Stuttering occurs in approximately 1% of the population and can significantly impact children's social, emotional, educational, and vocational development. Numerous empirical studies and theoretical perspectives have linked emotion to the onset and/or the development of childhood stuttering, but the precise role of emotion within the causal nexus of stuttering has yet to be determined. To date, these studies have shown that young children who stutter (CWS), compared to children who do not stutter (CWNS), differ in emotional temperament and behavioral responses to arousing situations. Critically, temperamental characteristics of negative emotional reactivity have recently been linked to an increased risk for stuttering persistence. However, the field currently lacks replicable objective markers as well as a systematic understanding of possible neurophysiologic mechanisms of emotional contributions to stuttering. This gap in our knowledge represents an important problem, because it appreciably restricts our ability to develop emotion-related markers of risk for stuttering onset and persistence and develop innovative diagnostic/therapeutic approaches. To address these issues, the present application is designed to: (1) determine emotion-related cortical and autonomic markers of risk for stuttering, and (2) empirically examine the impact of emotion on cognitive control (inhibition, execution), processes employed in linguistic planning and speech-motor control that may be vulnerable to emotional interference. The present proposal's central hypothesis is that increases in emotion reactivity interfere with cognitive control processes necessary for the early development of fluent speech-language planning and production. The psychophysiological biomarkers of these cognitive- emotion mechanisms will be tested via three specific aims: (1) to test for differences in cortical and autonomic biomarkers of emotion between CWS and CWNS, (2) to determine the impact of emotional arousal on cognitive control performance in CWS and CWNS, and (3) to examine the relation of emotional arousal and cognitive control performance to CWS's stuttering frequency. For all three aims, the PI will employ well- established methods in speech-language science, cognitive neuroscience, and psychophysiology. The proposed study is innovative in that it represents the first project to systematically explore psychophysiological biomarkers of cognitive-emotional mechanisms in early childhood stuttering using a multi-method approach. The proposed project is significant because findings will significantly impact our empirically-based understanding of childhood stuttering, and may lead to translational studies attempting to facilitate and enhance assessment and treatment of childhood stuttering. For example, physiological cognitive- emotional markers may confer risk for persistent stuttering, and may lead to the development of novel treatment approaches tailored to the individual. Thus, the proposed research supports the mission of NIDCD by discovering new knowledge that has the potential to improve the lives of people who stutter.
The proposed project is relevant to public health because it addresses an important and under-investigated area relating to how emotion impacts cognitive processes that facilitate fluent speech-language planning and production in childhood stuttering. The results of this work are expected to identify psychophysiological biomarkers of these cognitive-emotional mechanisms that may confer risk for the onset and persistence of stuttering and lead to novel targets for assessment of intervention efficacy as well as new intervention approaches. This work is relevant to the mission of NIDCD because it focuses on developing new knowledge that will improve the health and outcomes of young children who stutter.
