Fabiola Staróbole Juste

Tipologia das rupturas de fala e classes gramaticais em crianças gagas e fluentes

BACKGROUND Developmental stuttering is a pathology which begins during childhood. during the phase of language acquisition and development and is characterized as being chronic. AIM To verify the influence of typology and grammatical classes on the occurrence of speech disruptions of stuttering and fluent children. METHOD Participants of this study were 80 children, with ages between 4.0 and 11.11 years, residents in the city of São Paulo. Participants were divided in two groups: GI (research group) was composed by 40 children (29 male and 11 female) with the diagnosis of stuttering, and with no other associated communication. neurologic and cognitive deficits: GII (control group) was composed by 40 fluent children, paired by age and gender with the participants of GI. RESULTS The data indicate that the groups do not differ regarding the occurrence of typical disfluencies. Less typical disflucncies occurred predominantly for GI. As for the grammatical class, speech disruptions were more frequent in function words for both groups. CONCLUSION These results indicate that the analyses of speech disruptions, in terms of typology and grammatical classes, bring several information that are necessary for the assessment and diagnosis of childhood stuttering. This analysis points the differences and similarities between stuttering and fluent children.

Atividades de fala e não-fala em gagueira: estudo preliminar

BACKGROUND: stuttering. AIM: to compare muscle activation in fluent and stuttering individuals during speech and non-speech tasks. METHOD: six adults divided in two groups: G1 - three fluent individuals; G2 - three stuttering individuals. Muscle activity (surface electromyography) was captured by disposable electrodes fixed in four regions. Testing situations: muscle rest tension, speech reaction time, non-verbal activity, verbal activity. RESULTS: There was no significant statistical difference between the groups for the rest tension; G2 present longer speech reaction times; G2 presented muscle activity during the non-verbal task similar to that observed during rest; Muscle activity of G1 and G2 during the verbal task demonstrated to be similar. CONCLUSION: these results suggests that for G2 there is a poor control of timing for the coordination of motor processes.

Modelamento da fluência com o uso da eletromiografia de superfície: estudo piloto

BACKGROUND: the use of a technological resource in fluency promotion. AIM: to verify the effectiveness of a stuttering treatment based on the use of surface electromyography (SEMG) exclusively. METHOD: participants were four stuttering adults of both genders. Assessment, pre and post-treatment, consisted of a speech gathering session and the analyses of the rest tension and of the reaction time for speech. Treatment consisted of twelve twenty minute training sessions monitored by SEMG. RESULTS: there was a statistically significant reduction in the number of stuttering-like disfluencies (p = 0.094) and in the number of other disfluencies (p = 0.014). The other parameters, as well as differences in the electromyographic measurements, did not present significant variation. CONCLUSION: SEMG proved to be effective in the reduction of stuttering, with no need of association to other techniques.

Qualidade de vida em indivíduos com gagueira desenvolvimental persistente

BACKGROUND: quality of life. AIM: to verify the influence of the readiness of speech - regarding affective, behavioral and cognitive reactions - over the life quality of fluent individuals and those with persistent developmental stuttering (PDS). METHOD: 40 adults divided in two groups, paired by gender and age. The research group (GI) consisted of 20 individuals with PDS, with no other associated deficit. The research group (GII) consisted of 20 fluent individuals. All of the participants answered a Self-Assessment Protocol - version for adults. This protocol is composed by three thematic sessions, each one presenting five questions. Each question should be answered by choosing a number on a scale that varies from 1 (completely disagree) to 7 (completely agree). The first session corresponds to the affective reactions, the second to the behavioral reactions and the third to the cognitive reactions. All of the participants answered all of the 15 questions. RESULTS: the findings indicate that a difference in the perception of speech and speech fluency exists between fluent individuals and individuals with PDS. For the individuals with PDS, the different stuttering severity levels did not present divergent points; on the contrary, even the individuals with mild PDS presented the same affective, behavioral and cognitive profiles of those with a more severe stuttering. CONCLUSION: the results indicate that the experience with stuttering is different among the individuals in terms of the observable speech characteristics, functional communication difficulties experienced by the individual in everyday situations, having a negative impact in the quality of life.

