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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 36  |  Issue : 2  |  Page : 31-36

Situational variations in disfluencies in bilingual person with no stuttering and person with stuttering


1 Bangalore Speech and Hearing Research Foundation, Dr. S.R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, Karnataka, India
2 Bangalore Speech and Hearing Research Foundation, Dr. S.R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, Karnataka; Speech and Hearing Unit, Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission21-Nov-2022
Date of Decision18-Dec-2022
Date of Acceptance19-Dec-2022
Date of Web Publication10-Jan-2023

Correspondence Address:
Mr. Abhilash Ghadei
At-Jagapur Road, Post-Daspalla, Nayagarh - 752 084, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisha.jisha_31_22

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  Abstract 


Introduction: Literature evidence that “Disfluency” is normal, nonstuttered disruptions can be seen in nonstutterers, whereas “Dysfluency” refers to stuttered interruptions of speech common in stutterers. Variation of dis/dysfluencies may vary according to situation and language. The existing evidence is limited for explaining the variation of stuttering (dysfluency) or stuttering-like behaviors (disfluency) across different daily life situations and based on langue use in a person with stuttering (PWS) and person with no stuttering (PWNS). The aim was to compare self-reported situational variations of dis/dysfluencies in L1 and L2 among bilingual PWNS as well as bilingual PWS. The study design involves a comparative study. Method: Participants in the age range of 18–24 years were considered in two groups that are a group of PWS and PWNS. In both groups, 112 were recruited (85 were PWNS and 27 were PWS). For the PWS group, individuals with developmental stuttering with a severity above a mild degree, as assessed on SSI-4 by a speech-language pathologist, were selected. As the study tool, a self-reported questionnaire was prepared and administered to check the situational variation of dis/dysfluencies among the participants (for both L1 and L2), which included their rating (0–5 Likert scale). Descriptive statistics and repeated ANOVA were done. Results: Outcomes revealed that there was a significant difference seen in the frequency of dis/dysfluencies when situations in L1 and situations in L2 were compared, respectively, in PWNS and also when L1 and L2 were compared in PWNS, whereas there were no significant differences seen when situations in L1 and situations in L2 were compared, respectively, in PWS and also when L1 and L2 were compared in PWS. Conclusion: Further Investigation on the topic of situational variation of dys/ disfluency could be attempted considering more daily life situations.

Keywords: Bilinguals, disfluency, dysfluency, language, situational variation


How to cite this article:
Ghadei A, Kumari A, Thontadarya S, Srividya A. Situational variations in disfluencies in bilingual person with no stuttering and person with stuttering. J Indian Speech Language Hearing Assoc 2022;36:31-6

How to cite this URL:
Ghadei A, Kumari A, Thontadarya S, Srividya A. Situational variations in disfluencies in bilingual person with no stuttering and person with stuttering. J Indian Speech Language Hearing Assoc [serial online] 2022 [cited 2023 Feb 5];36:31-6. Available from: https://www.jisha.org/text.asp?2022/36/2/31/367507




  Introduction Top


The current research into fluency disorders has markedly increased in the past century. Mainly the existing studies focused on diverse aspects like and types of fluency disorders and characteristics. There are certain ambiguous terminologies concerning fluency disorders. Dysfluency and disfluency are one of the most controversial emerging terms that encompass the clinical state. The term disfluency is the most commonly addressed term to specify a fluency disorder. Where the use of the term “dysfluent” rather than the conventional “disfluent” is also common in clinical circumstances.[1] Hence, what makes both of the terms different? “Dis” is originally a Latin prefix that means “lack of” or “not.” It is used as a fairly simple negation, removal, or reversal. The term “disfluency” is used to indicate a type of speech that is merely not fluent. It is a sterile and clinical term that turns our wild forms of speech variation into a simple lack or failure judged against the presumed normalcy and desirability of smooth speech. “Disfluent” hides its values behind apparent objectivity. Dys-is originally a Greek prefix indicating “bad, difficult” or “destroying the good sense of a word, or increasing its bad sense.” dys- is not a simple negation, but marks a transgression. “Dysfluency” is a far more honest term than “disfluency” for the disordered population.[2],[3] Hence, in easier terms, disfluency is normal, nonstuttered disruptions commonly seen in speech, whereas dysfluency refers to stuttered interruptions of speech. In other words, dysfluency (stuttered behaviors) is can be addressed for a stuttering population, whereas disfluency (stuttering-like behaviors) is mainly used for normal individuals. The current evidence also explains that the term disfluency is more allied to stutterers, which means for an existing disorder, whereas dysfluency is not exactly related to disorder specific.[2],[3] When it comes to daily life, the occurrence of dys/disfluency may also be related and associated with different factors day-to-day life situations, and emotional sensitivity. This association of dys/disfluency with different factors is evidenced both in person with stuttering (PWS) and without stuttering (PWNS).[4],[5],[6],[7],[8] One of the common forms of the emotional aspect is “anxiety” which is chiefly noted in different day-to-day social situations.[9],[10],[11] Higher degree of anxiety for different social situations is called communication apprehension. It is evidenced that dys/disfluency sharply increases when their anxiety level rises as a result of various real-life circumstances.[12],[13],[14] Existing literature also evidenced that adults without any stuttering problem have reported alteration or variation of speech rate, use of fillers, conjunctions, etc., and that can also vary based on different daily life situations.[13] Particularly, it has been demonstrated that frequency dis/dysfluency varies in various speaking contexts, which is sometimes related to communicational hesitancy. Numerous studies have examined the frequency of stuttering/stuttering-like behaviors varies according to different speech settings both for stuttered and nonstuttered individuals.[15] Different speaking situations such as speaking alone (or with a single person), speaking in front of a group, and speaking over the phone are some of the circumstances that are most frequently studied by the researchers. These scenarios allegedly depict a scale of speaking difficulties, with a rise in speech dis/dys fluency as a result.[16] Features of social situations and communicative anxiety in speakers have a major influence on various speech fluency in an individual.[17]

