VOLUNTARY CONTROL OF RESPIRATION IN STUTTERING

人们普遍认为，适当的呼吸控制是必要的， 成功的言语产生（45），呼吸控制在某种程度上 影响口吃。事实上，现有的文献一致地 表明不仅是言语呼吸， 一般来说，口吃是异常的（5，12，19，33，34）。 但鲜为人知的 呼吸异常在口吃中的患病率， 这种异常可能在这种疾病中起作用。 这里提出的实验的一个主要目标是测试一些基本的 呼吸感觉和运动控制方面的口吃， 与正常人相比。实验拟：1）调查 口吃者感知和控制口吃相关的 压力和肺容量，与正常扬声器相比; 2） 详细描述呼吸不适（呼吸困难）， 伴有不流利，并将呼吸困难的质量和强度与 呼吸模式;以及3）研究肺容量的相互作用， 语言结构和语音起始时间。 口吃似乎是一种异质性疾病（2）。 进一步的目标是 这项建议旨在确定能够识别口吃者的措施， 其中呼吸控制对疾病有重要作用。 因此，所有方法都是非侵入性的，以使测试相对 大量受试者，包括广泛的严重程度。 识别口吃与强烈的呼吸成分是 作为设计临床策略的第一步， 旨在满足客户的需求。 此外，全面了解 呼吸口吃几乎肯定需要使用 一些高度侵入性的技术（例如，记录横隔膜和 喉EMG）。 了解哪些主题，哪些方面 呼吸系统受损最严重，将大大提高 在这样的调查中取得成功。 口吃并不是一种罕见的疾病;估计成年人的患病率是 约占人口的1%。 然而，最近一项关于 实践的言语语言病理学家透露，口吃， 成年人是医生最不舒服的疾病之一 部分原因是目前的治疗方法不足以 （39）。 希望在此提出的工作将有助于改善这一点 促进目前对联合国作用的理解， 口吃时的自主呼吸控制。

It is generally agreed that adequate respiratory control is necessary for successful speech production (45), and that respiratory control is somehow affected in stuttering. in fact, the available literature consistently suggests that not just speech breathing, but voluntary breathing in general, is aberrant in stuttering (5,12,19,33,34). Yet little is known of the prevalence of respiratory anomalies in stuttering, or of the role that such anomalies may play in this disorder. A major goal of the experiments proposed here is to test some basic aspects of respiratory sensation and motor control in stuttering as compared to normal subjects. Experiments are proposed to: 1) investigate stutterers' abilities to sense and to control respiratory-related pressures and lung volumes, compared to those of normal speakers; 2) describe in detail the respiratory discomfort (dyspnea) that often accompanies disfluency, and relate quality and intensity of dyspnea to breathing patterns; and 3) investigate the interactions of lung volume, linguistic structure, and voice onset time in stutterers' speech. Stuttering appears to be a heterogeneous disorder (2). A further goal of this proposal is to identify measures that can identify those stutterers in whom respiratory control contributes significantly to the disorder. Thus all methods are non-invasive, to enable the testing of relatively large numbers of subjects encompassing a broad range of severity levels. Identification of stuttering with a strong respiratory component is desirable as a first step toward designing clinical strategies that are designed to match the clients' needs. Also, a complete understanding of respiration in stuttering will almost certainly necessitate the use of some highly invasive techniques (e.g., recording diaphragmatic and laryngeal EMG). A knowledge of which subjects, and which aspects of respiration, are most compromised, would greatly improve the possibility of success in such investigations. Stuttering is not a rare disorder; the estimated prevalence in adults is approximately 1% of the population. Yet, a recent review of the attitudes of practicing speech-language pathologists revealed that stuttering in adults ranks among the disorders that practitioners are most uncomfortable in attempting to treat, in part because current therapies are inadequate (39). It is hoped that the work proposed here will help to improve this situation by contributing to current understanding of the role of voluntary respiratory control in stuttering.