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Stuttering
08-23-2004, 04:03 AM
Purdue News

July 22, 2004

Stuttering more than talk – research shows brain's role in disorder

WEST LAFAYETTE, Ind. – New research from Purdue University shows that even when people who stutter are not speaking, their brains process language differently.

"Traditionally, stuttering is thought of as a problem with how someone speaks, and little attention has been given to the complex interactions between neurological systems that underlie speaking," says Christine Weber-Fox, an assistant professor of speech sciences who is interested in the brain's involvement in language processing.

"We have found differences in adults who stutter, compared to those who don't, in how the brain processes information when people are thinking about language but not speaking. For example, there was a significant delay in response time when subjects were given a complex language task. We also found that in people who stutter, certain areas of the brain are more active when processing some language tasks."

Weber-Fox, a cognitive neuroscientist, teamed with Anne Smith, a professor of speech science who studies the neurophysiological bases of speech production, to study language and speech production systems. A series of studies were conducted to measure semantic (word meaning in sentence processing), grammatical and phonological (sounds of the language, such as rhyming) aspects of language. In each study, the brain activity of adults who stutter and don't stutter were measured when they responded silently, by pressing a button, to questions regarding sentence meaning, grammar or sentence structure, and rhyming. This is believed to be the first time brain electrical activity has been studied in a series of language tasks in people who stutter to determine whether their brains function differently even when there are no overt speaking demands.

The researchers' findings will be presented Friday (July 23) in Portland, Ore., at the American Speech-Language Hearing Association's conference on Fluency and Fluency Disorders. Their study, "Phonologic Processing in Adults Who Stutter: Electrophysiologic and Behavioral Evidence," is scheduled to be published in the December issue of the Journal of Speech, Language and Hearing Research. The research was funded by the National Institutes of Health.

"Adults who stutter often have great language skills, meaning they don't have problems with rules of grammar or with the sounds we use to code the words of our language," Weber-Fox says. "When they speak, however, their motor output falters, so they pause or trip over words. We wanted to evaluate the brain activity when they were not stuttering and, in fact, when they were not having to engage their speech motor systems."

Smith, who also is head of Purdue's Department of Audiology and Speech Sciences and has been studying the physiological aspects of stuttering since 1988, says, "Our research found many complex interactions between the language and motor systems, which leads us to believe that there is no single cause for stuttering. Stuttering is the result of a complex interaction among many factors, including genetic, language, motor and emotional. But our research found many complex interactions between the language and motor systems, which leads us to believe that there is no single cause for stuttering. These findings will help reduce the stigma – such as the myth that the disorder is the result of poor parenting or a psychological problem – often associated with stuttering."

Stuttering, which interrupts the flow of speech, affects 5 percent of people in the United States at some time in their lives. Stuttering usually begins in the preschool years, and there is a higher incidence in males. Characteristics of the disorder can range from repetition of sounds, prolongation of syllables, elongated pauses between words and speech that occurs in spurts.

Weber-Fox and Smith's most recent study focused on phonological aspects of language, specifically rhyming. Just as in the earlier studies that evaluated responses to semantic and grammar language tasks, brain activity was measured in milliseconds. This non-invasive technique uses a skull cap with electrodes to measure activity for groups of brain cells. Response accuracy and time also were measured in this study.

In the rhyming study 22 subjects, half of whom stutter, saw a series of two words flash on a computer screen. Their task was to identify which pairs of words rhymed without saying the word out loud. Some word groups were spelled alike but did not rhyme, such as "gown" and "own," and others did not look similar but did rhyme, such as "cone" and "own." The other variations were words that looked similar and did not rhyme, such as "gown" and "own," and words that did not look similar or rhyme, such as "cake" and "own." This method evaluated the adults' ability to translate sounds when not verbalizing them.

The researchers found that individuals who stutter experienced similar brain activity, response accuracy and response time when it came to three of the four rhyming variations. For example, if two of the words look alike and rhyme, such as "thrown" and "own," most people can quickly identify that they rhyme. But if two words look alike but didn't rhyme, such as "gown" and "own," then the response was delayed to 410 milliseconds for those who stutter. The other three variations averaged about 350 milliseconds among all participants.

