Language Profiles of Thirty-Nine Children Who Stutter Grouped by Performance of a Motor Problems Inventory

Citation preview

l

33 048 9

FROM THE COLLECTION OF THE

PATRONS OF THE LIBRARY

~? I

I

I

I

I

DONOR

LANGUAGE PROFILES OF THIRTY-NINE CHILDREN WHO STUTTER GROUPED BY PERFORMANCE OF A MOTOR PROBLEMS INVENTORY

A Thesis Presented to the Faculty of California State College , Fullerton

In Partial Fulfillment of the Requirements for the Degree Master of Arts in Speech

by

Jeanna Riley June 1971

~al·Slclte L. •

1

©

1971

RAE JEANNA RI LEY

ALL RIGHTS RESERVED

LANGUAGE PROFILES OF TII IRTY-NINE CHILDREN WHO STUTTER GROUPED BY PERFORMANCE OF A MOTOR PROBLEMS INVENTORY

A Th es is Presented to the Faculty of Cali f ornia State College , Fulle r t on

By

Jeanna Riley June 1971

Approved by:

lj~ ~a~e 1 ? (_/ /

lN\°i ii

18 tW1 I I

Date

ABSTRACT The pur pose of this study was to compare the lang uage par ameters of chi.ldren who stutter and who have low motor coordination abi·1i·ti·e s to stuttering chi·1 dren with normal motor coordination abilities. Thirty- nine chi ldren who stuttered were administered the Stuttering Severity test , the Il l inois Test of Psycholinguistic Abilities , and the Mo tor Problems Inventory. The stutte rers were then divided into three groups a cco r d ing to their ability to perform on the motor test.

The

fifteen stutterers who d emonstrated little or no motor p r oblems formed the Control Group ; the t en stutterers who showed moderate motor p roblems were the Experimental Group one arid the fourteen stutterers who exhibited the most motor problems on the motor test were placed in Experimental Group Two .

Results for each ITPA s ub-test and for the total

language ability were analyzed fo r significant differences using the Mann-Whitney U procedure. Al l groups scored low on v erbal expr ession . Chi l dren with moderate coordination problems scored low o n visual reception , auditory association, grammar and total lang u age .

Child r en with extreme coordination problems scored

l ow on a uditor y association, grammar, auditory and visual e r y low o n total language . memor y and V iii

TABLE OF CONTENTS Chapter I.

REVIEW OF LITERATURE AND HYPOTHESIS . .

. . . .

Background . . . . Motor Factors Amo~g . Stutt~r~r~ : : : : : : Language Factors Among Stutterers . . . . Purpose . . . . . . . . . . . . . . . . . Definitions . . . . . . . . . . . Hypotheses . . . . . . . . . . . . . . Summary. . . . . . . . . II.

III .

. . . . . . . . .

METHODOLOGY .

.

.

1

. . . . . . . . . .

1 4 8 10 11 14 18

• 20

20 Case Selection . . . • • • • • • • • • • • • . . . . . . . . . . 21 Examiners . . . . . . . . . . . . . . . 21 Group Selection . . . . . . . . . . . . 22 Instrumentation 26 . . PRESENTATION OF DATA . . .

.

Results. . . · · · · · · · · . . . . 26 Acceptance and Rejection of Hypotheses . . . . . 31

IV .

CONCLUSIONS AND IMPLICATIONS . . . specific Conclusion~ . conclusions Concerning Research Methods · · · Implications ·

BIBLIOGRAPHY. APPENDIX.

·

·

·

·

·

·

.

35

· · · · · . . . . . . 35 Stuttering · · · · · . . . . . . 37 · · · · · · · · · · . 38

. . . . . . . . . . . . . · . . . . . . . . . . . . . . ..

iv

42

• • 50

LIST OP TABLES P a ge

Table

1.

Comparison of Groups C, E

2.

Normative Data of the Stuttering Sev e rity Scale . . . . . . . . . . . .

3.

Comparison of ITPA Profile Means of Group s C, E 1 and E 2 . . . . . . · · · · · · · · ·

4.

Significant Differences Among Groups (Based on the Mann-Whitney U Test) . . . . ·

5.

Comparison of Groups C , E 1 and E 2 by Stuttering Severity . . . . . .

1

a nd E

v

2

b y Age . . . · ·

. . .

21 25 27

. . .

. · · · ·

·

29

31

CHAPTER I REVIEW OF THE LITERATURE AND HYPOTHESIS Bac kground Stuttering has r emain ed a p uzzl e with many missing pieces .

No one stutterer "fits" into all the available

theories nor does one theory explain all stutterers.

In

attempting to reach a "conclusive" and "inclusive" theory, c ertain data are often neglected or over-looked.

The

unitary theory has been the dominant approach in research, stated or implied .

The unitary approach is a term used

to describe the application of a single theory to all stutte r ers .

The implic ation is that the causation p roposed can

explain the related behavior of all stutterers. When the main theories are reviewed, it is use f ul to classify the findings in three broad categories; developmental (Johnson , 1942; Leutenegger, 1955; Bloodstein, 1965; Wis c hner , 1948) , intra- and interpersonal (Coriat, 1942; Sheehan , 1 954; Bender , 1 942; Murphy , 1960; Glasner , 1953; Doug l ass and Quarrington , 1952) , and organic (Travis, 1931; West , 1 958 ; Kar lin , 1959; Weiss, 1950; Bryngelson , 1 958). var ying research lends support for each of these a r eas .

However , t h ere also exists contradictory evidence

1

2

for each . theory .

Not all a u t h ors adh~ ~ r e to the single cau sation S ome hav e proposed the i'dea that two or more

etiolog i es may e xis t a n d th a t no unitary . theory can account for all the k nown facts concernin g s t utterers (Luchsinger and Arnold, 1 9 6 5 ; Ro bi'ns o n , 1 96 4). maintaine d by Boome (1941).

A two cause theory was

He viewed the instability of

the nervous s y stem a s a p r e di spo sin g factor to stuttering . He liste d e nvironme ntal influe nces to b e the other cause . Blueme l,

(1957) distinguishes b e t wee n t wo types of stutter-

ing which h e d e scribe s as non-or ganiz ed and disorganized speech.

He labe ls them stuttering a nd s t ammer i n g , r espec-

tive l y .

Wy k e

(1969) describes t wo clinic a l types , volun t a ry

stammere rs and r e flex stammerers. The ef forts to employ a single maj o r t heory c o u ld be a hindrance to accomplishing definitive a n d meaningf ul research.

In a recent book by Be ech a nd Fr a ns e lla,

(1968,

p. l) a comprehensive survey of the availa ble r e s earch is made, in which they state: Part of the problem of cond~ct ing r e s earch and the rapy in the field.of st~~t~ring max s~em ~rom the kinds of assurn~tions w ic a r e mh a e inta ~a~ce f imental evidence. Perhaps t e mos o vious 0 ehxpe r and one which is undoubtedly e asi e st to of t ese ' · · a unt7· t ar y d is · or d erfand make, is that stuttering is 1 that stutterers belong to a par icu ar c 1 ass o . d' 'd als in a more fundame ntal sense than that in ivi U ' d'i ff icu ' lty in ' they are all p r one to experience speaking. could the often reported " no s ignificant difference" found in many experimental studie s result from an

3

invalid evaluation due to the lack of differentially diagnosing the stutterer?

Beech and Fransclla (1968 , p . 94)

note that the "large variability among stutterer ' s responses to various experimental condi'ti' ons is a constantly recurring The majority of experi-

theme throughout the literature ."

mental studies have compared a stuttering population with a normal population although several studies have clearly indicate d that often there have been greater differences among stutte rers than between the stutterers and the normal population (St . Onge and Calvert , 1964; Mccrosky , 1957; Knott, et al., 1959; Starr, 1922) . One explanation for the differences found may be the given type of population studied.

