The need for self-report data in the assessment of stuttering therapy efficacy: repetitions and prolongations of speech. The stuttering syndrome.
The need for self-report data in the assessment of stuttering therapy efficacy: repetitions and prolongations of speech. The stuttering syndrome.
复制标题
评估口吃治疗效果时需要自我报告数据：言语的重复和延长。
DOI：
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复制
发表时间：
2006
影响因子：
2.4
通讯作者：
T. Saltuklaroglu
中科院分区：
文献类型：
--
作者：
V. Guntupalli;J. Kalinowski;T. Saltuklaroglu
背景
布拉德斯坦回顾了数百项研究，这些研究调查了改善口吃综合征的治疗方案的有效性。令人惊讶的是，几乎所有的方法都有效地显著减少了明显可察觉的行为，如重复和延长语音。考虑到许多治疗方法在原理和实施程序上截然相反(例如，精神分析、药物治疗、行为主义、认知行为治疗和带有频率控制的听觉反馈装置等)，这些结果似乎非常不可能。此外，时间和自我报告等更生态有效的方法表明，公开的成功衡量标准是脆弱的，它们的改善效果往往会随着时间的推移而急剧减弱，并且表现出很差的普适性。此外，口吃治疗中真正的难题是未能承认口吃是一种连续代偿行为的完整综合征。
目标
强调自我报告测量如何作为一种主要工具，用于了解口吃的症候群性质，并在临床范围和口吃者的需求之外测试治疗的有效性。
方法和程序/结果和结果
在过去，治疗效果通常是通过减少明显可见和可计数的口吃事件来衡量的，如重复和延长。然而，最近的神经成像数据和我们的研究表明，口吃综合征不仅仅是外围语言障碍的存在。口吃是一种中枢的、经验性的“失去控制”的感觉，它通过从中枢神经系统向外到语言外周的一系列补偿行为表现出来。换句话说，异常的神经活动，以及隐蔽的口吃行为、潜意识的口吃形式和公开的言语中断，都是对中枢不自觉的“神经阻滞”的影响或补偿。因此，通过只计算可察觉到的障碍部分，功效测量“未能捕捉到”“失控”的经验感和障碍的隐蔽补偿行为(即，避免使用词语或情景、替代、迂回、潜意识的口吃形式等)。此外，听起来不自然的语音、说话的简易性降低、诊室流畅度的提高以及计算口吃行为的可靠性较差，混淆了临床环境中的公开测量。因此，尽管单独使用显性措施仍然很重要，但它们不能提供疗效的“真正衡量标准”。
结论
任何有效和有效的长期评估干预方法的方法都应该包括一种自我报告的形式，作为主要工具，因为它最能获得“失控”和其他隐蔽行为的经验感。应使用公开措施补充或补充自我报告数据。
BACKGROUND
Bloodstein reviewed hundreds of studies that investigated the efficacy of therapeutic protocols for ameliorating the stuttering syndrome. Surprisingly, almost all were effective in significantly reducing overtly perceptible behaviours such as repetitions and prolongations of speech sounds. These results seem highly improbable considering that many of the treatment methods were diametrically opposed in their principles and implementation procedures (e.g. psychoanalysis, drug therapy, behaviourism, cognitive behavioural therapy and auditory feedback devices with rate control, etc.). In addition, time and more ecologically valid methods such as self-report measures demonstrate that overt measures of success are tenuous, their ameliorative effects tend to diminish drastically over time and show poor generalizability. Further, the real conundrum in stuttering therapy is the failure to acknowledge stuttering as a complete syndrome of continuous compensatory behaviours.
AIMS
To highlight how self-report measures serve as a primary tool to understand the syndrome-like nature of stuttering and to test the efficacy of the therapy outside the confines of the clinic and the needs of the people who stutter.
METHODS & PROCEDURES/OUTCOMES & RESULTS
In the past, therapeutic efficacy has typically been measured by the reduction in overtly observable and countable events of stuttering such as repetitions and prolongations. However, recent neuroimaging data and our research suggest that the stuttering syndrome is more than the mere presence of peripheral speech disruptions. Stuttering is a central, experiential sense of 'loss of control' that manifests itself across a continuum of compensatory behaviours from the central nervous system outwards to the speech periphery. In other words, aberrant neural activity, as well as covert stuttering behaviours, subperceptual stuttering forms and overt speech disruptions are all effects or compensations for the central involuntary 'neural block'. Hence, by counting only perceptible portions of the disorder, efficacy measures 'fail to capture' the experiential sense of 'loss of control' and the covert compensatory behaviours of the disorder (i.e. avoidances of words or situations, substitutions, circumlocutions, subperceptual stuttering forms, etc.). Furthermore, unnatural sounding speech, decreased ease of speech production, elevated levels of clinic room fluency and poor reliability in counting stuttering behaviours confound the overt measures in the clinic milieu. Therefore, while overt measures remain important, used in isolation, they cannot provide a 'true metric' of efficacy.
CONCLUSIONS
Any efficient and effective means of evaluating intervention methods over the long-term should include a form of self-report as a primary tool as it best accesses the experiential sense of 'loss of control' and other covert behaviours. Overt measures should be used to supplement or complement the self-report data.
国家口吃协会参与者的言语治疗和支持小组经验。
影响因子：
2.1
作者：
Yaruss,JScott;Quesal,RobertW;Reeves,Lee;Molt,LawrenceF;Kluetz,Brett;Caruso,AnthonyJ;McClure,JamesA;Lewis,Fred
通讯作者：
Lewis,Fred
声学 LRT 在非口吃者、轻度口吃者和重度口吃者中的生理基础。
DOI：
10.1044/jshr.3004.434
发表时间：
1987
期刊：
Journal of speech and hearing research
影响因子：
--
作者：
Watson,BC;Alfonso,PJ
通讯作者：
Alfonso,PJ
口吃者流利言语的运动学前后比较。
DOI：
10.1044/jshr.3905.991
发表时间：
1996
期刊：
Journal of speech and hearing research
影响因子：
--
作者：
Story,RS;Alfonso,PJ;Harris,KS
通讯作者：
Harris,KS