Rhythm Perception Training for Stuttering

Overseen By Soo-Eun Chang, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Neurological, Psychiatric, Hearing loss, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 3 years

500 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how rhythm perception and production differ between children who stutter and those who do not. By examining performance on rhythm tasks, researchers aim to learn more about the link between rhythm skills and brain activity related to stuttering. The trial seeks children who have stuttered and primarily speak English, as well as English-speaking children who have never stuttered. As an unphased study, this trial offers a unique opportunity for participants to contribute to groundbreaking research that could enhance the understanding of stuttering.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that rhythm discrimination is safe for children?

Research on rhythm discrimination, the focus of this study, has shown it to be generally safe and well-tolerated. No evidence links this method to harmful side effects. One study examined the relationship between rhythm skills and reading disorders, raising no safety concerns. Other research suggests that music training, including rhythm discrimination, can enhance listening skills without causing harm.

This trial is labeled "Not Applicable" in phase, indicating an early study. It aims to understand rhythm perception rather than test treatment effects. As a result, safety information might not be as detailed as in later trials. However, given the nature of rhythm-based activities, significant risks are not expected. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about rhythm discrimination training for stuttering because it offers a fresh approach to improving speech fluency. Unlike traditional speech therapy, which often focuses on speech exercises and techniques, this method aims to enhance rhythm perception, which could fundamentally help in processing speech patterns. By targeting the brain's ability to recognize and synchronize with rhythmic patterns, this approach might address the neurological aspects of stuttering more directly. This could potentially lead to more lasting improvements in speech fluency for children who stutter.

What evidence suggests that rhythm discrimination is effective for stuttering?

Research shows that understanding rhythm might help treat stuttering. Studies have found that children who stutter often struggle with tasks involving rhythm recognition, making it difficult for them to distinguish various rhythmic patterns. Another study found that these children also have weaker brain connections related to rhythm. This trial will include two groups: children who stutter and children who do not. Training to improve rhythm skills could strengthen these connections and, in turn, enhance speech fluency. While more research is needed, early findings suggest that rhythm training could be promising for helping those who stutter. ^{4 6 7 8 9}

Who Is on the Research Team?

Soo-Eun Chang, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for children who currently or previously had a stutter and speak English as their primary language. It's not suitable for kids with hearing loss, significant language/motor delays, head trauma with unconsciousness, major medical illnesses, neurological/psychiatric conditions under treatment, or certain facial/motor abnormalities.

Inclusion Criteria

I have been diagnosed with stuttering, now or in the past.

You have been diagnosed with stuttering now or in the past.

Exclusion Criteria

My child does not stutter but has hearing loss.

My child does not stutter and has no face, motor, or reflex abnormalities.

My child stutters and has physical abnormalities.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete rhythm discrimination and finger tapping experiments annually

3 years

1 visit per year (in-person)

Follow-up

Participants are monitored for performance on rhythm tasks and brain activity

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Rhythm discrimination

Trial Overview

The study is examining how well children who stutter and those who don't can perceive and produce rhythms. The goal is to understand the relationship between rhythm tasks performance and brain activity in these groups.

How Is the Trial Designed?

Group I: Children who stutter Experimental Treatment 1 Intervention

Children who stutter

Group II: Children who do not stutter Experimental Treatment 1 Intervention

Children who do not stutter

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

Adults with persistent developmental stuttering (PDS) show normal brain responses to simple tone contrasts but exhibit enhanced brain activity in response to phonetic contrasts, indicating abnormal processing of speech sounds.

This enhanced brain response correlates with the severity of speech disfluency, suggesting that the way the brain represents speech sounds may contribute to the challenges faced by individuals with stuttering.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Abnormal speech sound representation in persistent developmental stuttering. Corbera, S., Corral, MJ., Escera, C., et al.[2006]

In a study involving 33 adults (16 who stutter and 17 who do not), it was found that adults who stutter had significantly fewer speech disfluencies when speaking in sync with a rhythmic beat compared to normal speech, indicating that rhythm can help improve fluency.

Neuroimaging revealed that rhythmic speech increased connectivity in cerebellar regions associated with timing and motor control, suggesting that targeting the cerebellum could enhance therapeutic approaches for stuttering.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Neural Circuitry Underlying the "Rhythm Effect" in Stuttering. Frankford, SA., Heller Murray, ES., Masapollo, M., et al.[2022]

Adults who stutter show greater anticipation in timing tasks compared to fluent speakers, indicating a potential timing deficit that extends beyond speech to nonspeech activities.

Despite these timing differences, individuals who stutter did not struggle with adjusting their timing during tempo changes, suggesting that their synchronization issues may be more nuanced than previously thought.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adults who stutter and metronome synchronization: evidence for a nonspeech timing deficit. Sares, AG., Deroche, MLD., Shiller, DM., et al.[2021]

Using magnetoencephalography, the study found that adults who stutter show timing differences in auditory processing during speech tasks, specifically shorter M100 latencies in the right hemisphere compared to the left, while fluent speakers had similar latencies across both hemispheres.

