Stuttering and Phonological Disorders in Children

Abstract

The purpose of this study was to evaluate whether the Covert Repair Hypothesis (CRH; Postma & Kolk, 1993), a theory designed to account for the occurrence of speech disfluencies in adults who stutter, can also account for selected speech characteristics of children who stutter and demonstrate disordered phonology. Subjects were 9 boys who stutter and exhibit normal phonology (S + NP; mean age=61.33 months; SD=10.16 months) and 9 boys who stutter and exhibit disordered phonology (S + DP; mean age=59.11 months; SD=9.37 months). Selected aspects of each child's speech fluency and phonology were analyzed on the basis of an audio/videotaped picture-naming task and a 30-min conversational interaction with his mother. Results indicated that S + NP and S + DP children are generally comparable in terms of their basic speech disfluency, nonsystematic speech error, and self-repair behaviors. CRH predictions that utterances produced with faster articulatory speaking rates or shorter response time latencies are more likely to contain speech errors or speech disfluencies were not supported. CRH predictions regarding the co-occurrence of speech disfluencies and speech errors were supported for nonsystematic ("slip-of-the-tongue"), but not for systematic (phonological process/rule-based), speech errors. Furthermore, neither S + NP nor S + DP subjects repaired their systematic speech errors during conversational speech, suggesting that systematic deviations from adult forms may not represent true "errors," at least for some children exhibiting phonological processes. Findings suggest that speech disfluencies may not represent by-products of self-repairs of systematic speech errors produced during conversational speech, but that self-repairs of nonsystematic speech errors may be related to children's production of speech disfluencies.

Full text

Journal
of
Speech
and
Hearing
Research,
Volume
39,
349-364,
April
1996
Stuttering
and
Phonological
Disorders
in
Children:
Examination of
the
Covert
Repair Hypothesis
J.
Scott
Yaruss
Northwestern
University
Evanston,
IL
Edward
G.
Conture
Syracuse
University
Syracuse,
NY
The
purpose
of
this study
was
to
evaluate
whether
the
Covert
Repair
Hypothesis
(CRH;
Postma
&
Kolk,
1993),
a
theory
designed
to
account
for
the occurrence
of
speech
disfluencies
in
adults
who
stutter,
can
also
account
for
selected speech
characteristics
of
children who
stutter
and
demonstrate disordered phonology.
Subjects
were
9
boys who
stutter
and
exhibit
normal
phonology
(S
+
NP;
mean
age
=
61.33
months;
SD
=
10.16 months)
and
9
boys
who
stutter
and
exhibit
disordered
phonology
(S
+
DP; mean
age
=
59.11
months;
SD
=
9.37
months).
Selected
aspects of
each
child's
speech
fluency
and
phonology
were
analyzed on
the
basis
of
an
audio/videotaped
picture-naming
task
and
a
30-min conversational
interaction
with
his
mother.
Results
indicated
that
S
+
NP
and
S
+
DP
children
are
generally
comparable
in
terms
of
their
basic
speech
disfluency,
nonsystematic speech
error,
and
self-repair
behaviors.
CRH
predictions
that
utterances
produced with
faster
articulatory
speaking
rates
or shorter
response time latencies
are
more
likely
to
contain speech
errors
or speech
disfluencies
were
not
supported.
CRH
predictions
regarding
the
co-occurrence
of
speech
disfluencies
and
speech
errors
were
supported
for
nonsystematic
("slip-of-the-tongue"),
but
not
for systematic
(phonological process/rule-based), speech
errors.
Furthermore,
neither
S
+
NP
nor
S
+
DP
subjects
repaired
their
systematic
speech
errors
during conversational
speech,
suggesting
that
systematic
deviations
from
adult
forms
may
not
represent true
"errors,"
at
least
for
some
children
exhibiting phonological
processes. Findings
suggest
that
speech
disfluencies
may not
represent
by-products
of
self-repairs
of
systematic speech
errors
produced
during conversa-
tional speech,
but
that
self-repairs
of
nonsystematic
speech
errors
may
be
related
to
children's
production
of
speech
disfluencies.
KEY WORDS:
stuttering,
phonology,
speech
errors,
self-repairs,
phonological
processes
Considerable evidence
indicates
that
children
who
stutter
are
more
likely
than
children
who
do
not
stutter
to
demonstrate
concomitant phonological
concerns
(e.g.,
Bloodstein,
1995;
St.
Louis
&
Hinzman,
1988;
Wolk,
Conture,
&
Edwards,
1990).
Although Nippold
(1990)
has
raised
valid
concerns
about the
methodology
of
certain
studies
on
the co-occurrence
of
stuttering
and
various speech
and
language
disorders, Wolk et
al.
(1990)
presented
a
detailed
review
of
studies
on
the
co-occurrence
of
stuttering
and
articulation
or phonological disorders
in
children
and
demonstrated that,
on
average,
approximately
30%-40%
of
children
who
stutter
also
exhibit
disordered
articulation or
phonology-considerably
more
than
the
2%-6%
found
in
the
general
population
(Beitchman,
Nair,
Clegg,
&
Patel,
1986).
More
specifically,
in
a
descriptive
study
comparing
30
children
who
stutter
and
30
children who do
not
stutter,
Louko,
Edwards, and
Conture
(1990)
found
that
children
who
stutter
produced
a
greater
number and
variety
of
phonological
processes
(i.e.,
systematic or
rule-governed
sound changes
affecting
sequences
or
classes
of
©
1996,
American
Speech-Language-Hearing
Association
349
0022-4685/96/39020349
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350
Journal
of
Speech
and Hearing
Research
sounds; after
Edwards
&
Shriberg,
1983),
as
well as
a
greater
number
of
"atypical"
phonological
processes
such
as
vowel
changes
or
glottal
replacement.
Also,
Wolk,
Ed-
wards,
and
Conture
(1993)
found that
although
the
speech
disfluency
behaviors
(e.g.,
frequency
and
duration
of
within-
and
between-word
speech
disfluencies)
of
children
exhibit-
ing
both
stuttering
and
disordered
phonology
(S +
DP)
were
generally
similar
to
those
of
children
exhibiting only stutter-
ing
(S +
NP),
S +
DP
children
produced
significantly
more
sound
prolongations
than
S +
NP
children.
This
suggests
a
fundamental difference
in
the
speech
disfluencies
of
S
+
DP
children,
because
the
presence
of
frequent
sound prolon-
gations
is
viewed
as
an
important
indicator of
stuttering
severity or
chronicity
(e.g.,
Conture,
1990; Riley,
1981;
Schwartz
&
Conture,
1988).
Furthermore,
such
findings
suggest
that
there
may be
an
interaction
between
stuttering
and
phonological disorders,
though
the
nature
of that
inter-
action
is
unclear.
Although
there
are
presently few
empirical
studies
on
the
interaction
between
stuttering
and
phonology,
there
is
some
clinical
evidence
that
the
co-occurrence of
speech
disfluen-
cies
and
phonological
speech
errors
in
some
children
may
not
be
purely
coincidental.
For
example,
practicing
speech-
language
pathologists occasionally
report
that
a
small
num-
ber
of
children
receiving speech
treatment
for
articulation/
phonological problems
may
exhibit
an
increase
in
the
frequency
of their
speech
disfluencies
during the course
of
treatment
(e.g.,
Comas,
1974;
Hall,
1977;
Ratner,
1995). The
cause and
nature
of
this
increased
disfluency
is
not
readily
apparent,
and
controlled
research on
this
change
in
speech
fluency
has
not
yet
been
conducted.
Thus,
it
is
difficult
to
precisely determine
the
relationship
between
articulation/
phonological
treatment
and
children's production
of
speech
disfluencies.
Nevertheless,
it
seems
reasonable
to
assume
that
some
aspect
of
the
children's
phonological disorder
or
the
nature
of
treatment
for
the
phonological
disorder
may
be
related
to
this
apparent
change
in
children's
speech
fluency.
In
addition,
children demonstrating both stuttering
and
dis-
ordered
phonology
may
benefit
from different
treatment
paradigms than
children
demonstrating
only
one
of
the
two
disorders
(e.g.,
Conture, Louko,
&
Edwards,
1993;
Louko,
Wolk,
Edwards,
&
Conture,
1989).
Thus,
there
are
theoretical
as
well
as
therapeutic
needs
for
further
evaluation
of the
potential
relationship
and
interaction
between speech
dis-
fluencies
and
speech
sound
errors
in
children
who
stutter.
Covert Repair
Hypothesis
Among
available
explanations
of the
potential
relation-
ships
between
stuttering
and
phonological disorders
in
children
(see
Louko
et
al.,
1990),
one
recent theory,
the
Covert Repair
Hypothesis
(CRH;
e.g.,
Kolk,
Conture,
Postma,
&
Louko,
1991;
Postma,
1991;
Postma
&
Kolk,
1993;
Postma,
Kolk,
&
Povel,
1990a,
1991)
appears
to
be
relatively
thoroughly
defined
and
empirically testable.
The
CRH
is
based,
in
part, on
recent
psycholinguistic
speech
production
models, such
as
Levelt's
(1989)
"blueprint for the
speaker"
and
Dell's
(1986, 1988)
spreading
activation theory
of pho-
nological
encoding,
as
well
as
on
studies
of
adults'
speech
errors
(e.g.,
Dell
&
Reich,
1981;
Fromkin,
1971;
Meyer,
1992;
Shattuck-Hufnagel,
1979).
In
essence,
the
CRH
makes
the
following
assumptions:
(a)
Speakers
typically
monitor
their
speech before
it
is
produced
for
accuracy
and
appropriate-
ness
of
content,
form,
and
intent
(e.g.,
Blackmer
&
Mitton,
1991;
Garnsey
&
Dell,
1984;
Laver,
1973,
1980;
Levelt,
1983),
(b)
During
this
monitoring
process,
speakers
have
the
ability
to
detect
errors
that
arise
in
their
phonetic
plan
(i.e.,
the
"internal representation
of
how
the
planned
utterance
should
be
articulated,"
Levelt,
1989,
p.
12)
before
such
errors
are
produced,
and
(c)
Following
detection
of
errors,
speakers
may
elect
to
interrupt
their
ongoing
speech
in
order
to
repair
such
errors
(Bredart,
1991; Levelt,
1983;
Nooteboom,
1980).
(Note
that
it is
assumed
that
different
speakers
may
have
differing
abilities
or
propensities
to
detect
and
repair
speech
errors.)
According
to
the
CRH,
speech
disfluencies
occur
as a
by-product
of
this
detection
and
repair
process
when
a
speaker
disrupts
ongoing
speech
production
in
an
attempt
to
covertly
repair
errors
within their
phonetic
plan
before
such
errors
are
overtly
produced.
