Attentional control in children who stutter

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PROJECT SUMMARY Stuttering is a neurodevelopmental disorder with devastating consequences on communication and quality of life. The etiology of stuttering is influenced by dynamic interactions between genetic and epigenetic factors, including speech motor control, emotion regulation, cognitive-linguistic processes, and environmental factors. The current project focuses on attentional control in children who stutter (CWS), a cognitive skill critical for regulating and maintaining attention toward a stimulus or task. Atypical attentional control in CWS, indicated by theoretical models of stuttering, is supported by recent empirical evidence of atypical neural connectivity between attention and somatomotor networks. However, it is not yet known how these atypical connectivity patterns impact neural functions for attention in CWS, which may impact fluent speech productions. Reduced or discoordinated attentional control in CWS, who have vulnerable speech motor systems, may contribute to disfluent speech by affecting initiation or maintenance of the goal-directed actions of speech production. The current proposal extends previous behavioral and neuroimaging findings in CWS by evaluating distinct attentional control systems in the same child to elucidate the nature of attentional control in 5- to 8-year-old CWS. Three distinct attentional control systems, which together regulate attention, will be assessed: Alerting (response to a stimulus), Orienting (directing toward a stimulus), and Executive Control (maintaining goal- directed behaviors and response inhibition). Attentional control will be evaluated using a battery of behavioral and neurophysiological tasks. The specific aims of this proposal are: (1) Characterize and contrast neural processes underlying distinct attentional control systems in CWS and fluent peers. Neurophysiological data (event-related brain potentials [ERPs]) will be acquired during attentional control tasks to evaluate the effects of distinct attentional control system on neural processing. (2) Characterize and contrast attentional control profiles in CWS and fluent peers. A battery of multiple and complementary tasks will evaluate performance on distinct attentional control tasks. (3) Develop and evaluate a preliminary model of attentional control in CWS. Relationships between ERP and behavioral performance as well as parental reports of behavior in CWS will be used to construct latent attentional control factors and determine which of these factors most strongly predicts stuttering severity. Including parental reports will support translation of our findings to clinical settings. This project will establish whether distinct attentional control systems, or attentional control more broadly, are atypical in CWS. This project will lay the groundwork for future research informing two long-term goals: 1) The evaluation of changes in attentional control over time in younger CWS, leading to refinement of predictive factors of persistence versus recovery, and 2) The enhancement of traditional treatment approaches to incorporate attention systems that differ in CWS and most strongly predict stuttering severity, thereby informing development of evidence-based treatment programs with the greatest potential to maximize outcomes in CWS.