Executive functions and stuttering severity in Persian adults
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Abstract
Introduction: Fluent speech requires executive functions for identification, inhibition, and modification of speech interruptions to continuously regulate the speech process. The current study examined the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity.
Materials and methods: This research is a descriptive-analytic cross-sectional study. The participants included 32 AWS (mean age = 28 years; SD = 6.79 years) who were divided into three groups of mild, moderate, and severe severity and 32 AWNS (mean age = 28.57 years; SD = 6.53 years; 28). Selected tests from Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains.
Results: The results of this study showed that AWS performed significantly lower than AWNS in working memory (p = 0.009), problem solving and planning (p < 0.001), verbal cognitive flexibility (shifting) (p < 0.001), and verbal inhibitory control (p < 0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, there was a significant relationship between stuttering severity and executive function domains.
Conclusion: Together, this study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.
1. Guitar B. Stuttering: An integrated approach to its nature and treatment: Lippincott Williams & Wilkins; 2013.
2. Howell P. Signs of developmental stuttering up to age eight and at 12 plus. Clinical psychology review. 2007;27(3):287-306.
3. Büchel C, Sommer M. What causes stuttering? PLoS Biol. 2004;2(2):e46.
4. Smith A, Kelly E. Stuttering: A dynamic, multifactorial model. Nature and treatment of stuttering: New directions. 1997;2:204-17.
5. Smith A, Weber C, editors. Childhood stuttering: Where are we and where are we going? Seminars in Speech and Language; 2016: Thieme Medical Publishers.
6. Felsenfeld S, van Beijsterveldt CEM, Boomsma DI. Attentional regulation in young twins with probable stuttering, high nonfluency, and typical fluency. 2010.
7. Watkins KE, Smith SM, Davis S, Howell P. Structural and functional abnormalities of the motor system in developmental stuttering. Brain. 2008;131(1):50-9.
8. Gkalitsiou Z, Byrd C, Griffin Z. Executive control in adults who stutter: The antisaccade task. Journal of Speech, Language, and Hearing Research. 2020;63(6):1688-99.
9. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology. 2000;41(1):49-100.
10. Diamond A. Executive functions. Annual review of psychology. 2013;64:135.
11. Baggetta P, Alexander PA. Conceptualization and operationalization of executive function. Mind, Brain, and Education. 2016;10(1):10-33.
12. Karr JE, Areshenkoff CN, Rast P, Hofer SM, Iverson GL, Garcia-Barrera MA. The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Psychological bulletin. 2018;144(11):1147.
13. Lehto JE, Juujärvi P, Kooistra L, Pulkkinen L. Dimensions of executive functioning: Evidence from children. British journal of developmental psychology. 2003;21(1):59-80.
14. Collins A, Koechlin E. Reasoning, learning, and creativity: frontal lobe function and human decision-making. PLoS biology. 2012;10(3):e1001293.
15. Lunt L, Bramham J, Morris RG, Bullock PR, Selway RP, Xenitidis K, et al. Prefrontal cortex dysfunction and ‘Jumping to Conclusions’: Bias or deficit? Journal of neuropsychology. 2012;6(1):65-78.
16. Byrd CT, McGill M, Usler E. Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences. Journal of Fluency Disorders. 2015;44:17-31.
17. Bajaj A. Working memory involvement in stuttering: Exploring the evidence and research implications. Journal of fluency disorders. 2007;32(3):218-38.
18. Byrd CT, Vallely M, Anderson JD, Sussman H. Nonword repetition and phoneme elision in adults who do and do not stutter. Journal of fluency disorders. 2012;37(3):188-201.
19. Bosshardt H-G. Effects of concurrent cognitive processing on the fluency of word repetition: Comparison between persons who do and do not stutter. Journal of Fluency Disorders. 2002;27(2):93-114.
20. Jones RM, Fox RA, Jacewicz E. The effects of concurrent cognitive load on phonological processing in adults who stutter. 2012.
21. Gkalitsiou Z, Byrd CT. Working memory in adults who stutter using a visual N-back task. Journal of Fluency Disorders. 2021;70:105846.
