Wednesday, April 29, 2009

IFA Program

Here is the program for the IFA conference in Rio in August. Click on the week days to get the name of the speakers.

As I said before, not too impressed by the key speakers. NOTE THE LIDCOMBE PEOPLE GIVE TALKS ABOUT ALL KIND OF THINGS BUT NOT ON THEIR OWN FOLLOW-UP STUDY OF THEIR FAMOUS PSEUDO RANDOM CONTROL TRIAL. WHY? EVEN THEIR FLAWED SETUP SHOWS THAT THE RATE WAS NOT CLEARLY BETTER THAN NATURAL RECOVERY. That's how research is done. If you don't like your results, you don't spend the effort to promote it! Instead they talk about refinements like time to treat, individual differences, technical aids, and so on. Needless to say that it is all completely useless given that it is already tricky to properly do overall sucess rate due to statistical erros from high natural recovery rate: they search in the haystack when in fact it is not even possible to locate the haystack! But of course if you do not understand stats well and are not trained in hard science, you just don't see the issues and your brain gives great meaning to a research that is meaningless.

Here are the talks I would consider going to. And of course all the posters. I often find that posters contain more interesting research, and by grad students who are still clear thinking and not corrupted by bad role models. But often overly impressed by authority.

Recovery from stuttering
Howell Peter, Davis Stephen

A longitudinal study of syntax, prosody and recovery from stuttering
Rusbridge Sarah, Howell Peter

Stuttering and the ICD 9/10: A debate within our profession
Bernstein Ratner Nan, Maguire Gerald

Dysfluency levels in various speaking conditions in acquired neurogenic stuttering
Balasubramanian Venu, Cronin Kristine, Max Ludo

Comparing sequence learning and retention in stuttering and Parkinson’s disease
Smits-Bandstra Sarah, Gracco Vince, De Nil Luc

peech and nonspeech sensorimotor learning in individuals who stutter
Max Ludo, Baldwin Caitlin J., Cronin Kristine L., Flanagan J. Randall

Genetic epidemiological relations between Stuttering, Cluttering and Specific Language Impairment
Fibiger Steen, von Bornemann Hjelmborg Jacob, Fagnani Corrado, Skytthe Axel

Multiple facets of stuttering: Insights from brain and behavioural research
Luc De Nil

Neurobiological explanations of developmental stuttering: Contributions from brain imaging studies
Watkins Kate, Ward David

Association Studies of chromosome 18 microsatellites and Familial Persistent Stuttering n
Domingues Carlos Eduardo

Parent-child interaction after the Lidcombe Program and the DCM-based treatment
Oonk Leonoor, Franken Marie-Christine, Koedoot Caroline

Wednesday, April 22, 2009

Another neuroscience article from China

Here is another article from the same Chinese group Lu et al in another good journal. Again, sounds interesting. And they look like serious professional scientists. They have another article out in Neuroscience; I need to compare to see what is different. Here they seem to look into Per's hypothesis that the pathway involving the basal ganglia is affected in stuttering people. And they find all kind of anatomically and connective differences. I need to look at the complete article in detail. But I keep on promising that I look at articles carefully and report back. But I never do... :-(

Cortex. 2009 Mar 13.

Altered effective connectivity and anomalous anatomy in the basal ganglia-thalamocortical circuit of stuttering speakers.

State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.
Combining structural equation modeling (SEM) and voxel-based morphometry (VBM), this study investigated the interactions among neural structures in the basal ganglia-thalamocortical circuit (BGTC) in the left hemisphere of stuttering and non-stuttering speakers. Stuttering speakers (n=12) and non-stuttering controls (n=12) were scanned while performing a picture-naming task and a passive-viewing (baseline) task. Results showed significant differences between stuttering and non-stuttering speakers in both effective connectivity and anatomical structures in the BGTC in the left brain. Specifically, compared to non-stuttering speakers, stuttering speakers showed weaker negative connectivity from the left posterior middle temporal gyrus (PMTG) to the putamen, but stronger positive connectivity from the putamen to the thalamus, from the thalamus to the PMTG and anterior supplementary motor area (preSMA), and from the anterior superior temporal gyrus (ASTG) to the preSMA. Accompanying such altered connectivity were anatomical differences: compared to non-stuttering controls, stuttering speakers showed more grey matter (GM) volume concentration in the left putamen, less GM volume concentration in the left medial frontal gyrus and ASTG, and less white matter volume concentration underlying the left posterior superior temporal gyrus inside the BGTC. These results shed significant light on the neural mechanisms (in terms of both functional connectivity and neural anatomy) of stuttering.

Tuesday, April 21, 2009

Back from Paris

I was in Paris this weekend competing in the Toastmaster's division International Speech contest after I won my club and area contests. There were six contestants from each area covering the Benelux countries and France. Unfortunately, I didn't make it into the Top3; only the first three are announced. But it was a great experience, and the delivery of my speech my best so far. And many people came up to me after the talk, and congratulates me: Best talk I have heard for ages, Very inspiring, My No1. And so on... So why did I not make it into the Top3? God knows what the judges were thinking. But seriously, I really enjoyed my presentation, they laughed at all my jokes, and everyone was listening... The only one who did not congratulate me was a person who also stutters, sorry who is a recovering stutterer from the McGuire course! ;-)

The speech was recorded, so I will try to post it. Try out Toastmaster!

