Fluency Disord. 2006;  31(2) 90-115
  • 41 Hewat S, Onslow M, Packman A, O'Brian S. A phase II clinical trial of self-imposed time-out treatment for stuttering in adults and adolescents.  Disabil Rehabil. 2006;  28(1) 33-42
  • 42 Vanryckeghem M, Brutten G J, Hernandez L M. A comparative investigation of the speech-associated attitude of preschool and kindergarten children who do and do not stutter.  J Fluency Disord. 2005;  30(4) 307-318
  • 43 Boey R A, Van de Heyning P H, Wuyts F L, Heylen L, Stoop R, De Bodt M S. Awareness and reactions of young stuttering children aged 2-7 years old towards their speech disfluency.  J Commun Disord. 2009;  42(5) 334-346
  • 44 Bernardini S, Vanryckeghem M, Brutten G J, Cocco L, Zmarich C. Communication attitude of Italian children who do and do not stutter.  J Commun Disord. 2009;  42(2) 155-161
  • 45 Johannisson T B, Wennerfeldt S, Havstam C, Naeslund M, Jacobson K, Lohmander A. The Communication Attitude Test (CAT-S): normative values for 220 Swedish children.  Int J Lang Commun Disord. 2009;  44(6) 813-825
  • 46 Vanryckeghem M, Mukati S A. The Behavior Assessment Battery: a preliminary study of non-stuttering Pakistani grade-school children.  Int J Lang Commun Disord. 2006;  41(5) 583-589
  • 47 Yaruss J S, Coleman C, Hammer D. Treating preschool children who stutter: description and preliminary evaluation of a family-focused treatment approach.  Lang Speech Hear Serv Sch. 2006;  37(2) 118-136
  • 48 Langevin M, Huinck W J, Kully D, Peters H FM, Lomheim H, Tellers M. A cross-cultural, long-term outcome evaluation of the ISTAR Comprehensive Stuttering Program across Dutch and Canadian adults who stutter.  J Fluency Disord. 2006;  31(4) 229-256
  • 49 Langevin M, Packman A, Onslow M. Peer responses to stuttering in the preschool setting.  Am J Speech Lang Pathol. 2009;  18(3) 264-276
  • 50 Langevin M. The Peer Attitudes Toward Children who Stutter scale: reliability, known groups validity, and negativity of elementary school-age children's attitudes.  J Fluency Disord. 2009;  34(2) 72-86
  • 51 Craig A, Blumgart E, Tran Y. The impact of stuttering on the quality of life in adults who stutter.  J Fluency Disord. 2009;  34(2) 61-71
  • 52 Brundage S B, Graap K, Gibbons K F, Ferrer M, Brooks J. Frequency of stuttering during challenging and supportive virtual reality job interviews.  J Fluency Disord. 2006;  31(4) 325-339
  • 53 Onslow M, Menzies R G, Packman A. An Operant Intervention for Early Stuttering . An operant intervention for early stuttering. The development of the Lidcombe program.  Behav Modif. 2001;  25(1) 116-139
  • 54 Jones M, Onslow M, Packman A et al.. Extended follow-up of a randomized controlled trial of the Lidcombe Program of Early Stuttering Intervention.  Int J Lang Commun Disord. 2008;  43(6) 649-661
  • 55 Rousseau I, Packman A, Onslow M, Harrison E, Jones M. An investigation of language and phonological development and the responsiveness of preschool age children to the Lidcombe Program.  J Commun Disord. 2007;  40(5) 382-397
  • 56 Kingston M, Huber A, Onslow M, Jones M, Packman A. Predicting treatment time with the Lidcombe Program: replication and meta-analysis.  Int J Lang Commun Disord. 2003;  38(2) 165-177
  • 57 Goodhue R, Onslow M, Quine S, O'Brian S, Hearne A. The Lidcombe program of early stuttering intervention: mothers' experiences.  J Fluency Disord. 2010;  35(1) 70-84
  • 58 Jones M, Onslow M, Harrison E, Packman A. Treating stuttering in young children: predicting treatment time in the Lidcombe Program.  J Speech Lang Hear Res. 2000;  43(6) 1440-1450
  • 59 Jones M, Onslow M, Packman A et al.. Randomised controlled trial of the Lidcombe programme of early stuttering intervention.  BMJ. 2005;  331(7518) 659
  • 60 Miller B, Guitar B. Long-term outcome of the Lidcombe Program for early stuttering intervention.  Am J Speech Lang Pathol. 2009;  18(1) 42-49
