Effects of attentional focus on speech motor control in adults who stutter with and without social evaluative threat

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PROJECT SUMMARY/ABSTRACT The attentional focus in people who stutter (PWS) when speaking under social evaluative threat (SET) condi- tions and its effects on speech-motor control is unknown. My long-term goal is to advance treatment for PWS by supporting the need to integrate attention focus strategies in therapy in order to reduce anxiety and improve communication. The overall objectives in this application are to establish the effects of attentional shifts on speech motor control in PWS and determine how this relationship is influenced by social stress. The central hypothesis is that PWS engage a self-focus of attention when speaking under SET and this leads to a speech motor system that is more susceptible to breakdown. The rationale is that high anxious people who do not stut- ter shift to a self-focused attention when under SET and due to the high levels of anxiety reported in PWS, it is suspected that they also engage a self-focused attention when under SET. Due to their unstable articulatory coordination patterns, a self-focused attention is suspected to interfere with fluent speech. The hypothesis will be tested by pursuing three specific aims: 1) Determine the effects of cued attentional focus on articulatory control and stuttering frequency in adolescents and adults who stutter; 2) Determine the attentional focus in adolescents and adults who stutter when under SET and its effects on articulatory control and stuttering fre- quency; and 3) Determine the effects of cued attentional focus on articulatory control and stuttering frequency in adolescents and adults who stutter when speaking under SET. Under the first aim, adolescents and adults who do and do not stutter will repeat sentences under baseline, cued-internal, and cued-external attentional focus conditions. For the second aim, adolescents and adults who stutter will repeat sentences in front of an audience trained to exhibit negative, positive, or neutral behaviors. Attention will be assessed using the Detec- tion of Audience Behavior questionnaire and scores will be used to form subgroups based on attentional focus. For the third aim, adolescents and adults who stutter will repeat sentences under SET when engaging a cued- internal and – external attentional focus. Articulatory variability will be assessed using STI and RQA measures of lip aperture and posterior tongue. Number of stuttered sentences will be calculated. Age and self-reports of social anxiety will be used as covariates. Stressor effects will be assessed using skin conductance levels. The research proposed in this application is innovative because it will be the first to (i) assess whether PWS en- gage a self-focus of attention during SET, (ii) determine how changes in attentional focus affects speech motor control in PWS, (iii) include the much-needed assessment of tongue kinematics, and (iv) determine if cues to shift attention effects speech-motor control in AWS during SET conditions. The proposed project is significant because it will explain some of the inconsistencies in the literature reporting a destabilizing effect on speech- motor control in AWS when under social-cognitive demands by suggesting that attention plays a mediating role and support the development of therapeutic approaches that encourage healthy social interactions.