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The Effect of Spontaneous Hand Gestures on Stuttering in Children With Down Syndrome

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ClinicalTrials.gov Identifier: NCT03698539
Recruitment Status : Recruiting
First Posted : October 9, 2018
Last Update Posted : August 13, 2020
Sponsor:
Collaborators:
Marguerite-Marie Delacroix
KU Leuven
Information provided by (Responsible Party):
Universitaire Ziekenhuizen Leuven

Brief Summary:

This study wants to determine the relationship between spontaneous hand gestures, stuttering and intelligibility in individuals with Down syndrome. One third of these individuals has fluency problems, such as stuttering. Gesture use appears to be a strength in individuals with Down syndrome. While they are able to compensate for their language problems, it is not clear if they also use gestures to compensate for their speech problems. Therefore, this study will observe the impact of their gesture use on the stuttering frequency/severity and on the intelligibility of children with Down syndrome.

This study has three research questions. The first question is: Is there a difference in gesture use between individuals with Down syndrome who stutter and individuals with Down syndrome who do not stutter? The hypothesis is that the children who stutter will make more gestures to compensate for the fluency problems. The kind of spontaneous hand gestures will also be considered. These results will be compared to those of typical developing individuals.

The second research question is: Are stuttering events that are accompanied by a gesture more intelligible than stuttering moments that are not accompanied by a gesture? Research showed that the use of signs has an positive impact on the speech intelligibility of individuals with Down syndrome. Here it is investigated if this is also true for spontaneous hand gestures. In case of better speech intelligibility it is investigated if the gain in intelligibility is caused by how recognizable the gesture is or by the effect of the gestures on speech itself. The effect of different types on the speech intelligibility of the stuttering events will also be investigated. Typically developing individuals who stutter will function as control group.

The third research question is: 'Does gestural priming have an influence on the fluency of children with Down syndrome? Gestural priming is a secondary speech signal that gives feedback to the first speech signal by simultaneously mimicking the first speech signal. In this research a hand puppet will imitate the mouth movements of the participants. Next to that, the speech will be simultaneously be accompanied by beat gestures, meaningless up and downward movements. The hypothesis is that due to mirror neurons, the participants will become more fluent. Mirror neurons are neurons in the brain that can produce a neural basis for fluency by the perception of the second speech signal.


Condition or disease Intervention/treatment
Stuttering Down Syndrome Intelligibility, Speech Gestures Behavioral: hand gestures

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Study Type : Observational
Estimated Enrollment : 60 participants
Observational Model: Case-Control
Time Perspective: Cross-Sectional
Official Title: The Effect of Spontaneous Hand Gestures on Stuttering in Children With Down Syndrome
Actual Study Start Date : December 5, 2018
Estimated Primary Completion Date : November 30, 2021
Estimated Study Completion Date : August 31, 2022

Resource links provided by the National Library of Medicine


Group/Cohort Intervention/treatment
Down syndrome who stutter

This group consists of individuals with Down syndrome who stutter. They have a mild or moderate intellectual disability and are able to understand and produce a three word sentence.

Spontaneous hand gestures and stutter frequency are investigated in this group.

Behavioral: hand gestures
We observe the use of spontaneous hand gestures in all the groups.

Down syndrome who do not stutter

This group consists of individuals with Down syndrome who do not stutter. They have a mild or moderate intellectual disability and are able to understand and produce a three word sentence.

Spontaneous hand gestures are investigated in this group

Behavioral: hand gestures
We observe the use of spontaneous hand gestures in all the groups.

Typically developing children who stutter
This group consists of typically developing children who stutter. They function as a control group to the individuals with Down syndrome.
Behavioral: hand gestures
We observe the use of spontaneous hand gestures in all the groups.

Typically developing children who do not stutter
This group consists of typically developing children who do not stutter. They function as a control group to the individuals with Down syndrome.
Behavioral: hand gestures
We observe the use of spontaneous hand gestures in all the groups.




Primary Outcome Measures :
  1. Gesture frequency [ Time Frame: This frequency is measured in the spontaneous telling task and in the gestural priming experiment over a period of 4 - 6 months. ]
    This frequency is calculated by adding up all the gestures used by the participant and dividing it by the total of words the participant said. Tis total is multiplied by 100 to get a percentage. For example, if a participant used 10 spontaneous hand gestures in a speech sample of 50 words, he has a spontaneous hand gesture frequency of 20%. The speech samples are defined by the length of the videos. Every outing of the participant is included in the sample.

  2. Stuttering frequency [ Time Frame: This frequency is measured for the first, and third research question, once per participant who stutters over a period of 4-6 months. ]
    This frequency is calculated for the children with Down syndrome who stutter. The total number of stuttering moments is divided by the total number of words in the speech sample. This number is multiplied by 100 to get the stutter frequency. For example, if a participant had 9 stuttering moments in a speech sample of 90 words, he would have a stutter frequency of 10%. Stuttering moments are defined by repetitions of short words, interjections, syllables or sounds, the prolongation of sounds and blockages. The stutter frequency is calculated in all the studies. The length of the videos defines the speech samples. Every outing of the participant is included in the sample.

  3. Intelligibility [ Time Frame: This frequency is measured for the second research question, over a period of two months. ]
    The intelligibility of the individuals who stutter is measured with a 7-point Likert scale with 1 = completely unintelligible to 7 = completely intelligible


Secondary Outcome Measures :
  1. Stuttering discrimination [ Time Frame: This is measured once before the start of the first research question. ]
    The ability to discriminate between stuttered and fluent speech is measured by a new test developed by the researcher.

  2. Stuttering awareness [ Time Frame: This is measured once before the start of the first research question. ]
    Stuttering awareness is measures by a new test developed by the researcher.