The nature of a given

facility may account for the high concentration of a similar type of stutterer.

A clinic administe r ed under the ausp ice s

of a psychology department, for example, will probabl y attract stutterers who by introspe ction or referral e xhibit emotional problems .

On the other hand , a clinic in a

hospital setting would tend to receiv e stutterers by medical r eferral .

Another factor that could effect test r esults is

that adult stutterers have masked many features which are n oted in children who stutter .

Motor problems may be out-

g r own or compensated , a strong emotional overlay may have d eve l oped, and the relationship between motor and emotional p rob l ems may no longer be readily discernab l e .

At the

adult age , i t can be d i fficu l t to know whether the s tutterer

4 is primarily reacting to h'is stuttering . or if his stuttering is a r eac t i o n to his emotional status.

The optimum ages for

testing motor a n d language factors are four through eleven becau se most ins t ruments are designed for these ages . The r efore ' childr en wh o stutter are able to present less dis to rted info r mation concernin g selected factors than adults who stut ter . It would seem that t he pe r s i s t ent assumptio n in res earch is that s tutte r e rs a r e a homogeneous group , in spite o f sign i f icant e vidence to the contrary .

Tr ends and

even sig ni f icant d if fe r e nces may be masked and e l iminated by failin g t o classify stutte r e rs i nto meaningful subgroup s.

Arnold (1965, p . 622) s t ates :

We should r e cognize fir s t t hat ther e are various t ype s o f stutte ring of psyc hogenic , neurogenic and biogenic orig in . Th i s l eads to dia g nostic distinction of its ma in types . . . . Motor Factors Among Stutterers When stutterers are diff e r e ntially diag nos e d, one of the sub-groups that emerg es is found t o d e mon s trate · 1 i'nability than other s tut t e r e r s . When greater motorica 'fferentially diagnos ed , the r esearch exh ibits they are not dl. a widespread variability . Following are some of the studies that concern motor and neurological development of stutte rers.

Kopp (1943)

investigated 4 50 stutterers using the Oseretsky test and · relationship between stutterers and motor found a positive

5

incoordination.

She concludes Lhat heredity defects

affecting motor disturbances are stuttering and are also is acquired. and that the

found in "constitutional"

h somew at present when stuttering

The fact that it was not a double blind study · examiner's subjectivity affects the score on

the Oseretsky , could have influenced the results .

In an

attempt to duplicate Kopp ' s study , with some modifications, Finklestein and Weisberger (1954) found that the stutterers were slightly superior in motorical ability than the nonstutterers.

Simon (1945) found that stutterers demonstrated

motorical "disintegration" in a series of complex tests that he devised.

On the other hand, Ross ' s

(1955) finding did

not support this evidence whe n he attempted duplication of the study.

Stuttering severity and anxiety involvement were

the criteria used by Snyder (1958) to sub- divide the groups. stuttering and coordination we re tested with t he fol l owing results; the moderate and severe stuttere rs scored s ignif icantly below the control in all but one test.

In an

earlier study , cross (1936) noted no significant difference in the motor capacities of stutterers and non-stutterers but he did find that stutterers had more difficulty with r epetitive lip , tongue and jaw movements. Spriestersbac h his study . (

1 941

However,

( 1940 ) did not support these f i ndings with

I n regard to large muscle abilities , Bilto

) found stutterers to be inferior to chil dren with

norma l speec h ·

Wesphal

(1933) had previously noted no

6 diffe r e nc e . Th e contradictory evide nc e c o nce r n ing the mot or abili t i es of stutt erers continues to b e common in the res e a r c h stud ies o f the early 19 0 0s .

F or e xample , rega r di· n g

rhy thmic voluntary movements , some investi · g a t or s h a v e f o u n d stutter er s t o be inferior

(Blackburn , 1931; Hunsley , 1937 )

while oth e rs have r eported that no sig ni f icant diffe r e nces existed (Se t h , 19 3 4; Kr i egman , 19 44) .

In a study de sig n ed

to d e termine the r e lationship of stu t t ering to me ntal fatigue, Bills (1934) conclud e d t hat t her e was a c orre la tion betwe e n delayed r e a ction a nd stutte r ing .

He postulated

that the re was a common neurologi c al bas i s which effected the loss o f cont rol or coord ina tion . In a more r e c e nt s tudy , Adams and Di etze (1965) r eported that the reaction time s of s tut t erers to wor d a ssociations were slowe r than non-s tutte r er s.

Rotter (1955 )

investig ated to dete rmine t he a bility o f stu tter ers t o s ort c ards with the right a nd lef t hands.

He f ou nd them to be

i nferior to non-stutte rer s. Re g arding r epetitive ma nua l reac tion, We st i s

(19 2 9)

study showe d a positive r e lationshi p bet ween stutte rers a nd a ma nua l inabil ity .

Strother and Kr i e gman (1 944) found no

rs arrhy t homokine si s among s t u ttere .

In anothe r study ,

. g di'adoch okinesis , Strothe r s a nd Kre igma n (1943) conce rn in stu tterers were superior to non-stutte r e rs, r e p o r ted that although not s i g n if icantly .

7 A few studies h a v e b een done concerning eye moveme nts o f

stutte r e r s .

Posit ive correlations between irreg-

ular eye move me nts a nd stutter e r s have been found by s everal inve stig ators (Murr ay , 19 32; Jasper and Murr ay , 19 32 ; Strothe r, 1937; Mos e r , 1 93 8) . The wid e range of f indings , t hough extensiv e , is overlapping and il l -def ined .

Confusion h as c ontinued to

r e s ult in the r e se a rch when atte mp ts to corre late mot or problems with stutter i ng hav e been made .

A r e view of t he

literature r e veals a v ari e t y of r e asons f or conf u s ion.

A

var iation of instrumen t s has bee n e mployed to t e st t he s ame type of prob l em ; tec hnique s as we ll as p op ulations h a v e dif fere r ed as s t ud i es o n similar per f ormances h a ve b een conduc ted .

The r e sults have b een as v a ried as the

ins trume nts , tec h niq u e s and p opulations that have b e en us e d.

F or e x a mp l e , the rhythmical move ments o f stutterer s

in Blackburn's e arly study (19 31) wer e tested b y t he u se of a kymo g r a phic r e cording t e chniqu e and the stutter e rs were f o und to be i n fe rior while Strothe r and Kriegman (1944) in t he ir later s tudy o f r hythm among s tutter e rs used a tambour o n p l a t e as meas ur ement.

They found that stut-

ter e r s we r e s lig htly super ior to nonstutterer s . studi e s cou ld b e cited.

Many other

A stu dy that demons tr ates a d i f -

ference in t he number of population u sed and a p o ss i b l e ;n i'nterpreting the same i n strument is in t he diff e renc e ~ Finkleste in and Weisberge r (19 5 4) d up l i c ation of the Kopp

8

study ( 19 4 3 ) .

0

. pposing results were obtained .

'rhe term "motor " ha cs b cen u sed to describe a wide scope of neuromuscular activity .

The less obvious motor

dysfunctions f requently r emaine . d unde t ected .

It has been

noted that "soft" n e urological s igns may exist in a child that are not det ec t e d b Y the classical neurological examination.

Arno ld (1960, p . 25) describes these p roblems

as "micro-neurologic" or a "sub-clini cal dysfunction. " Another term developed to describe them is " sub-clinical diffuse organic involvement"

(de Hirsch, 1960, p . 47).

Stutterers are differentiated fr om other stuttere rs by means of clinical obse rvations.

These observations lack

support of definitive and empirical res earch studie s. The application of rece ntly developed measurements of minimal motor problems may well help clarify the char acteristics of these children.

