Physiological Correlates of Stuttering

描述（由申请人提供）：口吃是一种言语障碍，估计占世界人口的1%。对个人来说，这往往是一个严重的沟通问题，限制了教育和就业机会以及社会和心理适应。口吃的确切病因是未知的，治疗策略和结果是高度可变的。理解口吃的病因和发展成功的治疗技术的一个主要障碍是缺乏对这种疾病的生理基础的理解，特别是当这种疾病出现在学龄前时。口吃表现为言语运动过程的障碍。已知影响口吃发生的复杂因素最终必须对产生语音所必需的生理事件产生影响。在了解成人口吃的生理基础方面取得了重大进展。然而，口吃是一种发育障碍，平均发病年龄为3岁。几乎没有关于幼儿口吃生理学的研究，以帮助我们了解发育生理学和口吃的病因。在我们关于口吃的理论框架中，我们认为运动、语言、认知、心理社会和遗传因素在口吃的发生和发展中起作用。此外，这些因素的影响很可能会随着口吃者的寿命而变化。我们选择在这个项目中主要集中在运动和语言因素的学龄前儿童谁是口吃和他们通常流利的同龄人。我们假设，当一个孩子无法获得稳定的运动控制和言语协调过程时，口吃就会出现，从而使他或她在面对增加的处理需求时容易崩溃。我们测试的假设，口吃的孩子落后于他们正常流利的同龄人在发展言语运动控制和协调过程。此外，我们评估是否口吃的儿童的言语运动系统异常敏感，增加语言处理的要求。我们试图确定在口吃的成年人的大脑活动中检测到的语言处理差异是否在口吃的早期也很明显。通过采用纵向实验设计，我们可以确定一组与语言和运动功能相关的生理指标是否可以区分持续口吃的儿童和康复的儿童。公共卫生相关性：目前，我们无法预测哪些口吃的学龄前儿童（占学龄前人口的5%）会发展成慢性口吃问题，以及谁会康复。口吃不是一种危及生命的疾病，但它是一种改变生活的疾病，在1%的美国人中，口吃持续到成年，教育成就，心理社会发展和就业机会往往受到负面影响。我们的目标是使用生理学措施来开发一套测试，可以预测哪些口吃的学龄前儿童可能发展为慢性问题，以便可以开发早期和更成功的口吃干预措施。

DESCRIPTION (provided by applicant): Stuttering is a disorder of speech with a prevalence estimated to be 1% of the world's population. It is often a significant communicative problem for the individual, limiting educational and employment opportunities and social and psychological adjustment. The precise etiology of stuttering is unknown, and treatment strategies and outcomes are highly variable. A major impediment to understanding the etiology of stuttering and to the development of successful therapeutic techniques is the lack of understanding of the physiological bases of the disorder, especially as the disorder emerges in the pre-school years. Stuttering manifests itself as a breakdown in speech motor processes. The complex factors known to affect the occurrence of stuttering must ultimately have an effect on the physiological events necessary for the production of speech. There has been significant progress in understanding the physiological bases of stuttering in adults. Stuttering, however, is a developmental disorder with an average age of onset of 3-years. There is almost no work on the physiology of stuttering in young children to help us understand the developmental physiology and the etiology of the disorder. In our theoretical framework on stuttering, we posit that motor, linguistic, cognitive, psychosocial, and genetic factors play a role in the onset and development of stuttering. Further it seems likely that the influence of these factors changes over the lifespan of the individual who stutters. We elect to focus in this project primarily on motor and linguistic factors in preschool children who are stuttering and their normally fluent peers. We hypothesize that stuttering emerges when a child fails to acquire stable motor control and coordination processes for speech, thus making him or her vulnerable to breakdown in the face of increased processing demands. We test the hypothesis that children who stutter lag their normally fluent peers in developing speech motor control and coordination processes. Furthermore, we assess whether the speech motor systems of children who stutter are exceptionally sensitive to increased linguistic processing demands. We seek to determine if language processing differences detected in the brain activity of adults who stutter are also evident in the early years of stuttering. By employing a longitudinal experimental design, we can determine whether a set of physiological measures related to language and motor functions can discriminate children who will persist in stuttering from those who will recover. PUBLIC HEALTH RELEVANCE: At present, we have no means to predict which preschool children who are stuttering (5% of the preschool population) will develop a chronic stuttering problem and who will recover. Stuttering is not a life-threatening disorder, but it is a life-altering disorder, and educational achievement, psychosocial development, and employment opportunities are often negatively affected in the1% of Americans who persist in stuttering into adulthood. Our goal is to use physiological measures to develop a set of tests that can predict which preschool children who are stuttering are likely to develop a chronic problem, so that early and more successful interventions for stuttering can be developed.