Acoustic analyses of diadochokinesis in fluent and stuttering children

OBJECTIVES: The purpose of the study was to acoustically compare the performance of children who do and do not stutter on diadochokinesis tasks in terms of syllable duration, syllable periods, and peak intensity. METHODS: In this case-control study, acoustical analyses were performed on 26 children who stutter and 20 aged-matched normally fluent children (both groups stratified into preschoolers and school-aged children) during a diadochokinesis task: the repetition of articulatory segments through a task testing the ability to alternate movements. Speech fluency was assessed using the Fluency Profile and the Stuttering Severity Instrument. RESULTS: The children who stutter and those who do not did not significantly differ in terms of the acoustic patterns they produced in the diadochokinesis tasks. Significant differences were demonstrated between age groups independent of speech fluency. Overall, the preschoolers performed poorer. These results indicate that the observed differences are related to speech-motor age development and not to stuttering itself. CONCLUSIONS: Acoustic studies demonstrate that speech segment durations are most variable, both within and between subjects, during childhood and then gradually decrease to adult levels by the age of eleven to thirteen years. One possible explanation for the results of the present study is that children who stutter presented higher coefficients of variation to exploit the motor equivalence to achieve accurate sound production (i.e., the absence of speech disruptions).

Análise sistemática da efetividade do uso da alteração do feedback auditivo para a redução da gagueira

PURPOSE To perform a systematic review of studies related to the effects of delayed auditory feedback on speech fluency in individuals who stutter. RESEARCH STRATEGY Concepts of the Cochrane Handbook were followed: formulation of initial question (theme to be reviewed), location and selection of studies (PubMed database) and compatibilization among researchers (aiming to minimize possible citation losses). SELECTION CRITERIA The following were excluded: citations in languages other than English, citations that did not allow access to full text, repeated citations due to the overlap of keywords, studies developed exclusively with fluent individuals, case reports, reviews of the literature, letters to the editor, and texts that were not directly related to the theme. Hence, texts that were related to treatment with delayed auditory feedback (DAF) and frequency-altered feedback (FAF) were analyzed. DATA ANALYSIS Data were analyzed according to research indicators and according to study quality markers. RESULTS The results indicated that the use of altered auditory feedback devices for the reduction of stuttering events still do not have robust support for their applicability. Methodological variability does not allow a consistent answer, or a trend about the effectiveness of the device, to be drawn. CONCLUSION Although the limitations in the studies prevent generalizations about the effectiveness of the device for the reduction of stuttering, these same limitations are important resources for future research planning.

Speech Disfluency Types of Fluent and Stuttering Individuals: Age Effects

OBJECTIVE The purpose of the present study was to quantify and compare the typology of speech disruptions presented by stuttering and fluent Brazilian Portuguese-speaking children, adolescents and adults. SUBJECTS AND METHODS Participants were 150 individuals, with ages between 4.0 and 49.11 years, who were divided into six groups: children who stutter (n = 25), children who do not stutter (n = 25), adolescents who stutter (n = 25), adolescents who do not stutter (n = 25), adults who stutter (n = 25) and adults who do not stutter (n = 25). For each participant, the frequency of stuttering-like disfluencies (SLD) and other disfluencies was calculated based on the video recordings of spontaneous speech samples. RESULTS The results obtained for SLD were significant when comparing stuttering and fluent individuals. In children who stutter, adolescents who stutter, and adults who stutter, a higher frequency of SLD was found. Other disfluencies did not differentiate the groups. CONCLUSION The age factor did not qualify quantitatively any of the groups, but indicated qualitative differences (in terms of the type of speech disfluencies) between groups. The results revealed similarities when compared with studies carried out in different languages.Objective: The purpose of the present study was to quantify and compare the typology of speech disruptions presented by stuttering and fluent Brazilian Portuguese-speaking children, adolescents and adults. Subjects and Methods: Participants were 150 individuals, with ages between 4.0 and 49.11 years, who were divided into six groups: children who stutter (n = 25), children who do not stutter (n = 25), adolescents who stutter (n = 25), adolescents who do not stutter (n = 25), adults who stutter (n = 25) and adults who do not stutter (n = 25). For each participant, the frequency of stuttering-like disfluencies (SLD) and other disfluencies was calculated based on the video recordings of spontaneous speech samples. Results: The results obtained for SLD were significant when comparing stuttering and fluent individuals. In children who stutter, adolescents who stutter, and adults who stutter, a higher frequency of SLD was found. Other disfluencies did not differentiate the groups. Conclusion: The age factor did not qualify quantitatively any of the groups, but indicated qualitative differences (in terms of the type of speech disfluencies) between groups. The results revealed similarities when compared with studies carried out in different languages.