  • 61 Lattermann C, Shenker R C, Thordardottir E. Progression of language complexity during treatment with the Lidcombe Program for early stuttering intervention.  Am J Speech Lang Pathol. 2005;  14(3) 242-253
  • 62 Lattermann C, Euler H A, Neumann K. A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers.  J Fluency Disord. 2008;  33(1) 52-65
  • 63 Franken M-CJ, Kielstra-Van der Schalk C J, Boelens H. Experimental treatment of early stuttering: a preliminary study.  J Fluency Disord. 2005;  30(3) 189-199
  • 64 Lewis C, Packman A, Onslow M, Simpson J M, Jones M. A phase II trial of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention.  Am J Speech Lang Pathol. 2008;  17(2) 139-149
  • 65 Koushik S, Shenker R, Onslow M. Follow-up of 6-10-year-old stuttering children after Lidcombe program treatment: a phase I trial.  J Fluency Disord. 2009;  34(4) 279-290
  • 66 Millard S K, Nicholas A, Cook F M. Is parent-child interaction therapy effective in reducing stuttering?.  J Speech Lang Hear Res. 2008;  51(3) 636-650
  • 67 Yaruss J S, Coleman C, Hammer D. Treating preschool children who stutter: description and preliminary evaluation of a family-focused treatment approach.  Lang Speech Hear Serv Sch. 2006;  37(2) 118-136
  • 68 Trajkovski N, Andrews C, Onslow M, Packman A, O'Brian S, Menzies R. Using syllable-timed speech to treat preschool children who stutter: a multiple baseline experiment.  J Fluency Disord. 2009;  34(1) 1-10
  • 69 Bothe A K, Davidow J H, Bramlett R E, Ingham R J. Stuttering treatment research 1970-2005: I. Systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches.  Am J Speech Lang Pathol. 2006;  15(4) 321-341
  • 70 Law J. Behavioral stuttering treatments are effective but no one treatment approach is more effective over other treatment approaches.  Evidence-Based Communication Assessment & Intervention. 2007;  1(1) 14-15
  • 71 Carey B, O'Brian S, Onslow M, Block S, Jones M, Packman A. Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program.  Int J Lang Commun Disord. 2010;  45(1) 108-120
  • 72 Hearne A, Packman A, Onslow M, O'Brian S. Developing treatment for adolescents who stutter: a phase I trial of the Camperdown Program.  Lang Speech Hear Serv Sch. 2008;  39(4) 487-497
  • 73 O'Brian S, Onslow M, Cream A, Packman A. The Camperdown Program: outcomes of a new prolonged-speech treatment model.  J Speech Lang Hear Res. 2003;  46(4) 933-946
  • 74 O'Brian S, Packman A, Onslow M. Telehealth delivery of the Camperdown Program for adults who stutter: a phase I trial.  J Speech Lang Hear Res. 2008;  51(1) 184-195
  • 75 Huinck W J, Langevin M, Kully D, Graamans K, Peters H FM, Hulstijn W. The relationship between pre-treatment clinical profile and treatment outcome in an integrated stuttering program.  J Fluency Disord. 2006;  31(1) 43-63 quiz 58-60
  • 76 Teshima S, Langevin M, Hagler P, Kully D. Post-treatment speech naturalness of comprehensive stuttering program clients and differences in ratings among listener groups.  J Fluency Disord. 2010;  35(1) 44-58
  • 77 Blomgren M, Roy N, Callister T, Merrill R M. Intensive stuttering modification therapy: a multidimensional assessment of treatment outcomes.  J Speech Lang Hear Res. 2005;  48(3) 509-523
  • 78 Menzies R G, Onslow M, Packman A, O'Brian S. Cognitive behavior therapy for adults who stutter: a tutorial for speech-language pathologists.  J Fluency Disord. 2009;  34(3) 187-200
  • 79 Menzies R G, O'Brian S, Onslow M, Packman A, St Clare T, Block S. An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering.  J Speech Lang Hear Res. 2008;  51(6) 1451-1464
  • 80 Iverach L, O'Brian S, Jones M et al.. Prevalence of anxiety disorders among adults seeking speech therapy for stuttering.  J Anxiety Disord. 2009;  23(7) 928-934
