1. fluency introduction

Fluency- definition, factors effecting, development &

dimensions of fluent speech

Presented by:Sweety joy

II nd M Sc

Fluency,DisfluencyDysfluency

Introduction

The term fluency means non-stuttered and forward moving speech in regards to both content and production (Stark weather, 1987).

Fluency is the effortless production of long continuous utterance at a rapid rate. These 3 elements of fluency are related to each other. The pauses and hesitations break up to the smooth continuous flow of speech, and this determines the length and influences the rate of each utterance. These slow down the rate at which words are produced (stark weather 1987).

Factors influences fluency are1. Stress which depend upon language and

environment.2. duration of sound 3. co articulation4. effort

1. Muscular2. Mental effort

5. Anatomical and physiological constraints also.

Disfluency refers to normal, non-stuttered interruptions of speech and Dysfluency refers to stuttered interruptions of speech (Stark weather, 1987; Manning, 2001).

A Dysfluency is anything that disrupts the smooth flow of speech. this would include word finding problems found in aphasia and groping behaviors characteristic of apraxia

Shipley & McAfee 1992

Fluency

The term fluency is derived from the Latin word ‘flure’ – flowing, describes what the listener perceives when listening to some one who is truly adept at producing speech. The speech flows easily and smoothly in terms of both sound and information.

There is no disruption of the stream and the listener can attend to the message the overall effect of the performance- rather than considering how it was produced.

We use the speech mechanism to produce speech and some people produce speech more easily smoothly and rapidly than others.

The ease with which some people speak may result from characteristics present in the mechanism they use (Stark weather 1987).

The speech flows easily and smoothly in terms of both sound and information.

The effect is similar to observing any accomplished athletic performance that requires complicated sequential movements, such as gymnastics, i.e. skating, diving or swimming. The impression when observing such athletes in one of smoothness and ease.

Fluency requires facility at a minimum of two levels of production: language and speech. Filmore (1979) described the three types of language fluency, which are interpreted by Stark Weather (1987) as syntactic, semantic, and pragmatic fluency. Stark Weather adds 4th components which he describes as phonologic fluency.

Speakers who are syntactically fluent are able to construct highly complex sentences. Speakers who are semantically fluent possess and able to access large vocabularies.

Speakers who are pragmatically fluent are adept at verbal response in a variety of speaking situations. Stark weather’s term phonologically fluent describes those speakers who are able to pronounce long and complicated sequences of sounds and syllables including nonsense and foreign words.

Although language fluency is a pre requisite for the production of fluent speech

It is not the case that individuals who stutter are deficient in these aspects of language competence or ability. People who stutter do however, exhibit difficulties in speech fluency.

Stark Weather’s Definitions of Fluency

Fluency: “Facility of speech and language performance. People who are fluent are so skilled in the performance of speech and language behaviours that they don’t need to put much thought or energy into talking.” (C.W. Stark weather, 1987, p.11).

The coordination and timing of speech segments can affect the articulation which in turn affects fluency. Others such as reaction time for speech changes in the feedback during speech can also affects fluency. Certain anatomical constraints on the child’s vocal system may also influence fluency.

Younger children shows

a smaller vocal tract

Less coordination

Less control of the movement of vocal tract

Coordination

Planning

Execution

This all disrupts fluency.

Acoustic basis of fluency includes rhythm some language are syllable timed and some language and some are time where some kind of a rhythm is maintained. Hence this should also be considered while evaluating fluency.

Children’s speech becomes increasingly fluent as they become mature when children are first begin to use speech to convey ideas their speech lacks fluency.

It is produced slowly and many of the features of normal rhythm are missing .

As their fluency increases children also learn to read to deal with lapses of fluency such as discontinuities in a more sophisticated way. Stark weather 1987).

Some children do not develop the capacity for fluent made by their environment are too much for them to handle.

Since their environment demands are greater than their capacity to produce, the child lacks fluency in speech.

Conditions that arise as a result of fluency disruptions include stuttering and cluttering.

FEW STUDIES

Few studies (Branscom et al 1955, Silverman 1972,1973 Helmrich and Bloodstein 1973, Kowal et al 1975, Haynes & hood 1977, Suzan, Zunkerman 1980 and Dejoy & Gregory 1983)have been conducted to explore fluency development in children .