In addition to everyday circumstances, language use has a significant impact on a person's ability to speak fluently. Variation of dis/dysfluencies might also be related to the language use of the individuals. Stuttering affects people of all linguistic and cultural backgrounds, including bilinguals and monolinguals.[18],[19],[20],[21] The prevalence of stuttering among the 4827 children surveyed in one of the earliest studies on bilingualism and stuttering by Travis, Johnson, and Travis et al. was 1.80%, 2.80%, and 2.38% for monolingual (English-speaking) children, children who spoke two languages, and children who spoke more than two languages in addition to English, respectively.[22],[23],[24],[25] Stern conducted similar research in 1948 with 1861 students from four different schools in Johannesburg (South Africa).[26] Stuttering prevalence was 1.66% in monolingual children and 2.16% in bilingual children. In addition, several scientists noted that bilinguals who stuttered had a substantially greater severity rate of stuttering than monolinguals who stuttered.[27] There is more evidence to show that bilinguals or multilinguals stutter in both, or all of their, languages. If stuttering only occurs in one language (i.e., language-specific stuttering), it is probably an exception and related to a significant imbalance in proficiency in each language. Still, this conclusion could not be drawn by many authors, and further clarification is needed. There are several research gaps for analyzing the difference in speech fluency for bilingual PWNS and PWS across language use and various daily life settings.[28] The primary goal of the study is to assess the variation of speech fluency across different daily life situations in both of their language. The current study's aim is to compare self-reported situational variations of dis/dysfluencies in L1 and L2 among bilingual PWNS as well as bilingual PWS. The objectives of the current study are to investigate the situational variation of dis/dysfluencies in L1 in both groups, to investigate the situational variation of dis/dysfluencies in L2 in both groups, to conduct a within-group comparison of situational dis/dysfluencies across L1 and L2 in each of the groups, to conduct a between-group comparison of situational dis/dysfluencies across L1 of both groups and L2 of both groups, to compare the type of dis/dysfluencies seen in discourse across L1 and L2 in both groups.


  Materials and Methods Top


Written informed consent was obtained from each participant, and the research received ethical approval through the Institutional Ethics Committee. The names of the participants are all pseudonyms. Participation was completely voluntary, and no financial incentive was offered.

Participants criteria

For the current study, all the participants under the PWNS group were recruited from an Institution in Bangalore, whereas stuttering individuals were recruited from various private clinical setups across India. The participant's ages ranged from 18 to 24 years, with a mean age of 20.2 years. Two groups of participants were considered for the study, one is a group of PWS and other is a group of PWNS. In both of the groups, 112 were recruited (85 were PWNS and 27 were PWS). For the PWS group, a clinical diagnosis of stuttering by a qualified speech-language pathologist following the test protocol. Assessment of stuttering was done using SSI-4 (Stuttering Severity Index).[29] All the participants with mild-to-moderate stuttering severities were included. All the participants (PWS) should be Hindi–English bilinguals without any comorbid conditions (i.e., a concurrent diagnosis of psychosis, intellectual disability, neurological condition, and substance abuse). Participants other than 18–24 years were excluded from the study. Similarly, for PWNS group, the individuals should not have any associated neurological conditions and no reported cognitive impairments with normal speech fluency. All the PWNS participants should be bilinguals groups such as Kannada–English, Tamil–English, Hindi–English, and Malayalam–English adults who do not stutter and not associated with any chronic neurological/medical issues or any cognitive issues were not included in the study.