In
this
way,
the
CRH
seeks
to
account for
the
mechanisms
underlying
all
types
of
speech
disfluencies,
including
those
produced
by individuals
who
stutter.
Based
on
studies
of speech planning
(e.g.,
Postma,
Kolk,
&
Povel,
1990b),
as well
as
rate and
timing
abilities
(see
Caruso,
1991,
and
Starkweather,
1987)
of
individuals
who
stutter,
Kolk
(1991;
Kolk
et al.,
1991)
suggested
that
individ-
uals
who
stutter
may
demonstrate
an
impairment
in
their
phonological
encoding
mechanisms.
This assumption
leads
to the
prediction
that
the activation
of
target
phonemes
(e.g.,
Dell,
1986,
1988)
is
somewhat delayed
for
people
who
stutter
(see
Figure
1),
resulting
in
a
relatively
long
period
of
time
when
target
phonemes
are
in
competition
with
other
phonemes. Kolk
et
al.
(1991)
further suggested
that
individ-
uals
who
stutter
may
attempt
to
speak faster
than
their
peers
or
tend
to
initiate
speech
too
rapidly
(i.e.,
demonstrate
relatively
short
response
time
latencies).
Accordingly,
indi-
viduals who
stutter
may
not
allow
enough
time
for
their
relatively
slow-to-activate
phonological
encoding
mecha-
nisms
to
select appropriate phonological
targets
(e.g., Dell
&
Reich,
1980),
thereby
increasing
the
likelihood that
phono-
logical
encoding
errors
will
become part of their
phonetic
plan. Based
on
the
CRH,
if
the
phonological
encoding
error
is
detected
by
the speaker's
internal
self-monitoring
pro-
cesses,
the
speaker
may
attempt
to
covertly
repair
the
error
before it
is
overtly
produced
and,
as a
by-product
of
this
process,
produce
a
speech
disfluency.
The CRH
and
children
who
stutter.
Kolk
et
al.
(1991)
indicated
that
the
basic assumptions
of
the
CRH
can
be
applied
to
children.
Specifically,
they
suggested
that
chil-
dren
who
stutter
may
demonstrate
an
impairment
in
their
phonological encoding
mechanism
that,
combined with
a
tendency
to
use rapid
articulatory speaking
rates
or
short
response
time
latencies, might
not
permit
sufficient
time
for
their
phonological
encoding
mechanisms
to
make
appropri-
ate
selections
of
target
phonemes.
Although there
is
prelim-
inary
support
for
the
suggestion that children
who
stutter
speak
more
quickly
than
their
peers
who
do
not
stutter
(e.g.,
Meyers
&
Freeman,
1985)
and
that their
articulatory
speak-
ing
rates may
exceed
their
motoric
abilities
(Conture,
Ya-
39
349-364
April 1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
351
High
Activation
Level
Low
High
Activation
Level
Low
TU
=
Target
Unit
TU
CU
Normal
Activation
TU
>
CU
A
Time
of
Selection
j.V,
-J
time
TU
CU
Delayed
Activation
TU=
CU
o
n
Time
of
Selection
time
FIGURE
1.
Normal
versus
delayed
activation
of
phonological
units.
With
normal
activation
(top),
the
target
unit
(TU)
achieves
higher
activation
(expressed
on
the
ordinate
in
arbitrary
units
of
activation
level)
than
the competing
unit
(CU)
at
the time
of
selection
(TU
>
CU).
With
delayed
activation
(bottom),
the
target
unit
(TU)
is
in
competition
with
competing units
(CU)
at
the time
of
selection
(TU
=
CU),
increasing
the
likelihood that
an
inappropriate
target
will
be
selected.
The
rate
of
activation
is
considered
an
automatic
process
(i.e,
an
event
that
a
person
cannot
regulate),
whereas
the
time
of
selection
is
considered
a
controlled
process
(i.e.,
an
event
that
a
person can
regulate).
Adapted
from Kolk
et
al.
(1991).
Note
that
this
figure
does
not
indicate
decay
of
activation
(the
construct typically
used
in
such
models
to
account
for
the system's
ability
to
keep
from
repeat-
ing
the
same
act
continuously).
russ,
&
Edwards,
1995;
Costello,
1983),
there
is
also
evi-
dence
that
the
articulatory
(and
overall)
speaking
rates
of
children
who
stutter
do
not
differ
appreciably
from
those
of
children
who
do
not
stutter
(e.g.,
Kelly
&
Conture,
1992;
Ryan, 1984;
Yaruss
&
Conture,
1995).
In
addition,
the
only
published
study
on
the
response time latencies
of
children
who
stutter
in
spontaneous conversational
speech
found
no
significant
differences
between
children who
stutter
and
their
nonstuttering
peers
(Kelly
&
Conture,
1992),
although
there
was
a
significant
correlation
between
the
duration
of
mother/child
conversational overlaps
("simultalk")
and
the
severity
of
the
child's
stuttering.
Thus,
further
research
on
the
relationship
between
articulatory
speaking
rates,
re-
sponse time
latencies,
and
the production of
speech
disflu-
encies
appears warranted.
Because
the
CRH
incorporates
phonological
constructs
in
its
attempts
to
account
for
both
the
occurrence
and
nature
of
speech disfluencies, the
CRH
appears
to
provide
a
salient
and
promising framework
for
examining
the
co-occurrence
of
children's
stuttering
and
phonological
disorders. How-
ever,
one
concern
with
the
application of
the
CRH
to
the
speech
errors
of
children
is
that
many
children-particularly
those
children
exhibiting phonological
disorders-frequently
produce
both
systematic
and
nonsystematic
speech
errors
(see
Table
1).
It
is
not clear whether
children's
systematic
speech
errors,
which
are
often
described
in
terms
of
pho-
nological
processes
(e.g.,
Edwards,
1992;
Edwards
&
Shri-
TABLE
1.
Definition, description,
and
hypothesized
causes
of
nonsystematic
and
systematic
speech errors.
Nonsystematic
("slip-of-the-tongue")
speech
errors
Definition: Nonhabitual speech
errors
that occur
relatively
infrequently
in
not
necessarily
predictable locations during
conversation.
Description:
Error
is
not rule-based;
that
is,
it
does
not
typically
follow
the
same
pattern
and
is affected
by
the other
words
in
the
utterance
(e.g.,
the
segment
in
error
is
influenced
by,
or
tends
to
"slip"
with,
other
sounds
in
the
same
word
or
utterance,
e.g.,
when
/IV is
affected
by
a
nonsystematic
error,
it
may
be
replaced
by
another segment from
the
same
utterance).
This error
is
commonly described
as a
"slip-of-the-tongue"
error.
Intentionality:
Error
clearly
represents
deviation
from
the
speaker's
intention.
Hypothesized
Cause:
Cause
of
error
is
phonological
or
lexical
encoding
error.
Error
Detection:
Can
be
detected
and repaired
either
(a)
before
production,
resulting
in
covert-repair, or
(b)
after
production,
resulting
in
overt-repair.
Relationship
to
CRH:
Represent
errors
described
by the
CRH
as
currently
defined
for
adults.
Systematic
("phonological
process")
speech
errors
Definition:
Habitual
speech
errors
that occur
relatively
frequently
and
predictably during
conversation,
but not
necessarily
with
100%
consistency
(i.e.,
error
may
occur
at
some
times but not
at
others
during conversation).
Description:
Error
is
rule
based;
that
is,
it
typically
follows the
same
pattern
(i.e.,
the segment
in
error
is
consistently
replaced
by
a
different
sound
in
a given
phonological setting,
regardless
of
the
specific
words
in
the
utterance,
e.g.,
when
/I/
is
affected
by
the
process
of
gliding
of
liquids,
it
is
consistently
replaced by
/w/).
This
error is
commonly described
as
a
"phonological
process"
error.
Intentionality:
Unclear
whether "error"
represents
deviation
from
speaker's
intention.
Hypothesized
Cause:
Precise
cause
in
children's
speech
is
not
clear.
Error
Detection:
Potential
for
being
detected
and repaired
has
not
been
carefully
examined.
Relationship
to
CRH:
Unclear
whether
these
are
errors
described
by
the
CRH
as
it
is
currently defined
for
adults.
berg, 1983),'
are
similar
to
the
nonsystematic
or
"slip-of-
the-tongue"
speech
errors
(e.g.,
Jaeger,
1992;
LaSalle
&
Conture,
1995;
Stemberger,
1989)
on
which the
CRH
was
originally
modeled.
Certainly,
if
children
are
able
to
detect
systematic
errors
in
the
same
manner
as
nonsystematic
errors,
they
might
attempt to
repair
the
detected systematic
errors,
thereby
producing speech disfluencies.
However,
present
uncertainties
about
the relationship
between
chil-
dren's
systematic
and
nonsystematic
speech
errors
and
'Throughout
this
manuscript,
a
distinction
will
be made
between
systematic
and
nonsystematic
speech
errors.
Systematic speech
errors
produced
by
children
are
often
described
in
terms. of
phonological
processes
(e.g.,
Edwards,
1992;
Edwards
&
Shriberg,
1983).
Phonological
processes tradi-
tionally
refer
to
a
set
of
mental
operations
thought
to
be
used
by
children
to
simplify
their
speech
output
(e.g.,
Stampe, 1973);
however,
in
the
present
investigation
the
term
will
simply
refer
to
a
descriptive
system
used
to
categorize
classes
of
rule-based
sound
errors.
A
_
w
..
I
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352
Journal of
Speech
and
Hearing
Research
speech
disfluencies, suggest
the
need
for
empirical
investi-
gations
of
the
CRH.
Furthermore,
the
CRH
has been
tested
primarily
with
adults
(e.g.,
Postma
&
Kolk,
1990,
1992a;
1992b;
Postma et
al.,
1990a,
1991;
cf.
LaSalle
&
Conture,
1995)
and
several
hypotheses
resulting from
the
CRH
have
not
yet
been
examined.
Thus,
further
research on
how
the
CRH
might explain
the
relationship
between
childhood stut-
tering
and
disordered phonology,
and
the
factors
that
affect
each
disorder, seems
warranted.
The
purpose
of the
present
study
was
to
assess
whether
the
CRH
accounts
for
selected
aspects
of
the
speech
of
children who
demonstrate stuttering
and
disordered
phonol-
ogy.
Given
the
basic
CRH
assumption
that
speech
disfluen-
cies
arise
as
a
by-product
of
the
self-repair
process,
a
number
of predictions
about
potential
relationships
between
stuttering
and
phonological
disorders
can
be
derived.
