Laura W. Plexico

Coping responses by adults who stutter: part I. Protecting the self and others.

UNLABELLED Using a grounded theory approach, four clusters were identified that represent patterns of coping by adults who stutter. In order to understand the complexities within the coping responses of speakers to the experience of stuttering, this first of two companion papers summarizes the literature on the human coping response to stress and the nature of two of the four main findings identified. These findings describe a coping process that emphasizes strategies of protecting both the speaker and the listener from experiencing discomfort associated with stuttering. The companion paper describes the remaining two main findings that emphasize the characteristics of self-focused and action oriented coping responses. EDUCATIONAL OBJECTIVES The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with the process of coping with stuttering, (2) describe the basic rationale for the procedures associated with grounded theory methods, (3) describe the factors that influence the choice to use emotion-focused and problem-focused coping strategies, and (4) explain the factors that contribute to the use of methods of escape.

Coping responses by adults who stutter: part II. Approaching the problem and achieving agency.

UNLABELLED As with the first of two companion manuscripts, this investigation employed a grounded theory approach to identify patterns of coping responses by adults responding to the stress resulting from the threat of stuttering. The companion paper described emotion-based avoidant coping responses that were used to protect both the speaker and the listener from experiencing discomfort associated with stuttering. This paper describes two cognitive-based approach patterns that emphasize self-focused and problem-focused forms of coping. The first of the cognitive-based coping patterns involved speakers approaching stuttering with a broader perspective about themselves and the experience of stuttering, resulting in an improved self-concept and increased self-confidence. The second coping pattern involved speakers focusing on their own goals which results in increased agency and self-confidence. Participants described the development of more functional coping responses. They moved from emotion-based avoidant patterns of coping that focused on protecting the self and the listener from experiencing discomfort associated with stuttering to cognitive-based approach patterns that focused on the needs of the speaker. As the participants chose to approach rather than avoid or escape stuttering, they experienced many positive social, physical, cognitive, and affective results. EDUCATIONAL OBJECTIVES The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with the process of coping with stuttering, (2) describe the basic rationale for the procedures associated with grounded theory methods, (3) describe the factors that influence coping choices, and (4) explain the factors that contribute the use of approach-oriented and agentic coping strategies.

Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering

UNLABELLED The treatment components that contribute to and account for successful therapeutic outcomes for people who stutter are not well understood and are debated by many. The purpose of this phenomenological study was to describe in detail the underlying factors that contribute to a successful or unsuccessful therapeutic interaction between clients and their clinicians. Twenty-eight participants, 19 men and 9 women, who had received from 6 months to more than 12 years of therapy for stuttering were studied. The participants were asked to consider their experience with one or more speech-language pathologists with whom they had received fluency therapy and to describe the characteristics that made that individual effective or ineffective in promoting successful change in their ability to communicate. Analysis of these data resulted in 15 primary categories. Finally, the essential structure of an effective and ineffective therapeutic interaction was described. Results highlighted the importance for effective therapy of understanding the stuttering experience, forming a positive client-clinician, alliance, and being knowledgeable about stuttering and its treatment. EDUCATIONAL OBJECTIVES The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with an effective therapeutic interaction, (2) describe, from the perspective of a select group of adults who stutter, the themes associated with an ineffective therapeutic interaction, and (3) describe the ways in which an effective or ineffective therapeutic interaction could impact a person who stutters.

Coping with a Child Who Stutters: A Phenomenological Analysis.

UNLABELLED Qualitative methods were used in the form of a phenomenological analysis to explore how families cope with having a child who stutters. Twelve participants, 2 men and 10 women, who have children who stutter participated in this study. The participants were asked to consider their experiences with being the parent of a child who stutters. Analysis of these data resulted in 3 primary categories. The results indicate that parents experience and cope with stresses associated with being the parent of a child who stutters. The participants described feelings of uncertainty and concern as well as the desire to do what is best for their children. Results highlight the importance of providing information and avenues of support that will help parents more effectively cope with having a child who stutters. EDUCATIONAL OBJECTIVES The reader will be able to: (a) describe, from the perspective of a parent of a child who stutters, the themes associated with the process of coping with a child who stutters, (b) describe types of coping resources, (c) describe the factors that influence the choice to use emotion-focused and problem-focused coping strategies, and (d) describe four specific areas to consider when providing resources for families of children who stutter.

Influence of Vowel Selection on Determination of Phonation Threshold Pressure

OBJECTIVE/HYPOTHESIS Phonation threshold pressure values reported in the literature have largely been determined with use of one of three consonant-vowel sequences, /pi/, /pae/, and /pa/; however, it is not currently known if vowel choice influences phonation threshold pressure values. Based on the evidence that describes velopharyngeal closure variations between vowels, this research effort hypothesized that phonation threshold pressure values measured from the consonant-vowel sequence /pi/ would be significantly lower than the /pae/ and /pa/ sequences. METHODS Twelve female participants aged between 20 and 27 years produced five-syllable trains of /pi/, /pae/, and /pa/ at low, modal, and high pitches. STUDY DESIGN A within-subject repeated measures approach was conducted to compare phonation threshold pressure value differences between the three consonant-vowel sequences for three different pitches while controlling for other task elicitation variables that may also influence phonation threshold pressure values. RESULTS Repeated measures analysis of the data indicated that there was no significant difference (P<0.05) in phonation threshold pressure values between the three consonant-vowel sequences at any frequency assessed. Further, for all three consonant-vowel sequences measured, significant differences of phonation threshold pressure magnitude were observed when comparing the high frequency versus the low and modal frequencies, a finding consistent with previous publications. CONCLUSIONS The vowel selected for task elicitation for phonation threshold pressure determination does not appear to significantly affect phonation threshold values, indicating flexibility of the vowel aspect of this measure for clinical use of phonation threshold pressure.