Stuttere rs who demonstrate

moderate or severe motor coordination difficulties may present quite a different language syndrome than stutterers who do not have motor problems. Language Factors .Among Stuttere rs The study of a central language problem in stutterers has been limited to the "clutter-stuttering" syndrome. the centra l in detail .

Arnold ,

(Luchsinger , and Arnold, 1965) describes

language disorder noted in clutter- stutterers Both Arnold and Weiss (1964) view the language

8

study (1943).

0

.

pposing results were obtained.

The term "motor " has been used to descr ibe a wide scope of neuromuscular a c t'ivity. .

The less obvious motor

dysfunctions frequently remained undetected.

It has been

noted that "soft" neuro 1 o gical · signs may exist in a child that are not detect e d b Y t h e classical · · neurological examination.

Arnold (1960 , p . 25) describes these problems

as "micro- neurologic" or a "sub -cl inic al dysfunction." Another term developed to describe t h em is "sub-clinica l diffuse organic involvement "

(de Hirsch , 19 60 , p. 47).

Stutterers are differentiated from other stutterers by means of clinical obse rvations.

These observations lack

support of definitive and empirical res ea rch studies. The application of rec e ntly developed measuremen t s of minimal motor problems may well help clarify the characteristics of these chi l dren.

Stuttere rs who demonstrate

moderate or severe motor coordination difficulties may present quite a different language syndrome than stutterer s who do not have motor problems . Factors Among Stuttere rs Languag e The study of a central language problem in stutlimited to the "clutter-stuttering" terers h as been rnold, (Luchsinger , and Arnold , 1965) describes syndrome . A language disorder noted in clutter- stutterers the central Both Arnold and Weiss (1964) view the language in detail .

9

imbalance as b e ing c on

. genita l in etioJogy .

s upport this , includ i n g th

Several studies

e geme llogic i nvestigations by

Lu chsinge r, 1940, 1944 , 19 55 ; lla n bert , 1 9 47; Seeman, 193 7, 1959; Schmid t , 1940.1 matism , short auditory

The syn drome is composed of dysgramme mor y atten t ion span , disor gani z ed

l anguag e f ormu l ation a nd d e layed lang u age .

Concomi tan t

symptoms consist of de l ayed mo t or ma t u r a t i o n and l atera l ity disorders . While language ability in r e lati on to s t ut t ering has not been investigated , correlation of single language factors and stuttering has been not ed .

For e x a mple, t h e

auditory processing a bility of stuttere rs. have varied.

The r e s u lts

No signi f i cant difference was found b e t ween

a dult non- stutterers and adult stutterers whe n t e ste d f or a uditory central nervous system disorde rs (Gregory , 19 6 4) . In testing the visual and auditory a bilities o f stuttere rs vs . non- stutterers on a task involving slur vianis ms , Winga t e

c1 9 6 7) no t ed tha t both groups did l e ss wel l on the auditory a s pect but stutterers per f ormed sig nificant1y lowe r . The ass umption that stuttere rs have a def e ctive a u d i tory feedba c k sys tem cont inues to be the object of much r e s ear ch (Shan e , 1 955 ; Cherry a nd Sayers , 1 95 6; Chase , 1958 ; Mysak , 1 96 0 ) .

At this point , more studies h ave been con-

cerned with t he use o f de l ayed a uditory feedback (DAF) and lstudi e s cited by Ar nold .

10 its effect upon th

e normal population as well as upon

stutterers than with the act

. . . ua 1 investigation of the

presence of defective audi'tory 1950; Black, 1951; Maraist and

feedback in stutterers (Lee, Hutton , 1957; Neelley , 1961 ;

Sutton and Chase, 1961; Go l diamond , 1966).

The disturbed

feedback may persist among some stutterers while not present in others.

This may account for the fact that speaking

slower than usual benefits some stutterers but does not seem to effect others (Soderberg , 1968). Soderberg ' s

(1967) research on the linguistic

factors in stuttering, notes that uncertainty of grammatic structure may be r e lated to stutte ring in young children. A study by Bloodstein and Gantwerk (1967) referred to grammatical function and stutterers .

However , the emphasis

was placed on the frequency of stuttered speech on grammatical parts of speech. Clinical observations have supported the evidence that some stutterers have language problems .

It has been

noted that even after the stuttering has b een treated a nd minimized , language problems persist .

However , there is a

paucity of literature regarding the over-all language abilities of stutterers. l anguage probl ems popul ation and

i

A

study is needed to determine if

do exist among some of the stuttering

'f they can be differentially diagnosed by

a description of the language parameters. The relationship between language problems and motor

11 development has been supported by Karlin (1965) and Arnold (Luchsinger and Arnold , 1965) . de Hirsh (1960) reports that most cases of severe language problems are combined with poor visual-motor and motor patterning .

Pearson (1966)

notes that language disability and expressive dysrhythmia are often related .

Th e li' terature support s motor prob 1 ems

in c onjunction with language problems .

Locomotor function,

psychomotor, dominance, balance and manual dexter ity are all related to lang uage development (Wood , 1964).

Motor

involvements such as confused lateral dominance, lack of coordination and disturbance of balance are often associated with auditory disorders (Myklebust , 1954). The noted differences and disagr e ements concerning such terms as "congenital" and "acquired" language disabilities continues but there is little disagr eement that gross and or minimal motor problems e xist in c onnection with l anguage problems . The purpose of this study was to compare the language parameters of children who stutter and who have varying degrees

of motor problems( to children who stutter

and who have no motor problems. Definitions Motor problems . - - The normal range of motorical In order to establ ish deve lopment ].·n children is broad . the existence of a motor pro blem ' a child must exhibit an

12 inability to perform muscle behavior Lasks that most children his age can do well .

A child ' s motor development

is related to the ad equate growth and integration · · of his central and perip · h eral nervous system and muscular system. Certain milestones have been established that mark expected motor accomplishments for the average child (Gesell, 1946) . (When a child performs below the range set by norms as being average , then he can be diagnosed as having motor p roblems .)

The motor probl ems were operationally defined

for this study by the use of a standardized motor problems inventory which consists of four sections:

small muscle

coordination ; l arge muscle coordination; laterality; and general observations .

The general observations c onsisted

of hyperactivity , persever ation , distractiblity, reading ability and writing ability (or Draw-A-Person) .

Motor

problems are described as scoring below the normal range as determined on the test (desc ribed in Chapter II) . stutterin~ . --stuttering is cha racterized by abnormal

dysfluencies and abnormal r eactions to speaking.

The

e made up of repetition of initial sounds in dysf lue ncies ar a single word, repetition of a single syllable , repetition of single sy llable words, blocking or prolongi ng the initiaThese dysf luencies are accompanied by tion of a sound · . f f stration social pain and embarrassment feelings o ru ' (Wingate , 1964) ·

13 Language · --Language is the systematic , arbitrary (learned) u se of auditor Y and other symbols to transmit a variety of messages from one individual to another .

During

the transmis sion of a language message, both sender-feedback and receiv er -feedback are in operation.

Thus the ability

of the sender to transmi't a message depends on the integrity of his auditory, visual , tactual , kinesthetic , propriocep tive internal feedback and upon the auditory and visual feedback from th e receiver.

Along each of these channels,

several leve ls of processing are requi r ed suc h as , sensa tion, perception , imagery, memory , closure , association, decoding, syntax planning , vocabular y selection, motor planning and execution and muscle response .

These p roc es s es

apply primarily to auditory and visual channe ls, a lthough other channels may be used , i.e ., tactual for the blind. This linguistic system is overlaid with a semantic system which involves words and their meaning. Groups .--The stutterers were divided into three rding to their ability to perform on an Experigroups acco mental Motor Problems Inventory (MPI ). The fifteen children

O to 1.50 (normal is 1) were the whose MPI ratios were Control Group (C) ; the ten children who scored 1.51 to 2.49 on the MPI were Experimental Group One (E1 ); and the fourteen who Scor

ed 2.50 or higher were Experimental Group

14 Clutter-stutterer .--A stutterer who first e xhibited symptoms of a clutterer.

The definition of c luttering ,

according to Weiss (1964) is a speech disorder that is characte riz ed by the clutterer ' s unawar e ness of his disorder, by a short attention span , by distur bances in perception , articulation and formulation of speech and often by excessive speed of delivery .