Persistent developmental stuttering as a cortical-subcortical dysfunction: evidence from muscle activation.

BACKGROUND One contemporary view of stuttering posits that speech disfluencies arise from anomalous speech motor control. PURPOSE To verify the rest muscle tension and speech reaction time of fluent and stuttering adults. METHOD 22 adults, divided in two groups: G1--11 fluent individuals; G2--11 stutterers. Electromyography recordings (inferior orbicularis oris) were collected in two different situations: during rest and in a reaction time activity. RESULTS The groups were significantly different considering rest muscle tension (G2 higher recordings) and did not differ when considering speech reaction time and muscle activity during speech. There was a strong positive correlation between speech reaction time and speech muscle activity for G2--the longer the speech reaction time, the higher the muscle activity during speech. CONCLUSION In addition to perceptible episodes of speech disfluency, stutterers exhibit anomalies in speech motor output during fluent speech. Correlations with a possible cortical-subcortical disorder are discussed.

Impacto do uso do SpeechEasy® nos parâmetros acústicos e motores da fala de indivíduos com gagueira

Purpose To investigate variations in speech motor skills in adults who stutter and those who do not, using the SpeechEasy® altered auditory feedback device. Methods 1 2 Results The spontaneous speech task was the only task to show significant differences in both the intragroup and intergroup comparisons. In this task, the use of SpeechEasy® resulted in significant improvement in speech fluency, as measured by the percentage of stuttered syllables, for the group who stuttered. For the fluent group, the device produced the opposite effect: a significant increase in the frequency of stuttered disfluencies was observed with the device. No significant differences were found in either intragroup or intergroup comparisons relating to the acoustic aspects of the diadochokinesis and target phrase production tasks. Conclusion The results indicated that the use of SpeechEasy® improved the fluency of participants who stutter, without appearing to interfere with speech naturalness.

Gagueira desenvolvimental persistente familial: perspectivas genéticas

A gagueira e uma desordem da comunicacao oral que tem uma caracteristica multidimensional. A predisposicao biologica no desenvolvimento da gagueira ainda nao e bem compreendida, mas contribuicoes geneticas para esta predisposicao sao reforcadas tanto por referencias a agregacao familial da gagueira, quanto a gagueira familial, que tem aparecido na literatura ha mais de 70 anos. Assim, procuramos estabelecer uma revisao quanto aos provaveis fatores geneticos envolvidos com a manifestacao da gagueira desenvolvimental persistente familial. A identificacao de genes relacionados a gagueira, bem como de alteracoes em suas estruturas (por exemplo, mutacoes), contribuem significativamente para sua compreensao. O modelo exato de transmissao da heranca genetica para a gagueira ainda nao esta claramente definida e, provavelmente pode ser diferente entre diferentes familias e populacoes. As analises genomicas demonstram, concomitantemente, a relevância dos componentes geneticos envolvidos e sua complexidade, sugerindo assim tratar-se de uma doenca poligenica, na qual diversos genes de efeitos variados podem estar envolvidos com o aumento da susceptibilidade de ocorrencia da gagueira. O clinico devera estar alerta ao fato de que uma crianca com historico familial positivo para gagueira podera ter uma forte tendencia a desenvolver o disturbio de forma cronica. E importante que o clinico esteja atento, de modo a fornecer as familias orientacoes precisas sobre o disturbio. As avaliacoes objetivas e os tratamentos controlados tem um papel muito importante para o dominio da evolucao do disturbio.