Influence of Syllable Train Length and Performance End Effects on Estimation of Phonation Threshold Pressure

OBJECTIVES The purpose of this study was to determine whether the number of syllables collected and performance end effects had a significant effect on phonation threshold pressure (PTP) estimates. METHODS Ten adult females with normal voices produced five- and seven-syllable trains of /pi/ at low, modal, and high pitches. The results were analyzed using repeated-measures analysis of variance to determine whether a difference existed in PTP when a five-syllable train was collected versus when a seven-syllable train was collected and whether the typically discarded first and last syllables within a train differed from the middle syllables. RESULTS The results indicated that there was no significant difference in estimated PTP values when calculated from a five-syllable versus a seven-syllable train or between the first, middle, and last syllables within a train. CONCLUSIONS Based on these findings, it appears that a five-syllable train provides adequate information from which to estimate PTP values. Furthermore, these findings also suggest that within the five-syllable train, any three adjacent syllables could be used to estimate PTP. These findings are significant in developing a clinically standardized, effective, and efficient method for collecting PTP.

The Effect of Traditional Singing Warm-Up Versus Semioccluded Vocal Tract Exercises on the Acoustic Parameters of Singing Voice.

OBJECTIVES/HYPOTHESES This study investigated the effect of traditional vocal warm-up versus semioccluded vocal tract exercises on the acoustic parameters of voice through three questions: does vocal warm-up condition significantly alter the singing power ratio of the singing voice? Is singing power ratio dependent upon vowel? Is perceived phonatory effort affected by warm-up condition? Hypotheses were that vocal warm-up would alter the singing power ratio, and that semioccluded vocal tract warm-up would affect the singing power ratio more than no warm-up or traditional warm-up, that singing power ratio would vary across vowel, and that perceived phonatory effort would vary with warm-up condition. STUDY DESIGN This study was a within-participant repeated measures design with counterbalanced conditions. METHODS Thirteen male singers were recorded under three different conditions: no warm-up, traditional warm-up, and semioccluded vocal tract exercise warm-up. Recordings were made of these singers performing the Star Spangled Banner, and singing power ratio (SPR) was calculated from four vowels. Singers rated their perceived phonatory effort (PPE) singing the Star Spangled Banner after each warm-up condition. RESULTS Warm-up condition did not significantly affect SPR. SPR was significantly different for /i/ and /e/. PPE was not significantly different between warm-up conditions. CONCLUSIONS The present study did not find significant differences in SPR between warm-up conditions. SPR differences for /i/, support previous findings. PPE did not differ significantly across warm-up condition despite the expectation that traditional or semioccluded warm-up would cause a decrease.

Influence of Glottal Fry on Acoustic Voice Assessment: A Preliminary Study

PURPOSE This preliminary study examined the influence of glottal fry on measurement of speaking fundamental frequency (SF0) and whether sex differences influence the impact glottal fry has on SF0 and cepstral peak prominence (CPP). It was hypothesized that SF0 and CPP would decrease as percent glottal fry in the sample increased, with larger changes observed in the female voice. METHODS Twenty-six participants (13 men, 13 women) completed the study. Participants were recorded reading the Rainbow Passage. SF0 and CPP were determined from the original sample. Percent glottal fry SF0 was determined and semitone change was recalculated after removal of glottal fry from the sample. Regression analysis was used to determine the impact of glottal fry and sex on semitone change and CPP differences in SF0. RESULTS Significant differences were found for both sex and percent glottal fry on semitone change in SF0. A significant relationship was not found between CPP and semitone change when sex was accounted for. CONCLUSIONS Findings from this study indicate that the measurement of SF0 for women will decline as percent of glottal fry increases. These findings have clinical implications for interpretation of SF0 measurement and evidence-based outcomes for voice therapy.

Personality and Specialty Choice in Speech-Language Pathology Students

The role of personality in specialty choices of speech-language pathology (SLP) students was examined. Specialty choices were obtained using a demographic questionnaire, and personality was measured with the Multidimensional Personality Questionnaire (MPQ) in an electronic survey. The personalities of SLP students were compared to students in nine educational majors using Hotelling’s T 2-test analyses. Multivariate analyses of variance were conducted to evaluate the effects of the 11 primary personality traits on age and setting choice. SLP students were found to significantly differ from the nine examined majors in the MPQ primary traits—social potency, alienation, aggression, harm avoidance, and control. Students were found to be organized, trusting of peers, nonaggressive, and harm avoidant when compared to other student groups. Personality traits did not significantly contribute to age or facility choice, and the degree of variance in the responses may indicate that a variety of personality types can thrive within the field.