  • 81 Bray M A, Kehle T J. Self-modeling as an intervention for stuttering.  School Psych Rev. 1996;  25(3) 358-369
  • 82 Bray M A, Kehle T J. Self-modeling as an intervention for stuttering.  School Psych Rev. 1998;  27(4) 587-599
  • 83 Bray M A, Kehle T J. Long-term follow-up of self-modeling as an intervention for stuttering.  School Psych Rev. 2001;  30(1) 135-141
  • 84 Cream A, O'Brian S, Onslow M, Packman A, Menzies R. Self-modelling as a relapse intervention following speech-restructuring treatment for stuttering.  Int J Lang Commun Disord. 2009;  44(5) 587-599
  • 85 Bothe A K, Davidow J H, Bramlett R E, Franic D M, Ingham R J. Stuttering treatment research 1970-2005: II. Systematic review incorporating trial quality assessment of pharmacological approaches.  Am J Speech Lang Pathol. 2006;  15(4) 342-352
  • 86 Ludlow C L. Neuropharmacology of stuttering: concepts and current findings. Bernstein N, Tetnowski J Current Issues in Stuttering Research and Practice. Mahwah, NJ; Lawrence Erlbaum 2006: 239-254
  • 87 Maguire G A, Riley G D, Franklin D L, Maguire M E, Nguyen C T, Brojeni P H. Olanzapine in the treatment of developmental stuttering: a double-blind, placebo-controlled trial.  Ann Clin Psychiatry. 2004;  16(2) 63-67
  • 88 Stuart A, Kalinowski J, Saltuklaroglu T, Guntupalli V K. Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: one-year follow-up.  Disabil Rehabil. 2006;  28(12) 757-765
  • 89 Stuart A, Frazier C L, Kalinowski J, Vos P W. The effect of frequency altered feedback on stuttering duration and type.  J Speech Lang Hear Res. 2008;  51(4) 889-897
  • 90 Pollard R, Ellis J B, Finan D, Ramig P R. Effects of the SpeechEasy on objective and perceived aspects of stuttering: a 6-month, phase I clinical trial in naturalistic environments.  J Speech Lang Hear Res. 2009;  52(2) 516-533
  • 91 O'Donnell J J, Armson J, Kiefte M. The effectiveness of SpeechEasy during situations of daily living.  J Fluency Disord. 2008;  33(2) 99-119
  • 92 Armson J, Kiefte M. The effect of SpeechEasy on stuttering frequency, speech rate, and speech naturalness.  J Fluency Disord. 2008;  33(2) 120-134
  • 93 Armson J, Kiefte M, Mason J, De Croos D. The effect of SpeechEasy on stuttering frequency in laboratory conditions.  J Fluency Disord. 2006;  31(2) 137-152
  • 94 Antipova E A, Purdy S C, Blakeley M, Williams S. Effects of altered auditory feedback (AAF) on stuttering frequency during monologue speech production.  J Fluency Disord. 2008;  33(4) 274-290
  • 95 Lincoln M, Walker C. A survey of Australian adult users of altered auditory feedback devices for stuttering: use patterns, perceived effectiveness and satisfaction.  Disabil Rehabil. 2007;  29(19) 1510-1517
  • 96 Kalinowski J, Saltuklaroglu T. Choral speech: the amelioration of stuttering via imitation and the mirror neuronal system.  Neurosci Biobehav Rev. 2003;  27(4) 339-347
  • 97 Sakai N, Masuda S, Shimotomai T, Mori K. Brain activation in adults who stutter under delayed auditory feedback: an fMRI study.  Int J Speech Lang Pathol. 2009;  11(1) 2-11
  • 98 Takaso H, Eisner F, Wise R JS, Scott S K. The effect of delayed auditory feedback on activity in the temporal lobe while speaking: a positron emission tomography study.  J Speech Lang Hear Res. 2010;  53(2) 226-236
  • 99 Bernstein Ratner N. Evidence-based practice in stuttering: some questions to consider.  J Fluency Disord. 2005;  30(3) 163-188
  • 100 Floyd J, Zebrowski P M, Flamme G A. Stages of change and stuttering: a preliminary view.  J Fluency Disord. 2007;  32(2) 95-120
  • 101 Wampold B E, Brown G S. Estimating variability in outcomes attributable to therapists: a naturalistic study of outcomes in managed care.  J Consult Clin Psychol. 2005;  73(5) 914-923

Nan Bernstein RatnerEd.D. 

Department of Hearing and Speech Sciences

0100 Lefrak Hall, University of Maryland, College Park, MD 20742

Email: nratner@umd.edu

    >