Of these that by Kowal et al 1975 illustrates some aspects of fluency development. They asked 168 children 24 children at each of 7 different age levels to describe a series of cartoons. They considered 5 categories of non fluent

unfilled pausesfilled pausesRepetitionfalse startsParenthetical remarks.

Their study indicated that vocal hesitations, in general do not decreases with age but fluctuate with development increasing between kindergarten and fourth grade, then declining by 6 th grade increasing again through 8 th grade and then declining at senior year to the same level as kindergarten.

In the early ages children exhibit more of unfilled pauses, filled pauses and repeats which predominate which decreases in frequency which increasing age.

However an increase in false starts and parenthetical remarks is noticed in the older age groups.

Aspect of fluency

There are several dimensions of speech fluency .Stark weather (1987) discusses speech fluency in terms of continuity,rate,duration,coarticulation and effort. The coordination of timing of speech segments can effect the articulation which in turn affects fluency.

Continuity refers to speech that flows without hesitation or stoppage.

It relates to the degree to which syllables and words are logically sequenced as well as the presence or absence of pauses.

If the semantic unit follows one another in a continuant flow of information, the speech is interpreted as fluent.

If the units of speech fail to flow in a logical sequence, information does not flow.

Another aspect of continuity has to do with a disruption in the flow of sound in the form of pauses i.e. filled and unfilled pauses (lasting longer than approximately 250 milliseconds (ms). (Goldman – Eisler,1958) .

Clarke (1971).

Conventional pauses

idiosyncratic pauses

Signals linguistically important

Aspects of performance reflecting hesitations of uncertainty over word choice. Single or syntax style.

Rate refers to the speed in which the words are spoken.

Rate of speech also signals the perception of fluency.

Most people talk about as fast as they can, as indicated by Tiffany(1980), who noted that the maximum and ordinary rates tend to be similar.

According to speaking task, there is considerable variability in rate in terms of such factors as

formality of speaking situation,

time pressure,

interference from background noise

or competing message.

These appear to be a reasonably wide rage of acceptable rates in the judgment of fluency.

It is well known that if communication failure is likely, such as when speaking in a noisy environment, speakers are likely to slow down (Long Hurst & Siegel, 1973).

Likewise if a speaker is producing a lengthy utterance, the rate of speech is likely to be more rapid (Malecot, Johnson & Kizzear, 1972).

Rate is typically measured in terms of words

or syllables per minute.

Stark weather notes that as children mature their syllable rate increase while rate variability decreases. For English-speaking adults, the mean overall speaking rate is 170 words per minute (w/m), substantially quicker than the approximately 120 w/m that stutterers produce.

Although the rate of speech production is obviously one aspect of fluency, it does not appear to be a primary dimension.

The flow of speech and information is based not only on rate but on a combination of many factors, particularly the ease of production.

Effort refers to the ease with which an act is performed. Stark weather (1987) distinguishes 2 types of effort:

• Effort associated with linguistic planning (mental)

• Effort associated with muscle movement (physical)

Effort can be neuromuscular in the timing and co-ordination of respiration, phonation, and articulation.

Effort can also be mental in terms of formulating the content of a response and arranging content in an appropriate syntactic sequence.

Ease of speaking refers to the amount of effort being expanded to produce speech. Fluent speakers put very little muscular or physical effort into the act of speaking, while stutterers exert a relatively large amount of muscular effort to produce the same speech.

In addition to the physical effort involved in producing speech, the mental effort is usually much greater in stutterers than non-stutterers.

Duration of speech segments relates closely to the co articulation of the segments. The duration of the consonants and vowels of a language varies considerably with speech rate and phonetic and linguistic context. For example, stressed syllables are longer than unstressed ones (Umeda, 1975).

Sound segments are longer at the initiation and termination of syllables, words and phrases (Fowler, 1978). Much of what occurs in terms of the duration of individual sound segments and words appears to be related to the speaker’s anticipated flow of information during an utterance (Stark weather, 1978).

That is, the speaker may not need to plan all aspects of the upcoming utterances in terms of the necessary respiratory, phonatory and articulatory events. Rather the speaker would only need to have some idea about the amount of information the utterances would contain.