It is a disorde r

of the thought proc esses preparatory to speech and based on a hereditary disposi t ion. Hypotheses A.

The language abilities of child r en wi th moderate motor problems who stutter (Group E 1 ) are not significant l y different from other c hi ldren who stutter

(Grou p C ) •

sub-Hypotheses that emerge by using the nine parameters and the lan guage total defined by the ITPA: l .

difference between There is no significant in Auditory Decoding Group El and Group C abi l ity .

2.

difference between There is no significant in Visual Decoding Group E l and Group C abil i ty .

3.

difference between Ther e i s no significant i n Auditory Voc a l Group El and Gr oup C Association.

15

Hypotheses--Continued

4.

There is no significant difference between Group E 1 and Group

c in Visual Motor

Association. 5·

There is no significant difference between Group E 1 and Group

6.

There is no significant difference between Group E 1 and Group

7.

c in Vocal Encoding .

c

in Mo tor Encoding .

There is no significant diff e r e nc e between Group E

1

and Group C in Auditory Vocal

Automatic . 8.

There is no significant differ e nc e betwe en Group E

1

and Group

C

in Auditory Vocal

Sequencing. 9.

There is no significant differ e nc e between Group E

1

and Group C in Visual Motor

Sequencing. 10.

There is no significant difference between Group El and Group C in over-all language ability.

B.

The language abilities of children with severe motor probl ems who stutter (Group E 2 ) are not significantly different from other chil dren who stutter (C) · sub-Hypotheses ; 1.

There is no signific~nt difference

16 Hypothescs--Continued between Group 8

2 and Croup Decoding ability

2.

c

in Audjtory

There is no significant difference between Gro up E 2 and Group C in Visual Decoding ability.

3.

There is no significant difference between Group E 2 and Group

c

in Auditory Vocal

Association . 4.

There is no significant difference between Group E 2 and Group C in Visual Motor Association.

5,

There is no significant difference between Group E

6.

and Group C in Vocal Encoding .

There is no significant difference between Group E

7.

2

2

and Group C in Motor Encoding .

There is no significant difference between Group E

2

and Group C in Auditory Vocal

Automatic . 8.

There is no significant difference between Group E

2

and Group C in Auditory Vocal

Sequencing . 9.

There is no significant difference between Group E

2

and Group C in Visual Motor

sequ e n cing .

10.

Ther e is no significant difference between

17 Hypothcscs--C~inu c d

Gl o up E2 a nd

G t"OU['~ ('

. in ovrr-all 1 anguage

abi J i l y .

c.

The l a n guage abililies of children with moderate motor pro blems who stutter (Group E ) are not 1

signi fic a ntly different from children with severe mo tor p r oblems who stutter (Group E ) . 2 Sub- Hypothese s: 1.

The re i s no s igni f i c ant d i f f e r enc e between Group E 1 and E in Au ditor y Decoding 2 ability .

2.

There is no sig nificant d i f f e r ence between Group E

3.

1

and E

2

in Visual Decoding ab i lity .

There is no significan t d i f f e r e nc e be t ween Group E

1

and Group E 2 in Auditory Voca l

Association . 4.

There is no significant d i f f e r e nc e be t we en Group E

1

and Group E 2 in Visual Motor

Associat ion.

s.

There is no signif icant di f f e r e nc e between Group El and Group E 2 in Vocal Encoding.

6.

There is no significant differenc e betwee n Group E

7.

and Group E 2 in Motor Decoding . 1 There is no significant difference between

Group El and Group E 2 in Auditory Vocal Au t omatic .

18 Hypotheses--Continued

8.

There is no signi . ·r·icant difference between Group El and Group E in Auditory Vocal 2 Sequ e ncing.

9.

There is no significant · differe nce between Group El and . Group E

2

. v·isua 1 Motor in

Sequencing . lO.

There is no significant difference between Group E 1 and Group E in over-all language 2 ability. Summary

The underlying assumption in the majority o f research studies concerning stutterers i s that they form a homogeneous group to be compared to a non-stuttering group .

Ot her

authors have proposed varying etiolog ies among the stutt ering population .

Such authors as Luchsinger and Arnold , Boome ,

Bluemel and Wyke are in contrast to Johnson, Sheehan and Karlin , for example . among stutterers,

If significant differences do exist

then the research should define the type

of stutterer that is being compared to the non-stutterer. studies abound in the literature that are concerned with the correlation between motor problems and stuttering. Stutterers have been compared to non-stutterers and the resul ts have been varied and contradictory.

Kopp and Bilto

are among the few researchers who found stutterers to

19 exhibit motor p ro bl ems, while Finklestein ond WeisbPrger , among o thers , iound s t u LLcrcrs Lo be sliqhtly superior in motorical abilily . Children who have motor disorders often have accompanying language disorders

(Karlin , Pearson, and Wood) .

The l a n guage problems cover such aspects as dysgranunatism, short a u ditory memory span and disorganized language for mulat i o n, a mong othe rs.

Th i s motor-language syndrome

has bee n no ted by clinicians and r esea r chers , alike (de Hirsc h, We i s s).

The language probl em appears to be

related to the d ysfunction o f the c e ntr a l nervo us system . The central motor-language distur b ance has par t icular ly been not e d b y r e s e archers dealing with a "clu t ter-stut terer " population .

I n the area of lang uage disor der s , the auditory

channel has r e c e ived special attention.

Res ults have v ar ied

here , also , but there have been strong indica tors o f auditory disturbances among stutter e rs. A study designed to compare the l a n g u age paramete rs of children who Stu

tter and who h a v e va r yi n g degr ees o f

motor problems to c h i

'ld en who s tutter and wh o hav e no r

motor proble ms , is needed.

CHAPTER II METHODOLOGY Ca s e Se l e c tion The childre n f or t h i s study wer e s t utterer s selected from the case loads of p ublic sc hool t hera p i sts .

The

criteria for selection was base d on th e p r e s e nce of prolongations and syllable repetitions as me a sured by a stuttering severity scale.

Thirty-nine c h ild ren were taken

from a group of 108 stuttere rs. to nine years of age.

The y ranged f r om fi v e year s

The stuttere rs wer e function ing a t

grade level and they attended r e gular classrooms .

Any

disorder that would mask their lang uage diff e rences, such as cerebral palsy, mental retardation, or h e aring h as disqualified the stuttere r. used , nor a ny

No bilingual childre n wer e

noticeably culturally diff e rent c h ildren.

All

audiometric pure tone tests of 500, children passed t h e lOOO, Hz at 15 db ASA or 25 db ISO. It was 2000 1 4000 assumed that an over-riding disturbance or difference could confuse the results.

20

21 Examiners The e xaminers were graduate pathology , attending stutteri'ng

students in speech

seminars .

They were drawn

from the seminars over a period of two years.

They were

trained in the administration of the tests used .

Group Selection The stuttere rs were divided into three groups according to their ability to perform on an Experimental Motor Problems Inventory .

The groups were not significantly

different in r egard to ag e or sex.

