Early childhood stuttering and risk for persistence: The impact of emotion on speech and cognitive control

儿童早期口吃和坚持的风险：情绪对言语和认知控制的影响

• 批准号: 10681482
• 负责人: Robin Michael Jones
• 金额: $ 60.99万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-10 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681482
• 关键词: 4 year old; Address; Adult; Age; Age Months; Age Years; Anxiety; Articulation; Behavioral; Biological Markers; Child; Childhood Stuttering; Clinical; Clinical assessments; Cognitive; Contingent Negative Variation; Data; Development; Developmental Stuttering; Diagnostic; Early Intervention; Education; Emotional; Emotions; Enrollment; Event-Related Potentials; Galvanic Skin Response; Health; Knowledge; Language; Longitudinal Studies; Longitudinal cohort study; Measures; Methodology; Methods; Mission; National Institute on Deafness and Other Communication Disorders; Outcome; Pathogenesis; Performance; Physiological; Play; Predictive Value; Preparation; Process; Production; Prospective cohort; Public Health; Reaction Time; Research Personnel; Research Support; Risk; Risk Factors; Risk Marker; Role; School-Age Population; Severities; Speech; Speech Development; Stuttering; Task Performances; Temperament; Testing; Time; Translating; Visit; Vocation; Work; biomarker identification; cognitive control; comorbidity; design; early childhood; improved; improved outcome; indexing; longitudinal, prospective study; novel; novel marker; novel therapeutic intervention; outcome prediction; predictive modeling; prognostic indicator; response; sex; social

Developmental stuttering commonly emerges between 24-60 months of age with the majority of these children recovering from stuttering. For the remaining children, persistent stuttering into school-age years and adulthood confers significant risk for adverse impact on social-emotional, educational, and vocational outcomes. Although over the past years a variety of risk factors for stuttering persistence have been identified (e.g., stuttering severity, sex, age at onset, time since onset, articulation, language ability), there is still a critical need to optimize the accuracy with which stuttering persistence can be predicted. To date, predictive models have rarely considered the role of emotion; however, our preliminary data suggest that it plays a major role in stuttering persistence. Specifically, our cross-sectional work has demonstrated that cortical and autonomic markers of emotional reactivity and emotion-related cognitive control vulnerabilities in children who stutter (CWS) contribute to stuttering and are associated with persistence (pilot data). We recently extended this work and developed a novel methodology to test the effects of emotional reactivity on speech preparation and production in young children at risk for persistence. Based on our findings to date, the central hypothesis of the proposed project is that emotional reactivity plays a major role in stuttering persistence by interfering with both non-speech cognitive control (e.g. inhibition and execution) and speech preparation and production processes necessary for the early development of speech fluency and thereby confers heightened risk for stuttering persistence. To test this hypothesis, we will conduct a longitudinal study of young (3- to 4-year old) CWS. Annual lab visits will occur for 3 years from study enrollment and will involve a comprehensive stuttering assessment, a speech-language, cognitive, and temperament diagnostic battery as well as the systematic assessment of emotional reactivity, cognitive control, and speech preparation and production processes. The specific aims of the project are to: (1) determine if cortical and autonomic biomarkers of emotional reactivity predict outcome (persist versus recover) for CWS, (2) determine if emotion- related performance during a non-speech cognitive control task and a speaking task predicts outcome (persist versus recover) for CWS, and (3) determine whether markers of emotional contributions to stuttering provide additive predictive value when combined with other established variables associated with stuttering persistence. If successful, the proposed project addresses the continued clinical need to identify markers of risk for stuttering persistence and improve the accuracy of predictive models. These advances will allow clinicians to better pinpoint targets for assessment, set the stage for novel therapeutic approaches, and allow researchers to better evaluate the effects of early intervention due to an improved ability to distinguish persistent from transient cases. Thus, the proposed research supports the mission of NIDCD by discovering new knowledge that has the potential to improve outcomes of young children who stutter.

大多数这些儿童的开发口吃通常在24-60个月之间出现 从口吃中恢复。对于剩下的儿童，持续的口吃成学年时代 成年赋予对社会情感，教育和职业的不利影响的重大风险 结果。尽管在过去几年中，已经确定了持久性的各种风险因素 （例如，结结巴巴的严重程度，性别，发病年龄，自发作以来的时间，发音，语言能力），仍然有关键 需要优化可以预测口吃持久性的准确性。迄今为止，预测模型 很少考虑情感的作用；但是，我们的初步数据表明它在 口吃的持久性。具体而言，我们的横截面工作表明皮质和自主教 情绪反应性和与情感相关的认知控制脆弱性的标志 （CWS）有助于口吃，并与持久性有关（试点数据）。我们最近扩展了这项工作 并开发了一种新的方法来测试情绪反应性对语音准备的影响 有持久风险的幼儿生产。根据我们迄今为止的发现， 拟议的项目是，情感反应性通过干预在口吃持久性中起着重要作用 通过非语音认知控制（例如抑制和执行）和语音准备以及 早期发展语音流利性所必需的生产过程，从而赋予 持久持久性的风险增加。为了检验这一假设，我们将对 年轻（3至4岁）CWS。年度实验室访问将在研究入学率下进行3年，并将涉及 全面的口吃评估，语音语言，认知和气质诊断电池 以及对情绪反应性，认知控制和语音准备的系统评估以及 生产过程。该项目的具体目的是：（1）确定皮质和自主教是否是否 情绪反应性的生物标志物可以预测CWS的结果（持续与恢复），（2）确定情绪是否 - 在非语音认知控制任务和口语任务期间的相关性能预测结果（持续存在 与CWS的恢复与恢复，（3）确定对口吃的情感贡献标记是否提供 与口吃相关的其他已建立的变量结合在一起时，添加剂预测值 持久性。如果成功，则提议的项目解决了持续的临床需求，以确定 口吃持久性并提高预测模型的准确性的风险。这些进步将允许 临床医生可以更好地确定评估目标，为新颖的治疗方法奠定阶段，并允许 研究人员可以更好地评估由于有提高的区分能力而提高早期干预的影响 持续存在瞬态案例。因此，拟议的研究通过发现NIDCD的使命 有可能改善口吃的幼儿的新知识。