Co articulation: The co articulatory effects are greater when the speech rate is increased (Gay, 1978; gay &Hirose 1973; Gay Ushijima, Hirose & Cooper 1974).

co articulatory effects contribute to the timing and smoothness of speech. In fluent speech articulatory movement between the sounds, syllables, and words are done with ease. The transitions are smooth and there is a continuous flow of overlapping sounds.

Rhythm rather than being a dimension of fluency, it seems to promote or enhance fluency. Specifically, it seems that speech rhythm serves fluency by making it easier for us to talk faster. It does this in several ways. Unstressed syllables are shorter and thus require less time.

In addition rhythm assists in rapid speech production by providing a means for us to anticipate upcoming movements. There is certain rhythm to speech.

Allen, 1968 theorizes that rhythm is imposed on speech for the same reasons that any movement might be organized temporarily, to facilitate execution. Martin, 1972 however says that “rhythmic patterning carries a heavy information load in ordinary connected speech”.

Classification of disfluencies:

Johnson 19611. Interjections of sounds , syllables, words, phrases

extraneous sounds such as uh, er, hmmm, extraneous words such as well which are distinct from sounds and words associated with the fluent text or with phenomena, included in other categories.

2. part word repetition3. word repetitions4. phrase repetition

5. Revision

6. Incomplete phrases

7. Broken words

8. Prolonged sounds.

William, Silverman & Kools (1968)

Revised version of Johnson’s Disfluency classification system they include Part word repetition Whole word repetition Phrase repetition Interjection Revision

Tense pauses: (the occurrence of a tense pauses is indicated by the presence of audible manifestation of heavy breathing or muscle tension)

Disrhythemic phonations: It is with in a word event that may constitute a prolonged sound an accent or timing. it is notably un usual an improper stress, a break, or any other speaking behavior not compatible with fluent speech and not included in another category.

Yairi (1981) Disfluency in 8 categories:

Part word, phrase repetition, interjection, revision, disrhythmic phonation, tense pauses, word repetition (single syllable word, multi syllable word repetition).

Clarke (1971).

Conventional pauses

idiosyncratic pauses

Signals linguistically important

Aspects of performance reflecting hesitations of uncertainty over word choice. Single or syntax style.

Compound disfluencies:Two or more types of disfluencies can occur successively.Clustering: term used by Silverman (1969) to describe the occurrence of more than one Disfluency on the same word or consecutive words or both.

Oscillation: a term used by Mysak 1978 to describe the no of repetition instance of Disfluency.Silverman (1969)refers to the oscillation phenomenon as duration of fluency.

Characteristics of stutteringStuttering disrupts the fluency of speech. Hence, “stutters” are often referred to as “dysfluencies” or “nonfluencies”. They may be in the form of prolongations, blocks or repetitions. One or any combination of these features may be present, consistently or variably.

Disfluency in speech, including repetitions and prolongations, is normal for all speakers, but stuttering is distinct from normal Disfluency in that it occurs with greater frequency and severity – the disfluencies occur much more often and tend to last longer with more strain.

The types of disfluencies are also markedly different: normal disfluencies tend to be a repetition of whole words or the interjection of syllables like “um” and “er,” .

while stuttering tends to be repetition and prolongation of sounds and syllables. The various behaviors that can disrupt the smooth flow of speech include repetition, prolongations, and pauses.

Repetition occurs when a unit of speech, such as a phrase, word, or syllable, is superfluously repeated. Examples: Phrasal repetition would be, “I want... I want. to go... I want to go to the store, “or, “I want to go to the – I want to go to the store”.

A word repetition would often resemble, “I want to-to-to go to the store,” and a syllable or sound repetition being, “I wa-wa want to go to the store” or, “I w-w- want to g-go to the store”.

Repetition occurs in the speech of both stutterers and non-stutterers, but non-stutterers are less likely to repeat shorter units of speech, mainly repeating phrase and sometimes words but rarely syllables.

Non-stutterers will also, in the majority of cases, repeat the unit once or twice as opposed to the 6 or so times common from stutterers.

Prolongations are one of the least typical behaviors exhibited by stutterers. Prolongations normally happen with child stutterers and with the sounds //, //, /v/, and any other fricative consonant or vowel.

With stutterers, prolonging a sound sometimes leads to a pitch and volume increase.