22. Eggers K, & Alewaters, H. Inhibitory control in
adults who stutter. Poster presented at the 3rd European Symposium
on Fluency Disorders, Antwerp, Belgium. 2012.
23. Markett S, Bleek B, Reuter M, Pruess H, Richardt K, Müller T, et al. Impaired motor inhibition in adults who stutter–evidence from speech-free stop-signal reaction time tasks. Neuropsychologia. 2016;91:444-50.
24. TRELEAVEN S, COALSON G. Motor response inhibition and severity of stuttered speech in adults.
25. Maxfield N, editor Inhibitory executive function in adults who stutter: Behavioral and ERP evidence. Poster presented at the Annual American Speech Language and Hearing Association Convention, Boston, MA, United States; 2018.
26. Treleaven SB, Coalson GA. Verbal response inhibition in adults who stutter. Journal of Speech, Language, and Hearing Research. 2021;64(9):3382-97.
27. Farazi M, Gholami L, Khoda Bakhshi A, Shemshadi H, Rahgozar M. The effect of a combination of cognitive therapy and speech in stutterers. Thoughts and Behavior in Clinical Psychology. 2014;8(30):37-46.
28. Ghawami H, Raghibi M, Tamini BK, Dolatshahi B, Rahimi-Movaghar V. CROSS-CULTURAL ADAPTATION OF EXECUTIVE FUNCTION TESTS FOR ASSESSMENTS OF TRAUMATIC BRAIN INJURY PATIENTS IN SOUTHEAST IRAN. Behavioral Psychology/Psicologia Conductual. 2016;24(3).
29. Homack S, Lee D, Riccio CA. Test review: Delis-Kaplan executive function system. Journal of clinical and experimental neuropsychology. 2005;27(5):599-609.
30. Delis DC, Kaplan E, Kramer JH. Delis-Kaplan executive function system. 2001.
31. Masumi E, Kashani ZA, Hassanpour N, Kamali M. The effect of syllable structure on the frequency of disfluencies in adults with stuttering. Middle East Journal of Rehabilitation and Health. 2015;2(2).
32. Logan GD. Executive control of thought and action: In search of the wild homunculus. Current Directions in Psychological Science. 2003;12(2):45-8.
33. Packwood S, Hodgetts HM, Tremblay S. A multiperspective approach to the conceptualization of executive functions. Journal of clinical and experimental neuropsychology. 2011;33(4):456-70.
34. Ahlsén E. Introduction to neurolinguistics: John Benjamins Publishing; 2006.
35. Castro-Meneses LJ. Applying the stop signal task to speech: Neural and behavioural investigations of proactive and reactive inhibition. 2015.
36. Luschei ES, Goldberg LJ. Neural mechanisms of mandibular control: mastication and voluntary biting. Comprehensive physiology. 2011:1237-74.
37. Eggers K, Luc F, Van den Bergh BR. Exogenously triggered response inhibition in developmental stuttering. Journal of Fluency Disorders. 2018;56:33-44.
38. Eggers K, Luc F, Van den Bergh BR. The efficiency of attentional networks in children who stutter. 2012.
39. Eggers K, Luc F, Van den Bergh BR. Inhibitory control in childhood stuttering. Journal of fluency disorders. 2013;38(1):1-13.
40. Wingate M. Behavioral rigidity in stutterers. Journal of Speech and Hearing Research. 1966;9(4):626-9.
41. Eisenson J, Pastel E. A study of the perseverating tendency in stutterers. Quarterly Journal of Speech. 1936;22(4):626-31.
42. Eggers K, Luc F, Van den Bergh BR. Temperament dimensions in stuttering and typically developing children. Journal of fluency disorders. 2010;35(4):355-72.
43. Postma A, Kolk H. The covert repair hypothesis: Prearticulatory repair processes in normal and stuttered disfluencies. Journal of Speech, Language, and Hearing Research. 1993;36(3):472-87.
44. Doneva S, Davis S, Cavenagh P. Comparing the performance of people who stutter and people who do not stutter on the Test of Everyday Attention. Journal of Clinical and Experimental Neuropsychology. 2018;40(6):544-58.
45. Eggers K, Jansson-Verkasalo E. Auditory attentional set-shifting and inhibition in children who stutter. Journal of Speech, Language, and Hearing Research. 2017;60(11):3159-70.
