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

基本信息

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
项目类别：
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

项目摘要

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.

发育性口吃通常出现在 24-60 个月之间，其中大多数儿童从口吃中恢复。对于剩下的孩子来说，到了学龄期仍持续口吃，成年期会给社会情感、教育和职业带来不利影响的重大风险结果。尽管在过去的几年里，已经发现了多种导致口吃持续存在的危险因素（例如，口吃的严重程度、性别、发病年龄、发病以来的时间、发音、语言能力），仍然存在一个关键因素需要优化预测口吃持续性的准确性。迄今为止，预测模型很少考虑情感的作用；然而，我们的初步数据表明，它在口吃的坚持。具体来说，我们的横断面工作表明，皮质和自主神经口吃儿童情绪反应和情绪相关认知控制脆弱性的标志 (CWS) 会导致口吃并与持久性相关（试验数据）。我们最近扩展了这项工作并开发了一种新颖的方法来测试情绪反应对演讲准备和演讲的影响幼儿的生产有持续的风险。根据我们迄今为止的发现，中心假设拟议的项目是，情绪反应通过干扰在口吃持久性中发挥着重要作用具有非言语认知控制（例如抑制和执行）和言语准备和言语流畅性的早期发展所必需的生产过程，从而赋予持续口吃的风险增加。为了检验这个假设，我们将进行一项纵向研究年轻（3 至 4 岁）CWS。年度实验室访问将在研究注册后 3 年内进行，并涉及全面的口吃评估，包括言语、认知和气质诊断电池以及对情绪反应、认知控制和言语准备的系统评估生产流程。该项目的具体目标是：（1）确定皮质和自主神经是否情绪反应性的生物标志物可预测 CWS 的结果（持续与恢复），(2) 确定情绪是否非言语认知控制任务和言语任务期间的相关表现可预测结果（坚持与恢复）对于 CWS，以及（3）确定情绪对口吃的贡献标记是否提供与与口吃相关的其他既定变量相结合时的附加预测价值坚持。如果成功，拟议的项目将解决识别标记物的持续临床需求口吃持续性的风险并提高预测模型的准确性。这些进步将允许临床医生可以更好地确定评估目标，为新的治疗方法奠定基础，并允许由于区分能力的提高，研究人员可以更好地评估早期干预的效果从暂时的情况持续存在。因此，拟议的研究通过发现来支持 NIDCD 的使命新知识有可能改善口吃幼儿的结果。