Pauses: are a common source of Disfluency in both stutterers and non-stutterers. Most pauses can be dividing into two categories:

filled pauses unfilled pauses

Pauses

Unfilled pauses are extraneous portions of silence in the ongoing stream of speech. These pauses differ from the pauses that punctuate normal speech, where they reflect common sentence structure or are used to add a particular rhythm or cadence to speech.

Unfilled pauses by stutterers are usually unintentional and may cause the larynx to close, restricting the flow of air necessary for speech. Stutterers refer to this as “blocking”.

Filled pauses are interjections typical in normal speech like “um”, “uh”, “er”, and so on. In speech these serve as a kind of place-holder – a way a speaker lets listeners know that he or she still has the floor and is not finished speaking.

In addition to being used as a way of preempting interruption, they are also used by stutterers as a way of easing into fluency or deflecting embarrassment when they cannot speak fluently.

Development of fluency:

The findings related to fluency development make it clear that children’s speech becomes increasingly fluent as they mature. When children first begin to produce speech to convey ideas, it is produced slowly, and many of the features of the rhythm are missing.

As their fluency increases, children also learn to deal with lapses of fluency in more sophisticated ways.

Why do we know about the dimensions of fluent speech?

In order to appreciate the nature of non fluent speech production, it is necessary to understand the dimensions of fluent speech. Even the best of speakers speaking under ideal conditions are apt to produce breaks in the flow of words.

Language and speech production is a complex task. It takes many years of experience to do it well, especially under conditions of stress.

Demands and Capacities Model of Fluency

Development:Growth in the capacity for fluency speech comes from several areas. There is increasing control over the movements of the vocal tract.

Another capacity for fluency comes from rhythm. The sense of rhythm makes it easier for a child to anticipate movements of speech production, and as a result it will give him a motoric confidence for fluency.

The increased demand for fluency also comes from the child’s development of language skills. Increased syntactic, semantic, phonologic and pragmatic knowledge all contribute to this demand for fluency.

The people with whom children communicate – also place demands on them. According to Stark weather, the increasing fluency is accompanied by an increasing demand for fluency from the environment, or even from within the child.

Development – Speech Continuity

Findings From 29 mths – 33 mths – 37 mths, discontinuities decline from 6.5% to 5.10% to 4.10% (Yairi, 1981)

Discontinuities decline from 14.6% to 9.1% from ages 2-4 but then remain the same from 4-6 yrs (Wexler & Mysak, 1982)

From 3 ½ - 5 yrs, discontinuities decline from 11.9 – 9.5% (Dejoy & Gregory, 1975). Kindergarten and first grade children’s speech is approximately 2% and more discontinuities than that of high school children (Kowal, O’Connell & Sabin, 1975)

Two types dominate the discontinuities of 2 yr olds • Repetitions of small units (parts of words…)

• Interjections and revisions (Yairi, 1981)

Development of rate

The rate at which speech is produced is an important aspect of fluency and it shows clear development trends. These trends are evident in several different measures – pause duration, length of utterance, syllables / sec and segment.

Pause duration:

Several of Kowal, O'Connell & Sabin's observations suggest that the duration of unfilled pauses is an excellent measure of fluency development. It directly influences the rate of speech It shows strong development trends that parallel another fluency measure of known clinical importance – part word repetitions

It shows a clinically important difference between the sexes – unfilled pause duration presents one difficulty as a measure of speech fluency – it is not independent of language fluency.

Children with abnormally long unfilled pauses may be using the extra time to plan language, not speech.

Speech has many levels of organization – words are nested within utterances, syllables within words, sounds within syllables, and individual gestures within sounds. The rate of speech is seen a little different at each of these levels of organization.

The most complex level is the utterance, and the length of an utterance is related to the rate at which it is produced. This relation seems to be determined by the amount of speech produced. This relation seems to be determined by the amount of information the utterance contains.

Although a longer utterance typically contains more information than a short one, the amount of information in each word of a longer utterance is less than that in a shorter utterance because of the additional redundancy of the context. One can supply the missing item more readily in a longer utterance because of the additional context.

Context is redundancy, so there is less information in each word of a longer utterance than there is in a shorter one.