"We saw no difference in the fundamental processing when looking at words like gown and own," Weber-Fox says. "The difference was in the complexity of the language task. Also of note during this study was the increase in activity in the brain's right hemisphere for participants who stuttered as they viewed the rhyming words. This shows the individuals who stutter are using right hemisphere brain areas to a greater extent to accomplish the rhyming tasks than those who don't stutter."

Weber-Fox says this relationship to the right hemisphere is a consistent finding that has been shown in other forms of brain imaging, such as functional magnetic resonance imaging. The right hemisphere is considered the non-dominant hemisphere for language, and the activity may indicate that the right hemisphere is compensating for something that is not happening in the left hemisphere, she says.

In similar experiments, the researchers are now looking at stuttering in children and are introducing a hearing task for adults who stutter.

"We looked at the brain's reaction when reading words, and now we are focusing on hearing words," Weber-Fox says. "Do we see atypical responses when somebody who stutters is listening to sentences instead of reading them? We have preliminary data that suggests yes."

Purdue's Department of Audiology and Speech Sciences is ranked among the top 10 in the nation by U.S.News & World Report. The master's and doctoral degree program in speech-language pathology and audiology are ranked third and eighth, respectively.

Writer: Amy Patterson-Neubert, (765) 494-9723, apatterson@purdue.edu

Sources: Christine Weber-Fox, (765) 494-3819, weberfox@purdue.edu

Anne Smith, (765) 494-3788, asmith@purdue.edu

Purdue News Service: (765) 494-2096; purduenews@purdue.edu

Note to Journalists: The researchers' findings will be presented July 23 in Portland, Ore., at the American Speech-Language Hearing Association's conference on Fluency and Fluency Disorders.

PHOTO CAPTION:
Christine Weber-Fox, assistant professor of speech sciences, and John Spruill III, a doctoral student in the Department of Audiology and Speech Sciences from Virginia Beach, Va., prepare a subject for a continuing study to evaluate the brain's role in language processing in adults who do and do not stutter. Weber-Fox and Anne Smith, a professor of speech science who studies the neurophysiological bases of speech production, conducted a series of studies that looked at the brain activity of people who stutter when they are performing language tasks but not speaking. They found that there are some differences in brain activity when adults who stutter respond to complex language tasks, even in the absence of overt speaking demands. (Purdue News Service photo/David Umberger)

A publication-quality photo is available at http://ftp.purdue.edu/pub/uns/+2004/weberfox-research.jpg

GRAPHIC CAPTION:
In a silent rhyming task for children, the neural activity over the left hemisphere occurred later for children who stutter but earlier over the right hemisphere compared to their normally fluent peers. The deep blue colors in the figure indicate changes in activity over anterior brain regions that occur for making a rhyme decision. These preliminary findings in children are similar to results found in a series of past studies of adults who stutter. Christine Weber-Fox, assistant professor of speech sciences, and Anne Smith, a professor of speech science who studies the neurophysiological bases of speech production, conducted studies that looked at the brain activity of people who stutter when they are performing language tasks but not speaking. They found that there are some differences in brain activity, including in the right hemisphere, when adults who stutter respond to complex language tasks, even in the absence of overt speaking demands. (Purdue University graphic)

A publication-quality graphic is available at http://ftp.purdue.edu/pub/uns/+2004/weberfox-research2.jpg


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ABSTRACT

Phonological Processing in Adults Who Stutter: Electrophysiological and Behavioral Evidence

Christine Weber-Fox, Rebecca M.C. Spencer,
John E. Spruill III, and Anne Smith

Event-related brain potentials (ERPs), judgment accuracy and reaction times (RTs) were obtained for 11 adults who stutter and 11 normally fluent speakers as they performed a rhyme judgment task of visually presented word pairs. Half of the word pairs (i.e., prime, target) were phonologically and orthographically congruent across words. That is, the words looked orthographically similar and rhymed (e.g., THROWN, OWN) or did not look similar and did not rhyme (e.g., CAKE, OWN). The phonologic and orthographic information across the remaining pairs was incongruent. That is, the words looked similar but did not rhyme (e.g., GOWN, OWN) or did not look similar but rhymed (e.g., CONE, OWN). Adults who stutter and those who are normally fluent exhibited similar phonologic processing as indexed by ERPs, response accuracy and RTs. However, longer RTs for adults who stutter indicated their greater sensitivity to the increased cognitive loads imposed by phonologic/orthographic incongruency. Also, unlike the normally fluent speakers, the adults who stutter exhibited a right hemisphere asymmetry in the rhyme judgment task, as indexed by the peak amplitude of the rhyming effect (difference wave) component. Overall, these findings do not support theories of the etiology of stuttering that posit a core phonologic processing deficit. Rather we provide evidence that adults who stutter are more vulnerable to increased cognitive loads and display greater right hemisphere involvement in late cognitive processes.


