Indicators of speech fluency in stuttering and in phonological disorder
Indicadores de fluência da fala na gagueira e no transtorno fonológico
Priscila Biaggi Alves de Alencar, Talissa Almeida Palharini, Lídia Maurício da Silva, Cristiane Moço Canhetti de Oliveira, Larissa Cristina Berti.
Abstract
Purpose: To identify the indicators of speech fluency that differs subjects with stuttering, with phonological disorder, and with the two disorders in comorbidity.
Methods: Thirty subjects aged 4-11 years old were divided into 3 groups, each one with 10 subjects: groups with developmental stuttering (SG), phonological disorder (PDG), and with two diagnoses in comorbidity (SPDG) participated in this study. The procedures were speech fluency and phonology evaluation. The data were submitted to statistical analysis.
Results: Subjects from SG and SPDG showed a greater occurrence of stuttering-like disfluencies and total of disfluencies in relation to the subjects with PDG. Regarding to the other disfluencies, the three groups were similar. Subjects with PDG showed fewer monosyllabic word repetitions, part of word repetition and prolongations in relation to subjects from SG and SPDG. Blocks occurred more frequently in the two groups with stuttering (SG and SPDG) than in the group with PDG. Interjection occurred more frequently in subjects from SG than in PDG.
Conclusion: The PDG was the most differentiated in quantitative and qualitative terms in the three groups analyzed. The similarities and differences between the groups will assist the differential diagnosis and, consequently, will enable improved therapy. The presence of blocks represents an important marker for the diagnosis of stuttering.
Keywords
Resumo
Objetivo: Identificar os indicadores de fluência da fala que diferenciam os sujeitos com gagueira, com transtorno fonológico e com os dois distúrbios em comorbidade.
Método: Participaram deste estudo 30 sujeitos de 4 a 11 anos, separados em 3 grupos, cada um com 10 sujeitos: grupo com gagueira do desenvolvimento (GG), transtorno fonológico (GTF) e os dois diagnósticos em comorbidade (GGTF). Os procedimentos foram: avaliação da fluência da fala e da fonologia. Os dados foram submetidos à análise estatística.
Resultados: Os sujeitos do GG e GGTF apresentaram maior ocorrência das disfluências típicas da gagueira e do total das disfluências em relação aos do GTF. Em relação às outras disfluências, os três grupos foram semelhantes. O GTF manifestou menor quantidade de repetições de palavra monossilábica, de parte de palavra e prolongamentos em relação aos sujeitos dos GG e GGTF. Os bloqueios ocorreram mais frequentemente nos dois grupos com gagueira (GG e GGTF) em relação ao GTF. A interjeição ocorreu com maior frequência no GG quando comparado com o GTF.
Conclusão: Dos três grupos analisados, o GTF foi o que mais se diferenciou em termos quantitativo e qualitativo. As semelhanças e diferenças entre os grupos auxiliarão o diagnóstico diferencial e, consequentemente, possibilitarão melhor terapia. A presença de bloqueio representa um importante marcador para o diagnóstico de gagueira.
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References
1. Chang S, Garnetti EO, Etchell A, Chow HO. Functional and neuroanatomical bases of developmental stuttering: current insights. Neuroscientist. 2019;25(6):566-82. PMid:30264661.
2. Smith A, Weber C. How stuttering develops: the multifactorial dynamic pathways theory. J Speech Lang Hear Res. 2017;60(9):2483-505. http:// dx.doi.org/10.1044/2017_JSLHR-S-16-0343. PMid:28837728.
3. Sasisekaran J. Exploring the link between stuttering and phonology: a review and implications for treatment. Semin Speech Lang. 2014;35(2):95-113. http://dx.doi.org/10.1055/s-0034-1371754. PMid:24782273.
4. Postma A, Kolk H. The covert repair hypothesis: prearticulatory repair processes in normal and stuttered disfluencies. J Speech Hear Res. 1993;36(3):472-87. http://dx.doi.org/10.1044/jshr.3603.472. PMid:8331905.
5. Tsai PT. Phonological neighborhood effect in spontaneous speech in adults who stutter. J Fluency Disord. 2018;58:86-93. http://dx.doi.org/10.1016/j. jfludis.2018.08.005. PMid:30180994.
6. Blood GW, Ridenour VJ Jr, Qualls CD, Hammer CS. Co-occurring disorders in children who stutter. J Commun Disord. 2003;36(6):427-48. http://dx.doi.org/10.1016/S0021-9924(03)00023-6. PMid:12967738.
7. Louko LJ, Edwards ML, Conture EG. Phonological characteristics of young stutterers and their normally fluent peers: preliminary observations. J Fluency Disord. 1990;15(4):191-210. http://dx.doi.org/10.1016/0094- 730X(90)90001-9.
8. Berti LC, Marino VCC. Marcas linguísticas constitutivas do processo de aquisição do contraste fônico. Rev GEL. 2008;5(2):103-21.
9. Gregg BA, Yairi E. Disfluency patterns and phonological skills near stuttering onset. J Commun Disord. 2012;45(6):426-38. http://dx.doi. org/10.1016/j.jcomdis.2012.08.001. PMid:22939524.
10. Tumanova V, Conture EG, Lambert EW, Walden TA. Speech disfluencies of preschool-age children who do and do not stutter. J Commun Disord. 2014;49:25-41. http://dx.doi.org/10.1016/j.jcomdis.2014.01.003. PMid:24503151.
