Genetic factors and therapy outcomes in persistent developmental stuttering.

PURPOSE: We investigated whether outcomes of therapy for persistent developmental stuttering differ in individuals who carry a mutation in one of the known genes associated with stuttering compared to individuals without such mutations. METHOD: We studied outcomes of an intensive fluency shaping-based therapy program in individuals with persistent developmental stuttering. We evaluated a cohort of 51 stuttering individuals with who carried a mutation in either the GNPTAB, GNPTG, NAGPA, or AP4E1 gene. We compared therapy outcomes in these individuals with outcomes in 51 individuals matched for age, gender, and ethnicity, who stutter and underwent the same therapy program, and did not carry a mutation in any of these genes. Fluency pre- and post-therapy was evaluated using blinded observer-based quantitative stuttering dysfluency measures (Dysfluent Words Score, DWS), and by subjects' self-reported measures of struggle, avoidance and expectancy behavior associated with speaking (Perceptions of Stuttering Inventory, PSI). The difference between pre- and post-therapy fluency scores was taken as the measure of near-term therapy efficacy. RESULTS: Comparison of fluency measures showed a strong effect of therapy overall. Mutation carriers achieved significantly less resolution in PSI following therapy, with PSI scores showing significantly less improvement in individuals who carry a mutation (p = 0.0157, RR = 1.75, OR = 2.92) while the group difference in DWS between carriers and non-carriers was statistically not significant in the present study, the trend observed in the results warrants further research focused on this important issue. CONCLUSIONS: These results suggest stuttering is more resistant to therapy in individuals who carry a mutation in one of the genes known to be associated with stuttering.

Adolescent Summaries of Narrative and Expository Discourse: Differences and Predictors.

Purpose: Summarizing expository passages is a critical academic skill that is understudied in language research. The purpose of this study was to compare the quality of verbal summaries produced by adolescents for 3 different discourse types and to determine whether a composite measure of cognitive skill or a test of expressive syntax predicted their performance. Method: Fifty adolescents listened to, and then verbally summarized, 1 narrative and 2 expository lectures (compare-contrast and cause-effect). They also participated in testing that targeted expressive syntax and 5 cognitive subdomains. Results: Summary quality scores were significantly different across discourse types, with a medium effect size. Analyses revealed significantly higher summary quality scores for cause-effect than compare-contrast summaries. Although the composite cognitive measure contributed significantly to the prediction of quality scores for both types of expository summaries, the expressive syntax score only contributed significantly to the quality scores for narrative summaries. Conclusions: These results support previous research indicating that type of expository discourse may impact student performance. These results also show, for the first time, that cognition may play a predictive role in determining summary quality for expository but not narrative passages in this population. In addition, despite the more complex syntax commonly associated with exposition versus narratives, an expressive syntax score was only predictive of performance on narrative summaries. These findings provide new information, questions, and directions for future research for those who study academic discourse and for professionals who must identify and manage the problems of students struggling with different types of academic discourse. Supplemental Material: https://doi.org/10.23641/asha.6167879.

Exploring Summarization Differences for Two Types of Expository Discourse in Adolescents With Traumatic Brain Injury.

Purpose: Annually, nearly 700,000 U.S. children and adolescents experience a traumatic brain injury (TBI). Many of them struggle academically, despite failing to qualify for special education services because their cognitive communication impairments are subtle. Method: In this exploratory study, five adolescents with TBI provided verbal summaries of two expository lectures (compare-contrast, cause-effect) and participated in cognitive and expressive syntax testing. Their performance on these tasks was compared descriptively to that of 50 adolescents with typical development. Results: For adolescents with TBI, mean summary quality scores for both exposition types were at least 1 SD lower than those of adolescents with typical development and notably 2 SDs below for the cause-effect passage. The adolescents with TBI who had below-average cognitive scores showed better performance on compare-contrast summaries compared to cause-effect, whereas the majority of adolescents with typical development showed the opposite tendency. Conclusions: These results provide preliminary evidence that students with TBI, particularly those with cognitive deficits, may struggle with expository discourse despite acceptable performance on a measure of expressive syntax. This study also indicates that researchers should explore how students with TBI perform on academically relevant discourse tasks in order to inform future assessment and intervention efforts. Supplemental Materials: https://doi.org/10.23641/asha.5572786.

The Effect of Stimulus Valence on Lexical Retrieval in Younger and Older Adults.

Purpose: Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults. Method: Eighteen healthy younger adults and 18 healthy older adults named positive, negative, and neutral images, and reaction time was measured. Results: Reaction times for positive and negative images were significantly longer than reaction times for neutral images. Reaction times for positive and negative images were not significantly different. Whereas older adults demonstrated significantly longer naming latencies overall than younger adults, the discrepancy in latency with age was far greater when naming emotional pictures. Conclusions: Emotional arousal of pictures appears to impact naming latency in younger and older adults. We hypothesize that the increase in naming latency for emotional stimuli is the result of a necessary disengagement of attentional resources from the emotional images prior to completion of the naming task. We propose that this process may affect older adults disproportionately due to a decline in attentional resources as part of normal aging, combined with a greater attentional preference for emotional stimuli.

Negative Word Production in Adults With Right Hemisphere Brain Damage: Effects of Implicit Assessment and Contextual Bias.

PURPOSE: Both theory and evidence suggest that unilateral right hemisphere brain damage (RHD) should impair the processing of negative emotions. Typical metalinguistic assessments, however, may obscure processing strengths. This study investigated whether adults with RHD would produce proportionately fewer negative emotion words than control participants in an implicit assessment task and whether a negatively toned contextual bias would enhance performance. METHODS: Eleven participants with RHD and 10 control participants without brain damage watched a video in 2 parts and described each segment. Between segments, participants evaluated the emotion conveyed by sentences designed to induce the negative bias. RESULTS: The primary outcome measure, percentage of negative emotion words in video descriptions, did not differ between groups. After the contextual bias, this measure significantly increased for both groups, whereas production of motion words, a control variable, remained constant. CONCLUSIONS: Findings are consistent with a view that attributes some deficient RHD performances to the nature and/or demands of explicit metalinguistic assessment tasks. These results call for modulation of prevailing hypotheses that attribute negative emotion processing as an undifferentiated whole solely to the right cerebral hemisphere. The results also further substantiate the rationale of an experimental treatment that exploits contextual bias and priming for individuals with RHD.