Stutter-Free Speech Following Response-Contingent Time-Out From Speaking in Young Children Who Stutter

Purpose: The purpose of this study was two-fold: 1) to determine if response-contingent time-out from speaking (RCTO) could effectively reduce stuttering frequency in young children, and 2) to determine if differences in participant awareness, emotional state, speech timing, and utterance length could be detected following RCTO.Background: RCTO is a fundamental component of operant treatments used for stuttering. RCTO requires the individual to pause from speaking immediately after a stuttering behavior has occurred. Well-controlled experimental investigations over the past 30 years have consistently demonstrated the robust and immediate effects of RCTO on stuttering (Prins & Hubbard, 1988), but few studies have examined the possible mechanism(s) responsible for these effects. At present, the processes mediating reductions in stuttering following RCTO are unknown. Factors such as cognitive processes, changes in affect, and modification of speech production systems have been implicated as underlying mechanisms, but findings have been inconsistent and inconclusive (Prins & Hubbard, 1988).Method: A time-series single-subject A1BA2 experiment was conducted on each of 5 children between the ages of 4 and 7 years while they engaged in several different linguistic tasks. Stuttering frequency was measured to determine the effectiveness of RCTO. Articulation rate and mean length of utterance were calculated from stutter-free speech samples obtained from all phases of the experiment (baseline, treatment, extinction). Reports were also obtained from the children after completion of the experiment regarding their awareness and feelings towards the RCTO stimulus used in the investigation.Results: RCTO effectively reduced stuttering frequency; however, positive results differed across linguistic tasks and were dependent on the child's compliance with the procedure. Explicit awareness was not required for RCTO to work effectively and the time-out response stimulus did not result in adverse emotional consequences. Changes observed for articulation rate and mean length of utterance were task dependent and differed for each child.Conclusions: The factors examined in the present investigation did not adequately account for the positive effects of RCTO on reductions in stuttering frequency. Theoretical considerations potentially underlying the positive effects of RCTO are discussed