Information from the National Library of Medicine

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Ages Eligible for Study:   6 Years to 21 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
The groups will be assembled from individuals with Down syndrome and typically developing children who do and do not stutter who live in Flanders. They will be recruited via regular and special education primary schools, via speech language pathologists, via revalidation centra and via the Down syndrome association Flanders.
Criteria

Inclusion Criteria for the participants with Down syndrome

  • Stuttering (group 1)
  • No stuttering (group 2)
  • Able to understand and produce a three-word sentence
  • Mild to moderate mental disability

Exclusion Criteria:

  • Severe mental disability
  • No understanding and/or production of a three-word sentence
  • Uncorrected visual or auditory impairment

Inclusion Criteria for the typically developing participants

  • Stuttering (group 1)
  • No stuttering (group 2)
  • Able to understand and produce a three-word sentence

Exclusion Criteria:

  • No understanding and/or production of a three-word sentence
  • Uncorrected visual or auditory impairment
  • Other language/speech problems

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03698539


Contacts
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Contact: Babette Maessen, Master 016 37 24 89 ext +32 babette.maessen@kuleuven.be
Contact: Ellen Rombouts, Doctor 016 37 77 67 ext +32 ellen.rombouts@kuleuven.be

Locations
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Belgium
Experimental Oto-Rhino-Laryngology, Departement Neurowetenschappen Recruiting
Leuven, Belgium, 3000
Contact: Babette Maessen    016 37 24 89 ext +32    babette.maessen@kuleuven.be   
Sponsors and Collaborators
Universitaire Ziekenhuizen Leuven
Marguerite-Marie Delacroix
KU Leuven
Investigators
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Principal Investigator: Inge Zink, Professor Experimental Oto-Rhino-Laryngology, Dept. Neursciences, KU Leuven
Principal Investigator: Bea Maes, Professor Parenting and Special Education, Faculty of Psychology and Educational Sciences, KU Leuven
Principal Investigator: Ellen Rombouts, Doctor Experimental Oto-Rino-Laryngology, Department Neurosciences, KU Leuven
Principal Investigator: Babette Maessen, Master Experimental Oto-Rino-Laryngology, Department Neurosciences, KU Leuven
Publications:
Bray M, Is stuttering therapy useful for adolescents and adults with Down syndrome who are dysfluent. Procedia. 2015; 193:51-61.
Bijlsma EK, Oosterwijk JC, Leschot NJ, Geraerdts, JPM, Prok JC, editors. Leerboek medische genetica [Textbook medical genetics]. Maarssen: Elsevier gezondheidszorg; c2005. 430 p. (Cassiman JJ, Engelen JJM, editors. Chromosomale overerving [Chromosomal inheritance]; vol.6).Dutch
Chapman RS (1997). Language development in children and adolescents with Down syndrome. Ment Retard Develop Dis Res Rev. 1997; 3: 307-312.
Fletcher P, Macwhinney B, editors. The handbook of child language. Oxford,UK:Blackwell; c1995. 800 p. (Chapman RS, editor. Language development in children and adolescents with Down syndrome; vol. 3).
Góral-Półrola J, Zielińska J, Jastrzebowska, G, Tarkowski, Z. Cluttering: Specific communication disorder. Acta neuropsych. 2015; 14(1): 1-15.
Guitar B. Stuttering. An integrated approach to its nature and treatment.3re ed. Baltimore: Lippincott, Williams & Wilkins; 2006. 376 p.
Hammond G, editor. Cerebral control of speech and limb movements. Amsterdam: North-Holland; c1990. 708 p. (Flanagan R, Feldman, A, Ostry. Control of human jaw and multi-joint arm movements; vol.1).
Loncke F, Nijs M, Smet L. SMOG: Spreken Met Ondersteuning van Gebaren [SMOG: Speaking With Support of Signs].4th ed. Antwerpen: Garant; 2012. 180 p. Dutch
Preus, A. Treatment of mentally retarded stutterers. J Fluency Dis. 1990; 15(4):223-233.
Pruess JB, Vadasy PF, Fewell RR. Language development in children with Down syndrome. Educ Train Ment Retard. 1987; 22(1): 44-55.
St. Louis KO, Myers, FL. Clinical management of cluttering. Lang Speech Hear Serv Schools. 1995; 26(2): 187-195.
Velthuijs M. Een taart voor kleine beer [A pie for little bear]. Rijswijk: De Vier Windstreken;1995. 27 p. Dutch
Arenas, R. M. Conceptualizing and investigating the contextual variability of stuttering: The speech and monitoring interaction (SAMI) framework. Speech, Lang. Hear. 20, 15-28 (2017).
Clibbens, J. & Powell, G. Actions speak louder than words: signing and speech intelligibility in adults with Down syndrome. Down Syndr. Res. Pract. 2, 127-129 (2007).

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Responsible Party: Universitaire Ziekenhuizen Leuven
ClinicalTrials.gov Identifier: NCT03698539    
Other Study ID Numbers: s62049
First Posted: October 9, 2018    Key Record Dates
Last Update Posted: August 13, 2020
Last Verified: August 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Universitaire Ziekenhuizen Leuven:
Stuttering
Down syndrome
Gestures
Intelligibility
Additional relevant MeSH terms:
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Down Syndrome
Stuttering
Syndrome
Disease
Pathologic Processes
Intellectual Disability
Neurobehavioral Manifestations
Neurologic Manifestations
Nervous System Diseases
Abnormalities, Multiple
Congenital Abnormalities
Chromosome Disorders
Genetic Diseases, Inborn
Speech Disorders
Language Disorders
Communication Disorders