The context for this study is an exhaustive empirical examination of a research-based and computer-managed treatment for adult developmental stuttering known as the Modifying Phonation Intervals (MPI) program. Within that context, the studies described in this proposal will test a number of hypotheses concerning the relationships among several critical factors: stuttering behavior, the neurology of stuttering, the cognitive and affective components of stuttering, stuttering treatment approaches, and the maintenance of stuttering treatment gains. Thus, this proposal simultaneously addresses two overwhelming needs: efficacious stuttering treatments for adults, and the integration of basic knowledge, such as knowledge about the neurology of stuttering, with information from treatment research to develop comprehensive neurophysiologic and behavioral models of stuttering and stuttering treatment. It is hypothesized that (a) a necessary prerequisite for durable treatment benefits is normalized cerebral blood flow within regions that constitute an emerging model of the neurophysiology of stuttering, and (b) this result can be achieved by establishing a speech pattern that requires the production of speech with a reduced proportion of short phonated intervals (Pis).
These aims will be met in a treatment comparison study that employs repeated behavioral, cognitive, and affective evaluations derived from the MPI program and a prolonged speech (PS) program that represents the current standard of care for adult stuttering. This evaluation format will be conjoined by repeated PET scanning, to identify specific speech-motor and neural system changes generated by these treatments and described by an empirically derived stuttering system model. Both treatments include identical transfer and maintenance components plus within- and beyond-clinic assessments that extend over the course of treatment and 12 months after its cessation. Repeated performance-correlation analyses of the derived brain imaging data will test the principal theoretic proposition that the system model regions functionally control the efficacy of stuttering treatment. The overall study also constitutes a Phase II treatment efficacy study that will determine the need for a Phase III treatment trial of the MPI program.
|Ingham, Roger J; Ingham, Janis C; Bothe, Anne K et al. (2015) Efficacy of the Modifying Phonation Intervals (MPI) Stuttering Treatment Program With Adults Who Stutter. Am J Speech Lang Pathol 24:256-71|
|Cieslak, Matthew; Ingham, Roger J; Ingham, Janis C et al. (2015) Anomalous white matter morphology in adults who stutter. J Speech Lang Hear Res 58:268-77|
|Bainbridge, Lauren A; Stavros, Candace; Ebrahimian, Mineh et al. (2015) The efficacy of stuttering measurement training: evaluating two training programs. J Speech Lang Hear Res 58:278-86|
|Wymbs, Nicholas F; Ingham, Roger J; Ingham, Janis C et al. (2013) Individual differences in neural regions functionally related to real and imagined stuttering. Brain Lang 124:153-64|
|Ingham, Roger J; Wang, Yuedong; Ingham, Janis C et al. (2013) Regional brain activity change predicts responsiveness to treatment for stuttering in adults. Brain Lang 127:510-9|
|Ingham, Roger J; Grafton, Scott T; Bothe, Anne K et al. (2012) Brain activity in adults who stutter: similarities across speaking tasks and correlations with stuttering frequency and speaking rate. Brain Lang 122:11-24|
|Ingham, Roger J; Ingham, Janis C; Bothe, Anne K (2012) Integrating functional measures with treatment: a tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter. Am J Speech Lang Pathol 21:264-77|
|Ingham, Roger J (2012) Comments on recent developments in stuttering treatment maintenance research using the Camperdown Program. J Speech Lang Hear Res 55:306-9; author reply 310-2|
|Ingham, Roger J; Bothe, Anne K; Wang, Yuedong et al. (2012) Phonation interval modification and speech performance quality during fluency-inducing conditions by adults who stutter. J Commun Disord 45:198-211|
|Liotti, Mario; Ingham, Janis C; Takai, Osamu et al. (2010) Spatiotemporal dynamics of speech sound perception in chronic developmental stuttering. Brain Lang 115:141-7|
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