http://news.uns.purdue.edu/UNS/html4ever/2004/040722.Weber-Fox.research.html

NickTony
02-01-2008, 04:29 AM
Well I thought I'd come back to these forums after a 12-month hiatus. I stumbled across this message, and thought it was very interesting that no one has replied to it, even though it was posted over 3 years ago.

Is that because this study proves that stuttering IS in fact a neurological condition? (Something which I always suspected.) Is this something that stutterers would prefer to ignore, instead choosing to believe that stuttering is nothing more than a physical problem, and not psychological, which so many "experts" keep on telling us?

I simply cannot understand those experts who say stuttering is only a physical problem, and nothing more. Of course it's physical, but it's so much more than that. Given that this study has shown that stutterers tend to use their right brain hemisphere more than non-stutterers, it would seem that stuttering will always be a part of the genetic make-up of the individual -- meaning that conscious effort will always be required to maintain fluent speech. This is in keeping with speech pathologists who have always said that there is no "cure" for stuttering -- rather there is treatment which can virtually eliminate it with conscious effort and certain exercises.

Roley
02-03-2008, 12:02 AM
Thanks for bringing this information "back" to us. I'm relatively new in the forum and haven't searched past threads. This one is extremely interesting to me.

I wonder if the dopamine difference between stutterers and non-stutterers is related at all to findings from the studies by Dr. Weber-Fox.

I'm 59, and have gone through many years of many kinds of therapy, and while I'm not a neurologist at all, I'm convinced that stuttering is a neurological "issue." Not something physical.

Mullen
02-03-2008, 04:00 AM
Teaching stutterers to talk again using another part of the brain reminds me a little of the bygone effort to teach left-handed people to use their right hands.

The idea sounds plausible (speech afterall is an act of coordination), but I just wonder how difficult and successful it would be.

JDRow
02-03-2008, 03:09 PM
Is that because this study proves that stuttering IS in fact a neurological condition? (Something which I always suspected.) Is this something that stutterers would prefer to ignore, instead choosing to believe that stuttering is nothing more than a physical problem, and not psychological, which so many "experts" keep on telling us?

Neurological is different from psychological. As far as I know, a neurological problem would be considered a physical one, since it means there's a cause located somewhere in the body. I think when people talk about stuttering being psychological, they don't mean that it's a problem that has something to do with the brain, but that it's a problem that is caused by the stutterer thinking the wrong things and having emotional issues.

Roley
02-04-2008, 12:13 AM
Let's get the neurological stuff fixed, then the psychological stuff will go away. Okay, maybe some of it any way.

3FingerBrown
02-06-2008, 09:22 PM
Let's get the neurological stuff fixed, then the psychological stuff will go away. Okay, maybe some of it any way.

I disagree...
I realized that even if I woke up tomorrow knowing that my stutter had vanished and was never coming back that I'd still have the mind of a stutterer.
Though stuttering is a neurological problem, the psychological issues and cognitive disorders are learned behaviors and must therefore be unlearned.
The anxieties took years or decades to form and they won't just go away. People often fear things that no longer need to be feared and not all fears are rational or realistic; post traumatic stress disorders being the extreme example.
PWS have the same frequencies of mental illness as the general population. Our anxieties are not caused by chemical imbalances but are learned rational reactions to irrational situations.
The only way to change a learned behavior is to learn a new replacement behavior and this takes worthwhile time and effort.
Ari

Roley
02-07-2008, 02:36 PM
I don't mean to imply that fixing the neurological aspects will make stuttering go away. But maybe with medications for the neurological "issues," we can then concentrate on the psychological "issues" which we ALL have. I'd take a 25% decrease in my disfluency any day. If your disfluency decreases, then you'll feel more positive in general; maybe then the snowball effect will kick in, which will help you ... etc., etc.