In
this
study,
one
set
of
such
predictions
was selected
for
evalua-
tion,
specifically:
(a)
Children's
production
of
speech
disflu-
encies should be related
to
their production
of
(non)system-
atic
speech
errors
because the
production of
speech errors
provides
an
opportunity
for
the
detection
of
errors
and
self-repair,
(b)
Children
who
stutter
and
exhibit
disordered
phonology
should
produce
more
speech
disfluencies
than
children
who
only
stutter
because
children
with
phonological
disorders
produce
more (systematic)
speech
errors
and
therefore
may
have
more
opportunities for
error
detection
and
self-repair,
and
(c)
The rate
of production
of
children's
utterances
should
affect
the
occurrence
of
speech
errors
and
speech
disfluencies
because
faster
utterances should
be
associated with
an
increased
likelihood
of
errors
occur-
ring
in
the phonetic
plan.
Method
Subjects
Subjects
were
18
boys
who
stutter
(age
3
to
6),
divided
into
two
groups
based
on
their
phonological
development
(normal
vs.
disordered).
As
shown
in
Table
2,
the
normal
phonology
group
(S +
NP)
consisted
of
9
boys
with
a
mean
age
of
61.33
months
(SD
=
10.16
months,
range
=
49
to
82
months)
and
the disordered
phonology
group
(S +
DP)
consisted of
9
boys
with
a
mean
age
of
59.11
months
(SD
=
9.37
months,
range
=
45
to
74
months).
There
were
no
significant
between-group
differences
in
chronological
age
(Mann-Whitney
U
=
36.0;
p
=
.69)
or
reported
time
since
onset
of
stuttering
(U
=
37.5;
p
=
.79).
In
order
to
minimize
the
potential
effects
of
speech-language
treatment
on
chil-
dren's
speech
fluency,
phonology,
and
self-repair
behaviors,
TABLE
2.
Chronological
ages,
reported time since onset
of
stuttering,
and
Stuttering Severity
Instrument
(SSI,
Riley,
1981)
scores
for
children exhibiting Stuttering
and
Disordered
Phonology
(S
+
DP) and
children
exhibiting
Stuttering
and
Normal
Phonology
(S
+
NP).
SSI
Age
at time
Time
since
Physical Total
Subject
of
onset
of
Frequency Duration
concomitant
overall
number
videotaping
stuttering
task
score score score
score
S
+
DP
D1
45
18 10
2 1 13
D2
50
20
10
2 2 14
D3
53
21
10
3
4
17
D4
56
26
12
2 2 16
D5
58
2
6
2
0
8
D6
62 20
14
2 1 17
D7
64
35
12
1 2 15
D8
70' 36
8 2
1 11
D9
74
20
6
3 5 14
M
59.11
22.00 9.78
2.11
2.00
13.89
SD
9.37
10.06
2.73 0.60
1.58
2.93
S
+
NP
N1
49
15
6 3
7 16
N2
49
17 8 2 0
10
N3
54
22 16 2 3
21
N4
61
23
6 2
1
9
N5
63
14
12
2
0
14
N6
63
36
12
2
3
17
N7
65
23
10
2 1 13
N8
66 30
10
3 3 16
N9
82
34
6
2 0
8
M
61.33 23.78 9.56
2.22
2.00
13.78
SD
10.16
8.03
3.43
0.44
2.29
4.24
M
-
WU
a
36.0 37.5
43.5
37.0 44.5
42.0
p
.69
.79
.79
.70
.72
.90
aMann-Whitney
U
test
statistic.
39
349-364
April
1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
353
all
subjects
participated
in
the
present
study
before
receiv-
ing
treatment
for
stuttering, disordered
phonology,
or
any
other
concerns.
Subjects
were
paid volunteers
from
Stan-
dard-American-English-speaking
families
and
were
unfamil-
iar
with
the
specific
purposes
of this
study.
Subjects
were
referred
to
a
university
speech-language-
hearing
clinic
because
of
concerns
about
the
child's
phono-
logical development
and/or
speech
fluency.
Formal and
informal
testing
of
each
child's
speech
and
language
devel-
opment,
conducted
by ASHA-certified speech-language
pa-
thologists
at
the
child's
home
before
the
present
study,
indicated
that
no
child
in
either
subject
group demonstrated
any
speech,
language,
or
hearing
concerns
other than
stuttering
or
disordered phonology,
and
there
were
no
known
or suspected
neurological, academic,
emotional,
or
social
problems
in
any
of
the
18
subjects.
Criteria
for
Subject
Inclusion
and Classification
Stuttering
(S).
Each
of
the
18
children
in
the
present
study
were
classified
as
children who
stutter
on
the
basis
of
the following two subject-inclusion
criteria:
(a)
The
child
produced
at least
3
within-word
speech
disfluencies
(i.e.,
sound/syllable
repetitions, monosyllabic
whole-word
repeti-
tions,
audible
or
inaudible
sound
prolongations,
or
within-
word
pauses; Conture,
1990)
per
100
words
of
speech
during
a
transcribed
300-word
conversational
speech
sam-
ple
taken
while
the
child
was
conversing
with
his
mother.
and
(b)
An
adult listener
familiar with the
child
had
expressed
concern
that the
child
was
stuttering or
at
risk
for
stuttering
(e.g.,
Kelly
&
Conture,
1992; LaSalle
&
Conture,
1991;
Zebrowski
&
Conture,
1989).
Table
2
summarizes
children's
scores
on
the Stuttering
Severity Instrument
(SSI;
Riley,
1980).
Disordered Phonology
(DP).
The
18
children
who
stutter
were
divided
into
two
groups
(n
=
9)
according
to the
number
and
nature
of
their
systematic
speech
errors
or
phonological
processes
(i.e.,
systematic sound
changes
affecting
sequences
or classes
of
sounds;
Edwards,
1992;
Edwards
&
Shriberg,
1983)
following
guidelines
of
Edwards
and
Shriberg
(1983),
Grunwell
(1982),
McReynolds
and
Elbert
(1981),
and
Stoel-Gammon
and
Dunn
(1985).
A
sub-
ject
was classified
as
demonstrating normal
phonology
if
he
exhibited
no
phonological processes
or
if
all
of
his
phono-
logical processes
were
judged
to
be
typical of
normal
phonological
development
and
appropriate
for
his
age
(e.g.,
Edwards
&
Shriberg,
1983;
Grunwell,
1982;
Stoel-Gammon
&
Dunn,
1985).
A
subject
was
classified
as
demonstrating
disordered
phonology
if
he
exhibited
either
(a)
two
or more
phonological
processes not considered appropriate
for his
age
(e.g.,
weak
syllable
deletion
or
stopping
of
the
fricative
/s/
demonstrated by
a
4-year-old)
or
(b)
one or more
phonological
processes
that
do
not
typically occur
in
chil-
dren's
normal
phonological
development
(e.g.,
velarization,
glottal
replacement).
(A
more
complete discussion
of
these
processes
is
available
in
Edwards
&
Shriberg,
1983, and
Stoel-Gammon
&
Dunn, 1985.)
Furthermore, each
subject's
classification
in
the
disordered
phonology
group
was
con-
firmed
on
the basis
of
their
performance
on
the
Goldman-
Fristoe
Test
of
Articulation
(Goldman
&
Fristoe,
1982).
Data
Collection
Testing
conditions.
All
subjects
were
audio/videotaped
with
their
mothers during
data
collection
sessions lasting
approximately
11/2
hours.
Recording
sessions
were
divided
into
3
sections
administered
in
a
random
order
to
each
child:
(a)
a
parent-child
(P-C)
conversational interaction,
(b) a
picture-naming
task
(PNT),
and
(c)
a
diadochokinetic
task
(which
was not
analyzed
in
the
present
study
and
will not
be
detailed
further).
Brief rests were
provided
between
each
section
to
minimize
children's
fatigue.
Parent-Child
(P-C)
interaction.
In
order
to
obtain
a
conver-
sational
speech sample
in
as
natural
a
setting
as
possible,
children
and
their
mothers
were
seated
opposite
each
other
at
a
small
table
containing age-appropriate
toys
(e.g.,
a
space
station
and
figurines).
Mothers
were
asked
to
play
with
their
children
"as
they would
at
home"
and
not
to try
specifically
to
get
their
children
to talk
or
to
speak
fluently.
Conversational
topics
often
related
to
the
toys;
however,
older
subjects
and
their
mothers
often
talked about
other
topics
(e.g.,
activities
at
school, birthdays,
etc.). The
P-C
interaction
typically
lasted
approximately
30
to
35
min;
however,
if a
child
was
especially nontalkative
during
this
portion
of the
recording
session,
the
recording time
was
extended
until
a
representative
300-word
conversational
sample
was
obtained.
Picture
Naming
Task
(PNT).
In
order
to
obtain
a
tightly
controlled
sample
of
words
for
a
thorough
analysis
of
the
child's
phonological
development,
each
child
was
adminis-
tered
a
120-word or
162-word
2
Picture
Naming
Task
(PNT;
e.g.,
Wolk et
al.,
1993)
by
a
certified speech-language
pathologist.
The
PNT
was
designed
to
provide
an
opportu-
nity
to
produce
all
of
the sounds
of
English
in
all
positions
(initial, medial, final)
in
at least
two
familiar,
age-appropriate,
and readily
picturable
words.
The
length
and
difficulty
of
the
words,
as well
as
the
vowel
contexts that
consonants were
sampled with,
was
varied
throughout
the
corpus.
Two
separate
randomized
orders
of
the
elicitation pictures
were
used
and
selected
at random
for
each
child.
Because
imitated responses
may
overestimate
a
child's
true phonological
ability
(Elbert
&
Gierut,
1986;
Ingram,
1976;
Stoel-Gammon
&
Dunn,
1985),
examiners
attempted
to
elicit target
PNT
words
in
isolation
(i.e.,
without modifiers
or
determiners) and
without
providing
a
direct
model
by
presenting
open-ended
"elicitation
phrases"
(Examiner:
"This
boy
just
received
a
present.
He
ought
to
say...
";
Child:
"thank you").
On
occasion,
elicitation
phrases
and
other
cues
were
not
sufficient
to
prompt
the
child's
re-
sponse,
so
the
examiners
provided
a
model,
then
elicited
the
child's
response
through
delayed
imitation
(e.g.,
"He
ought
to
say
thank
you.
Can
you
tell
me
that?
He
ought
to
say...
"). Finally,
if
a
child
produced
a
speech
disfluency
during
his
production of
the
target
word,
examiners
at-
tempted
to
elicit
the word
a
second
time
without
drawing
attention
to
the
child's
disfluent production
of
the target
word.
2
Six
children
(5 S
+
NP
and
1
S
+
DP) were
administered
the
expanded
162-word
PNT,
which
was
a
superset
of
the
120-word
PNT.
Only
the
120
words
common
to
both
PNT
tests
were
analyzed
in
the
present
study.
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354
Journal
of
Speech
and Hearing
Research
Instrumentation
Specific
procedures
and
instrumentation
use
for
audio/
videotape-recording of
the
testing
procedures
have
been
detailed
elsewhere
(e.g.,
Wolk
et
al.,
1993).