46. Neef NE, Anwander A, Bütfering C, Schmidt-Samoa C, Friederici AD, Paulus W, et al. Structural connectivity of right frontal hyperactive areas scales with stuttering severity. Brain. 2018;141(1):191-204.
2. Howell P. Signs of developmental stuttering up to age eight and at 12 plus. Clinical psychology review. 2007;27(3):287-306.
3. Büchel C, Sommer M. What causes stuttering? PLoS Biol. 2004;2(2):e46.
4. Smith A, Kelly E. Stuttering: A dynamic, multifactorial model. Nature and treatment of stuttering: New directions. 1997;2:204-17.
5. Smith A, Weber C, editors. Childhood stuttering: Where are we and where are we going? Seminars in Speech and Language; 2016: Thieme Medical Publishers.
6. Felsenfeld S, van Beijsterveldt CEM, Boomsma DI. Attentional regulation in young twins with probable stuttering, high nonfluency, and typical fluency. 2010.
7. Watkins KE, Smith SM, Davis S, Howell P. Structural and functional abnormalities of the motor system in developmental stuttering. Brain. 2008;131(1):50-9.
8. Gkalitsiou Z, Byrd C, Griffin Z. Executive control in adults who stutter: The antisaccade task. Journal of Speech, Language, and Hearing Research. 2020;63(6):1688-99.
9. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology. 2000;41(1):49-100.
10. Diamond A. Executive functions. Annual review of psychology. 2013;64:135.
11. Baggetta P, Alexander PA. Conceptualization and operationalization of executive function. Mind, Brain, and Education. 2016;10(1):10-33.
12. Karr JE, Areshenkoff CN, Rast P, Hofer SM, Iverson GL, Garcia-Barrera MA. The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Psychological bulletin. 2018;144(11):1147.
13. Lehto JE, Juujärvi P, Kooistra L, Pulkkinen L. Dimensions of executive functioning: Evidence from children. British journal of developmental psychology. 2003;21(1):59-80.
14. Collins A, Koechlin E. Reasoning, learning, and creativity: frontal lobe function and human decision-making. PLoS biology. 2012;10(3):e1001293.
15. Lunt L, Bramham J, Morris RG, Bullock PR, Selway RP, Xenitidis K, et al. Prefrontal cortex dysfunction and ‘Jumping to Conclusions’: Bias or deficit? Journal of neuropsychology. 2012;6(1):65-78.
16. Byrd CT, McGill M, Usler E. Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences. Journal of Fluency Disorders. 2015;44:17-31.
17. Bajaj A. Working memory involvement in stuttering: Exploring the evidence and research implications. Journal of fluency disorders. 2007;32(3):218-38.
18. Byrd CT, Vallely M, Anderson JD, Sussman H. Nonword repetition and phoneme elision in adults who do and do not stutter. Journal of fluency disorders. 2012;37(3):188-201.
19. Bosshardt H-G. Effects of concurrent cognitive processing on the fluency of word repetition: Comparison between persons who do and do not stutter. Journal of Fluency Disorders. 2002;27(2):93-114.
20. Jones RM, Fox RA, Jacewicz E. The effects of concurrent cognitive load on phonological processing in adults who stutter. 2012.
21. Gkalitsiou Z, Byrd CT. Working memory in adults who stutter using a visual N-back task. Journal of Fluency Disorders. 2021;70:105846.
22. Eggers K, & Alewaters, H. Inhibitory control in
adults who stutter. Poster presented at the 3rd European Symposium
on Fluency Disorders, Antwerp, Belgium. 2012.
23. Markett S, Bleek B, Reuter M, Pruess H, Richardt K, Müller T, et al. Impaired motor inhibition in adults who stutter–evidence from speech-free stop-signal reaction time tasks. Neuropsychologia. 2016;91:444-50.
24. TRELEAVEN S, COALSON G. Motor response inhibition and severity of stuttered speech in adults.
25. Maxfield N, editor Inhibitory executive function in adults who stutter: Behavioral and ERP evidence. Poster presented at the Annual American Speech Language and Hearing Association Convention, Boston, MA, United States; 2018.
