Developmental Trajectories to Stuttering Persistence and Recovery

总结 口吃或儿童期发作的流畅性障碍，影响5-8%的学龄前儿童。尽管许多 儿童的口吃在发病后12-24个月内消退，那些在7岁以后仍然口吃的人， 严重的慢性口吃风险。对于坚持的孩子来说，说话往往会成为一生的挣扎。的 对学业/职业成就和心理社会发展的负面影响， 这些儿童中有许多是长期存在的。 先前对学龄前口吃儿童（CWS）的研究已经确定了人口统计学、行为学和 与口吃持续性相关的生理因素，通过比较各组的表现， 学龄前儿童然而，我们不知道儿童独特的发展途径如何引导他们恢复或 坚持口吃。这限制了我们预测孩子患持续性（慢性）口吃风险的能力 并制定有效的预防和治疗策略。 这个项目转移实验的重点，第一次，对个别儿童，提供了一个动态的 说明神经，行为和经验因素如何随着时间的推移展开，并有助于不同的 口吃的结果。我们通过全面的纵向设计和结构方程来实现这一目标 模型框架，在其中我们映射的发展轨迹的关键因素牵连口吃。 在我们的方法中，我们使用了一种新的神经成像技术，功能近红外光谱（fNIRS）， 让我们可以记录大脑活动的同时，连续的语音生产，一个明显的优势， 法我们将评估在我们的研究中确定的来自fNIRS记录的神经标记物是否 与年龄较大的CWS可以区分学龄前儿童的风险，持久性，从而有助于建立一个神经 口吃持续和恢复的基础。我们还将评估是否非典型耦合之间 在横断面研究中检测到的交感神经系统活动和言语输出， 慢性口吃的因素。最后，口吃会给坚持的孩子留下持久的印记。充分的证据 年龄较大的儿童和成年人更有可能对他们的言论和/或 产生沟通焦虑。然而，我们缺乏关于这些问题如何在年轻人中发展的连续图片。 孩子们对口吃的认识正在逐渐形成。我们将研究行为、情感和 经验因素随着时间的推移展开，并探讨他们在口吃持续或恢复中的作用， 形成消极的沟通态度。 这个项目将带来新的，全面的见解，为什么口吃坚持在个别儿童， 同时，帮助更好地优先考虑治疗资源，确定预防的病因学目标， 干预，并加快新疗法的开发。

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.