In
brief,
high-
quality
audio/videotape
recordings
of
both
the
P-C
interac-
tion
and
the
PNT
were
obtained
to
facilitate
later
analysis
of
the
data.
During
the
P-C
interaction,
both
the children
and
their
mothers
were
audio/video
recorded simultaneously
using
a
split-screen
image (mother's image
on
the
left half
of
the
screen;
child's
image
on
the
right)
because
previous
research
has
shown
that
knowledge
of
a
mother's
behavior
during
parent-child interactions
often
provides
a
valuable
perspective
on
the
child's
behaviors
(e.g.,
Conture
&
Kelly,
1991;
Schwartz
&
Conture,
1988).
Data
Transcription
and
Analysis
Picture
Naming
Task.
During
administration
of the
PNT
a
trained expert
in
phonetics
and
phonological
analysis
pre-
pared
a
preliminary
"live"
transcription
of
the
child's
pro-
ductions
in
accord with
Principles
of
the
International
Pho-
netics Association
(IPA,
1949).
Next,
transcriptions
were
refined
on
the
basis
of
repeated
viewing
of
the audio/
videotapes
by
investigators
trained
in
narrow
phonetic
tran-
scription
of
children's
speech.
Instances
of
disagreement
were
resolved
on
the
basis
of
the
input of
a
third
trained
investigator.
Each
child's
PNT
speech
sample was then
analyzed
for
the
presence
of
systematic
(phonological process) speech
errors
commonly
demonstrated
by
children
(see
process
definitions
in
Edwards
&
Shriberg,
1983;
Grunwell,
1982;
Hodson
&
Paden,
1991; Ingram, 1976;
Stoel-Gammon
&
Dunn,
1985).
In
order
for
an
error
pattern
to
be
considered
a
phonological
process
(i.e.,
a
systematic
error)
the
error
had
to
occur
in
at
least
25°%
of
all
possible
locations,
given
at
least
four
opportunities
to
occur
(McReynolds
&
Elbert,
1981).
Speech
sound
errors
that
follow
common phonolog-
ical
process patterns,
but
which
occurred
less
than
25% of
the
time
or
which
did
not
have at
least
four
opportunities
to
apply,
were
not
included
in
that
child's
list
of
phonological
processes.
These
seemingly
systematic
but
inconsistent
speech
sound
errors
(which
may
indicate
very
sporadic
phonological
processes
or
processes
that
are
"dropping
out")
were
called
"phonological process-like"
errors
to
distinguish
them from
nonsystematic
speech
errors
that
do
not
resemble
phonological
processes.
Spontaneous speech
sample.
A
75-utterance
conversa-
tional
speech
sample,
obtained
from
the
middle
10
min
(e.g.,
Kelly
&
Conture,
1992;
Zebrowski
&
Conture,
1989)
of
each
child's
P-C
interaction,
was
orthographically
and
phoneti-
cally
transcribed
into
a
customized computer
database.
An
utterance
was
defined
as
a
string
of
words,
which
(a)
communicated
an
idea,
(b)
was set apart
by
pauses,
and
(c)
was
bound
by
a
single
intonational
contour
(e.g.,
Kelly
&
Conture,
1992;
Logan
&
Conture,
1995;
Meyers
&
Freeman,
1985;
Yaruss
&
Conture,
1995).
Utterances
of
less
than
3
words
in
length
were
excluded
because previous
research
(Yaruss
&
Conture,
1995)
has
shown
that
utterances of
1
to
2
words
in
length can be
either
unusually
fast
(e.g.,
more
than
400
words
per
minute
[wpm])
or unusually
slow
(e.g.,
less
than
60 wpm),
depending
upon
the
pragmatic intent
of
the
speaker. Repeated
short
formulaic
utterances
or
lexical-
ized
phrases
(e.g.,
"I
don't
know")
were also
excluded
because
such
utterances
may
be
produced
at
a
faster-than-
normal rate. The
entire
75-utterance
sample
was
used
for
the
analyses
of
the
co-occurrence
of
speech
errors
and
self-repairs within
utterances;
the
first
300
words
of
the
75-utterance
sample
(divided
into
3
equal
samples
of
100
words
each)
were
used
for
measures
of
the
frequency
of
speech
disfluencies,
speech
errors,
and
utterance
timing.
Speech
Disfluencies,
Speech Errors,
and
Self-Repairs
Onset
and
offset
times
of
each
utterance
(within
1
video-
frame,
or
33.33
ms)
were
recorded
in
the
database, along
with the onset
and offset
times
and
types
of
all
instances
of
within-
and
between-word speech disfluencies,
(non)sys-
tematic
speech
errors, and
overt
and
covert
self-repairs
summarized below.
Within-word
speech disfluencies.
Within-word
speech
disfluencies
were
defined
as
(a)
sound/syllable
repetitions
(SSR),
(b)
monosyllabic whole-word repetitions
(MWR), and
(c)
audible
(ASP)
and
inaudible
(ISP)
sound prolongations
consisting of
(tense)
pauses
or
stoppages
occurring
within
or
at
the
beginning
or end
of
words
(e.g.,
Conture, 1990;
Conture
&
Kelly,
1991;
Schwartz
&
Conture,
1988;
Schwartz,
Zebrowski,
&
Conture,
1990).3
Between-word
speech disfluencies. Between-word
speech
disfluencies
were
defined
as
(a)
interjections
(INT;
e.g.,
an
editing
term
such
as
"um"),
(b)
polysyllabic
whole-
word
repetitions
(PWR),
or
(c)
phrase
repetitions
(PR)
con-
sisting
entirely
of
whole
words
or
containing
a
cutoff word
(e.g.,
Berg, 1986,
Blackmer
&
Mitton,
1991;
Bredart,
1991;
Evans,
1985;
LaSalle
&
Conture,
1995;
Levelt,
1983).
Systematic speech
errors.
Systematic
speech
errors
char-
acteristic of
the
child's
phonological
processes
(e.g.,
cluster
reduction,
gliding
of
liquids, vocalization)
were
identified
on
the
basis of
the
analysis
of
the
child's
PNT
speech
sample
described
above.
All
opportunities
for
each
child's
system-
atic
sound
errors
to
occur
were
also
tallied
so
the
consis-
tency
of
errors
could
be
determined.
As noted
above,
errors
that followed
common
phonological process
patterns,
but
which
occurred
with
less
than
25%
consistency,
were
also
tallied
and
analyzed
separately
(phonological
process-like
errors).
Nonsystematic
speech
errors.
Nonsystematic
speech
er-
rors
were
defined
as
a
word
or
string
of words that
appar-
ently
deviated
from
the speaker's intention,
but
that
were
not
characteristic
of
the
child's
systematic
(phonological
pro-
3
The
relatively
definable
and replicable
measure
of
within-word
speech
disfiluencies
was
selected
for
analysis
in
this study
rather than
instances
of
"stuttering"
because
of
well-known
problems
in
reliably
defining
and
mea-
suring
instances
of
stuttering.
(Note,
however,
seminal
Work
by
Ingham,
Codes,
and colleagues
[e.g.,
Cordes,
1994;
Cordes
&
Ingham,
1g994,
Ingham,
Cordes,
&
Gow,
1993],
who
have
attempted
to
improve such
measures
by
evaluating
the
reliability
of
stuttering
measurements and
by
offering
alternative
means
for
identifying
the
occurrence
of
stuttering.)
39
349-364
April
1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
355
cess)
speech
errors
(see
Table
1
and
LaSalle
&
Conture,
1995,
Table
1).
Such
deviations
were
typically
indicated
by
the
interruption
or
repair
of
the
utterance
before
its comple-
tion
(e.g.,
"I'll
go-I'll
get
him";
"This-the
bad
guy
got
out");
however,
subjects occasionally
produced
nonsystem-
atic
speech
errors
that
were
not
repaired
(e.g.,
"he's
the
bad
buy"
for
"he's
the
bad
guy").
In
these
cases,
nonsystematic
overt
speech
errors
were
defined
as
a
word
or
string
of
words that
did
not
match
the
speaker's
apparent
intention
("slip-of-the-tongue
error";
e.g.,
Cutler,
1982; Fromkin,
1971,
1973;
Hockett,
1967).
Overt
and
covert
self-repairs.
An
overt
self-repair was
defined
as
a
between-word
disfluency
in
which
a
word
or
string
of
words
restated
or
reformulated
a
speaker's
prior
(non)systematic
speech
error
(e.g.,
"you
can
play-you
can
have
these").
A
covert
self-repair was
defined
as
a
within-
word
or
between-word speech
disfluency
(see
above)
in
which
such reformulation was
not apparent
(i.e.,
no
overt
error
was
repaired;
e.g.,
"she's
gonna
um
play"
or
"look
at
the-the
monster").
measures
that
takes
chance
agreement
into
account,
inter-
and
intrajudge
reliability
measures
for
measures
of
speech
disfluencies,
speech
errors, and
self-repairs
were
based
on
the
Kappa
statistic
(Cohen,
1960;
see
Hollenbeck,
1978).
Because
it
is a
relatively
conservative
test,
however,
Kappas
reported below
that
range
from
.60
to
.75
are
considered
"good,"
and
those
that
range
from
.76
to
1.00
are
consid-
ered
"excellent"
(after
Fleiss,
1981):
Within-word
speech
disfluencies
Types
of
within-word disfluencies
Between-word
speech
disfluencies
Nonsystematic speech
errors
Systematic
speech errors
Overt
self-repairs
Intrajudge
/
Interjudge
(Kappa
Statistic)
.77
/ .76
.82
/ .81
.88
/ .77
.75
/ .85
.76
/ .71
.79
/ .91
Because
articulatory
speaking
rate
and
response
time
latency
represent
continuous
measures,
rather
than
cate-
gorical
measures,
measurement
reliability
was
calculated
in
terms
of
mean
differences
(and
standard deviations),
rather
than
percent
agreement:
Articulatory
Speaking
Rate
and
Response
Time
Latency
Finally,
the
following
temporal aspects
of
the
children's
utterances
were
calculated
(within
1
videoframe,
or
33.33
ms)
from
frame-by-frame
analysis
of
the
audio/videotapes.
Articulatory
speaking
rate
(ASR).
Articulatory
speaking
rate
was
defined
as
the
child's
rate
of
speech
(in
syl/s)
excluding
all
instances
of
between- and
within-word
speech
disfluencies,
hesitations,
and pauses
of
greater than
250
ms
(e.g.,
Kelly
&
Conture,
1992;
Walker,
Archibald,
Cherniak,
&
Fish,
1992;
Yaruss
&
Conture,
1995).
Response
time
latency
(RTL).