Procedure

For the study, a questionnaire was prepared to take different situations in their daily life, and the content was validated by five speech-language pathologists with a minimum of 8 years of experience. The questionnaire contained different daily life situations. The participant had to rate on 1-5 Likert scale based on the level of disfluent behavior/dysfluencies they experienced for each of the situations mentioned in the questionnaire. On the Likert scale “1” denoted “not at all experience” and “5” is for “extremely all the time.” The participants had to rate the questionnaire separately for both of their languages that are L1 and L2. The questionnaire mainly contained basic demographic detail, their L1 and L2, etc., then it was divided into four different subsections they are general situations, work situations, social situations, and home situations. Under each subsections, different specific situations were mentioned, which are described in the questionnaire. Few of the examples are Speaking under time pressure, with a group of people, while using telephone, etc.

Data collection

A hybrid method of data collection was used, and the questionnaire was availed to the participants both by giving printed copies as well as Google Forms. As a part of our objective, a speech sample was collected from the participants (both PWS and PWNS) for both L1 and L2. A situational description task was given, and a speech sample of 100 words was recorded and analyzed. The speech sample was analyzed by a qualified SLP and the occurrence of types of dysfluency or disfluent behavior was analyzed. A comparison between type and number of dis/dysfluent behavior was made between their L1 and L2 samples. was Whether there is any variation in speech fluency for both the language was assessed and if any specific types of dysfluency or disfluent behavior is present. For both groups, this analysis was done. The comparison of dys/disfluent behavior across different situations was made for both L1 and L2. Further comparison of overall situational dys/disfluency with respect to L1 and L2 was also made for both of the PWS and PWNS groups. From the speech samples, whether any variation in speech sample for the same task is there when the language is varied, analyzed in detail.


  Results Top


All the responses of the questionnaire were collected for both of the groups using repeated measures, ANOVA was performed to compare the effect of four situations on self-rated disfluency levels. Post hoc test was also done and the difference was compared across the four situations. The recorded speech sample of L1 and L2 were analyzed and the types of dysfluencies were reported.

Demographic details

Eighty-five out of 112 participants were person with no Stuttering (PWNS), whereas 27 participants were PWS. Out of 27 PWS, 9 participants were moderate stuttering; 12 participants were severe stuttering, whereas 6 participants were very severe stuttering. All the participants were bilinguals with second language as English.

Situational variation of dys/disfluencies across l1 in group 1 and group 2

Situational variation of dys/disfluencies in L1 in Group 1

A repeated measures ANOVA was performed to compare the effect of four situations on self-rated disfluency level. There was a statistically significant difference in disfluency between at least two situations (F 60.2, P < 0.001). Post hoc test was also done, and the results showed that there were significant differences seen in all the situations except when Situation A was compared with Situation B (df 252, P 0.002) and situation C was compared with Situation D (df 252, P 0.004) [Table 1].
Table 1: Situational variation of dys/disfluencies in L1 in person with no stuttering using post hoc test

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Situational variation of dys/disfluencies in L1 in Group 2

Repeated ANOVA (F 1.19, P 0.321) showed that there were no statistically significant differences seen in all situations in L1 in Group 2. Post hoc test was also done, and results showed that there were no statistically significant differences seen in all situations [Table 2].
Table 2: Situational variation of dys/disfluencies in L1 in person with stuttering using post hoc test

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Comparison of situational variation of dys/disfluencies in L1 among both groups

Repeated ANOVA (F 1.19, P 0.321) showed that there were significant differences seen in all situations in L1 among both groups [Table 3], i.e., the frequency of dis/dysfluencies varied among both groups in L1. The occurrences of dysfluencies were more frequent in PWS as compared to disfluencies in PWNS.
Table 3: Situational variation of dys/disfluencies in L1 in person with stuttering versus person with no stuttering using repeated ANOVA

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Situational variation of dys/disfluencies, self-reported, across l2 in Group 1 and Group 2

Situational variation of dys/disfluencies in L2 in person with no stuttering

A repeated-measures ANOVA was performed to compare the effect of four situations on self-rated disfluency level. There was a statistically significant difference in self-rated disfluency between at least two situations (F (3, 84) = 122, P < 0.001). Post hoc test was also done, and results showed that there were no statistically significant differences seen in all situations except when Situation A was compared with Situation B (df 252, P 0.089) [Table 4].
Table 4: Situational variation of dys/disfluencies in L2 in person with no stuttering using post hoc test

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Situational variation of dys/disfluencies in L2 in person with stuttering

A repeated measures ANOVA was performed to compare the effect of four situations on self-rated disfluency level. There were no statistically significant differences seen in all situations in L1 in Group 2 (F (3, 84) = 1.70, P < 0.001). Post hoc test was also done, and results showed that there were no significant differences seen in all situations [Table 5].
Table 5: Situational variation of dys/disfluencies in L2 in person with stuttering using post hoc test