An analysis of the age

levels for the Control Group (C), Experimental Group One (El) and Experimental Group Two (E 2 ) showed that the C Group and E

Group were older than the E 1 Group but this dif2 ference was not statistically significant (X = 2 . 36 with 2

two degrees of freedom:

x2

= 5 . 99)

(see Table 1) •

.05 level of c onfidence requires a The stutterers were tested on TABLE 1

COMPARISON OF GROUPS C, El AND E 2 BY AGE No Motor Problems Age Range Age Mean

5 - 9 7. 7

Moderate Motor Problems

Severe Motor Problems

9

7 - 9

6.5

8. 5

4 -

22 fifteen items o f moto r b h . e avior . eral tong ue mov e me n t coordination,

(4)

"pub tub kuh," and skip, thig hs,

confu sed lateral ity ,

repet i tion of " puh ,"

(6 )

(5)

( 9)

(1) lat-

( 3 ) finger

repetition of

stop and s t art phonation ,

h ype r a c t i vi t y ,

(7) walk , run

balance ,

(1 2 ) distracti bility ,

(14) Draw- a-Perso n or poor handwriting ,

perse veration. Inve ntory

(2 )

(8) h o p withou t heel s l ap ,

(11)

ing delay ,

'

The items were:

(10) slap (13) read(15)

The f i f t een c hildr en whose Motor Problems

(Riley , 1971) r a tio s we r e

o

t o 1. 50 (normal is 1)

were the C Group; the ten children who s cored 1. 5 1 t o 2 . 49 on the Motor Problems Inve ntory (MPI ) we r e E

Gr oup; and

1

the fourteen who s core d 2. 5 0 o r h i ghe r wer e E

2

Gr oup .

A Stuttering Se verity I nstrument (Riley , 1 969) a n d the Illinois Test of Psycholing uistic Abi li t i e s

(ITPA) wer e

administered to all stutte rers. Ins trumenta tion The ITPA was chos e n b e cause it was the mos t def i n itive , standardize the time.

d t e st of lang uage abilitie s avai lab l e a t

standardize d on 1,100 ling uisticall y The test Wa s

norma l children who

were randomly se l e cte d.

They wer e

f 2 _o and 9-0. Seven hundred o f these between the ages 0 included in the final samp le. The test was children were h ive Osgood Model of Communication b ased on the compre ens 1 1 t e st-retest stability coefficient The over-a Processes .

was .97.

23

The MP I wa s Cla l sen becau se t he s ub-tests speci fi c a lly indi c ate the p r esence

o[

f ine moto r coo r tlina l ion prob l ems

and g r oss motor problems , con f u sed lateral i l y and ge n e ra l mo t o r i c behavior such a s h yperactivily , d is trac ti bi lity a nd per sev e r ation.

The s e latte r o bserva ti o n s hav e been signif -

ica ntly re l ated t o d'iagnosing childre n wi t h mi n imal c e r e bral damage and c onge ni ta l l a n g u age disabilities (Straus s , 1947; Wood, 1959; Myklebu s t, 19 5 4). dif f ere n t

The MPI cuts a cros s thr e e

par ameter s.

The over-all reliabi l ity o f the MPI was conse r vative l y estimated a t

.85 (see Appendix) .

The MP I is a

standardize d tes t a n d one o f the mor e eff e ctive t e sts available . Th e Stut t e r i n g Sever i t y Instrume nt (SSI) was developed to b e us e d in s e veral r e s earc h stu dies beginning in 1964 because the p r e viously u sed methods were e i t h er gen era l scales , s e l f -reports , or nume rica l fo r mul as .

These metho ds

d i d not meet a ll of the wer e not s e l e cte d b e c a u se they l y· (1 ) simpl e e nough to be used by research crite ria , na me · 2) as objective as possib l e (based a traine d therap i st , ( a udible components) , (3 ) sen s i t ive on e xte rnally v i s i b 1 e or . clinica lly sign ificant changes , (4) enough to r egi s t e r . t'cal cha r acter istic s , r e: r e liabili t y and acceptable s tatis i · data f or assignment alo ng the validity , (5) normative severity parame t e r . These parameters

were s e l e cted b e cause they met

24 a ll of the applicable criter·ia .

These parameters were:

(1 ) frequency of repetitions , pro 1 ongation . of sounds and syllables; conversational speech and reading, of the longest blocks,

(2) duration

(3) observable physical concomitants .

(see Appendix) . The inter-examiner reliability of the SSI was .84 when a tolerance of two stens was allowed.

In other words,

84 per cent of the judgments on each subject were within a two sten bracket .

Frequency and duration were most reliable

at . 9 1; physical concomitants was less reliable at .62. Part/whole reliabi l ity studies yield a r s correlation of .91 for frequency,

. 82 for duration and .86 for physical

concomitants . A validity study using eighteen stutterers and four the Iowa Scale of Stuttering Severity therapists Compared The obtained r s (Johnson , Darley and Spriestersbach, 1963) . wa s

. 89 .

for the SSI is shown in Table 2. Normative data r this study a child had to obtain a To qua l ify fo

s c ore of at least four on the

ssr.

25

'!'ABLE 2 NORMATIVE DATA OF THE STUTTERING SEVERITY SCALE

Severity Scale--Ages 4-13

Sten

Severity

Per cent

Score

1

0-4

0-5

Very Mild

2

5-11 12-23

6-8 9-13

Mild

24 - 40 41-60 61-77

14-15 16-19 20-23

Moderate

24-27 28-30

Severe

8

78-89 90-96 97-100

31-45

Very Severe

9

3 4 5

6 7

Cnl·State I illr J' Fullt:rrrn

Clll\P'l'EH r I I

PHESEN'I'l\'rION

or

Dl\'T'l\

Results The results of this study indicate significant differences of the language scores at the . OS level of confidence when the Control (C) group was compared to both Experimental (E , E ) g roups and the Experimental groups 1 2 were compar ed to each other . The sub-tests of the 1961 Experimental form of the ITPA a r e shown in Table 3 .

They are listed to represent,

fi r st , the receptive areas (1 and 2 ), the associative a r eas (3 , 4 , 7 , 8 , and 9 ) and the expressive areas (5 and 6). The three groups and their standard deviation scores are r ecor ded . The c group showed a significant difference downwa r d in the a r ea of verbal expression (sub-test S) . e x pression t ests the ability or willingness to talk .

Verbal The

et the reluctance of a stutterer to talk low s c o r e may re f l e as we ll as make specific statements about an object . Subrequires the child to repeat t e st 8 , a udi tory memory , ~f ter the examiner . This test , too , was numbe r s f or war d . . . 26

TABLE 3 COMPARISON OF I TPA PROFILE MEANS OF GROUPS C, El AND E 2

KEY:

1. Auditory decoding 2. Visual decoding

CONTROL GROUP No Motor Problems n - 15

3. 4. 7. 8.

Auditory association Visual association Aud . -vocal automatic Aud .-vocal sequential 9 . Vis. - motor sequential EXPERIMENTAL GROUP 1 Mild Motor Problems n - 10

5 . Aud . -vocal encoding 6 . Vis . -motor encoding

EXPERIMENTAL GROUP 2 Moderate to Severe Motor ProbleLls 14 T - - 1 . 05 sd n -

T -

T - -.9 sd

.3 sd

+. 4

3 +. 4

5 -. 6

1 +. 5

2 +.3

4

+. 2

6 +. l

2 -.15

l

3 -1 . 15 4

-.15

5 - .1 5 6

- .2

1 + .7 5

3 - .6

5 -1. 0

2 0.0

4

- . 25

6 0.0

7 +.2

7 -. 3

7 -. 1

8 -. 5

8 -.7

8 -1.l

9

9 -1 . 3

9

- .1

-.25

I\)

-.....)

28

sig ni f icantly low .

S tutterc r s ' Cls a

Lrouble

The next Lwo g r oups have these

p robl ems , also , and in some cases l n

lncr~asi n g

amoun ts .

The E 1 g r o up s h o ws a n added area of diff i cul ty . Thi s is the g roup with mild mot or pr ob l ems . audi to r y association ' sub -tes t dip amo n g this group .