Thursday, April 16, 2009

Hollins Institute in trouble

Ley Geddes/BSA has reported the Hollins Institue for exaggerated and unconfirmed success claims to the UK Advertising Standards Authority ( who can act internationally.

I got hold of the official complaint:

'Hollins claims for the efficacy of their programme are featured in their mailing pack (jpeg attached). As a charity and a leading authority on stammering/stuttering, the BSA asked for supporting evidence. Our areas of concern are as follows:

1. It is possible that 90% of people who stutter could achieve normal fluency by the end of an in-house program, but it would be useful to know how ‘normal fluency’ was defined and judged.

2. As I am sure all SLPs (speech therapists) know, the difficulty normally comes in finding ways to transfer the high level of fluency which can be achieved on a program (particularly, an in-house program) to normal life and then to maintain it. Thus it would be unusual for 75% of people who have attended an in-house program to be speaking with normal levels of fluency two years after a course had ended. So it would be very useful to know how this level of ‘normal fluency’ was defined, achieved and judged. It is highly debatable whether John Stossel's researcher (Stossel is a reporter on ABC News and a graduate of HCRI) had the necessary independence, experience or expertise to enable you to describe his phone interviews as independent verification of the efficacy of the program. And, incidentally, it would be useful to know how long ago these phone interviews were carried out.

3. It is not clear if the term ‘program graduates’ means everyone who was on the program or simply a select group. If, for example, it excludes those people who did not complete the program, or who were not judged to have graduated, then it would be useful to know what proportion of people who started the program are being defined as graduates.'

We explained again to HCRI that unless these claims can be substantiated we believe they will continue to give false hope to those who stammer and give people who do not stammer the false impression that stammering can be overcome in the vast majority of cases.'

As ASHA supports our campaign against misleading ads, and the HCRI Clinical Supervisor is ASHA certified, we have advised Arlene Pietranton of this action. HCRI have been told about this too.

I am personally sorry that it has come to this as we felt that HCRI could - or should - have been able to provide support, on a confidential basis if necessary, because these claims are a key element in the HCRI marketing proposition.

Neuroscience report from China

In another sign that China is catching up with Western dominated science, I found this article published in Neuroscience, a renowned journal. I cannot really find out from the abstract what is going on, and why they gave them a covert picture-naming task to do. Structural equation modeling is a statistical method combining quantitative data and qualitative causal assumptions, but that does not help me much. My guess is that they put some in a scanner and gave them a task and monitored the brain processes and used this structural equation modeling to gain information. But I never heard of this method before, but Neuroscience is a good journal so they don't just accept everything.

They claim functional disconnection from the left IFG to the left motor areas, and altered connectivity in the basal ganglia-thalamus-cortical circuit, and abnormal integration of supramodal information across the cerebellum and several frontal-parietal regions. From the words, it fits past neuroscience research, but really I would need to look at this in more depth!

Here is the abstract. Please send me the paper if you have access:

Neuroscience. 2009 Apr 10.
The Role of Large-Scale Neural Interactions for Developmental Stuttering.

Lu C, Ning N, Peng D, Ding G, Li K, Yang Y, Lin C.
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, P. R. China.

Using structural equation modeling (SEM) method, the present study examined the role of large-scale neural interactions in developmental stuttering while ten stuttering and nine non-stuttering subjects performed a covert picture-naming task. Results indicated that the connection patterns were significantly different between stuttering and non-stuttering speakers in both omnibus connection pattern and individual connection path coefficient. Specifically, stuttering speakers showed functional disconnection from the left IFG to the left motor areas, and altered connectivity in the basal ganglia-thalamus-cortical circuit, and abnormal integration of supramodal information across the cerebellum and several frontal-parietal regions. These results indicate that the large-scale dysfunctional neural interactions may be involved in stuttering speakers' difficulties in planning, execution, and self-monitoring of speech motor sequence during word production.

PMID: 19364522 [PubMed - as supplied by publisher]

Wednesday, April 15, 2009

Oprah Winfrey should be ashamed

I am utterly shocked by the Oprah Winfrey show on the Speech Easy device. I had never actually seen it. It is just so so bad. I have been critical of the Lidcombe trials and claims of efficacy, but this is a different league. The Lidcombe trials were just sloppy research done with good intentions but not so good scientific rigor. But the Oprah Winfrey show is about dumbing down realities, misleading, sloppy research, promising miracles, abusing the emotions of people, and getting the science wrong. They showed Ratstatter and Kalinowski as inventors of the device. That's a joke. Many people were thinking along similar lines. The worse was when Joe Kalinowski took out the device and stuttered severely. I can do that, too. And God made him suffer terribly to help others???? Wow!