It may be for this reason that the rate of speech in syllables / sec is faster in longer than in shorter utterance (Malecot, Johnston et al 1972)

The rate can be assessed in word and syllable levels also. Simth, 1978 compared the duration of 9 words in the speech in 2 and 4 yr children with that of adults. The duration of words was a direct function of the subject’s age.

It is evident that, the speech of children gets faster and faster with age.

The next level is syllable. Utterance duration and word duration seem to depend heavily on the amount of information contained in the utterances, but syllable/sec seems independent of content, as long as the sample is large enough to contain a large variety of syllables.

For this reason, the number of syllables/sec is the most common measure of speech production rate. The rate of speech in adults is 5-6 syllables/sec.

Development of speech rhythm:Findings: Young children (18-36 months) are unable to imitate sentences lacking normal rhythm (Eilers, 1975)2 year olds tends to use far fewer reduced syllables than do adults, so that their speech rhythm has fewer syllables per foot, or more beats per utterance, in short, it sounds more syllable timed (Allen and Hawkins, 1980).

Syllables are totally reduced (deleted) by 2-3 yr olds in two phonetic environments,

• world initial • next to another light (unstressed) syllable

(Hawkin, 1979)The rhythm of speech is an important perceptual cue to our recognition of speech has meaningful stimuli.

The very 1st words, children produce, do not show has much stress contrast as in adult speech (Ingram, 1974, Allen and Hawkins, 1980). The adult rhythm of language is not as easily discerned in the speech of children in the one and two word stages of development.

Two syllable word containing one heavy (stressed) and one light (unstressed) syllable are typically produced as if they were spondees, with both syllables being given full vowel, color and duration. The only indication of stress is in the raised. Fo of the stressed syllable.

Furthermore, many of the sounds in the unstressed syllable may be lost, and instead the child produces a nearby, usually adjacent, stress syllable. Typically, a child’s reduplication consists of one heavy accented syllable followed by a heavy unaccented syllable (Hawkins, 1979). E.g. “ray-ray” for “raisin” or “bebe” for “betty”

Development of ease in speech:

We have no direct measures of the effort children expend in the production in the speech, either muscular effort or mental effort, and thus no findings on this topic.

Anyway, some thought is required before an utterance to plan its execution, but once this planning is accomplished the utterance is executed automatically.

When this conclusion is put together with the data reported earlier on the length of unfilled pauses in children’s speech which tend to shorten as the child grows, it appears that young children spend more time planning an utterance, and that the planning time decreases as the child develops.

Since the rate of speech increases as the children grow, once can conclude that acquire the ability to talk with less muscular effort.

CONTINUM OF DISFLUENT SPEECH BEHAVIOURS. From R.Curlee, Stuttering and related disorders of fluency. (1999) .More usual: typical dis fluencies in pre school children. More unusual: A typical disfluencies that are very in frequent in the speech of children

INDIAN STUDIES: SOME ASPECTS OF FLUENCY IN CHILDREN 4-5 YEARS 1990INDU .V.197Subjects: 12 Kannada speaking children, from middle socio economic status.Task: conversation, rhymes, picture description & story telling.Descriptive analyses were done.Kinds of disfluencies includes: filled pauses, unfilled pause, parenthetical remarks, false starts, prolongation, and audiable inspiration.

Results show that children in the age group 4-5 year had more filled pauses followed by repetition and parenthetical remarks.More Disfluency occurred before the content words especially (nouns) than before functional words. More Disfluency occurred on the initial part of the utterance than in the medial and final part. On the basis of result a test has been proposed using picture description task and a cut off scores and ranges for different disfluencies at each group been given.

Study 2

Differential diagnosis of stuttering and normal non fluency.

Soumya srinivasan

May 1992

Subjects : 25 children

Age: 3-7 years

Belonging to middle socio economic status

Task :

picture description task

Connected pictures

Cartoons

Panchatantra story

Age range was divided in to

3-4

4-5

5-6

6-7 year old children

Responses were recorded. Speech samples were transcribed verbation and analyzed for

the following disfluencies.

Unfilled pausesFilled pausesRepetitionProlongationAudiable inspirationParenthetical remarks

False startsPart question repetition Broken wordhesitations

Data compared with the normative data given by Nagapoornima , Indu, Yamini, (1990) Rajendraswamy (1991) for the diagnosis of stuttering or normal non fluency.Also a comparison of the diagnosis of the child on the basis of the fluency test was made with that of a speech pathologist.