26. Treleaven SB, Coalson GA. Verbal response inhibition in adults who stutter. Journal of Speech, Language, and Hearing Research. 2021;64(9):3382-97.
27. Farazi M, Gholami L, Khoda Bakhshi A, Shemshadi H, Rahgozar M. The effect of a combination of cognitive therapy and speech in stutterers. Thoughts and Behavior in Clinical Psychology. 2014;8(30):37-46.
28. Ghawami H, Raghibi M, Tamini BK, Dolatshahi B, Rahimi-Movaghar V. CROSS-CULTURAL ADAPTATION OF EXECUTIVE FUNCTION TESTS FOR ASSESSMENTS OF TRAUMATIC BRAIN INJURY PATIENTS IN SOUTHEAST IRAN. Behavioral Psychology/Psicologia Conductual. 2016;24(3).
29. Homack S, Lee D, Riccio CA. Test review: Delis-Kaplan executive function system. Journal of clinical and experimental neuropsychology. 2005;27(5):599-609.
30. Delis DC, Kaplan E, Kramer JH. Delis-Kaplan executive function system. 2001.
31. Masumi E, Kashani ZA, Hassanpour N, Kamali M. The effect of syllable structure on the frequency of disfluencies in adults with stuttering. Middle East Journal of Rehabilitation and Health. 2015;2(2).
32. Logan GD. Executive control of thought and action: In search of the wild homunculus. Current Directions in Psychological Science. 2003;12(2):45-8.
33. Packwood S, Hodgetts HM, Tremblay S. A multiperspective approach to the conceptualization of executive functions. Journal of clinical and experimental neuropsychology. 2011;33(4):456-70.
34. Ahlsén E. Introduction to neurolinguistics: John Benjamins Publishing; 2006.
35. Castro-Meneses LJ. Applying the stop signal task to speech: Neural and behavioural investigations of proactive and reactive inhibition. 2015.
36. Luschei ES, Goldberg LJ. Neural mechanisms of mandibular control: mastication and voluntary biting. Comprehensive physiology. 2011:1237-74.
37. Eggers K, Luc F, Van den Bergh BR. Exogenously triggered response inhibition in developmental stuttering. Journal of Fluency Disorders. 2018;56:33-44.
38. Eggers K, Luc F, Van den Bergh BR. The efficiency of attentional networks in children who stutter. 2012.
39. Eggers K, Luc F, Van den Bergh BR. Inhibitory control in childhood stuttering. Journal of fluency disorders. 2013;38(1):1-13.
40. Wingate M. Behavioral rigidity in stutterers. Journal of Speech and Hearing Research. 1966;9(4):626-9.
41. Eisenson J, Pastel E. A study of the perseverating tendency in stutterers. Quarterly Journal of Speech. 1936;22(4):626-31.
42. Eggers K, Luc F, Van den Bergh BR. Temperament dimensions in stuttering and typically developing children. Journal of fluency disorders. 2010;35(4):355-72.
43. Postma A, Kolk H. The covert repair hypothesis: Prearticulatory repair processes in normal and stuttered disfluencies. Journal of Speech, Language, and Hearing Research. 1993;36(3):472-87.
44. Doneva S, Davis S, Cavenagh P. Comparing the performance of people who stutter and people who do not stutter on the Test of Everyday Attention. Journal of Clinical and Experimental Neuropsychology. 2018;40(6):544-58.
45. Eggers K, Jansson-Verkasalo E. Auditory attentional set-shifting and inhibition in children who stutter. Journal of Speech, Language, and Hearing Research. 2017;60(11):3159-70.
46. Neef NE, Anwander A, Bütfering C, Schmidt-Samoa C, Friederici AD, Paulus W, et al. Structural connectivity of right frontal hyperactive areas scales with stuttering severity. Brain. 2018;141(1):191-204.
| Files | ||
| Issue | Vol 18 No 2 (2024) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v18i2.15977 | |
| Keywords | ||
| Executive function, developmental stuttering, severity, adult, D-KEFS test | ||
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How to Cite
1.
Salehi Darjani M, Shahbodaghi MR, Jalaie S. Executive functions and stuttering severity in Persian adults. jmr. 2024;18(2):199-208.
