Richard F. Curlee

Prevalence and nature of dysphagia in va patients with copd referred for videofluoroscopic swallow examination

This retrospective study investigated the prevalence and nature of dysphagia in 78 male outpatients whose primary diagnosis was chronic obstructive pulmonary disease (COPD) and who were referred for modified barium swallow studies at the Veterans Affairs Medical Center (VAMC) in Tucson, Arizona, 1992-1995. Nearly 85% of these patients evidenced some degree of dysphagia, and laryngeal penetrations or aspirations were observed in 44 of them. Agreement between VAMC swallow assessments and those of a three-judge panel of certified speech-language pathologists supported the reliability and validity of the information extracted from VAMC records. The high percentage of silent laryngeal penetrations and aspirations observed in this sample suggests that COPD patients respiratory status should be considered as well as overt symptoms of a swallowing disorder, such as coughing, in making referrals for video-fluoroscopic swallow studies for such patients.

Evaluating treatment efficacy for adults: Assessment of stuttering disability

Abstract The proposed strategy for evaluating the efficacy of treatment for adults who stutter involves repeated assessments of stuttering and speech naturalness from conversation samples recorded in and away from the clinic. This strategy conceptualizes chronic stuttering among adults as a disorder that is best viewed and measured at three levels: impairment, disability, and handicap. A common goal of current treatments for adult stuttering is the reduction or elimination of the disability of stuttering. Therefore, the evaluation of treatment efficacy is logically and most directly related to measures of stuttering disability. Both basic and optional measures of the disability of stuttering are proposed and discussed.

The Relative Effects of Questions and Comments on Children's Stuttering

Parents of children who stutter often are advised to eliminate or reduce the number of questions they ask a child because of the belief that questions elicit or maintain stuttering. This study comp...

Demands and capacities versus demands and performance

Abstract This article examines the proposed relabeling of “capacities” as “performance” in the Demands and Capacities Model of stuttering in terms of four issues involving the models demands component, theoretical versatility, genetic potential, and current clinical uses. Although the proposed changes should resolve the measurement issues of concern, it is suggested that this change may not be of sufficient value or significance for a Demands and Performance Model to supplant the Demands and Capacities Model.

Cluttering : Data in search of understanding

Much of what is known about cluttering is the product of anecdotal clinical observations rather than findings from systematic empirical research. As a result, the credibility of much of this information is substantially compromised as is its diagnostic value. Current research efforts, unfortunately, continue to reflect many of these same weaknesses.

To treat or to prevent: Are those the issues?

Abstract In the second of two articles on identifying and preventing stuttering, Hamre has argued that stuttering does not evolve from the normal disfluencies of childhood, usually does not persist or worsen after it begins, and cannot, therefore, be prevented. For those children whose stuttering does persist, he recommends early treatment. This paper focuses on the need for more empirical information rather than persuasive arguments to support such critical clinical decisions for children at risk for stuttering.

Comments on “Stuttering prevention I”

Abstract Hamre has argued that stuttering is qualitatively different from other disfluencies, that it is easy to identify, and that procedures directed at its prevention are misguided. This paper focuses on the lack of empirical evidence either to support or refute these arguments in a conclusive manner. Nevertheless, it is acknowledged that persuasive arguments will continue to have unwarranted influence on this area of clinical practice until there is systematic longitudinal research with large numbers of young children who are at risk for stuttering.