Developmental Trajectories to Stuttering Persistence and Recovery

口吃持续和恢复的发展轨迹

• 批准号: 9973268
• 负责人: BRIDGET M WALSH
• 金额: $ 63.6万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9973268
• 关键词: Achievement; Address; Adopted; Adult; Affect; Age; Anxiety; Arousal; Assessment tool; Attitude; Awareness; Behavioral; Biological Markers; Brain; Brain imaging; Brain region; Child; Childhood; Chronic; Clinical; Cognitive; Communication; Coupling; Cross-Sectional Studies; Data; Development; Diagnostic; Disease; Emotional; Emotions; Equation; Etiology; Goals; Guidelines; Individual; Influentials; Intervention; Lead; Learning; Life Experience; Light; Linguistics; Link; Longitudinal Studies; Maps; Mission; Modeling; Near-Infrared Spectroscopy; Neurologic; Nursery Schools; Outcome; Output; Pathway interactions; Performance; Physiological; Preschool Child; Prevention strategy; Preventive Intervention; Production; Quality of life; Recovery; Research; Resources; Risk; Risk Factors; Risk Marker; Role; Scientist; Severities; Speech; Speech-Language Pathology; Structure; Stuttering; Sympathetic Nervous System; Techniques; Testing; Time; Translating; United States National Institutes of Health; Variant; adverse outcome; aged; base; combinatorial; emotional factor; experience; hemodynamics; imaging modality; imprint; improved; insight; longitudinal design; neuroimaging; neurophysiology; novel; psychosocial development; relating to nervous system; response; skills; treatment strategy

Summary Stuttering or childhood onset fluency disorder, affects 5-8% of preschool-aged children. Although many children’s stuttering resolves within 12-24 months of onset, those who continue to stutter beyond age 7 are at significant risk for chronic stuttering. For children who persist, speaking often becomes a lifelong struggle. The negative consequences for academic/vocational achievement and psychosocial development suffered by many of these children are substantial and long lasting. Prior studies in preschool children who stutter (CWS) have identified demographic, behavioral, and physiological factors associated with stuttering persistence by comparing performance across groups of preschool children. Yet, we do not know how a child’s unique developmental pathway leads them to recover or persist in stuttering. This limits our ability to predict a child’s risk of developing persistent (chronic) stuttering reliably and to develop efficacious prevention and treatment strategies. This project shifts experimental focus, for the first time, to the individual child, providing a dynamic account of how neurological, behavioral, and experiential factors unfold over time and contribute to different stuttering outcomes. We achieve this through our comprehensive, longitudinal design and structural equation modeling framework, in which we map the developmental trajectories of critical factors implicated in stuttering. In our approach, we use a novel neuroimaging technique, functional near-infrared spectroscopy (fNIRS), that allows us to record brain activity concurrent with continuous speech production, a distinct advantage of this technique. We will assess whether neural markers derived from fNIRS recordings identified in our research with older CWS can distinguish preschool children at risk for persistence, thereby helping to establish a neural basis for stuttering persistence and recovery. We will also assess whether atypical coupling between sympathetic nervous system activity and speech output, detected in cross-sectional studies, represents a risk factor for chronic stuttering. Finally, stuttering leaves a lasting imprint on children who persist. Ample evidence shows that older children and adults are more likely to harbor negative emotions about their speech and/or develop communication anxiety. We lack a continuous picture, however, of how these issues develop in young children whose awareness of stuttering is emerging. We will examine how behavioral, emotional, and experiential factors unfold over time and explore their roles in stuttering persistence or recovery and in the development of negative communication attitudes. This project will bring new, comprehensive insights into why stuttering persists in individual children, and, in parallel, help better prioritize therapy resources, identify etiological targets for prevention and intervention, and accelerate the development of new treatments.

概括 口吃或童年发作流利性障碍会影响5-8％的学龄前儿童。虽然很多 儿童的口吃决心在发病的12-24个月内，那些继续结婚7岁以上的人在 长期口吃的重大风险。对于那些坚持不懈的孩子来说，讲话经常成为一生的斗争。这 对学术/职业成就和社会心理发展的负面影响 这些孩子中有许多是巨大的持久。 先前对口吃（CWS）的学龄前儿童的研究已经确定了人口统计学，行为和 通过比较各组的表现 学龄前儿童。但是，我们不知道孩子的独特发育途径如何导致他们康复或 坚持口吃。这限制了我们预测孩子出现持久性（慢性）口吃的风险的能力 可靠并制定有效的预防和治疗策略。 该项目首次将实验重点转移到个别孩子，提供了动态 描述神经，行为和经验的因素如何随着时间的流逝而展开并有助于不同 口吃的结果。我们通过全面的，纵向的设计和结构方程来实现这一目标 建模框架，其中我们绘制了在口吃中实施的关键因素的发展轨迹。 在我们的方法中，我们使用一种新型的神经影像学技术，功能性近红外光谱（FNIRS），该技术是 允许我们记录与连续语音产生并发的大脑活动，这是一个明显的优势 技术。我们将评估我们研究中确定的FNIRS录音的神经标记物是否 使用较老的CW可以区分有持久风险的学龄前儿童，从而帮助建立中立 口吃持久性和恢复的基础。我们还将评估是否在 在横截面研究中检测到的交感神经系统活动和语音输出代表了风险 慢性口吃的因素。最后，口吃给那些坚持不懈的孩子留下了持久的烙印。充足的证据 表明，大孩子和成人更有可能对他们的言语和/或 开发沟通动画。但是，我们缺乏一幅不断的描述，即这些问题如何在年轻人中出现 对口吃意识的孩子正在出现。我们将研究行为，情感和 专家因素会随着时间的流逝而展开，并探索他们在口吃持久性或恢复中的作用以及 发展负面沟通参与者。 该项目将为为什么在个别孩子中持续结结巴巴，为何持续解决， 并且，同时，有助于更好地确定治疗资源的优先级，确定预防和 干预，并加快新疗法的发展。