The Science, The Treatments, and The Controversies of Stuttering
Good to see another post here Tom. Last one was in September, where have you been?
Great interview!It is crucial to point out some aspects, nonetheless: An association does not mean causation. What I mean is as follows: There are some differences between stutterers and non-stutterers in terms of brain structure. So far, so good. That is irrefutable. However, those differences might be epiphenomena (*). In other words, they might be a byproduct of stuttering and not necessarily the cause of stuttering. A simple analogy would be: A paraplegic person invariably has muscle mass loss. Although muscle atrophy is associated with paraplegia, it does not cause paraplegia.It occurs that all neuro-imaging studies carried out so far focus on the "muscle mass loss" part only.Pay a lot of attention here: there is no single article published in the earth's history showing irrefutably a single, clear and consistent factor that causes stuttering.--*Epiphenomemon = a secondary phenomenon accompanying another and caused by it
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@ Tiago Perreira:I widely agree with you. I also think that most of the functional and structural anomalies found in the brain of PWS are consrquences or concomitants of stuttering – most, but not all.Underactivation in perceptive brain regions during speech – in the superior and middle temporal gyrus as well as in the supramarginal gyrus – and their weak functional and structural connectivity with brain regions involved in speech planning and -control (e.g., left inferior frontal gyrus, supplementary motor area, basal ganglia) can hardly be interpreted as byproducts of stuttering.I don't believe that auditory perception or -processing changes because of stuttering – but there is evidence of aberrant central auditory processing in PWS, as well as of deficits in attention regulation, particularly of auditory attention. And there is evidence that auditory attention has a great impact on speech perception and -processing, which might be also true for the perception and processing of auditory feedback of one's own speech. Here we should look for the cause of stuttering.
DAF applications to at least create an experience of fluency, in clear terms of fluid motor planning and execution, sort of side stepping the formation of blocks and habitualized concomittants of dysfluency...can be quote beneficial in my experience. May be viewed in my estimation as a big clue; why does choral Speech, auditory masking, or speaking under water for that matter, result in the stuttering switch to be amazingly turned off, or greatly diminished? Conversely, I must ask if Central auditory processing and perception of one's own speech is abberrant, and dysfunctional auditory attention ( i.e., self monitoring auditory feedback loop) of say, one's natural speech motor planning, fluidity and integrity, is abberrant, then what good is voluntary stuttering? At least for some, voluntary stuttering provides almost an instant reduction in tension, a return to a resting state if you will, where by more volitional Speech motor controlled may be had. This seems to directly signal to the structural regions in the brain for Speech motor planning and control, that I am engaging this learned and aversive abberrant Speech struggle pattern, head on, sort of taking the charge out of it, or interrupting it preeminently through a controlled and volitional imitation, instead of avoiding at any cost to allow it to manifest. This act or process does not seem to have a great deal to do with auditory attention or processing, rather it does so appear to be strongly associated with intentional motor control and confronting the 'dragon' straight on (i.e., doing what I fear and avoid). What results is a reduction in struggle, tension, improved physiologic state of comfort, all condusive to natural fluency (absence of the general sequella of stuttering). However, I am not advocating full time voluntary stuttering either; just observing the mutiplicity of this cunning and baffling phenomena.
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