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These data support the notion that stutter-filled speech can elicit physiological and emotional responses in listeners. Clinicians who treat stuttering should be aware that listeners show involuntary physiological responses to moderate-severe stuttering that probably remain salient over time and contribute to the evolution of negative stereotypes of people who stutter. With this in mind, it is hoped that clinicians can work with people who stutter to develop appropriate coping strategies. The role of amygdala and mirror neural mechanism in physiological and subjective responses to stuttering is discussed.

Vocal fatigue is among the most debilitating conditions affecting individuals with voice disorders. Impressions about mechanisms potentially underlying vocal fatigue have varied depending on how fatigue is defined, participants studied, and measures made, thereby impacting the selection of treatment strategies that may alleviate the condition. However, little is currently known about actual metabolic mechanisms of vocal fatigue. The current study aimed to address this issue by investigating the hypothesis that neuromuscular inefficiency, cardiovascular recovery deficits, or both, may play a role in fatigue. The approach replicated well-vetted approaches in exercise physiology.Metabolic profiles of subjects with vocal fatigue were assessed using gas exchange measures in comparison to two non-fatigue groups: vocally healthy and cardiovascular trained individuals, recruited based on results from a newly vetted questionnaire, the Vocal Fatigue Index (VFI) and laryngeal examination. Participants read out loud at two different loudness levels for a duration of 5 minutes for each task with periods of rest between tasks. Metabolic cost for and recovery time from reading were same across all groups. Oxygen uptake and recovery kinetics (EPOC), ratings of perceived exertion revealed interesting patterns in individuals with vocal fatigue compared to cardiovascular trained individuals in particular.Specifically, slow oxygen uptake kinetics in the vocal fatigue compared to the cardiovascular iv trained group pointed to utilization of anaerobic energy source to meet the demands of the reading task in the vocal fatigue group, suggesting neuromuscular inefficiency. In contrast, rapid oxygen uptake kinetics in the cardiovascular trained group pointed to utilization of aerobic energy sources and greater neuromuscular efficiency. Similarly, a greater number of individuals in vocal fatigue and vocally healthy groups showed an increase in oxygen consumption post reading (EPOC) compared to the cardiovascular trained group, indicating possible cardiovascular recovery deficits in the former groups.In addition to uncovering potential mechanisms underlying vocal fatigue, including neuromuscular inefficiency and cardiovascular recovery deficits, results from the present study highlight the potential importance of aerobic training to generate aerobic energy required for vocal task demands for both ease of task performance and recovery from it. In sharp contrast to the situation for voice, fatigue as a common physical phenomenon more generally has received extensive attention in the physical therapy, sports medicine, and exercise physiology literature. Three broad schools of thought identify mechanisms pertaining to the origins of physical fatigue: (1) peripheral mechanisms (Allen, Lamb, & Westerblad, 2008;Asmussen, 1979;Edwards, 1981;Fitts, 1994;Westerblad, Allen, & Lannergren, 2002;Westerblad, Lee, Lannergren, & Allen, 1991), (2) The next pages and chapters provide pertinent background information on vocal fatigue, fatigue as understood ...

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