During passive listening, adults who stutter exhibited longer latencies for auditory responses (M50 and M100) than fluent speakers, suggesting potential auditory-motor integration issues in stuttering.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory evoked fields to vocalization during passive listening and active generation in adults who stutter. Beal, DS., Cheyne, DO., Gracco, VL., et al.[2010]

Stuttering individuals exhibit atypical auditory modulation, as they do not show the expected reduction in N1 amplitude when anticipating speech or hearing their own speech, unlike nonstuttering individuals.

This study indicates that stuttering speakers may have broader difficulties with auditory predictions, not just limited to their own speech production, as evidenced by their consistent N1 amplitude responses across different conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Electrophysiological evidence for a general auditory prediction deficit in adults who stutter. Daliri, A., Max, L.[2018]

Children who stutter (n=17) demonstrated significantly poorer rhythm discrimination abilities compared to typically-developing children (n=17), indicating a potential deficit in processing rhythmic patterns.

This study provides the first evidence linking impaired rhythm perception to developmental stuttering, suggesting that difficulties in generating internal rhythms may contribute to the speech challenges faced by these children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence for a rhythm perception deficit in children who stutter. Wieland, EA., McAuley, JD., Dilley, LC., et al.[2019]

Stutterers and non-stutterers generally have similar abilities in auditory-motor integration and interoception, suggesting that these factors may not be the primary causes of stuttering.

The study found that while speech auditory-motor synchrony and interoceptive awareness are not directly related, they each correlate inversely with different aspects of stuttering severity, indicating that stuttering may arise from multiple, unrelated timing issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Relationship Between Auditory-Motor Integration, Interoceptive Awareness, and Self-Reported Stuttering Severity. Assaneo, MF., Ripollés, P., Tichenor, SE., et al.[2022]

Individuals who stutter showed a higher incidence of auditory processing disorders compared to non-stutterers, indicating that stuttering may be linked to difficulties in processing auditory information.

The study found that individuals who stutter had an abnormal suppression effect of Otoacoustic Emissions (OAEs), suggesting a deficit in the functioning of the efferent medial olivocochlear system, which is important for auditory discrimination in noisy environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Research about suppression effect and auditory processing in individuals who stutter. Arcuri, CF., Schiefer, AM., Azevedo, MF.[2022]

This study found that individuals who stutter exhibited significant non-speech deficits, particularly in visuomotor and visuoperceptual tasks, indicating that stuttering may be linked to broader neuromotor control issues.

The research revealed that stutterers had slower reaction times and impaired dynamic visual perception, suggesting that these deficits could be related to the severity of stuttering and support the idea of a neurogenic cause for the disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visuoperceptual and visuomotor deficits in developmental stutterers: an exploratory study. Jones, RD., White, AJ., Lawson, KH., et al.[2019]

Stuttering significantly decreased during both noise and rhythmic stimulation, with rhythmic stimulation showing a greater reduction in stuttering compared to noise.

The study found a correlation between decreased stuttering and increased vowel duration during both conditions, suggesting that changes in speech timing may help reduce stuttering.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of noise and rhythmic stimulation on the speech of stutterers. Brayton, ER., Conture, EG.[2019]

Citations

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC5382013/

Evidence for a rhythm perception deficit in children who stutter

Performance on the rhythm discrimination task was assessed using a signal detection analysis to distinguish between participants' ability to discriminate same ...

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S0093934X22001493

Auditory rhythm discrimination in adults who stutter

Children who stutter have shown poorer rhythm discrimination and attenuated functional connectivity in rhythm-related brain areas.

3.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC8386014/

Speech Fluency Improvement in Developmental Stuttering ...

Relation between functional connectivity and rhythm discrimination in children who do and do not stutter. Neuroimage Clin. 12, 442–450. 10.1016/j.nicl ...

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withpower.com

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Rhythm Perception Training for Stuttering

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vumc.org

vumc.org/stuttering/sites/default/files/publication_files/A%20Preliminary%20Study%20of%20Speech%20Rhythm%20Differences.pdf

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A logistic regression model using two speech rhythm measures was able to discriminate the eventual outcome of recovery versus persistence, with 80 ...

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12460677/

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First, we investigated associations between musical rhythm discrimination abilities and a history of reading disorder. A 1 SD decrease in rhythm ...

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wires.onlinelibrary.wiley.com

wires.onlinelibrary.wiley.com/doi/10.1002/wcs.1528

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Impairment of beat-based rhythm discrimination in Parkinson's disease. Cortex, 45, 54–61. https://doi.org/10.1016/j.cortex.2008.01.005.

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sciencedirect.com

sciencedirect.com/science/article/pii/S0149763422002664

Does music training enhance auditory and linguistic ...

... training changes auditory skills. We provide meta-analytic evidence that music training can enhance aspects such as rhythm, pitch, and timbre discrimination.

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games.jmir.org

games.jmir.org/2025/1/e76435

Children's Improvement After Language and Rhythm Training ...

In our study, children's scores improved on both the discrimination and the phoneme deletion tasks (P=.03 and P<.001, respectively). The ...