11. Costa JB, Ritto AP, Juste FS, Andrade CRF. Comparison between the speech performance of fluent speakers and individuals who stutter. CoDAS. 2017;29(2):e20160136. PMid:28327784.
12. Alm PA. Stuttering and the basal ganglia circuits: a critical review of possible relations. J Commun Disord. 2004;37(4):325-69. http://dx.doi. org/10.1016/j.jcomdis.2004.03.001. PMid:15159193.
13. Ambrose N, Yairi E. Normative disfluency data for early childhood stuttering. J Speech Lang Hear Res. 1999;42(4):895-909. http://dx.doi. org/10.1044/jslhr.4204.895. PMid:10450909.
14. Berti LC, Pagliuso A, Lacava F. Speech evaluation instrument for acoustical analysis based on linguistic criteria. Rev Soc Bras Fonoaudiol. 2009;14(3):305-14. http://dx.doi.org/10.1590/S1516-80342009000300005.
15. Martins VO, Andrade CRF. Speech fluency developmental profile in brazilian Portuguese speakers. Pró-Fono R Atual Cient. 2008;20(1):7-12. http://dx.doi.org/10.1590/S0104-56872008000100002.
16. Hudock D, Kalinowski J. Stuttering inhibition via altered auditory feedback during scripted telephone conversations. Int J Lang Commun Disord. 2014;49(1):139-47. http://dx.doi.org/10.1111/1460-6984.12053. PMid:24372890.
17. Kronfeld-Duenias V, Ezrati-Vinacour R, Civier O, Ben-Shachar M. The frontal aslant tract underlies speech fluency in persistent developmental stuttering. Brain Struct Funct. 2014;14:912-8.
18. Vanhoutte S, Santens P, Cosyns M, van Mierlo P, Batens K, Corthals P, et al. Increased motor preparation activity during fluent single word production in DS: a correlate for stuttering frequency and severity. J Fluency Disord. 2015;75:1-10. PMid:26004061.
19. Tumanova V, Zebrowski PM, Goodman SS, Arenas RM. Motor practice effects and sensorimotor integration in adults who stutter: evidence from visuomotor tracking performance. J Fluency Disord. 2015;45:52-72. http:// dx.doi.org/10.1016/j.jfludis.2015.04.001. PMid:25990027.
20. Ambrose NG, Yairi E, Loucks TM, Seery CH, Throneburg R. Relation of motor, linguistic and temperamento factors in epidemiologic subtypes of persistente and recovered stuttering: initial findings. J Fluency Disord. 2015;45:12-26. http://dx.doi.org/10.1016/j.jfludis.2015.05.004. PMid:26117417.
21. Esmaili I, Dabanloo NJ, Vali M. Automatic classification of speech dysfluencies in continuous speech based on similarity measures and morphological image processing tools. Biomed Signal Process Control. 2016;23:104-14. http://dx.doi.org/10.1016/j.bspc.2015.08.006.
22. Crinion JT. Facilitating fluency in adults who stutter. Brain. 2018;141(4):944- 6. http://dx.doi.org/10.1093/brain/awy075. PMid:29596670.
23. Wertzner HF, Amaro L, Galea DE. Phonological performance measured by speech severity indices compared with correlated factors. Sao Paulo Med J. 2007;125(6):309-14. http://dx.doi.org/10.1590/S1516-31802007000600002. PMid:18317599.
24. Costa VP, Albiero JK, Mota HB. Aspects of speech fluency in children with and without evolutive phonological disorder. Rev CEFAC. 2015;17(Supl 1):9-16. http://dx.doi.org/10.1590/s1516-18462011005000063.
25. Seno MP, Giacheti CM, Moretti-Ferreira D. Narrative language and fluency in Down syndrome: a review. Rev CEFAC. 2014;16(4):1311-7. http://dx.doi.org/10.1590/1982-0216201424512.
26. Garnett EO, Chow HM, Nieto-Castañón A, Tourville JA, Guenther FH, Chang SE. Anomalous morphology in left hemisphere motor and premotor cortex of children who stutter. Brain. 2018;141(9):2670-84. http://dx.doi. org/10.1093/brain/awy199. PMid:30084910.
27. Connally EL, Ward D, Pliatsikas C, Finnegan S, Jenkinson M, Boyles R, et al. Separation of trait and state in stuttering. Hum Brain Mapp. 2018;39(8):3109. http://dx.doi.org/10.1002/hbm.24063. PMid:29624772.
28. Erdemir A, Walden TA, Jefferson CM, Choi D, Jones RM. The effect of emotion on articulation rate in persistence and recovery of childhood stuttering. J Fluency Disord. 2018;56:1-17. http://dx.doi.org/10.1016/j. jfludis.2017.11.003. PMid:29443691.
29. Wolk L, Edwards ML, Conture EG. Coexistence of stuttering and disordered phonology in young children. J Speech Hear Res. 1993;36(5):906-17. http:// dx.doi.org/10.1044/jshr.3605.906. PMid:8246479.
30. Caruso AJ, Abbs JH, Gracco VL. Kinematic analysis of multiple movement coordination during speech in stutterers. Brain. 1988;111(2):439-56. http:// dx.doi.org/10.1093/brain/111.2.439. PMid:3378144.
Submitted date:
01/09/2020
Accepted date:
06/12/2019
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