3FingerBrown
02-07-2008, 05:49 PM
I don't mean to imply that fixing the neurological aspects will make stuttering go away. But maybe with medications for the neurological "issues," we can then concentrate on the psychological "issues" which we ALL have. I'd take a 25% decrease in my disfluency any day. If your disfluency decreases, then you'll feel more positive in general; maybe then the snowball effect will kick in, which will help you ... etc., etc.

I think you misunderstood what I wrote.
As we know, stuttering is a neurological issue and is therefore a problem with your brain.
There is nothing physically wrong with the brain of a PWS which would physiologically be responsible for our learned anxiety problems.
Our anxiety/psychological problems are normal reactions to our stuttering but there is nothing physically wrong with the brain which would cause our anxiety problems.
Our fears and anxieties are learned reactions and behaviors but over time they develop legs of their own and no longer require the initial irritant/cause to continue and prosper. Our anxiety problems are classic cognitive disorders first pioneered by Dr Albert Ellis.

The stuttering is a physiological and without a cure you may never stop stuttering.
The anxiety problems are learned behaviors and can be unlearned.
Bad news is that if (and thats a hell of a big if) you stop stuttering your psychological problems will not magically be healed also.
Good news, you can continue to stutter and conquer your anxities.

2 doctors who may "speak" to you about this... Dr Albert Ellis and Dr Martin Seligman. I suggest looking into what each has/had to say.

Good luck,
Ari

Adrian
02-07-2008, 07:10 PM
Bad news is that if (and thats a hell of a big if) you stop stuttering your psychological problems will not magically be healed also.

Ari,

Good post. I agree with everthing except the above. I was basically fluent and completely in control of my speech following a therapy course for several weeks and the anxiety and psychological issues instantly dissappeared. Unfortunately, as the stuttering creeped back in, so did the baggage.

Of course everyone is different and the baggage may be more deep rooted for some.

Adrian

Roley
02-07-2008, 09:38 PM
Ari and Adrian ...

I agree with both of you. That's what I was trying to say. Once we're able to deal with the neurological (physical) stuff, it would be relatively easy to deal with the baggage we all carry around.

andrewg818
02-08-2008, 04:09 AM
I interpret this differently. See, when someone stutters--and they "think about language"-- their reaction** is different from that of a fluent person-- they scan ahead, they get tense, anxious--they, at the very least-- PREPARE for the extra effort of stuttering/avoiding/pushing through the words they see coming. All of this LEARNED excess preparatory behavior creates physical/biochemical responses which, of course, can be measured. That, however, does not mean that the brains of PWS are any different from fluent people. In contrast, it simply means that PWS think differently about speech--and thus, get a different biochemical result.
All PWS know they can speak just fine in many many contexts...

andrewg818
02-08-2008, 04:13 AM
Adrian writes:
Ari,

Good post. I agree with everthing except the above. I was basically fluent and completely in control of my speech following a therapy course for several weeks and the anxiety and psychological issues instantly dissappeared. Unfortunately, as the stuttering creeped back in, so did the baggage.

Of course everyone is different and the baggage may be more deep rooted for some.

Adrian

I reply:
This is a common psychological response. I, too, experienced it several times but was fortunate enough to perservere. Our subconscious minds accept our identity as a stutterer and they do not question it-- It simply is what is.. When fluency suddenly becomes prevalent.. and then remains so for a period of time, the subconscious becomes concerned..It is SUPPOSED To try to reestablish the identity: "I stutter"-- so it raises tension/anxiety-- brings about more and more concerns.. "baggage" about stuttering to the forefront-- in an attempt to reinstate the "norm"-- This is common psychology-- it's not just for stutterers..
HOWEVER, if the stutterer has support and perserveres and continues on -- understanding what is happening--the subconscious usually gives up after 2-3 weeks..and a profound peace actually occurs.
HOWEVER, I found that the subconscious sometimes re"attacks" each time the PWS overcomes a new hurdle.. i.e. fluency in a particular situation...