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

Trial Summary

What is the purpose of this trial?

This trial involves children listening to rhythms and tapping their fingers to see if there are differences between those who stutter and those who do not.

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 data supports the effectiveness of the treatment Rhythm discrimination for stuttering?

Research suggests that people who stutter may have difficulty with rhythm perception, and synchronizing speech with an external rhythm, like a metronome, can help reduce stuttering. This indicates that improving rhythm perception might be beneficial for those who stutter. ^{1 2 3 4 5}

Is rhythm perception training safe for humans?

The research articles provided do not contain specific safety data for rhythm perception training in humans. However, they do not report any adverse effects related to the use of rhythmic pacing or rhythm perception in the context of stuttering, suggesting it may be generally safe. ^{1 3 6 7 8}

How does the Rhythm discrimination treatment for stuttering differ from other treatments?

Rhythm discrimination treatment for stuttering is unique because it focuses on improving the ability to perceive and synchronize with rhythmic patterns, which can help individuals who stutter by enhancing their internal timing for speech. This approach is different from other treatments as it specifically targets the rhythm perception deficit found in people who stutter, potentially activating compensatory timing systems in the brain to improve fluency. ^{1 4 7 9 10}

Research Team

Soo-Eun Chang, PhD

Principal Investigator

University of Michigan

Eligibility Criteria

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.

My child speaks English primarily and does not stutter.

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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]

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]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Evidence for a rhythm perception deficit in children who stutter. [2019]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Electrophysiological evidence for a general auditory prediction deficit in adults who stutter. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Abnormal speech sound representation in persistent developmental stuttering. [2006]

4. United States pubmed.ncbi.nlm.nih.gov

Auditory evoked fields to vocalization during passive listening and active generation in adults who stutter. [2010]

5. Brazil pubmed.ncbi.nlm.nih.gov

Research about suppression effect and auditory processing in individuals who stutter. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

The Relationship Between Auditory-Motor Integration, Interoceptive Awareness, and Self-Reported Stuttering Severity. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

The Neural Circuitry Underlying the "Rhythm Effect" in Stuttering. [2022]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Visuoperceptual and visuomotor deficits in developmental stutterers: an exploratory study. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of noise and rhythmic stimulation on the speech of stutterers. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Adults who stutter and metronome synchronization: evidence for a nonspeech timing deficit. [2021]