Response
time
latency,
or
the
length
of
time
(in
ms)
of
the
silent
pause
between
the
end
of
the
mother's utterance
and
the
beginning
of
the
child's
utterance
(e.g.,
Kelly
&
Conture,
1992;
Newman
&
Smit,
1989;
Yaruss
&
Conture,
1995),
was
calculated
from
the
offset
time
of
the mother's preceding utterance
and
the
onset time
of
the
child's
utterance
for
those occasions
where
a
child's
utterance
followed
a
mother's
utterance.
Inter-
and
Intrajudge
Measurement
Reliability
Ten
utterances
were
selected
at
random
for
each
of
the
18
subjects
(total
=
180
utterances
[13.33%
of
all
utterances]
encompassing
1,148
words
[13.97%
of
all
words]).
Each
utterance
was
(re)analyzed
by
the
first
author
and
by
an
ASHA-certified speech-language
pathology
doctoral
candi-
date trained
in
the
analysis
of
videotapes
of
children's
spontaneous
speech
samples.
First,
the
occurrence
of
with-
in-
and
between-word
speech
disfluencies
and
(non)system-
atic
speech
errors
in
each
utterance
was
identified.
Next,
to
provide
an
additional
indication
of
reliability
for
the
pool
of
utterances
containing
within-word
speech
disfluencies,
judges
identified
the
types
of
disfluencies
produced.
Finally,
measures
of
articulatory
speaking
rate
and
response
time
latency
were
verified
for
all
of
the
180
utterances.
In
order
to
provide
a
reliability
index
for
categorical
Articulatory
speaking
rate (syl/s)
Response
time
latency
(s)
Intrajudge
-0.03
(0.45)
12.70
(118.90)
/
Interjudge
-0.25
/
(0.48)
/
-78.83
/
(114.59)
Although
the
mean
interjudge reliability
difference
for
RTL
was
greater
than
that
for
intrajudge
reliability,
the
mean
difference
is
still
equivalent'to
approximately
2
videoframes.
Further,
strong
positive
Pearson
product-moment
correla-
tions
were
found
for
response
time latency (r
=
.98;
p
<
.001
for
both
inter-
and
intrajudge
reliability) and
articulatory
speaking
rate
(r
=
.89;
p
<
.01
for
both inter-
and
intrajudge
reliability).
Results
Between-Group Differences
Because
of
the
relatively
small
number
of
children
in
the
two
subject
groups
in
this
study
and
the difficulty
of
deter-
mining
that
such
a
small
sample
is
normally
distributed
(Conover,
1980),
the nonparametric Mann-Whitney
U
statis-
tic
was
used
to
compare
between-group
differences
in
the
production
of
within-
and
between-word
speech
disfluen-
cies,
as
well
as
(non)systematic
speech
errors
between
subject
groups.
Bonferroni
corrections
for
multiple
compar-
isons
were
applied
where
appropriate.
Within-word
speech
disfluencies.
No
significant
be-
tween-group
difference
(U
=
42.50;
p
=
.86)
was
found
in
the
mean
frequency
of within-word
disfluencies produced
byS
+
NP(M
=
6.2;
SD
=
3.72)
and
S +
DP
(M
=
6.1;
SD
=
3.15)
subjects.
Likewise,
no
significant between-group
dif-
ference
(U
=
39.00;
p
=
.90)
was
found
in
mean
duration
of
within-word
disfluencies produced
by
S +
NP
(M
= 525.80
ms;
SD
=
166.49
ms)
and
S +
DP
(M
=
513.13
ms;
SD
=
148.60
ms)
subjects
during
the
300-word
conversational
speech
samples. Also,
as
shown
in
Figure
2,
no
significant
(Bonferroni-corrected)
between-group
differences
(Mann-
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356
Journal
of
Speech
and
Hearing Research
Types
of
Within-Word
Speech
Disfluencies
FIGURE
2.
No
significant
(Mann-Whitney
U,
p
>
.05)
differences were
found
between
children
exhibiting
stuttering
and
disordered phonology
(S
+
DP)
and
children
exhibiting
stuttering
and
normal
phonology
(S
+
NP)
in
the
percent occurrence
of
within-word
disfluency
types.
SSR
=
Sound/syllable repetition;
MWR
=
Monosyllabic whole-word
repetition;
SP
=
Sound
prolonga-
tion.
Vertical
bars
indicate
I
standard
deviation.
Whitney
U;
overall
a
>
.05; individual
a
=
.017)
were
found
in
the
relative
percent occurrence
of
3
different
types
of
within-word
speech
disfluencies
(sound/syllable
repetitions
[SSRs],
monosyllabic
within-word
repetitions
[MWRs],
and
(in)audible
sound
prolongations
[ASPs
and
ISPs]).
Between-word
speech
disfluencies.
No
significant
(U
=
23.5;
p
=
.13)
differences
were
found
in
the
number
of
utterances
containing
between-word
speech
disfluencies
during the
300-word
conversational speech samples
of
S
+
NP (M
=
13.00; SD
=
6.27) and
S
+
DP
(M
=
8.89;
SD
=
4.99)
subjects.
Systematic (phonological
process) speech
errors.
As
expected,
in
both
the
PNT
and
P-C
Interaction
speech
samples,
S
+
DP
subjects
exhibited
significantly
(PNT:
U
=
76;
P-C:
U
=
75;
p
=
.002)
more
phonological processes
(PNT:
M
=
5.8;
SD
=
2.6;
P-C:
M
=
3.11;
SD
=
1.62)
than
S
+
NP
subjects
(PNT:
M
=
1.7;
SDi=
1.5;
P-C:
M
=
0.56;
SD
=
1.01).
4
As
shown
in
Figures
3
and
4,
the
three
most
4
Differences
in
the
phonological
processes
identified
in
the
speech
samples
can
be
attributed
to
differences
in
the
number
of
opportunities
for
each
process
to
occur
in
conversational speech versus
the
highly
structured
elicitation
task,
as
well
as
to
previously
demonstrated
variations
in
phonolog-
ical
productions
based upon
the
speaking
task
(Morrison
&
Shriberg,
1992).
FIGURE
3.
Phonological
processes
exhibited by
at
least,2
subjects.on
the-Picture-Naming
Task
(PNT).
GL
=
Gliding
of
liquids;
VOC
=
Vocalizaton;
LA
=
Lbalization;
SR
=
s/-Cluster
Reduction;
WSD
=
Weak
Syllable
Deletion;
DP
=
Depalatllation;
GCR
=
Glide
CluSter
Reduction;
DA
=
Dealrlicatitn;
LOR
= Liquid
Cluster
Reduction
LA
=
Lablazn;
INT=
Interdentalization.
39
349-364
April
1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
357
Phonological
Processes
Exhibited
During the
P-C
Interaction
FIGURE
4.
Phonological
Processes
exhibited
by
at
least
2
subjects
during
the Parent-Child
(P-C)
Interaction.
VOC
=
Vocalization;
GL
=
Gliding
of
Liquids;
SCR
=
/s/-Cluster
Reduction;
WSD
=
Weak
Syllable
Deletion;
LCR
=
Liquid Cluster Reduction;
INT
=
Interdentalization.
common phonological processes during both
the
PNT
and
the
P-C
Interaction
were
Gliding
of
Liquids,
Vocalization,
/s/-Cluster
Reduction
for
S
+
DP
subjects
and
Gliding
of
Liquids,
Vocalization,
and Labialization
for
S +
NP
subjects.
It is
interesting
to
note, however,
that
some
phonological
processes
exhibited by
at least
2
S
+
DP
subjects
were not
exhibited
by
any
of
the
S
+
NP
subjects-such
processes
as
/s/-Cluster
Reduction,
Weak
Syllable
Deletion, Depalataliza-
tion,
Deaffrication,
and
Labial
Assimilation.
Furthermore,
only
3
of
the
9
S
+
NP
subjects
exhibited
systematic
speech
errors
during conversational
speech
that
reached
the
25%
cut-off for
consideration
as
a
phonological process
in
this
study.
"Phonological
process-like"
speech
errors.
Again,
as
expected,
S +
DP
subjects
exhibited
significantly
(U
=
65.0;
p
=
.015)
more
"phonological process-like"
speech errors
(i.e.,
systematic
speech
errors
that
occurred
in
less
than
25%
of
possible opportunities)
during
the
P-C
interaction
(n
=
476;
M
=
52.89;
SD
=
20.18)
than
S
+
NP
subjects
(n
=
223;
M
=
24.56;
SD
=
25.37). (Overall
a
=
.05
[individual
a
=
.017]
used
for
the
3
preceding
comparisons.)
Nonsystematic
(slip-of-the-tongue)
speech
errors
and
self-repairs.
No
significant
(U
=
25.0;
p
=
.17)
differences
were
found
in
the
mean
number
of
utterances
containing
overt speech
errors
in
the
75-utterance
conversational
speech
samples
of
S +
NP
(M
=
12.56; SD
=
5.55) and
S +
DP
(M
=
9.56; SD
=
3.05)
subjects.
Also,
no
significant
(U
=
30.5;
p
=
.37)
between-group
differences
were
found
in
the
mean
number
of
utterances
containing
overt
self
repairs
during the conversational speech samples
of
S +
NP (M
=
3.67;
SD
=
2.24)
and
S
+
DP
(M
=
2.67; SD
=
2.06)
subjects.
Repair-to-error
ratio.
The
number
of
utterances
contain-
ing
overt self-repairs
was
divided
by the
number
of
utter-
ances
containing
overt
speech
errors
to
derive
the
repair-
to-error
ratio.
No
significant
(U
=
31.5;
p
=
.43)
differences
were
found
in
the
mean
repair-to-error
ratios
of
S +
NP
(M
=
0.37; SD
=
0.25)
and
S +
DP
(M
=
0.28; SD
=
0.21)
subjects.
It
is
most interesting
to
note,
however,
that
no
subject
in
either
group evidenced any self-repairs
of
system-
atic
(phonological
process)
speech
errors
in
their
conversa-
tional
speech samples
(i.e.,
none
of
the
871
instances
of
systematic
speech
errors
in
the
total
corpus
of
8,213
words
were self-repaired).
Mean
articulatory
speaking
rate
(ASR).
No
significant
between-group
difference
(U
=
29.00;
p
=
.31)
was
found
in
the
mean ASRs
of
S +
NP
(M
=
3.82
syl/s;
SD
=
0.30
syl/s)
and
S
+
DP
subjects
(M
=
3.65
syl/s;
SD
= 0.24
syl/s).
Mean
response
time
latency
(RTL).
As
noted
above,
subjects'
mean
response
time latencies
were
calculated
from
those
utterances
in
the
75-utterance
conversational
speech samples
that followed
a
parent
utterance.
The
number
of
utterances
used
for calculation
of
mean
RTLs
ranged
from
17
to
47
utterances,
but
did
not
differ
between
subject
groups
(U
=
56.00;
p
=
.17).