Pearson correlation test was performed.Results indicated that repeats unfilled pauses and filled pauses to a greater extent and prolongation and audiable inspiration to a lesser extent seem to guide in the diagnosis of the child as a stutterer.Unfilled & filled pauses in the younger rage group.Repeats and filled pauses in the older age group.

It was observed that strict and uniform measure was to be followed by the speech pathologist to diagnose a case as stutterer or normally non fluent.Based on this results the test was found to be valid and clinically useful in differentiating young stutterers from their normal nonfluent peers

Fluency test provides a set criteria which could be used as a diagnostic tool.How ever the fluency test needs modification in the terms of reduced length of testing ,decrease in the no of picture description task deletion of parenthetical remarks ,false starts from list of disfluencies.Validated modified form of the fluency test may be used by SLP tp ve uniformity in their diagnosis.

Fluency test .Study given by nagapoornima1990,indu 1990,yamini 1990,rajendraswamy 1991Were conducted to analyze the percentage of disfluencies of normal kannada speaking children in the age range of 3-7 years.Based on this test was proposed .Validity of this test was not established.

Disfluency types in %

3-4y 4-5y 5-6y 6-7y

FilledUnfiledRepetitionParenthetical remarksFalse startsSound prolongationPart question repetitionAudiable inspirationBroken wordsHesitationtotal

9.68-64.02.50.16-----24.86

121.520.695.270.390.13-0.18--20.18

7.669.23.217.496.511.110.045.38--35.60

7.41.536.376.542.881.84-2.790.190.1329.67

Epidemiology of Stuttering in the Community Across the Entire Life

SpanAshley Craig ,Karen Hancock ,Yvonne Tran& Magali Craig . Journal of Speech, Language, and Hearing Research Vol.45 1097-1105 December 2002.

A randomized and stratified investigation was conducted into the epidemiology of stuttering in the community across the entire life span. Persons from households in the state of New South Wales, Australia, were asked to participate in a telephone interview. Consenting persons were given a brief introduction to the research, and details were requested concerning the number and age of the persons living in the household at the time of the interview.

Interviewees were then given a description of stuttering. Based on this description, they were asked if any person living in their household stuttered (prevalence). If they answered "yes," a number of corroborative questions were asked, and permission was requested to tape over the telephone the speech of the person who stutters.

Confirmation of stuttering was based on (a) a positive detection of stuttering from the tape and (b) an affirmative answer to at least one of the corroborative questions supporting the diagnosis.

Results showed that the prevalence of stuttering over the whole population was 0.72%, with higher prevalence rates in younger children (1.4–1.44) and lowest rates in adolescence (0.53). Male-to-female ratios ranged from 2.3:1 in younger children to 4:1 in adolescence, with a ratio of 2.3:1 across all ages.

The household member being interviewed was also asked whether anyone in the household had ever stuttered. If the answer was “yes," the same corroborative questions were asked.

These data, along with the prevalence data, provided an estimate of the incidence or risk of stuttering, which was found to range from 2.1% in adults (21–50 years) to 2.8% in younger children (2–5 years) and 3.4% in older children (6–10 years). Implications of these results are discussed.

Clinical implications of situational variability in preschool children who

stutter

J. Scott Yaruss.

Journal of Fluency DisordersVolume 22, Issue 3, 1997, Pages 187-203

Abstract

Variability is one of the hallmarks of stuttering. Nevertheless, differences in children's frequency of stuttering in different speaking situations have not been thoroughly investigated.

This study examined variability in the frequency of disfluencies produced by 45 preschool children who stutter (mean age = 42.3 months) in five different speaking situations (parent-child interaction, play with clinician, play with pressures imposed, story retell, and picture description).

Significant differences were found in the frequency of disfluencies between these situations, and the variability between situations was significantly greater than the variability seen within a single speaking situation.

In general, the “play with pressure” situation elicited the highest frequency of disfluencies from many subjects, though subjects exhibited highly individualized patterns of variability.