3, t akes a v ery significant

Anothe r audi to r y c hanne l is effected

in the association area .

Sub- test 5 and s u b - test 8 aga i n

show u p as being sign if icant l y low . lowe r

The a r ea of

E

1

as a group s c o r es

t han the C gro up . The E

g r oup f ollowed the consiste nt patte rn of 2 scoring l ow on sub-te sts 5 a nd 8 , exc ept the y dippe d a full s be low the mean . sub - t est 3 .

They scored low on auditor y as s ocia tion,

I n t hes e 3 g roups tested , E 2 score s more than

1 s b e low the mean on sub-test 9 whi c h is visual motor seq u e ncing .

This is a nothe r test in memory , in which the

child watches the e xamine r arra n ge pictu res of geometr i c shape s and t hen he r eprod uces the sequence from memor y . Tabl e 4 c ompar es t he groups .

Sub-te st 3 on this

chart d emonstra t es that when the C group is compared to · n the area of auditory association , ther e is the E g roup l. 1 Ther e is a signi f a . 001 l e v e l o f conf i dence difference . thi s t est , a l so , b etween t h e C g r ou p icant di ffe r e nc e on and the E

g roup . 2 roup i s c ompar ed to the C group on g When the E 2 · a significantly lowe r score for the s u b-test 9, ther e 15

TABLE 4 SIGNIFICANT DIFFERENCES AMONG GROUPS (BASED ON THE MANN-WHITNEY U TEST)

ITPA sub- test C to E (lowerr C to E

2

El to E 2

1

2

3

.05

. 05 El

. 001 El

c

. 03 E2 ST* El

4

ST* E2

5

. 02 E2

6

9

7

8

.05 El

ST* El

. 05 E2

. 01 E2

. 01 E2

.025 E2

. 025 E2

T

. 025 El . 05 E2

* Strong trend but not significant at the . 05 level of confidence.

N

'°

30 E

gr oup .

When compared Lo Lhc E g 1 oup , l he E group is 1 2 s ti l l s i gnificantly lower . 2

A 'lest_ Lha'L has noL b een rnenlioncd is sub-test 1, a uditory decoding , which is pr imarily a test of receptive vocabulary ability. on this test . for this .

All th r ee groups scored relatively high

There are several ideas as to the reason

One reason might be inte lligence (Travis , 1959).

On e reason might be that stuttere rs develop an extensive v ocabulary in order to circumve nt a word they fear saying . Referring to the total language scores , the

c

gr oup had a language score of 0 . 3 s, the E1 group scor ed a -. 9 s and the E

2

group was a -1 . 05 s below the mean .

Refer -

r ing to the box at the bottom of the table, as before, it can be noted that statistica l ly E 1 and E 2 rate lower t han t he C group in over- a l l language ability. In general , the s t ut t erers in thi s study are less abl e or less wil l ing to express themselves v e rbally.

Those

wi t h mild motor coordination problems are low on auditory r all language ability . Those with a ssociation and Ove mode r ate to severe motor difficulties are somewhat low on b t what sets them apart is their low u and their low over-all language score s o n visua l memory ,

audito r y associ a tion

a b il i t y . An inciden ta l findi n g of this study was that the · tal gr oups was lower than t hat o t h e xperimen s e v e rity Of b but the d i ffere nce was not of the control g roup ,

31 substanti a l ly sig n ificant

nt t he . OS 1°v0 1 of confidence

(se e Table s ) •

'117\BLE 5

COMPARISON OF GROUI)S C , E /\ ND E BY 2 STUTTERING SEVE~ITY No Motor Problem Ran ge

Moderate Motor Problem

7 - 32 2 - 9

STEN

4 -

1 - 7

20 . 2 6

Me an

STEN

25

17 . 5 5

Severe Motor Problem 7 2

31 9

17 . 1 5

Acceptance and Rejection of Hypotheses A.

Nul l hypothesis number one; the language ab i lities of chi l dren with moderate motor p rob l e ms who stu tter (E 1 ) are not significantly differ e n t

from other children who stutter (C)

was rejected on t he basis of the rejection of t h e fo llowi ng s u b-hypotheses : l .

T

here is no significant difference between

El

and C in Auditory Decoding ability was

rejected at t h e .0 5 l evel o f c onfide nce . Th e c Gr o u p was i n ferior . 2.

Th e r e is n o signi fi c a n t diffe r e n ce between E

a nd

c

i n Vis ual Decoding a bility was

1

rej e cted at the . 0 5 l e v e l o f conf idence .

32 The C Group was supcrjor. 3.

There is no signi . ' f 'icant difference between El and C in Audi'tory Vocal Association .. was rejected at the . 001 level of confidence . The C Group was superior.

7•

There is no significant difference between El and C in Auditory Vocal Automatic (grammar) was rejected at .05 level of confidence.

10 .

The

c

Group was superior.

There is no significant difference between

E

and C in over-all language ability was 1 rejected at the .25 level of confidence . The C Group was superior.

B.

Null hypothesis number two; the language abilities of children with severe motor problems who stutter (E 2 ) are not significantly different from other children who stutter (C) was rejected on the basis of the rejection of the following sub-hypotheses: 3.

There is no significant difference between

E

and

c

in Auditory Vocal Association was

2 rejected at the . 025 level of confidence .

The C Group was superior.

s.

There

E

·s no significant difference between

J...

and C

in vocal Encoding was rejected at

2 e l of confidence. the .025 l ev

The C Group

33

was superior .

7.

The re is no signi.'fi.'cant difference between

E2 and C in Aud't l. ory Vocal Automatic was r ejected at the .O S level of confidence. The C Grou p was superior . . 8.

There is no significant difference between

E2 and C in Auditory Vocal Sequential was rejected at the .01 l evel of confidence. The C Group was superior.

9.

There is no significant difference between

E

and C in Visual Motor Sequencing was 2 r ejected at the . 01 level of confidence .

The C Group was superior.

10.

There is no signi ficant difference between

E

and C in over-all language ability wa s 2 rejected at the .OS l e v el of confidence.

The

c.

c

Group was superior .

Null hypothesis numb er three; the language abilities of children with moderate motor problems who stutter (E1 ) are not significantly diff erent

from children with severe motor

who stutter (E ) was rejected on the 2 reJ'ection of the following subbasis of the prob 1 ems

hypotheses: There is no significant difference between 8. E in Auditory Vocal Sequencing was El an d 2

34

rejected al . 025 10vr] of confid0ncc .

The

E 1 Group was superior . 9.

There is no significant diff0renc0 between E 1 and E 2 in Visual Moler Sequenc i ng was rejected at the . 025 level of confidence . The E 1 Group was superior .

CHAPTER IV CONCLUSIONS AND IMPLICATIONS Specific Conc l usions A stutte r e r wi· th motor problems exhibits an a ccompanying l a n g u age syndr ome .

Stutterers who have

moderate motor p rob l ems (Experi ment al Group I} demonstrate c entra l lang uage dysfunc tions which include auditory perc eption a nd integr at i on . simi lar to a n

11

This profile is one that is

aphas oid 11 child .

The child has norma l

potenti a l and per f orms norma l ly or above on sever al l anguage functions but he e x hibits certain lan g uage defi c i t s .

Hi s a u d itory system seems to c o nfu se the input

and h i s auditory r e a soning abi l ity is reduced . c o i ncides with wing ate ' s

This

(19 6 7) study which showed stut-

ter e r s to have a r e duce d abili t y t o decipher " slurviani sms " and the findings b y Gregory (1969 ) that stu tter ers mu l ti-ch anne l l i sten i ng . a r e 1 ess a d ep t a t The stutt e rer with s e vere motor p r obl ems ime ntal Gr oup

2

(Exper-

) e xhibits di ff icult ies t ha t a r e more clo s e l y - motor d y s f unctio ns,

(the ir ove r - all

associated wi th s e nsory l owest of the thre e groups ). This language scor e was t h e . y associative deficit whe n compare d group s hows a n a u ditor

35

36

to t h e Con tro l g roup b u L wh en c om parcel Lo Lhe g l motor p r obl e ms ) g r o u p , th c E

2 grou p

de mo n s t rated l ess d i ff iculty .