No
significant
differ-
ence
(U
=
26.00;
p
=
.20)
was
found
in
the
mean
RTL
of
S
+
NP
(M
=
699.28
ms;
SD
=
204.67
ms)
and
S
+
DP
(M
=
849.33
ms;
SD
=
205.56
ms) subjects.
Relationships
Between
Speech
Disfluencies
and
Speech
Errors
Correlations.
As
shown
in
Table
3,
Spearman
rho corre-
lations
were
used
to
examine
relationships
between
mea-
sures
of
speech
disfluencies
and
speech
errors.
The
corre-
lation
between
the number
of
nonsystematic overt errors
and
the
mean
frequency
of
within-word
speech
disfluencies
for
S +
NP
subjects
(rho
=
0.68;
p
=
.05)
reached
statistical
significance
at
individual
a(
=
.05;
however,
no
other
signif-
icant
Bonferroni-corrected
(overall
ca
=
.05)
correlations
were
found
between
measures
of
speech
disfluencies
(mean
frequency
and
duration,
and
overall
severity)
and measures
of
both systematic
(number
of
types
of
phonological
pro-
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358
Journal
of
Speech
and Hearing
Research
TABLE
3.
Spearman
rho
correlations
between
measures
of within-word
speech
disfluencies
and
(non)systematic
speech errors.
Spearman
rho
Correlation
Coefficients
Measures
of
within-word
No.
of
Total
no.
of
No.
of
speech
phonological
phonological
No.
of
PP-likeb
nonsystematic
disfluencies
processes
(PP)a
processes
errors
errors
errors
S
+
DP
Frequency
.10 .15
-.
12
.27
Duration
-.
45
-.
22
.23
-.
10
Severity
-.
21
-.
03
-.
13
-.
33
S
+
NP
Frequency
.25
.48
.25
.68c
Duration
.00
-.
26
-.
08
-.
17
Severity
.02
.00
-.
01
.13
Note. Severity
of
stuttering
is
based
on
the
Stuttering Severity Instrument
(SSI;
Riley, 1980)
Total
Overall
Score, based
on
an
analysis
of
the
subjects' within-word
speech
disfluencies.
aPhonological
process, or
systematic
speech
errors
that
occurred
with
at
least
25%
consistency.
bPP-Like
=
Systematic speech
errors
that
occurred with
less
than
25%
consistency.
Individual
a
=
.05.
cesses,
total
number
of
phonological
process
errors,
num-
ber
of
phonological-process-like
errors)
and
nonsystematic
(number
of overt
errors)
speech
errors
for
either
S
+
DP
or
S
+
NP
subjects.
Independence.
The
independence
of
within-word
speech
disfluencies
and
both systematic
(phonological
process)
speech errors
and
nonsystematic
(i.e.,
"slip-of-the-tongue")
speech errors
on
words produced during
subjects'
75-
utterance
conversational
speech samples
were
tested
using
chi-square
tests
for
independence calculated
on
2
x
2
contingency
tables
(Conover,
1980).
For
systematic
speech
errors,
separate
contingency
tables
were
calculated
for
those
words
that
provided
an
opportunity
for
a
child's
systematic speech
errors
to
occur
(i.e.,
words
that
contained
a
sound
affected
by
the
child's
systematic
speech
errors,
regardless
of
whether
the
error
occurred)
and
words
for
which
a
child's
systematic
speech
error
did
actually
occur.
Nonsystematic speech
errors,
There
was
no
significant
(p
>
.05)
dependence
between
the
occurrence
of
nonsys-
tematic
speech
errors and
between-word
speech
disfluen-
cies.
There was,
however,
a
significant
(p
<
.001)
depen-
dence between
the
occurrence
of
nonsystematic
speech
errors and
within-word
speech
disfluencies
for
both
S
+
DP
(T
=
30.49)
and
S
+
NP
(T
=
29.26)
subjects. Specifically,
as
shown
in
Table
4,
within-word
speech
disfluencies
and
nonsystematic
overt
speech
errors
co-occurred
at
a
rate
greater
than
that expected
by
chance.
Systematic
speech
errors.
There
was
no
significant
de-
pendence between
the
occurrence
of
systematic
speech
errors
and
the occurrence
of
either
within-
or between-word
speech
disfiuencies
on
words
that
provided
an
opportunity
for
a
child's
systematic
speech
errors
to-occur
(overall
level
of
significance
(
=
.05).
for
any
of
the
chi-square
tests
(T-values
ranged
from 0.05
to
4.60).
Likewise,
there
was
no
significant dependence
between
the
occurrence
of
system-
atic
speech
errors
-and
the
occurrence
of
either
within-
or
between-word
speech
disfluencies
on
words
for
which
a
child's
systematic
speech
errors
did-actually
occur
(overall
level
of
significance
ca
=
.05;
T-values
ranged
from
0.01
to
2.91),;
Articulatory
Speaking
Rate
and
Response
Time
Latency
in
Utterances
That
Contained
Speech
Errors
and
Speech
Disfluencies
Wilcoxon signed-rank tests,
calculated
separately
for
each
subject
group,
were
used
to
compare
differences
in
articulatory
speaking
rate
and
response
time
latency
be-
tween utterances
that
did
contain speech disfluencies
or
(non)systematic
speech
errors
and utterances
that'
did
not,
Table
5
summarizes
means
and
standard deviations
for
TABLE
4.
Group
contingency
tables
for
co-occurfence
of
non-
systematic
speech
errors
and
within-word
speech
disfluencies
on
words
produced
by
Stuttering
plus
Disordered Phonology
(S +
DP)
and
Stuttering
plus
Normal
Phonology
S NP
subjects. Within
each
cell
observed
values
are
followed
by
(expected
values).
Words
in
which.
nonsysternatic
speech
errors
Did
not'
Subjects
Did
occur occur
S
+
DP
Words
in
which
within-word
speech
disfluencies
did
occur
26
(9.69)
218
(234.3)
Words
in
which
within-word
speech
disfluencies
did not
occur
131
(147.3)
3580
(3564)
S
+
NP
Words
in
which
within-wbrd
speech
disfluencies-did
occur
36
(15,81)
252
(272.2)
Words
in
which
within-word
speech
disfluencies
did
not
occur
198
(218.2)
3777
(3757)
Note.
A
significant
dependence
was
fourndbetwtheno
occurrence
of
within-word
speech
disfluencies
and
noesystematic
speech
errors
on
words. Note
that
the
co-occurrence
of
stuttering
and
speech
errors
on
words
is
greater than
that
expected
iy
chance.
(Chi-square
test
of
independence,
p <
.001;
S
+
DP:
T
30.49;
S
+
NP:
T
=
29.26).
39
349-364
Apri
1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
359
TABLE
5.
Mean
articulatory
speaking
rates
(and
standard deviations)
in
syllables
per second
(syl/s)
for
Stuttering
and
Normal
Phonology
(S +
NP)
and
Stuttering
and
Disordered Phonology
(S +
DP)
subjects'
utterances
that
did
and
utterances
that
did
not
contain
(a)
within-word
speech
disfluencies,
(b)
between-word
speech
disfluencies,
(c)
nonsystematic
speech
errors,
and
(d)
systematic
speech
errors
(phonological
processes).
Also included
are
results
of
Wilcoxon
Signed
Ranks
tests
(and
p
values)
associated
with
differences between
utterance groups.
Articulatory
Speaking
Rate
(syl/s)
Stuttering
and
Normal
Phonology
Stuttering
and
Disordered
Phonology
Wilcoxon
Wilcoxon
Utterance
Utterance
Signed Ranks
Utterance
Utterance
Signed
Ranks
did
did
not
Test
did did not
Test
contain contain
(p-value)
contain contain
(p-value)
Within-word
speech
3.70
3.88
1.84
3.57
3.69
1.96
disfluencies
(0.36)
(0.35) (.066) (0.23) (0.27)
(.051)
Between-word speech
4.00
3.80
-1.36
3.31
3.69
2.67
disfluencies
(0.31) (0.34) (.17)
(0.24)
(0.24)
(.008)
Nonsystematic
speech
3.78 3.83
0.42
3.50
3.67
2.31
errors (slips-of-the-tongue)
(0.50)
(0.31)
(.68)
(0.30)
(0.24)
(.02)
Systematic
speech
errors
3.64 3.87 0.94 6.64
3.62
-0.53
(phonological
processes) (0.40) (0.28)
(.34)
(0.28)
(0.23)
(.59)
articulatory
speaking
rate
for
the
utterance groups,
as well
as
results
of
Wilcoxon
signed-ranks tests
referred
to
below.
Articulatory
Speaking
Rate
(ASR).
Within-word
speech
disfluencies.
The
difference
in
subjects'
mean ASR
between
utterances that did
and
utterances
that
did
not
contain
within-word
speech
disfluencies
approached
statistical
sig-
nificance
at
individual
a
=
.05
for
both
S +
NP
(Z
=
1.84;
p
=
.066)
and
S +
DP
(Z
=
1.96;
p
=
.051)
subject
groups.
For
both
S +
DP
and
S
+
NP
subjects,
utterances
that'
did
contain
within-word
disfluencies
appeared
to
be
produced
with
a
somewhat
slower
ASR
than
those
that
did
not;
however,
neither
of
these comparisons
reached
significance
at
a
Bonferroni-corrected
individual significance
level
of
=
.025 (overall
a
=
.05).
Between-word
speech
disfluencies.
The
difference
in
sub-
jects'
mean
ASR
between
utterances
that
did
and
utter-
ances
that
did
not
contain between-word
speech disfluen-
cies
was
significant
(overall
a
=
.05;
individual
a
=
.025)
for
S +
DP subjects
(Z
=
2.67;
p
=
.008),
but not
for
S +
NP
subjects
(Z
=
-1.36;
p
=
.17).
For
S +
DP
subjects,
utterances
that
did contain
between-word speech disfluen-
cies
were
consistently
produced
with
a
slower
ASR
than
utterances that did
not.
Nonsystematic speech
errors.
The
difference
in
mean ASR
between utterances
that
did
and
utterances
that
did
not
contain
nonsystematic
overt
speech
errors
was
significant
(overall
a =
05;
individual
a
=
.025)
for
S +
DP
subjects
(Z
=
2.31;
p
=
.02),
but not
for
S
+
NP
subjects
(Z
=
0.42;
p
=
.68).
For
S +
DP
subjects, utterances
that
did contain
nonsystematic speech
errors
were
produced
with
a
slower
ASR
than utterances
that
did
not.
Systematic speech
errors
(phonological processes).
No
significant
differences were
found
in
mean
ASR
between
utterances
that
did
and
utterances
that
did
not
contain
phonological
processes
for
either
S
+
DP
(Z
=
-0.53; p
=
.59)
or
S +
NP
(Z
=
0.94;
p
=
.35)
subjects.
Four
S +
NP
subjects
were
excluded
in
this
comparison
because
they did
not
demonstrate
phonological
processes
during
the
PNT.
