University of Ulm, Section of Phorziatrics, Schillerstr. 15, 89077 Ulm, Germany
The influence of selected psycholinguistic variables on the further course of childhood stuttering is presented and discussed by examining the study population from t0 (first contact, N=71) to t9 (4;6 years later). The stuttering children and their mothers were videotaped in 6 month-intervals in a play situation. The transcribed utterances of the children were analyzed with a sophisticated computer-based language profiling system. The results confirm the research data obtained up to date, stating that stuttering occurs more frequently with grammatically more complex and longer sentences. Results suggest that some syntactic variables are important with respect to the course of stuttering.
- Design and sample description
- A distinct reduction of stuttering towards and below the limit of 3 % of words stuttered
- The quality of disfluencies changed distinctly towards less stressed disfluencies, such as relaxed word-repetitions - No signs for associated behavior and/or avoidance behavior.
- Agreement with the parents.
Figure 1. Study design 408 Theory, research and therapy in fluency disorders
As can be seen in Table 1, the children were brought to our outpatient department at a mean age of 5 years because of stuttering. The children began to stutter at a mean age of 3 years and 1 month; the time span between the onset of stuttering and the point where professional help was sought was one year and 11 months. The sample group consisted of 53 boys and 18 girls. The children stuttered an average of 6.2% of the words at to. The differences in stuttering, age at onset ofstuttering, duration of stuttering, hereditary influence, language and cognitive abilities with respect to the childrenâ_˜s gender are not significant. For the assessment of cognitive abilities the German version of the Kaufmann Assessment Battery for Children (K-ABC, Kaufman & Kaufman, 1983) was applied. To test the language development the Heidelberger Sprachentwicklungstest (H-Sâ_ E-T, Grimm & Scholer, 1991) and the Aktiver Wortschatztest (AWST, Kiese & Kozielski, 1979) were employed. The H-S-E-T is a battery of 13 subtests, each of which is appropriate for a different linguistic area, assessing both receptive and expressive syntactic, semantic and pragmatic abilities. The AWST is a vocabulary test which requires the naming of non-colored drawings from every day objects and activities. Results showed no remarkable deficiencies in cognitive or linguistic performances of the whole group at entry in the longitudinal project. The mean results in K-ABC, H-S- E-T and AWST confirmed an appropriate state of the measured abilities. This is also true for the subtests in the K-ABC and in the H-S-E-T.
Table 1. Description of the sample at first Contact (t0)
- Methodology and results of the loci part of the study
Table 2. Description of the assessed syntactic variables and their allocation to linguistic development phases according to Clahsen et al. (o.c.)
In Table 3 it can be seen how many utterances were analyzed altogether at to, how many of them were not assessable and which types of utterances, sorted and summarized according to development stages, occurred at a certain frequency. In this table information on the most frequent and also most relevant categories in one developmental stage was added. All in all it becomes clear that the children can be allocated to two separate developmental stages (4 vs 5) with respect to fluent or disfluent speech according to MLU and that this is mostly so because children still often use stage I utterances especially in fluent speech (see table 2). Furthermore it becomes evident that stuttered utterances can be significantly more often analyzed, are not elliptic and longer (p <.00l). Results Show that all important linguistic structures are available to the children, they, however, do not employ them spontaneously to the expected extent. In this connection the many omissions are noteworthy that are rather typical for stage III.
Table 3. Absolute frequency of analyzed, not analyzed and elliptic utterances with distribution of analyzed utterances over the five stages of linguistic development
In order to be able to evaluate statistically to what extent certain linguistic structures coincide with stuttering, the absolute values (absolute frequency of occurrence of the variables presented in Table 2) were transformed into relative percentage values. The corresponding number of fluent or stutte-red utterances that had been analyzed were used as factor to calculate the relative percentage values. It is to be borne in mind that the sum of the relativized variables is > 100, since more syntactic criteria may apply per utterance. In order to display the results, the generic categories stages I - V can be used, as it became very quickly evident that the individual syntactic categories (see Table 2), if they occurred at a sufficient frequency (see Table 3), gave an identical picture. This means, the results presented for the individual linguistic developmental stages are generally also truefor the corresponding differentiated linguistic categories. The dominance of individual subcategories in the corresponding developmental stages also speaks well for the usage of the stages as generic categories.
Figure 2. Influence of syntactic variables, summarized according to linguistic developmental level, on stuttering at 10
It becomes evident, and this is in complete accordance with result obtained to date (Bernstein Ratner1997, Rommel, 1995, 1998, 2000, 2001), that linguistically more complex sentences more frequently trigger stuttering than syntactically simpler sentences. More precisely, it can be stated that syntactic structures from stage III on significantly increased the probability of the occurrence of stuttering. It can be ruled out that individual syntactic structures within one generic stage is particularly relevant with respect to triggering stuttering.
- Results of the prognostic part of the study
Figure 3. Influence of syntactic variables of stuttered parts of speech at to, summarized according to linguistic developmental levels, on the course of stuttering
- Summary and discussion
- First, already at an early developmental stage (duration of stuttering < 2 years) some stuttering children begin to employ linguistic avoidance strategies (unconscious, in the sense of verbal conditioning) and/or avoid to broaden their linguistic repertoire.
- Second, in the sense of Berstein Ratner (1997, pp. 103, 119), the results point to a sublime linguistic deficit of the stuttering children with respect to the generation of complex linguistic utterances; such deficit cannot be assessed with language tests available to date.
- Third, in this connection, in particular when you are used to thinking in a multidimensional and case-oriented way (e. g. Rommel & Burgmaier, 1993) also more complex interactions and combinations of problems are possible, where apart from linguistic variables also physiological (e. g. speech motor abilities) and psycho-social variables (e. g. verbal and non-verba1parent-child interaction Variables, see for example Rommel, 2000, 2001) are to be taken into consideration.
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