Sunday, November 24, 2024
11/24/2024
PROJECT SUMMARY The term adverse impact refers to the negative personal reactions, broader speech- or communication-related consequences, and overall life challenges that adults who stutter may experience as a result of their speaking difficulties. Though the risk of broader life impact is widely acknowledged, prior investigations have solely evaluated this risk via surface severity, which does not strongly relate with negative cognitive-affective reactions (negative thoughts and feelings). This limits the ability of clinicians and researchers to accurately identify whether specific individuals are at risk for broader life consequences associated with their stuttering. Similarly, most investigations of speech neurophysiology in people who stutter rely exclusively on surface severity to group and interpret data using tasks with low ecological validity (e.g., speaking alone in a scanner). This raises questions about whether the field’s current understanding of speech neurophysiology is applicable to real-world environments where people who stutter speak and, as a result, experience negative cognitive-affective reactions. The PI’s previous studies suggest that considering sub-group differences in cognitive-affective reactions (how speakers experience, manage, and cope with stuttering) can predict how speakers let stuttering manifest in their life. Pilot data collected for this proposal suggest that such sub-group differences can also predict broader life negative outcomes, such as social isolation. However, it is unknown if other negative life outcomes often associated with higher rates of mortality in the general population can be predicted from such sub-group perspectives. Therefore, for Aim 1, sub-group differences in speaker management strategies will be used to identify risk factors for social isolation, characteristics of depression, and characteristics of anxiety. For Aim 2, we will examine patterns in neurophysiology during speech and stuttering using ecologically valid speaking situations (speaking in front of a virtual audience, interviewing for a job), while simultaneously accounting for sub-group differences in one negative cognitive-reaction common in AWS, Repetitive Negative Thinking (RNT, i.e., Rumination). Engaging in RNT to high degrees activates right hemisphere attention areas that overlap with speech motor control, which may impact how well AWS compensate to speech motor deficits during speech. Overall impact: We will reconceptualize stuttering severity beyond surface features to account for cognitive- affective reactions when identifying broader life impact and employ this reconceptualization in studies of speech neurophysiology in ecologically valid communication. Discoveries from this research will, for the first time, directly connect knowledge of the underlying impairment (neurophysiological differences in speech and language production) and adverse impact (cognitive-affective reactions). Findings will increase the understanding of stuttering neurophysiology and lead to more effective and targeted treatment for personalized interventions to reduce health disparities and increase wellbeing in AWS.
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