DYNAMIC ASPECTS OF RESPIRATORY CONTROL IN STUTTERING

口吃者的呼吸中断(PWS)自1931年(7)以来被记录下来；它们与感知上流利的和口吃的言语以及非言语任务有关。然而，最近几乎没有关于PWS呼吸控制的研究，而且它对口吃病因的贡献尚不清楚。这里提出的这项研究旨在增加对口吃多因素模型(80，81，83,104)中呼吸位置的理解。识别与口吃高风险相关的呼吸控制方面被认为是描述呼吸与其他变量相互作用的先决条件，其他变量也在口吃的发生和维持中发挥作用。这里提出的这项研究旨在解决三个广泛的问题：1)在正常说话者中，当开始说话时，已知的维持生命的呼吸控制的不稳定会发生什么？这些不稳定性如何影响口吃的人？2)口吃者的运动系统是否普遍无法控制呼吸？3)PWS的呼吸控制是否更多地反应于与认知和情绪处理有关的唤醒？对于所有这些问题，初步数据都涉及动态过程，因此，重点放在施加时间限制的任务上，以及超出长期平均水平的分析，以查看正常和口吃的说话者的呼吸控制过程如何随着时间的推移而变化。在目前使用的治疗方法中，呼吸控制的状态从主要集中到不存在(20)。对呼吸在口吃中作用的更好的理解可能会对这种疾病的治疗实践产生重大影响，这种疾病影响着全球约1%的成年人口。

Disruptions of breathing in persons who stutter (PWS) have been documented since 1931 (7); they have been associated with perceptually fluent and stuttered speech and with nonspeech tasks. Yet there has been little recent investigation of respiratory control in PWS, and its contribution to the etiology of stuttering is unknown. The research proposed here is designed to increase understanding of the place of respiration within a multifactorial model of stuttering (80, 81, 83, 104). Identification of aspects of respiratory control associated with high risk for disfluency is seen as prerequisite for delineating the interaction of respiration with other variables which also play a role in the development and maintenance of stuttering. The research proposed here is designed to address three broad questions: 1) In normal speakers, what happens to known instabilities in the control of life-support breathing when speech is initiated? How do these instabilities affect stuttering speakers? 2) Does a general inability to take control of respiration characterize the motor systems of persons who stutter? 3) Is respiratory control in PWS more reactive to arousal associated with cognitive and emotional processing? For all of these questions, preliminary data implicate dynamic processes, thus, there is an emphasis on tasks that impose timing constraints, and on analyses that go beyond long-term averages to look at how respiratory control processes change over time in both normal and stuttering speakers. Among therapies in current use, the status of respiratory control ranges from major focus to nonexistent (20). Improved understanding of the role of respiration in stuttering has the potential to effect major change in the practice of therapy for this disorder, which affects approximately 1 percent of the adult population worldwide.