(moderate

(severe molor problem)

They show a digression in

the u se of g ranunar , i n t he mo r e automatic tasks of auditory memory and visua l me mory .

The problem thls group exhibits

wi th a v i sual moto r tas k ma y b e i ndi c ative of (1) problems in d i s cr iminating ,

( 2 ) mo t or ma nipul ativ e ability , or

(3) a tru e visual me mory proble m.

The t e rms dysarthria

or apr ax i a c oul d b e used to descri'be the E 2 group . Several f actors noted withi n b o th e x perimental groups p r ovide supportive e vide nce fo r c ertain descr iptive find ings attribute d to c l utte r- s tutte r e r s by Ar nold and We i ss .

Ar n old notes a clutte r e r ' s diffic u l ty wi t h motor

function s a n d he uses terms such as " c on genital dyspr a x ia" and Bakwin ' s " deve l opment a l dyspr a xia . "

He des cribes a

clutte rer as hav i n g a short auditor y me mory span , dysgr ammatism , d yspr as i a a nd a def icit auditory feed-ba ck syst e m. ort s f inding s mad e by We i ss conce rnThis study , al so , Supp ing the a u d i tory feedback syste m a nd the poo r memory o f According t o We i ss , Lie bman correct g r amma t ica l usage . (1900) divided the c l utterers into two s ub-group s consistThe motor sub-grou p had ing o f moto r a nd sen sory problems . articul atory d e viations and the accelerated speec h a nd d f ind ing prob l ems as is found i n sensory g roup had wor t e d these t wo s ub - g roups with two aphasia . Weis s suppl emen formulation pr oble ms " c orre s p onding more , one e xhibiting

37

ignored when describ.i.ng a stutterer. The three stu t teri.ng . populations used in this study exhibited difficult y in . expressing specific ideas .

This

could be attributed to a stuttering pattern of circumventing "fear" words or i t could reflect a general reluctance to expand on ideas or engage i·n e 1 aboration . Conclusions Concerning Stuttering Research Methods The need for differential diagnosis using language and motor parameters has been demonstrated by this study . To assume a homogeneity among stutterers is not feasible when comparing them to non-stutterers .

For example , some

stutterers exhibit more motorical involvement than other stutterers and they cannot be regarded as a single population .

When stutterers are compared to non-stutterers,

in such a case , the r esults do not reveal definitive information concerning the presence or absence of motor problems .

Thus , conflicting evidence is frequently found .

It has been noted in this study that some stutterers exhibit d f' · t i n auditory perception while others e ici When the demonstrate onl y a s l ight dip in this area . ·

.

.

a significant

38 auditory feed-back

system of stutterers i's being compared to non-stutterers, th h e eterogeneity among them has to be taken into consideratio

n.

Th

. e existence of differences as

indicated by this study , support f in ' a· ings by St . Onge and Calvert (1964), Mccrosky ( 19 5 7 ), Knott , et al .

(1959) and

others .

Implications Implications of much of the r esearch regarding stutterers are that they exist as a single population to be compared to non-stutterers.

Once this assumption is

evaluated in the light of evidence conce rning the existing differentiality of stutterers , then the r esults can provide new meaning . some of the differences tha t should be considered for future research are as follows:

1.

The stuttered speech may vary with a particular etiology .

The frequency, duration, type of

ical concomitants may produce blocks and Phys ttern when correlated with the a unique Pa rt has been noted by Weiss and Arnold etiology. clutterer-stutterer produces a speech that a that differs from other types of stutpattern tering . 2.

and motor parameters participate

Since l anguage in each stutterer ' s in varying degrees

39

patho logy , res e arch ne e d s determine which of the effective i n c

Lo b0 des i g n ed to

·1 avai a ble therapies is

· opi n g with t hese parameter s .

A

stu tterer who h as b ee n diagnosed as havi ng centr al-langu age d e ficits wi ll b e give n t he r apy des i g n ed t o r edu ce or alle viate t hese prob l e ms , a long with any other stutte ring the rapy being a dmini s ter e d.

A s tuttere r who e xhibits s ensory -

motor p roblems should have the rapy dire cte d towar d minimizing t hem and the relate d stutt e ring .

A s tudy that would comp ar e syste matic

t herapeutic p roc e dures directed toward the p roble ms noted and t he use of more conve ntional a pproache s to stutte ri ng would provide some useful r e sults . 3.

The cate gory of stutterer s des cribed in this study parallel some me d i c a l c a t egorie s suc h as hyp e ractive

childr e n who are " emotion al l y-

e r active children who a r e drive n " and h yp . - d r iven " and chi l dren wit h " n e urolog ica 11 y ob l ems with no medic al invo lve me nt. l e arning P r e dica l r esearch wit h the d i f The ne e d for m r is ur gent. . diagnose d s t u tte r e f erentiallY t hat a me dical inical e vide nc e Cl There is in conjunction wi t h speech p athology approach in tr e atme nt of ositive r e su lts can produ ce P

40 some languagc-

mo t o r pro bl e ms as wel l as some

cm t ' o ionally-oricnLe d b c h avi' o r s . a double-blind which dilantin

.

pile~ s tudy

For e xample ,

(Wheele r, 1 96 9) in

and placebos were used with

children , indicate d an imp r o v e ment in the stutterers who were e motiona lly drive n bu t l es s change in the s t u t terers with n e urolog ical involvement . 4.

The language-motor parame t e rs of s o me stutterers described in this study ne e d t o be evaluated in the light of the e ff e ct of o pe rant conditioning .

It is not e nough to know i f t he

fluency factor change s but inf ormation is n e ede d on the effect of operant conditioning on the other parameters.

The di f fer e ntially diagnosed

stutterer may provide some definitive information concerning operant conditioning .

5.

The language-motor problems of some stutterers have been observed to have a high correlation with heredity factors by some authors (de Hirsch, l966; Weiss , isolated the

1964; Arnold , 1965) .

A study that

heredity factor of the various

t rers could indicate the relationtypes of stut e a stutterer with central-language ship t.etween heredity , for example , or the problems a nd between a stutterer with r e l ations hip

41 sensory-motor deficits and h0r0diLy.

6.

Since significant dif fcrcnc0s have been demonstrated among stuttcr0rs as measured by the language-motor parameters , perhaps the same type of study could be executed with other parameters such as emotional disturbance . The methodology of the study suggests that a variety of parameters could be utilized to differentia l ly diagnose stutterers into significant groups .

These parameters might be

suggested by a factor analysis by means which certain £actors may be isolated to form a definitive measure related to stuttering.

BIBLIOGRAPHY

BIBLIOGRAPHY Adams, M. and Dietz o " Times of S~utte~er~ an~ Word Association •rest ,. Research , VIII (1 965 ) · I

~omparison of the Reaction onstutterers to I terns on a Journal of Speech and Hearing 19 5-202 .

Ar nold ' G . E . "Language Disability " and Therapy , VI ( 1963 ) , _ . · 15 23

Speech Pathology

in Ta c h YP h emia · : I . Present Concepts - - -f- - · . "Studies . 0 Etiologic Factors. " Logos, III (1960), 25 - 31 . Bakwin , R · M· and Bakwin, H. "Cluttering . " Pedriatrics , XV (1952) , 393 -4 06 .

