2 Participants Needed

Speech Sequencing Therapies for Stuttering

Recruiting at 2 trial locations
FH
BH
Overseen ByBarbara Holland
Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: Boston University Charles River Campus
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Persistent developmental stuttering affects more than three million people in the United States, and it can have profound adverse effects on quality of life. Despite its prevalence and negative impact, stuttering has resisted explanation and effective treatment, due in large part to a poor understanding of the neural processing impairments underlying the disorder. The overall goal of this study is to improve understanding of the brain mechanisms involved in speech motor planning and how these are disrupted in neurogenic speech disorders, like stuttering. The investigators will do this through an integrated combination of experiments that involve speech production, functional MRI, and non-invasive brain stimulation. The study is designed to test hypotheses regarding the brain processes involved in learning and initiating new speech sound sequences and how those processes compare in persons with persistent developmental stuttering and those with typical speech development. These processes will be studied in both adults and children. Additionally, these processes will be investigated in patients with neurodegenerative speech disorders (primary progressive aphasia) to further inform the investigators understanding of the neural mechanisms that support speech motor sequence learning. Together these experiments will result in an improved account of the brain mechanisms underlying speech production in fluent speakers and individuals who stutter, thereby paving the way for the development of new therapies and technologies for addressing this disorder.

Do I need to stop my current medications to join the trial?

If you have primary progressive aphasia (PPA), you cannot participate if you are taking medications that affect speech or language. For others, the protocol does not specify if you need to stop taking your current medications.

How is the Speech Sequencing Therapy for Stuttering different from other treatments?

This treatment is unique because it focuses on practicing non-native phoneme combinations and multisyllabic nonwords, which helps improve speech fluency by enhancing the brain's ability to store and recall speech sequences as cohesive chunks, reducing memory load and improving motor performance.12345

What data supports the effectiveness of the treatment Speech Sequencing Therapies for Stuttering?

Research shows that fluency training, which is part of speech therapy for stuttering, significantly reduces stuttering frequency and improves speaking rate and communication attitudes. Additionally, modified stuttering therapy programs focusing on self-therapy and specific target responses have led to greater improvements in speech fluency.46789

Who Is on the Research Team?

FH

Frank H Guenther, PhD

Principal Investigator

Boston University

SC

Soo-Eun Chang, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for native American English speakers with limited second language exposure. It includes children who pass a hearing test, adults without neurological issues (except stuttering), and those diagnosed with primary progressive aphasia by MGH-FTD. Excluded are individuals with contraindications to MRI or tDCS, certain medication use in PPA patients, severe cognitive impairment, and outside the age range for child participants.

Inclusion Criteria

My hearing is good at specific test frequencies.
I am healthy with no history of brain, speech, or hearing problems, except for stuttering.
Only native speakers of American English with limited exposure to a second language will be recruited
See 8 more

Exclusion Criteria

I am not on medications that could affect my speech or language.
You cannot participate in MRI studies if you have had seizures, severe claustrophobia, metal implants in your body, or if you are pregnant.
You cannot participate if you have metal implants in your head, certain medical devices in your body, a history of seizures, significant scalp injuries, or if you are pregnant.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants undergo training sessions to learn novel speech sequences using various methods such as tDCS and fMRI

2-3 days
6-8 training sessions

Intervention

Functional MRI and other assessments are conducted to measure brain activity and speech performance

1 day
1 fMRI session

Follow-up

Participants are monitored for changes in speech performance and brain activity post-intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Anodal tDCS
  • Learning of non-native phoneme combinations: 1 training session
  • Learning of non-native phoneme combinations: 6 training sessions
  • Learning of non-native phoneme combinations: 8 training sessions
  • Learning of novel multisyllabic nonwords
  • Sham tDCS
Trial Overview The study investigates brain mechanisms in speech motor planning through experiments involving speech production tasks, functional MRI scans, and non-invasive brain stimulation like sham and anodal tDCS. Participants will learn new phoneme combinations or multisyllabic nonwords across multiple sessions to help understand these processes in people with stuttering or neurodegenerative speech disorders.
How Is the Trial Designed?
7Treatment groups
Experimental Treatment
Placebo Group
Group I: Sub-syllabic learning in PPAExperimental Treatment1 Intervention
Group II: Sub-syllabic learning and fMRIExperimental Treatment1 Intervention
Group III: Sub-syllabic learning and anodal tDCS of inferior frontal sulcusExperimental Treatment2 Interventions
Group IV: Sub-syllabic learning and anodal tDCS of cerebellumExperimental Treatment2 Interventions
Group V: Multisyllabic learning in childrenExperimental Treatment1 Intervention
Group VI: Multisyllabic learning and fMRI in adultsExperimental Treatment1 Intervention
Group VII: Sub-syllabic learning and sham tDCSPlacebo Group2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials
125
Recruited
14,100+

University of Michigan

Collaborator

Trials
1,891
Recruited
6,458,000+

Massachusetts General Hospital

Collaborator

Trials
3,066
Recruited
13,430,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials
377
Recruited
190,000+

Published Research Related to This Trial

Both intensive (16 sessions over 4 days) and spaced (2 sessions per week for 8 weeks) fluency training formats significantly reduced stuttering frequency and improved speaking rate and communication attitudes in 20 adult and adolescent participants.
Both treatment formats were equally effective, but the maintenance of improvements varied across different speaking situations, indicating that tailored training may be necessary for specific contexts.
Relative efficacy of intensive and spaced behavioral treatment of stuttering.James, JE., Ricciardelli, LA., Hunter, CE., et al.[2017]
Fluency shaping (FS) and stuttering management (SM) are both evidence-based treatments for developmental stuttering in adults, with FS focusing on treatment outcomes and SM on understanding the nature of stuttering events.
While neither treatment guarantees uniform success, strategies like self-management and modeling are effective in both approaches and should be further studied for their efficacy, potentially using cognitive behavior theory as a framework.
Evidence-based treatment and stuttering--historical perspective.Prins, D., Ingham, RJ.[2022]
Nonspeech oral motor treatments (NSOMTs) are methods aimed at improving oral muscle function in children with developmental speech sound disorders, but their effectiveness is highly questionable.
Current research does not provide substantial evidence to support the use of NSOMTs as effective interventions for these speech disorders, raising concerns about their theoretical basis and clinical application.
Nonspeech oral motor treatment issues related to children with developmental speech sound disorders.Ruscello, DM.[2008]

Citations

Relative efficacy of intensive and spaced behavioral treatment of stuttering. [2017]
Evidence-based treatment and stuttering--historical perspective. [2022]
Nonspeech oral motor treatment issues related to children with developmental speech sound disorders. [2008]
[Treatment outcome study of the stuttering therapy summer camp 2000 for children and adolescents]. [2006]
Stutterers' perceptions of therapy improvement and of posttherapy regression: effects of certain program modifications. [2019]
Speech and nonspeech sequence skill learning in adults who stutter. [2015]
Chunking of phonological units in speech sequencing. [2020]
Measurement of trained speech patterns in stuttering: interjudge and intrajudge agreement of experts by means of modified time-interval analysis. [2013]
Practice and retention of nonwords in adults who stutter. [2021]
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