Subgrouping young stutterers: preliminary behavioral observations.

The purpose of this investigation was to identify speech and nonspeech behaviors associated with stuttering of young persons and to use these behaviors in attempts to discern and describe subgroups of these individuals. Forty-three young stutterers (10 girls and 33 boys) produced stutterings and associated behaviors during conversations that were video/audio recorded. Fourteen associated speech and nonspeech behaviors and speech disfluency types were identified and quantified for 10 stutterings from each of the 43 subjects. The 14 associated behaviors and speech disfluency types were further reduced to form three related indices: (a) Sound Prolongation Index, (b) Nonspeech Behavior Index, and (c) Behavioral Variety Index. Results indicated that five subgroups of young stutterers could be identified and described on the basis of these youngsters' number and variety of speech and nonspeech behaviors associated with their stuttering. Findings are taken to suggest that these speech and nonspeech behavioral differences reflect differences in young stutterers' reactions and adjustments to their problem.

Laryngeal behavior during stuttering: a further study.

The purpose of this study was to provide detailed, objective descriptions of stutterers' laryngeal behavior during instances of stuttering within conversational speech. Subjects were 11 adult stutterers who produced stutterings (sound prolongations and sound/syllable repetitions) while their laryngeal behaviors were observed by means of a flexible fiber-optic nasolaryngoscope (fiberscope). Laryngeal behaviors during 86 of the 11 stutterers' stutterings were categorized as adducted, intermediate, or abducted. Results indicate that during sound prolongations the vocal folds were more likely to be adducted and less variable in their movement than during sound/syllable repetitions. Results further indicated that the voicing characteristics of the stuttered sound (voiceless vs. voiced) and the type of stuttering (sound prolongation vs. sound/syllable repetition) interactively influenced laryngeal behavior. It is hypothesized that a complex interaction among the laryngeal, articulatory, and respiratory systems contribute to the occurrence of the inappropriate abductory and/or adductory laryngeal behavior which characterizes prolonged or repeated (stuttered) speech segments.

Hypoarousal in patients with the neglect syndrome and emotional indifference.

Physiologic theories of emotion suggest that activation is important in the experience of emotion; patients exhibiting "neglect" as a consequence of right parietotemporal of dysfunction show flattened affect. We studied arousal in patients with lesions of the right hemisphere who also exhibited emotional indifference, in aphasic patients with lesions of the left hemisphere, and in non-brain-damaged controls, by stimulating the forearm ipsilateral to the side of the brain lesion while recording galvanic skin responses (GSRs) from the fingers on the same side. The group exhibiting neglect had lower GSRs than aphasic patients or non-brain-damaged controls. Aphasic patients had higher GSRs than non-brain-damaged controls. These results suggest that neglect is associated with disturbances in bilateral arousal and that this disorder of arousal may be responsible in part for flattened affect. The heightened GSR in aphasic patients may reflect disinhibition, which might be partly responsible for increased emotionality in these patients.

New techniques for ion-selective measurements of ionized calcium in serum after pH adjustment of aerobically handled sera.

I report further experience in measuring ionized calcium (Ca2+) with the AMT Electron System and its serum standards and solid-state, dip, calcium-selective electrodes. With this system, serum pH can be adjusted with CO2 gas and Ca2+ and pH simultaneously measured; when 5.2% CO2 (40 mm pco2) is used for sample equilibration, the standard bicarbonate concentration is also provided. I measured serum Ca2+ as a function of pH between pH 7.0 and 9.0 and found the relationship to be reproducible, with no evidence of irreversible complexing of Ca2+. When the pH of aerobically exposed, mailed sera was restored to the original values, their values for Ca2+ were the same as for the fresh sera. Measurement of Ca2+ in routinely (aerobically) handled sera after pH restoration with CO2 gas was therefore validated, both samples from within an institution and mailed specimens. Standardization to pH 7.40 is recommended for routine measurements, is generally more accurate than use of heparin or quasianaerobic techniques, and is a practical approach. In patients with possible uncompensated acid-base disturbance (which may be indicated by an abnormal standard bicarbonate concentration if not suspected clinically), patient pH should be measured independently as part of the usual strict, anaerobic blood-gas-analysis procedures. Abnormal patient pH must be considered in the interpretation of Ca2+ results determined at pH 7.40 which are borderline or slightly abnormal; most accurately, Ca2+ may be measured in the separated sera at the previously determined patient pH value. Studies of aqueous solutions with the currently used Ca2+ electrodes showed a selectivity coefficient (the constant which relates the activity of an interfering ion to the activity of calcium that would contribute the same emf) KNa=0.0031 +/- 0.0003 (SE) and KMg=0.046 +/- 0.004 (SE). At physiological concentrations of Ca2+, physiologically encountered variation in Na+ is of no significance in resulting Ca2+, but extreme variation in Mg2+ may cause an error of approximately 1%.

Defective motor learning in ideomotor apraxia.

Liepmann suggested that the left hemisphere contained the engrams for motor sequences. Other investigators have suggested that ideomotor apraxia may be caused by either a destruction of these engrams or a disconnection of these engrams from motor systems in the nondominant hemisphere. If these hypotheses are correct, then ideomotor apraxics should not only show a defect on previously learned motor tasks but also a defect in new motor learning. Nine right-handed, hemiparetic, aphasic apraxics were given six trials on a rotary pursuit meter. Eight right-handed hemiparetic, aphasic, nonaprixic patients served as controls. All subjects were instructed to use their left (nonparetic) hand. The performance of the control group on the sixth trial was significantly better than that on the first trial, showing a distinct learning effect. In the apraxic group, however, there was no significant difference between the first and sixth trial, suggesting a defect in motor learning. This defect appeared to be caused by a combined defect of both acquisition and retention.

Serum ionized calcium by electrodes: new technology and methodology.

We report experience measuring serum ionized calcium (Ca2+) with new solid-state, specific calcium ion dip electrodes in a commercially available system for automated electrode measurments which permits stable measurements on thirty samples with up to six different electrodes simultaneously. The system provides electrostatic shielding, temperature regulation at 37degreeC, and adjustment of serum pH with CO2 gas, thereby making practical the use of serum standards and routine measurements on sera. When the electrodes are used with the rest of the measuring system and with serum standards, the system provides serum Ca2+ measurements with high precision (C.V. of 0.7%) and the calcium electrodes maintain good slopes for 50 to 150 hours of cumulative wet immersion. Response to new calcium activity is rapid, and wide variations in serum Ca2+ are readily measured.

A memory defect in uremic encephalopathy.

It has been demonstrated that anesthesia primarily affects the reticular activating system and psychological studies on patients undergoing anesthesia demonstrated a verbal memory defect. This study was performed in order to determine whether metabolic (uremic) encephalopathy follows the Jacksonian dissolution hypothesis and disrupts cortical function or whether it acts like an anesthetic, causes dysfunction in phylogenetically older systems and thereby produces a memory defect. Twenty-four uremic subjects were tested for memory function, language function, and intellectual function, and compared to 12 control subjects. The greatest difference between the groups was in immediate memory function suggesting that uremia probably acts in a manner similar to anesthesia (by causing dysfunction in the reticular activating system). It is postulated that poor arousal interferes with rehearsal and rehearsal is probably an important component of immediate memory.