Journal of

Beech , H. R. and Fransella , F . Research and Experiment in Stuttering . Oxford: Pergamon Press , 1968 . Bender , J . "The Stuttering Personality ." American Journal of Orthopsychiatry , XII (1942), 140-46. Bills , A. G . " The Relation of Stutte ring to Mental Fatique ." Journal of Experimental Psychology , XVII (1934), 575- 84 . Bi l to , E. w. " A comparative Study of Certain Physical Abi l ities of children with Speech Defects.and Children with Normal Speech . " Journa l of Speech Disorders , VI ( 1 9 41 ) ,

187-203 .

kb B II study of Voluntary Movem7nts in Stutur n, W. · k " Psychological Monographs, terers and Normal Spea ers . XLI (1 931) I 1 -13. k B "Grammatical Function in Bl oodstein, O . and Gant~er ~ n Young Children . " Journal of Re l ation to Stu~teringe~rch, X (1967), 786-89. Speech and Hearing Res 'ddle of stutterinq. Danville, Ill.: Blueme l, c . s . The Ri 1957 Interstate Publ ishing co. , · . 'ficant Theories and TherBoome E J stuttering: signi E ise a n. Stan ' • · gene an press, 1958 . a pie s . Edi e Y u·versity Calif.: Stan ford uni

Bl

ac

43

44

Br y n gelson , B . " A S tudy of Nor mal Speake r s . 11 La l cril l i Ly of Stutterers and Jou rna l of s · (19 40), 1 51- 55 . ocial Psychology , XI Ch e rry , C . and Say e r s B ,, 1, . Inhibition o f S ta~ · . Experiments upon the 'I'otal · · e r ing Some Clinical Res u lts 11 Jby Exter n a 1 c ontrol , and Research, I (1 95 6 ) , 2 3 _ ~urnal of Psychosomatic 3 46 coriat , I . H. " Th e P s y c hoanalytic Conception of stammering ." Ne rvous Child , II (1 9 4 3 ) ' 167 - 71 . Cr oss ' H • " The Motor Capa cities o f Stu t t e r ers . of Speech, I (1936) , 112- 3 2.

11

Archives

de Hirsc h , ~ · " Di c:i-gno~is o f Deve l opmen t al Language Diso r ders . . Studi e s in Tachyphemia : An I nvestigation of Clutt ering and Ge neral La n g uage Disabi l ity . New York : Speech Rehabilitation Institute , 1 96 4 . Doug l ass , E . and Quarrington , B. " The Diffe r entiation of Interiorized and Exteriori zed Secondary Stu ttering . " J..:,.. .::o.. .:.u;r.::....n:..:.=a:....:l=--o=-::.f--=S:...ip._e.:.. . . ;.e_c_h_a_n_d_f_Ie_a_r_ i _n....g'--D_i_ · s_o_ r_d_e_r_s , XV I I ( 19 5 2) , 3 77-85. Fink l es t ein , p . and We isberger , S . " The Motor Proficiency of s tut t erers . " Journal o f Speech and Hearing Disor ders , XIX (1954) , 52 - 58 . L . B . ; and Bull is , E . Th e Child from Gese ll, A .; Ames , New York : Har per a nd Br others , 1 946 . F ive to Ten . · F o "An Inve stigation o f t h e G la s ne r~ ~ . . a n d Vermi ly~~ ' th~ oiagnosis , ' Pr i mary StutDe f ini t i ona,~n~d~U~s~~~~f~~Sip~e~e~c~h ~~a~n~d~H~e::.:a::..:r::...i:::.'~n~g--=D:....:i:..:s:....o:....r=-d.;;.;..:;.e=-r~s , tering . '" !!ourna o XV III (1 953) , 161-6?. . a nd F l ue ncy a s Manipulable Gold i amo nd , I . " Stuttering " Resear ch in Behav ior Ope r a nt Respons e C~ass e~ . L Krasne r and L. P . Ullma n. Mod i f i c at i ons . Ed~te~ r i ~nd Winston , 19 65 . Ne w York: Holt , Rine a ' and Auditory centra l ~ervous . Gr egory H H • II Stutter .,.~1~n~g~~1:~~f~S~p~e::::e ~c~h~a'.,;.n:..::d:.-....:H::.e:::.a=r.;;;:1.;_n_...g ' • 11 Journa o Sys t em Di sorder . -) 335-41. R h VII (19 64 I e s earc ' . n in the Speec h Musculature 11 Dysii:teg~~~i~roduction of a N~~ve~~~~ Huns l e y, y . L . of S tut t e r e r s our ;,ngpsychological Monograp ' Temporal Pa t tern (1937), 3 2-4 9 .

45 Jasper, II. 11. a n d Mu r r ay , I!! 11 , movements o f Stu1- tcr c · S LucJ y o f Llip 1 ~ _ of Exper ime nta l Psychr~ During Or DL Rcddingy~ Journal o ogl'.. , xv (1 932 ) , s2a-3o .

0

Johnson, W. " A S tudy of th _ Stutter ing ." Jou rnal 0 cf On se L a n d Deve l opme n t of S p eec h Di sorde r s , VII (19 4 2) ' 251-57. Johnson, W.; Da rl ey , F . L • . Diagnos tic Meth ods in . sp!ndhSpr ies Lersbach , D . c . Harper a nd Row P u blish e c Pathologx . New York : er s , I nc ., 196 3 . Karlin , D. B. ~nd Ka rlin, L . G. De v e lopme n t and Disorders of Spee ch in Childho o d Springf i e l d , I ll i nois : Charle s C. Thomas , 196S.

Karlt~g. ; : ~I (~~~~~~e~~~~ ~. Ba s ically a n Or g a nic Disorder . "

0

Kirk, S . and McCarthy , J . I ll inois Te st o f Psyc h oli nguistic Abiliti e s. Urbana: University o f Ill i no i s Pr es s,

1959. Knott , J . R . ; Corre ll, R . E .; and Sh e pa r d , J . N . "Frequency Analysis of Ele ctroe nc ephal ograms o f Stutter e r s and Non- stutte r e r s . 11 J ourna l o f Speech and Hear i n g Research , I I (1959) , 74-80. Kopp , H . "The Relationship o f Stu tte ring to Motor Disturbances. 11 Ne rvous Ch i l d , II (1943 ) , 107-16 . Lee, B. s. 11 Effe cts o f De layed Speech Feedback.(" J furna l of the Acoustical socie ty o f America , XXII 1 950 , 824-26 . Leutenegger , R "'re ntative Theo ry ," in W~ndell Jhnson' s . . . Ch'ldren a nd Adults . Minneapolis : 1 Stuttering in 1 955 University of Minne sota Pr ess , ·

h on Metabolism: A compari son Mccrosky , R. "Effect of Sp~~~- s tu tter s .'' Jour na l o f Between Stuttere rs a~d d xxII (19 5 7), 46 - 5 2. . oisor e r s , Speech and nearing Audi t ory Mask0£ " Effects · " Journa l o f Sp eech e Maraist , J . A . and Hutton, stutte r e r s . 385-89. ing Upon the Speech of xxrr (19 57), and Hearing Disorder~,

46

Moser, II. "A Qualitat·ive Analy · · M. Duri ng Stu t tcring . II Journal sis 0 r Ey0-movcments (1938 ) , 131-39 . of Speech Disorders , III Murphy , A 7 T . and Fitzsimons . 8 Dynamics . New York: Ro . ldtuttering and Pe rsonality na Press , 1960 . Mur ray , E . " Dysintegration of B . i n Stuttering During Sil t reat~ing and Eye Movements Psychological Monographs enXLRieiadi(ng and Reasoning." -----~~...__;.,;..:::_:.:.::..:..:::::~-~~-~ , I 1932), 218-75 . Myk l ebu st , H . R. Auditory _ o 1·sorders in Children. Grune and Stratton , 1954 .

New Yo k r :

Mys a k , E • D · " Serv