Finally, children with a higher average frequency of “less typical” disfluency types exhibited a significantly higher degree of variability. Results highlight the importance of evaluating more than one speaking situation when diagnosing a child who stutters both to obtain a better understanding of the nature of the child's stuttering disorder and to ensure that the true extent of the child's stuttering is not overlooked.

Syntactic Complexity, Fluency, and Accuracy of Sentence Imitation in

Adolescents

Stacy W. Silverman Nan Bernstein Ratner. Journal of Speech, Language, and Hearing Research Vol.40 95-106 February 1997.

The majority of work that suggests a relationship between syntactic complexity and the frequency of stuttering has been carried out with young children.

In this paper, they investigate whether or not syntactic complexity exerts an influence on the frequency of stuttering in adolescent speech.

Fourteen adolescents, 7 of whom stuttered, and 7 of whom were normally fluent, ages 10–18 years, participated in a sentence imitation task in which stimuli were divided into three classes of grammatical complexity.

Results indicated that for both groups of speakers, normal disfluencies and errors in repetition accuracy increased as syntactic complexity increased. However, stuttering frequency did not appear to be affected by changes in the syntactic complexity of the target stimuli.

Such findings suggest either a diminution of the effects of syntactic complexity on stuttering over the course of language acquisition or changes in the mix of chronic and nonchronic stuttering speakers from those used in earlier studies of the effects of linguistic structure on stuttering in children.

Relationship between Language and Fluency in Children with

Developmental Language Disorders

Nancy E. Hall ,Toyoko S. Yamashita ,Dorothy M. Aram Journal of Speech and Hearing Research Vol.36 568-579 June 1993

The present investigation addresses two primary hypotheses: (a) that a subset of children with developmental language disorders exhibits significantly more disfluencies than other children with language disorders and (b) that differences between the disfluent and non disfluent groups observed in fluency may be related to differences in language deficits.

Spontaneous language samples from 60 preschool children with developmental language disorders were analyzed for frequency and type of disfluencies.

Comparisons of the frequency of disfluencies across subjects revealed that a subset of 10 subjects exhibited significantly more disfluencies than the other subjects with language disorders. Demographic, intelligence, and language variables were compared across the two groups to determine whether such factors could account for the differences in fluency.

The subjects with greater percentages of disfluencies were found to be significantly older and demonstrated significantly higher scores on two standard measures of vocabulary.

These findings were interpreted in light of two models of disfluencies: the neuro psycholinguistic (Perkins, Kent, & Curlee, 1991) and Demands and Capacities (Adams, 1990; Starkweather, 1987).

This suggests that some children with language disorders are at risk for fluency breakdown because of dysynchronies in the development of lexical and syntactic aspects of language or as a result of mismatches between speaking demands and capacities

Articulation, Language, Rate, and Fluency Characteristics of Stuttering and

Non stuttering Preschool Children

Bruce P. Ryan 1 Journal of Speech and Hearing Research Vol.35 333-342 April 1992.

Articulation (Arizona Articulation Proficiency Scale), language (TOLD, Peabody Picture Vocabulary Test), and fluency (Fluency Interview) tests were given to 20 stuttering and 20 nonstuttering male and female preschool children to examine potential performance differences between the two groups. Speaking rate was also measured.

There were several significant but minor differences between the two groups. The stuttering children scored lower on seven out of eight language measures than the non stuttering children and slightly lower than the average score for their age group when compared with the tests' normative samples. Girls demonstrated higher language scores and faster speaking rates.

There were no differences between the stuttering and non stuttering groups on articulation proficiency, although 25% of the stuttering group (all boys) later required articulation treatment.

There were few statistically significant correlations between measures of stuttering rate, speaking rate, and language performances within each of the two groups of children, although there were consistent, low-to-moderate negative correlations between stuttering rate and language measures and low positive correlations between speaking rate and language measures.

A stepwise regression analysis suggested that selected variables of language proficiency combined with speaking rate were at best moderately predictive (R=.52) of stuttering behaviour for the total group of children.

Reference : 1. Hugo H.Gregory., Stuttering therapy rationale and

procedure 2003.2. Walter .H. Manning., Clinical decision making in

fluency disorders .second edition.3. Stark weather W. Fluency and stuttering.19874. Dissertation – Indu .V. 1990 (197)5. Journal of Fluency disorders.6. Journal of speech and hearing disorders.