I would love to know what has happened with the two guys who were on the show. We need to find out their contact details and speak to them. One is called Mark Babcock. And the others Wesley Cock?

Let us know if you have more details!

Friday, April 10, 2009

Analysis of latest "research"

Greg Snyder at did a good job in commenting on the latest research. In fact, he did a better job than I am going to do here, because I am quite busy. Here is how scientists usually read articles. Remember time is very valuable.

A life-time of stuttering: How emotional reactions to stuttering impact activities and participation in older people? Bricker-Katz G, Lincoln M, McCabe P. Disabil Rehabil. 2009 Apr 3:1-11.

ok. might be a bit interesting as i have never heard anything about older stuttering people and how they handle stuttering. is of course dead-end research and will do nothing for better understanding of stuttering. but might be interesting to know more about this age group and one can use it to exert political pressure for more ressources.

Speech skill learning of persons who stutter and fluent speakers under single and dual task conditions. Smits-Bandstra S, De Nil L. Clin Linguist Phon. 2009 Jan;23(1):38-57.

Good scientists. They really seem to be obsessed with the single/dual task performances. Not necessarily a bad thing. If you find a difference, you should zoom into it as much as possible. Will try to read, but i am nearly convinced it is like the other papers. not very clear what is really going on and no very clear effects. But will read abstract and probably ask for paper.

Peer Responses to Stuttering in the Preschool Setting. Langevin M, Packman A, Onslow M. Am J Speech Lang Pathol. 2009 Mar 30.

dead-end research. seems plainly obvious. complete waste of time. i can tell you what is happening. either i ask a few speech therapists of their experiences. that takes me 4 emails to write and within a week i am done. or i guess: some kids will notice, either asking why do you stutter or they might laugh. but most will just accept it. so what have we learned. NOTHING. NOTHING. NOTHING AT ALL.

Social anxiety and the severity and typography of stuttering in adolescents. Mulcahy K, Hennessey N, Beilby J, Byrnes M. J Fluency Disord. 2008 Dec;33(4):306-19. Epub 2009 Jan 6.

dead-end and stamp collecting research. why do we need research to find out what all adolescents and adult stutters tell us. it is not easy in school and many of us experienced severe social anxiety.

Delayed auditory feedback effects during reading and conversation tasks: Gender differences in fluent adults. Corey DM, Cuddapah VA. J Fluency Disord. 2008 Dec;33(4):291-305. Epub 2009 Jan 3.

stamp collecting research. you make some observations and then? And I am never a friend of looking at speech data. way too down stream of the real issue.

Effects of altered auditory feedback (AAF) on stuttering frequency during monologue speech production. Antipova EA, Purdy SC, Blakeley M, Williams S. J Fluency Disord. 2008 Dec;33(4):274-90. Epub 2008 Oct 14.

also stamp collecting research. same as last one.

Non-linguistic auditory processing in stuttering: Evidence from behavior and event-related brain potentials. Hampton A, Weber-Fox C. J Fluency Disord. 2008 Dec;33(4):253-73. Epub 2008 Aug 30.

good scientists. might be interesting. will read abstract and might ask for paper.

Stuttering Hub interviews The Stuttering Brain

Hiten at Stuttering Hub posted an interview with me: check here. He did the interview a long time ago with me, but I still agree with me, which is not always the case!

Tuesday, April 07, 2009

Candy for kids?

I know I haven't been active for a few days. Too much work. I am writing my final essay in the neuroscience Master course on Cognitive Neuropsychology (Damaged Brains) and Connectionist Modelling (Neural Networks). And I have the CFA (chartered financial analyst) level II exam with 3000 pages beginning of June! I am way way behind schedule... Why do I do all these exams? Is PhD not enough?

As I said, I have no time. So I just listened to StutterTalk's interview with Barry Guitar. He is using voluntary stuttering with kids. If they voluntarily stutter, they get candy. Interesting idea... You instil positive or overwrite negative associations about stuttering into kids. Does this mean that they are more relaxed about their stuttering and therefore will stutter less or at the very least handle stuttering better? Or do they now stutter more because they have positive associations? It might well be more effective that the Lidcombe approach of just praising the kids or giving neutral feedback.

I am also amazed at his turn-around. I witnessed him praising a lot research on temperament and reactivity of stuttering kids and how it can explain non-recovery. And now I hear him talking about the great progress in brain imaging on stuttering kids, and how a bad neurology is really at the core of the problem! Is he starting to read my blog or what?? To be honest, he seems to be really getting into it. Now I am even concerned he is pushing the neuro stuff too far and ignoring the behavioural issues that come into existence due to the neurology and take on a life of its own!

In general, I am getting more concerned that the wave is splashing to the other extreme: from purely behavioural to purely neurological. I firmly believe that you need both. Sure, the source of stuttering is clearly neurological, but I also believe that most stuttering behaviour is independent of a neurological momentary delay and is behavioural: a natural reaction to delays in speech initiation which got associated to words, settings and situations.