My Client Knows That He's About to Stutter: How Can We Address Stuttering Anticipation during Therapy with Young People Who Stutter?

Jackson, Eric S.; Gerlach, Hope; Rodgers, Naomi H.; Zebrowski, Patricia M.

doi:10.1055/s-0038-1667164

Cited by 18 publications

(6 citation statements)

References 18 publications

(22 reference statements)

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“…Overt stuttering is an undesired action because of its associated negative consequences. Therefore, individuals who stutter employ proactive inhibitory control to cope with impending stuttering, and will often implement learned strategies such as modifying the speech plan to circumvent the anticipated word (e.g., by stalling or switching a word) [18,27,28]. This is consistent with the finding of delayed speech initiation times for anticipated words in Jackson et al (2022).…”

Section: Introductionsupporting

confidence: 72%

Reactive Inhibitory Control Precedes Overt Stuttering Events

Orpella

Flick

Assaneo

et al. 2022

Preprint

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Research points to neurofunctional differences underlying fluent speech production in stutterers and non-stutterers. There has been considerably less work focusing on the processes that underlie stuttered speech, primarily due to the difficulty of reliably eliciting stuttering in the unnatural contexts associated with neuroimaging experiments. We used magnetoencephalography (MEG) to test the hypothesis that stuttering events result from global motor inhibition–a “freeze” response typically characterized by increased beta power in nodes of the action-stopping network. We leveraged a novel clinical interview to develop participant-specific stimuli in order to elicit a comparable amount of stuttered and fluent trials. Twenty-nine adult stutterers participated. The paradigm included a cue prior to a go signal, which allowed us to isolate processes associated with stuttered and fluent trials prior to speech initiation. During this pre-speech time window, stuttered trials were associated with greater beta power in the right pre-supplementary motor area, a key node in the action-stopping network, compared to fluent trials. Beta power in the right pre-supplementary area was related to a clinical measure of stuttering severity. We also found that anticipated words identified independently by participants were stuttered more often than those generated by the researchers, which were based on the participants’ reported anticipated sounds. This suggests that global motor inhibition results from stuttering anticipation. This study represents the largest comparison of stuttered and fluent speech to date. The findings provide a foundation for clinical trials that test the efficacy of neuromodulation on stuttering. Moreover, our study demonstrates the feasibility of using our approach for eliciting stuttering during MEG and functional magnetic resonance imaging experiments so that the neurobiological bases of stuttered speech can be further elucidated.

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Section: Introductionsupporting

confidence: 72%

Reactive Inhibitory Control Precedes Overt Stuttering Events

Orpella

Flick

Assaneo

et al. 2022

Preprint

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“…Cognitive reactions include the thoughts that a person might have regarding their speech and stuttering. Common example of cognitive reactions includes rumination, also known as repetitive negative thinking (RNT), as well as anticipation about future speaking or stuttering experiences (Constantino et al, 2017; Jackson et al, 2015, 2018; Tichenor & Yaruss, 2020a). Repetitive negative thinking is the learned habit of engaging in recurrent, negative, and self-reflective thoughts about one's life, concerns, or experiences (Ehring et al, 2011; Nolen-Hoeksema, 1991, 2004; Watkins, 2008).…”

Section: Understanding the Stuttering Conditionmentioning

confidence: 99%

Understanding the Speaker's Experience of Stuttering Can Improve Stuttering Therapy

Tichenor

Herring

Yaruss

2022

Topics in Language Disorders

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This article highlights the value for speech-language pathologists of considering the overall stuttering condition-including speakers' experiences during and around moments of stuttering-in treatment with individuals who stutter. We first highlight a framework for conceptualizing the entirety of the stuttering condition. We then present recent research and clinical perspectives about stuttering to support the claim that speech-language pathologists who account for individual differences in how their clients experience stuttering are better positioned to treat stuttering more effectively. Ultimately, this will yield better treatment outcomes and help clinicians achieve greater gains in quality of life for their clients who stutter.

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“…Overt stuttering is an undesired action because of its associated negative consequences. Therefore, individuals who stutter employ proactive inhibitory control to cope with impending stuttering and will often implement learned strategies, such as modifying the speech plan, to circumvent the anticipated word (e.g., by stalling or switching a word; Jackson et al, 2015 ; Jackson et al, 2018 ; Jackson et al, 2019 ). This is consistent with the finding of delayed speech initiation times for anticipated words in Jackson et al (2022) .…”

Section: Introductionmentioning

confidence: 99%

Reactive Inhibitory Control Precedes Overt Stuttering Events

Orpella,

Flick,

Assaneo

et al. 2024

Neurobiology of Language

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Research points to neurofunctional differences underlying fluent speech between stutterers and non-stutterers. Considerably less work has focused on processes that underlie stuttered vs. fluent speech. Additionally, most of this research has focused on speech motor processes despite contributions from cognitive processes prior to the onset of stuttered speech. We used MEG to test the hypothesis that reactive inhibitory control is triggered prior to stuttered speech. Twenty-nine stutterers completed a delayed-response task that featured a cue (prior to a go cue) signaling the imminent requirement to produce a word that was either stuttered or fluent. Consistent with our hypothesis, we observed increased beta power likely emanating from the R-preSMA—an area implicated in reactive inhibitory control—in response to the cue preceding stuttered vs. fluent productions. Beta power differences between stuttered and fluent trials correlated with stuttering severity and participants' percentage of trials stuttered increased exponentially with beta power in the R-preSMA. Trial-by-trial beta power modulations in the R-preSMA following the cue predicted whether a trial would be stuttered or fluent. Stuttered trials were also associated with delayed speech onset suggesting an overall slowing or freezing of the speech motor system that may be a consequence of inhibitory control. Post-hoc analyses revealed that independently-generated anticipated words were associated with greater beta power and more stuttering than researcher-assisted anticipated words, pointing to a relationship between self-perceived likelihood of stuttering (i.e., anticipation) and inhibitory control. This work offers a neurocognitive account of stuttering by characterizing cognitive processes that precede overt stuttering events.

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My Client Knows That He's About to Stutter: How Can We Address Stuttering Anticipation during Therapy with Young People Who Stutter?

Cited by 18 publications

References 18 publications

Reactive Inhibitory Control Precedes Overt Stuttering Events

Reactive Inhibitory Control Precedes Overt Stuttering Events

Understanding the Speaker's Experience of Stuttering Can Improve Stuttering Therapy

Reactive Inhibitory Control Precedes Overt Stuttering Events

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