Response
Time
Latency
(RTL).
A
set
of
8
Wilcoxon
Signed-Rank
tests
was
conducted
to
examine differences
in
RTL
comparing utterances
that
did
contain
(a)
within-word
speech
disfluencies,
(b)
between-word
speech
disfluencies
(covert
repairs),
(c)
nonsystematic
overt
speech
errors,
and
(d)
systematic
speech errors
(phonological
processes)
to
utterances
that
did
not
for
both
S +
DP
and
S
+
NP
subject
groups.
None
of
the
8
statistical
comparisons
yielded
sig-
nificant
differences
in
response
time
latency (p-values
ranged
from
.173
to
1.00).
Discussion
Given
the
results
of
the
present
findings,
it
is
possible
to
evaluate
some
of the
basic
predictions
derived from
the
CRH
in
this study
regarding
the
speech
of
children who
stutter.
Differences
Between
S
+
DP
and
S
+
NP
Children
Frequency
of
speech
disfluencies.
Because
S
+
DP
children
produce
more
(systematic)
speech
errors
than
S +
NP
children,
the
CRH
would
appear
to
predict
that
S +
DP
children should
also
produce
more
speech disfluencies.
In
the
present investigation,
however,
few
differences
were
found
between
S +
DP
and
S +
NP
subjects
in
terms
of
measurable
aspects
of
their within-
and
between-word
speech
disfluencies.
For
example,
no
significant
differences
were
found
in
the
frequency
of
within-
and
between-word
produced
by
S +
NP
and
S
+
DP
children,
a
finding
consistent
with prior
findings
of
Louko
et
al.
(1990),
St.
Louis
and
Hinzman
(1988),
and
Wolk
et
al. (1993).
Furthermore,
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360
Journal
of
Speech
and Hearing
Research
and
again
consistent
with
Louko
et
al. (1990),
no
significant
between-group
differences
were
founclih
the
duration
of
within-word
speech
disfluencies. Within-word disfluency
durations
for the
4-
to
7-year-old
subjects
in
this
study
(approximately
.5 s)
were
similar
to
those reported
previ-
ously
by
Conture
and Kelly
(1992)
and
Zebrowski
(1991,
1994),
but
somewhat
shorter
than
those
reported
by
Louko
et
al.
(1990).
The
present
analysis
did
not
reveal
the
significant
be-
tween-group
difference
in
the
occurrence
of
sound
prolon-
gations
reported
by
Wolk
et
al.
(1993);
however,
Wolk's
analysis
appears
to
have measured
the
frequency
of
sound
prolongations
in
relation
to
all disfluency
types
(i.e.,
both
between-
and
within-word
speech
disfluencies),
rather
than
just
within-word
types
(SSR,
MWR,
and
SP)
as
in
the
present
study.
Indeed,
although
the
apparent
difference
did
not
reach
significance,
inspection
of
the
data
in
Figure
2
sug-
gests
that
SSRs
may
have
occurred
relatively
more
fre-
quently
in
some
S +
NP
subjects
than
S
+
DP
subjects,
a
pattern
somewhat
contradictory
to that
observed
by Wolk
et
al. (1993).
Combined,
these
results
suggest
a
continued
need
for
research on
the potential
differences
in
the
types
of
within-word
disfluencies
produced by
S +
DP
and
S +
NP
children.
Systematic
(phonological
process) speech
errors.
As
expected,
S +
DP
subjects
exhibited
more
systematic
speech
errors
than
S +
NP
children,
a
finding
consistent
with those of
Louko
et
al. (1990)
and
Wolk
et
al.
(1993),
Although
these results
are
not
surprising
because
of the
group-inclusion
criteria, the
findings do
confirm
that
S
+
DP
subjects produced
more
speech
errors
(and,
therefore,
may
have
had
more
opportunities for
self-repair
and speech
disfluencies)
than
S +
NP
children.
The
common
occurrence of
Gliding
of
Liquids
and
Vocal-
ization
in
both
subject
groups,
which
was
not
unexpected
given
the
relatively
young
age
of
the
subjects
in
this
inves-
tigation,
has
been
noted
in
prior
studies of
children
who
stutter
(e.g.,
Louko et
al.,
1990;
Wolk
et
al.,
1993),
as
well.as
in
studies
of
children
who
do
not
stutter
(see
Edwards
&
Shriberg,
1983).
Also
consistent
with
prior
studies
(e.g.,
Louko et
al.,
1990),
cluster
reduction processes
(including
Liquid Cluster
Reduction, Glide Cluster Reduction,
and
especially
/s/-Cluster
Reduction)
were
more
prevalent
for
S
+
DP
subjects
than
for
S +
NP
subjects.
Furthermore,
comparison
of
present
results
to those
of
Wolk
(1990,
Appendix
B)
reveals many
similarities
between
the
two
studies
in
the
phonological
processes
exhibited
by
S +
DP
subjects
but
not by
S +
NP
subjects
(e.g.,
Depalatalization,
Deaffrication,
/s/-Cluster
Reduction, Liquid
Cluster
Reduc-
tion,
Labial
Assimilation,
Weak
Syllable
Deletion).
Although
present
findings
cannot
be
considered
conclusive
because
of
the
small
number
of
subjects
in
this
and
other
studies,
similarities
and
differences
in
the
patterns
of
systematic
speech
errors
demonstrated
by
S +
DP
and
S +
NP
subjects
are
consistent
with those
described
elsewhere.
Nonsystematic speech
errors.
The
present
finding that
children
in
both
subject
groups
produced
relatively
few
nonsystematic
speech
errors
in
their conversational
speech
samples
is
consistent
with
previous
reports
that
children's
(and
adults')
nonsystematic
speech
errors
occur
relatively
infrequently
(Jaeger, 1992;
LaSalle
&
Conture,
1995;
Stem-
berger,
1989;
Warren,
1986)
Because
the
specific
frequency
of
children's
nonsystematicer
during
conversation
has
not
been
previously"
reported,
however,
it
is
difficult
to
determine
whether.present
error
levels
are
similar
to those
found by other
researchers.
It
is
interesting
to
note,
however,
that
the
two
oldest
S +
NP
subjects
produced
very
few
errors
of
any
kind during
the
conversational
speech
task.
Therefore,
it
may
be
necessary
to
consider
children's
chro-
nological
or
developmental
age
in
further
investigations
of
the occurrence
of
nonsystematic speech
errors.
Overt
self-repairs.
On
the
basis of
the
CRH,
Kolk
et
al.
(1991)
suggested
that
the
frequent
production
of systematic
speech
errors by
children
with disordered phonology
may
be
due
to
the
children's
inability
to
either
detect
or
success-
fully
repair
phonological
encoding
errors
in
their
speech
(i.e.,
their
internal
monitors
are
in
some way
deficient).
In
the
present
study,
however,
no
significant
between-group
dif-
ferences
were
found
in
children's ability
to
detect
and
repair
nonsystematic
speech
errors
as
indicated
by the
frequency
of
overt self-repairs
and
by
repair-to-error
ratios.
Thus,
although
the
present negative
findings
cannot
be
consid-
ered
conclusive,
it
does
not
appear likely
that
monitoring
difficulties
were
the
cause of
systematic
speech
errors
in
the
speech
of
these
S
+
DP
children.
Also,
as
previously
mentioned, it
is
interesting
to
note
that
subjects
did
not
overtly
repair
their systematic
speech
errors,
suggesting
that
children
may
not
consider
such
systematic
deviations from
adult forms
as
true "errors,"
that
is,
as
speech
behaviors
in
need
of
repair.
Relationships
Between
Speech
Disfluencies
and
Speech
Errors
The
CRH
also appears
to
predict
that
speech
disfluencies
are
related
to
speech
errors
(e.g.,
Postma
et
al.,
1990a).
The
present
finding
that
utterances
containing
nonsystematic
speech
errors
were
significantly
more
likely
to
contain
with-
in-word
speech
disfluencies
for
both
S +
DP
and
S
+
NP
subjects
provides
some
support for this
prediction. This
finding
is
similar
to
that
of
LaSalle
and
Conture
(1995),
who
found
that within-word
disfluencies
are
more
likely
to
coin-
cide
with
overt
errors
than
with
covert
error
words
for
children who
stutter.
t
is
interesting
to
note that
this
depen-
dence
was
not found
for
nonsystematic
speech
errors
and
between-word
speech
disfluencies, suggesting
that the
CRH's
predictions
may be
particularly
relevant
to
the
types
of
speech
disfluencies frequently produced
by
children
who
stutter.
Furthermore,
in
the
present
study,
no
dependence
was
found
between
within-word
speech
disfluencies
and
systematic speech'
errors,
again
suggesting
that
there
may
be
a
fundamental
difference between
children's
systematic
and
nonsystematic
speech
errors in'
relation
to
self-repairs
and
the production
of
speech
disfluencies.
Effects
of
Utterance
Timing
on
Speech
Disfluences
and
Speech
Errors
Effects
of
Articulatory
Speaking
Rate
and
Response
Time
Latency.
The CRH
assumes
that
individuals
who
39
349-364
Apri
1996
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Yaruss
&
Conture:
Stuttering
and
Phonological
Disorders
361
stutter
exhibit
delayed
phonological encoding
and
attempt
to
initiate
speech
too
rapidly or
use
too-fast
articulatory
speaking
rates.
As
described
above,
this
set
of
assumptions
leads
to
the prediction
that
utterances
produced
with
a
faster
ASR
are
more
likely
to
contain
a
speech
disfluency
or
overt
speech
error.
However,
present
findings
do not
appear
to
support
this prediction.
First,
no
significant
differences
were
found
between
S
+
DP
and
S +
NP
subjects
in
terms
of their
articulatory speaking
rate,
a
finding
similar
to that
of
Wolk et
al.
(1993).
Furthermore,
utterances
containing
with-
in-
and
between-word
speech
disfluencies
or
nonsystematic
speech
errors were
actually produced
by
some
subjects
with
a
slower
ASR
than
utterances
that
did
not.
This
finding
does
not
support
the
assumption
that
children
are
more
likely
to
produce
speech
disfluencies or
speech
errors
when
they
use
a
faster
articulatory
(or
overall)
speaking
rate
(e.g.,
MacKay,
1971).
However,
Logan and
Conture
(1995)
also
noted
that
some
of
their
subjects'
ASRs
were
slower
on
utterances that did contain
within-word
disfluencies
than
on
those that
did
not.
Thus,
it
appears
that
increased
ASR
by
itself
does
not increase
the likelihood
of
within- or
between-
word
speech
disfluencies or
(non)systematic
speech
errors.
There
also
appeared
to
be
no
difference
in
RTL
between
utterances
that
did contain
speech
disfluencies
and
speech
errors and
utterances
that
did
not.
