How Stuttering Develops: The Multifactorial Dynamic Pathways Theory

Abstract

Purpose: We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory. Method: We review evidence related to how stuttering develops, including genetic/epigenetic factors; motor, linguistic, and emotional features; and advances in neuroimaging studies. We update evidence for our earlier claim: Although stuttering ultimately reflects impairment in speech sensorimotor processes, its course over the life span is strongly conditioned by linguistic and emotional factors.

Communication attitudes in children who stutter: A meta-analytic review

“…Examples include the dual diathesis stress model (Walden et al, 2012); the demands and capacities model (Starkweather & Gottwald, 1990); and the integrated perspective on stuttering (Guitar, 2014). Recently, the Multifactorial dynamic pathways theory was proposed by Smith and Weber (2017). The MDP theory explains critical features of the stuttering disorder such as onset and development, natural recovery and the role of genetics in development of stuttering.…”

“…In line with the DSM-5 (APA, 2013), Smith and Weber (2017) defined stuttering as a neurodevelopmental disorder, in which "the primary symptoms of stuttering are dysfluencies, involuntary disruptions in the normal flow of speech" (p. 2485). The premise of multifactorial dynamic pathways (MDP) theory is that stuttering is caused by several different factors.…”

“…There are several gaps in the literature on the genetic contribution to the onset of stuttering and Yairi and Ambrose (2013) related this lack of understanding to the polygenic nature of stuttering. Smith and Weber (2017) highlighted the role of epigensis; that is, the timing and intensity of gene expression over development.…”

How Can We Overcome the Challenges of Providing School-Based Fluency Services?

“…Of utmost importance is the recognition that stuttering is a neurodevelopmental disorder 35 and may persist in some children. 36,37 The therapist explores perceptions and concerns from all relevant parties, and employs various standardized 38,39 as well as informal measures 40,41 to assess the fluency pattern. To gain deeper insight into how the problem is impacting the student's quality of life, other measures are utilized.…”

Cognitive bias and stuttering in adolescence

“…Stuttering is a multidimensional, neurodevelopmental communication disorder (A. Smith & Weber, 2017) that can deeply impact psychosocial outcomes for affected individuals (Beilby, 2014;Beilby, Byrnes, & Yaruss, 2012b;Boyle, 2015b;Briley, O'brien, & Ellis, 2019;Craig, Blumgart, & Tran, 2009;Erickson & Block, 2013;Yaruss & Quesal, 2006). Stuttering is characterized by an atypical frequency of stuttering-like disfluencies that interfere with the forward flow of speech including part-word repetitions (e.g., "a-a-and"), single-syllable word repetitions (e.g., "and-and"), prolongations (e.g., "aaaaand"), blocks (e.g., "---and"), and broken words (e.g., "o---pen") .…”