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Comparison of situational variation of dys/disfluencies in L2 among both groups

Repeated ANOVA (F 1.19, P 0.321) showed that there were significant differences seen in all situations in L1 in Group 2 [Table 6], i.e., the frequency of dis/dysfluencies varied among both groups in L1. The occurrences of dysfluencies were more frequent in PWS as compared to disfluencies in PWNS.
Table 6: Situational variation of dys/disfluencies in L2 in person with stuttering versus person with no stuttering using repeated ANOVA

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Within-group comparison of situational dis/dysfluencies across l1 and l2 in each of the groups

Situational variation of dys/disfluencies across L1 versus L2 in Group 1

One-way ANOVA was done to check the significant differences in L1 versus L2 in both groups. For Group 1 (PWNS), there was a significant difference seen in L1 versus L2 across situations (Situation A, Situation B, Situation C, and Situation D) [Table 7], i.e., the frequency of disfluencies varied among L1 and L2 in PWNS based on the language used. The occurrences of disfluencies were more frequent in L2 as compared to L1.
Table 7: Variation of dys/disfluencies across L1 versus L2 in Group 1

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Situational variation of dys/disfluencies across L1 versus L2 in Group 2

For Group 2 (PWS), there was a significant difference seen in L1 vs. L2 across situations (Situation A, Situation B, Situation C, and Situation D) [Table 8], i.e., the frequency of dysfluencies did not vary among L1 and L2 in PWS based on the language used. The occurrences of disfluencies were similar in L2 when compared to L1.
Table 8: Variation of dys/disfluencies across L1 versus L2 in Group 1

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Type of dys/disfluencies seen in discourse across l1 versus l2 in both groups

Recorded samples were analyzed by 2 Speech-Language Pathologists and it was found that for PWS, blocks, syllable, and part word repetition were mostly found across all severities (moderate, severe, and very severe). Prolongations and unfilled pauses were also found in participants with very severe stuttering. These dysfluencies were not language specific. For PWNS, it was found that participants showed more disfluencies in L2 than L1 and disfluencies seen were filled pauses and interjections.


  Discussion Top


The purpose of this study was to compare the self-reported situational variations of disfluencies in L1 and L2 among bilingual PWNS and PWS. This study was done on 112 participants, in which 85 were PWNS and 27 were PWS. Repeated ANOVA and post hoc tests were done, and results revealed that there was a significant difference seen when situations in L1 and situations in L2 were compared, respectively, in PWNS and also when L1 and L2 were compared in PWNS, whereas there were no significant differences seen when situations in L1 and situations in L2 was compared, respectively, in PWS and also when L1 and L2 were compared in PWS.

A similar result was found by Hahn,[30] where he measured the dysfluencies for reading tasks for stutters across different speaking situations. He reported that stutterers experience stuttering difficulty while reading orally alone, stuttering becomes more severe when a stutterer reads aloud to an unseen audience than when he reads aloud alone. Similarly, the frequency of stuttering varies little from a situation in which an individual reads to an unseen audience to one, in which he reads directly to a single listener. However, there is a substantial increase in stuttering occurrence in reading directly to a listener compared to reading alone. Stutterers have more stuttering difficulty in reading before a group than they experience in reading alone, in reading to an unseen listener, and in reading directly to a single listener. The outcome also revealed that observers could perceive stutterers' overt responses as indicative of emotional reactions to the social complexity of the oral reading situations. Some earlier evidence also supports the language dependency of stuttering behaviors. Stuttering occurs across cultures and languages and has been found to exist in both bilinguals and monolinguals.[19] Van Borsel et al. in their review study, found that stuttering is probably more prevalent in bilinguals than in monolinguals, and stuttering can affect one or both languages, that the two languages may be equally or differently affected, the indication of language-specific stuttering cannot be confirmed.[18] The result of the current study also did not show any variation of dysfluencies across language use in the PWS group. Despite objective-oriented results, the study has a set of limitations that needs to be focused on in further studies. The PWNS group included Kannada–English, Tamil–English, Hindi–English, and Malayalam–English bilingual groups, whereas the PWS group included only the Hindi–English bilingual group. In future studies, the similar bilingual group can be included for getting a more generalized outcome. The sample size of the study is less, especially for the PWS group, which can be further increased the generalization of the study outcome.


  Conclusion Top


Self-reported disfluencies vary according to situations among PWNS. Whereas in PWS, self-reported dysfluencies are similar across all situations studied. The language in which they speak may also contribute to disfluencies among PWNS.

Acknowledgments

The authors are grateful to the research department of Dr. S.R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, for guiding us throughout this research and Mr. Sanjay Kumar, Kumar Speech and Hearing Center, Rohtak, for letting us access the participants. We also pay our gratitude to all the participants.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

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