The
RTLs
of
S +
DP
and
S +
NP
children
have
not
been
compared previously,
so
it
is
difficult to
compare
the
present
nonsignificant
between-
group
differences
to
other
studies;
however,
prior
studies
have
indicated
no
significant
differences
in
the
RTLs
of
children
who
stutter
and
children
who
do
not
stutter
(Kelly
&
Conture,
1992;
Yaruss
&
Conture,
1995).
Thus, present
findings
do
not
support
the
CRH
predictions
that
faster
articulatory
speaking
rates
or
shorter
pausing
times
result
in
the production of
speech
disfluencies
or
speech
errors.
Clinical Implications/Extending
the
CRH
Although
the
present
study
did
not
support
the notion that
systematic
speech
errors
are
associated
with the
production
of
speech
disfluencies, results
still
appear
to
have
Clinical
implications for
treatment
of
children
who
exhibit
disordered
phonology.
Specifically,
the
CRH
mechanism
can
be ex-
tended
to
account for
one
of
the
clinical
phenomena some-
times
observed informally
by
speech-language
pathologists
treating
children who
stutter
and
demonstrate
disordered
phonology.
As
noted
above,
clinical
evidence
suggests
that
children
may
occasionally
begin
to
produce
frequent
speech
disfluencies
while receiving
treatment
for
phonological dis-
orders
(Comas,
1974; Hall, 1977; Ratner,
1995).
One
possi-
ble
explanation
for
this
increase
in
the
production
of
speech
disfluencies
is
that
during the course
of
speech
treatment
for
articulation
or
phonological
disorders, children
become
in-
creasingly
aware
of
and
sensitive
to the
differences between
their
own
productions
and
the
adult
form
of
the
target
words.
Thus,
as
children's
internal
monitors
become
more
sensitive
to
systematic speech
errors
(i.e.,
as children
are
better
able
to
detect
such
errors
within
their phonetic plans
or
recognize
that their
phonological
productions
are
not
correct),
children
may
become
more
likely
to try
to
repair
these
systematic
speech
errors,
which
they
did
not
previ-
ously
try
to
repair.
According
to
the
CRH,
such changes
in
children's
internal
monitors
may
result
in
more
frequent
speech
disfluencies
because children
are
trying
to
repair
more
of their
systematic
speech
errors.
Of
course,
subjects
in
the
present
study
had
received
no speech-language
treatment
before
their participation
in
this
study,
so
it
is
unlikely
that
these children were
engaging
in
such
error
repair behaviors.
Furthermore,
empirical
analyses
of
changes
in
children's
speech
fluency
during
articulation/
phonological
treatment
has
not yet
been
conducted.
Such
empirical
investigation
will
certainly
be
required
in
order
to
test
this
possible
extension
of
CRH.
Caveats
and
Additional
Suggestions
for
Further
Research
Statistical
issues.
As
with
many
studies
of
conversational
speech,
the
power
of
the
statistical
analyses
in
this
investi-
gation
may
have
been
affected
by
the
varying
number
of
speech
disfluencies,
speech
errors, and
self-repairs
pro-
duced
by each
subject
during
their
conversational
speech
samples. Conversational samples
were
specifically
selected
so
that
results
would
be
generalizable
to
naturalistic conver-
sational
settings.
Future
studies
of children's
speech
disflu-
encies
and
speech
errors
could
improve
statistical
power
by
employing
a
paradigm
that
allows
comparison
of
the
same
utterances
within
and
between
subjects
(e.g.,
split-plot
factorial
design);
however,
such
a
controlled
experimental
design
may
limit
the generalizability
of
findings
to
naturalistic
conversational
settings.
Nature
of
selected
utterances.
Again,
because
the
present
study
used
conversational speech
samples,
it
was
impossible
to
control
for
the
length
and
grammatical
and
phonological
complexity
of
the utterances
analyzed.
Be-
cause
of
the
apparent
relationship
between
utterance length
and
complexity
and
the
timing
of
utterances
(e.g.,
Amster
&
Starkweather,
1987;
Logan
&
Conture,
1995;
Meyers
&
Freeman,
1985;
Walker
et
al.,
1992),
further studies
of
the
co-occurrence
of
speech
errors
and
speech
disfluencies
should
consider
such
issues
as
utterance length
(e.g.,
Gaines,
Runyan,
&
Meyers,
1991;
Logan
&
Conture,
1995;
Peters
&
Hulstijn,
1987;
Ratner
&
Sih, 1987;
Weiss
&
Ze-
browski,
1992),
grammatical
complexity
(e.g.,
Logan
&
Con-
ture,
1995;
Gordon
&
Luper, 1989;
Gordon,
Luper,
&
Peter-
son,
1986;
Ratner
&
Sih,
1987),
and
phonologic
complexity
(e.g.,
Bauer,
1988;
Nelson
&
Bauer,
1991;
Throneburg,
Yairi,
&
Paden,
1994,
Waterson,
1978).
Definition
and
identification
of
phonological
pro-
cesses.
In
order
to
describe systematic
speech
errors
demonstrated by subjects,
this study
used
phonological
process
analysis,
a
technique
that
has.
previously
been
shown
to
be
a
meaningful
way
of
categorizing
children's
speech
sound
errors
for
clinical
and
research
purposes
(e.g.,
Edwards,
1992).
However,
informal
phonological
analyses
such
as
those
conducted
in
this
study
and
others
(e.g.,
Wolk
et
al., 1993)
may
not
be
specific
enough
to
reveal
subtle
relationships
between
systematic
speech
errors
and
speech
disfluencies
in
conversational
speech.
The
phonological
process
definitions
employed
in
the
present
study
were
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362
Journal
of
Speech
and
Hearing
Research
designed to
facilitate
between-subject
and
between-group
comparisons
of
children's
phonological
development;
how-
ever,
future
studies
may
need
to
specify
phonological
pro-
cesses
more
completely,
involving
such
factors
as
phonetic
context
or the
apparent
nature
of
the children's
underlying
phonological representations
(e.g.,
Dinnsen,
1984;
Elbert
&
Gierut,
1986;
Maxwell,
1984; Weismer,
1984).
Finally, rather
than
considering
error
patterns
(phonological
processes),
further
investigation
of
the
relationships
between
children's
systematic
speech
errors
and
speech
disfluencies could
also
take
into
account children's
(in)accurate
production
of
specific
words
or
sounds
(e.g.,
Caruso,
Angello,
&
Sommers,
1993).
Inclusion
of
control
groups.
In
the
present
study,
S +
NP
children
were
compared
to
S
+
DP children
in
an
attempt
to
examine
the
possible
interactions
between
disordered
pho-
nology
and
stuttering.
Questions
relating
to
the
CRH
might
further
be
evaluated
using
groups
of
children
with
normal
fluency
and normal
phonology
(NF
+
NP),
as
well
as
children
with
normal
fluency
and
disordered
phonology
(NF
+
DP).
Of
course,
in
these
populations,
it
is
quite
difficult
to
study
interactions
between,
for
example,
systematic phonological
errors
and
within-word
speech
disfluencies
because
these
groups,
by
definition,
will
produce very
few,
if
any,
of
these
types of
speech
errors
and
speech
disfluencies.
For
exam-
ple,
the
10
children
who do
not
stutter
examined
by
LaSalle
&
Conture
(1991)
produced
only
22
within-word
speech
disfluencies
during
their
conversational speech samples
totalling
3,000
words.
Because
of
the
small
number
of
such
disfluencies
produced
by
children
who
do
not
stutter,
the
applicability
of
inferential
statistical
analyses
to
examine
the
relationship between
speech
disfluencies
and
speech
errors
in
these
populations
is
severely limited.
However,
such work
might
be
useful
for
examining
potential
interactions
relating
between-word
speech disfluencies
to
nonsystematic
speech
errors
and
overt
self-repairs,
and
such
studies
are
currently
being
conducted
by the
present authors.
Summary
and
Conclusions
Present
findings support
some,
but not
all,
of
the
basic
predictions
of
the
Covert
Repair
Hypothesis
for
children
who
stutter
and
exhibit
disordered
phonology
(S +
DP)
and
children
who
stutter
and
exhibit
normal
phonology
(S +
NP).
Given
these
findings,
as
well
as
the apparent
differences
between
children's
systematic
and
nonsystematic
speech
errors,
it
seems
reasonable
to
conclude
that the
CRH
will
need
further
research and
elaboration
(such
as
that
offered
above
regarding
the apparent
increase
in
speech
disfluen-
cies
which sometimes
occurs
during treatment
for
articula-
tion
or
phonological
disorders)
if
it
is
to
provide
a meaningful
framework
for
evaluating
the
speech
disfluencies of
children
who
stutter,
and
particularly
of
children
who
stutter
and
exhibit
disordered
phonology.
Acknowledgments
This
research
was
supported
in
part
by an
NIH
Grant (DC000523)
to
Syracuse
University
and
was
completed
as
part
of
the
first
author's
doctoral
dissertation.
The
second
author
would
like
to
extend
his
appreciation
to
theNij4megen
Institute
of
Cognition
and
Information
(NICI),
University
of
Nijmegen,
where
he
was
a
visiting
researcher during
the
development
of
this
manuscript.
The
authors
would
like
to
thank
Dr.
Ken
Logan
for
his help with interjudge
measurement
reliability,
Dr.
Mary
Louise
Edwards
for
her help
with
the
phonetic
transcriptions,
and
Drs.
Linda
Milosky
and Mary
Louise
Edwards,
as
well
as
Drs.
Charles
Healey
and
Roger
Ingham
and
two
anonymous
reviewers,
for
their
insightful reviews
of
earlier
drafts
of
this
paper.
The
authors
are
also grateful
to
Drs.
Albert
Postma
and
Herman
Kolk
for
their
helpful
input
regarding
the
theoretical
frame-
work
of
the
Covert
Repair
Hypothesis.
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(1991).
Duration
of
the
speech disfluencies
of
beginning stutterers. Journal
of
Speech
and
Hearing
Research,
34,
483-491.
Zebrowski,
P.
M.
(1994).
Duration
of
sound
prolongations
and
sound/syllable
repetition
in
children
who
stutter:
Preliminary
ob-
servations.
Journal
of
Speech
and Hearing
Research,
2,
254-263.
Zebrowski,
P.
M.,
&
Conture,
E.
G.
(1989).
Judgments
of
disflu-
ency
by
mothers
of
stuttering
and
normally fluent
children.
Journal
of
Speech
and
Hearing
Research, 32,
625-664.
Received January
9,
1995
Accepted
September
12,
1995
Contact
author:
J.
Scott
Yaruss,
PhD,
Speech
and Language
Pathology, Northwestern University,
2299
North
Campus
Drive,
Evanston,
IL
60208.
Email:
jsyaruss@nwu.edu
39
349-364
Apri
1996
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