A Latent Trait Approach to the Development of Persistent Stuttering

Abstract

The premise that stuttering disorders develop according to the orthogenetic principle, preceding in a continuous, unilinear fashion from a state of relative lack of differentiation to a state of increasing differentiation and hierarchic integration, was examined. Responses to Woolf's Perceptions of Stuttering Inventory of 87 individuals who stutter were analyzed using a Rasch 1980 latent trait model for dichotomously scored data. Analyses of responses indicated struggle, avoidance, and expectation through the development of stuttering that became increasingly articulated, integrated, stable, and yet responsive to environmental changes. Four stages of development were noted: Stage I was characterized by the expectation of interruptions in the flow of speech, the addition of unnecessary sounds, and general body tension. Stage II was typified by distinctions between troublesome and not so troublesome words and sounds and between the speaker and various audiences and contexts for speaking. In Stage III, speech control decreased despite more focused and complex efforts to control the environment and the speech apparatus. Stage IV was characterized by automatic scanning of all speech, increasingly uncontrolled body movements, and attempts to produce fluent speech by way of comprehensive changes to sound, rhythm, and pitch. Follow-up of 29 respondents suggested the latent struggle was generally stable over time.

Intensive Stuttering Modification Therapy

“…Rothenberg's inventory showed high test-retest reliability among adult stuttering speakers, resulting in correlations of .88 for Struggle, .89 for Avoidance, and .85 for Expectancy (as cited in Woolf ). The PSI continues to be a popular measure of clientperceived aspects of stuttering (e.g., Brin, Steward, Blitzer, & Diamond, 1994;Ginsberg, 2000;Gordon et al, 1995;Kalinowski, Kalinowski, Stuart, & Rastatter, 1998;Langevin & Kully, 2003;Lawson, Pring, & Fawcus, 1993;Manning, Dailey, & Wallace, 1984;Webster, 1979). Ginsberg found that participants' self-ratings of stuttering severity were closely associated with their scores on the PSI (correlations ranged from .89 for expectancy to .92 for total perceptions of stuttering).…”

Stuttered and fluent speakers' heart rate and skin conductance in response to fluent and stuttered speech

“…to complex, highly developed strategies that are pervasive and highly integrated in their daily communication (for example, breathing noisily or with great effort while trying to speak, avoiding talking to parents, pretending to be angry when speaking, etc. ; Kalinowski et al 1998).…”

“…This percept is pervasive, widely held, and resistant to change. Simply put, it is a stereotype that can be found in numerous sub‐populations including 9–11‐year‐old children (Franck et al 2003), middle‐school students (Evans et al 2008), employers (Hurst and Cooper 1983), speech–language pathologists (Cooper and Cooper 1985, Lass et al 1989, Kalinowski et al 1993), those with no previous direct contact with PWS (Craig et al 2003), those who have familial relationships with PWS (for example, parents, relatives, and family members; Crowe and Cooper 1977, Doody et al 1993), and even PWS themselves (Lass et al 1995). Modifications or alterations of the stuttering stereotype appear to be difficult, if not impossible (Leahy 1994, McGee et al 1996).…”

The need for self‐report data in the assessment of stuttering therapy efficacy: repetitions and prolongations of speech. The stuttering syndrome

“…For example, people who stutter avoid using feared sounds or words, speaking over the telephone, speaking with strangers, ordering in a restaurant, etc. (Woolf 1967, Kalinowski et al 1998. They also continue to scan ahead when speaking to replace upcoming difficult words with synonyms that are less likely to be stuttered.…”