V&F Chapter 2

what do we know about constitutional factors in stuttering?

• Factors _____ the person—aspects of their constitutional makeup—influence their stuttering.

• Knowing this will help you counsel people who stutter and reassure parents of children who stutter to help them understand that stuttering is not their fault

• Factors INSIDE the person—aspects of their constitutional makeup—that influence their stuttering.

• Knowing this will help you counsel people who stutter and reassure parents of children who stutter to help them understand that stuttering is not their fault

the study of how your behaviors and environment can cause changes that affect how your genes work, without changing your actual DNA sequence

epigenetics

T/F stuttering is associated with epigenetics

TRUE - stuttering is associated with epigenetics

Hereditary factors - biological background

information about the biological or constitutional factors of stuttering collected through:

• _____ studies

• _____ studies

• _____ studies

• _____

information about the biological or constitutional factors of stuttering collected through: 

• Family studies

• Twin studies

• Adoption studies

• Genes

Family studies: findings

• T/F stuttering appears to be inherited

• stuttering is best explained as interaction of several ____ and the ______, including the effect of epigenetics

• children from families with ______ stuttering are more likely to have _______ stuttering themselves - EVIDENCE OF GENETIC COMPONENT

• TRUE

• stuttering best explained as interaction of several GENES and the ENVIRONMENT, including effect of epigenetics

• children from families with PERSISTENT stuttering are more likely to have PERSISTENT stuttering themselves

• parent should be told that stuttering is often ________, not a result of bad parenting

• prognosis for ______ recovery is related to a number of recovery factors

• inherited

• natural

• Stuttering in identical and fraternal twins.

• Greater concordance among _____ twins.

• Twin studies confirm that _______ influence in stuttering is a major factor, with ________ influence being important but having a little less influence.

• Stuttering in identical and fraternal twins.

• Greater concordance among identical twins.

  • *****genetic similarities are stronger with identical twins 

• Twin studies confirm that genetic influence in stuttering is a major factor, with environmental influence being important but having a little less influence.

• Environment should be made as _______ facilitating as possible, because it decreases any negative influence of environment and will help children who are genetically predisposed to stuttering.

• Environment should be made as fluency facilitating as possible, because it decreases any negative influence of environment and will help children who are genetically predisposed to stuttering.

• Adoption studies provide evidence for both genetic and environmental factors, with the influence of _______ factors being greater.

• Adoption studies provide evidence for both genetic and environmental factors, with the influence of genetic factors being greater.

• Fact that a relative has _______ stuttering does not assure that stuttering will occur.

• Environment should be made as _____-friendly as possible.

• Fact that a relative has persistent stuttering does not assure that stuttering will occur.

• Environment should be made as fluency-friendly as possible.

  • to make stuttering less likely

T/F there are particular genes and chromosomes that are associated with stuttering

TRUE

• chromosome ___ is significantly related to stuttering

• mutations of ____ different genes on this chromosome associated with stuttering - **unexplained change in genes (NOT INHERITIED)

• mutations may be a source of _____ control difficulties and _______ effects in stuttering

• chromosome 12 is significantly related to stuttering

• mutations of three different genes on this chromosome associated with stuttering - **unexplained change in genes (NOT INHERITIED)

• mutations may be a source of motor control difficulties and emotional effects in stuttering

___%- ____% of stutterers have no family history of stuttering

40%-70%

JUST READ

• Stuttering has been associated with:

  • Brain injury before or soon after birth - anoxia, cerebral palsy

  • Premature birth - structures don't fully develop

  • Surgery

  • Head injury

  • Intellectual disability

  • Intense fear

• Clinician should explore child’s early health history and events surrounding _____ of stuttering.

• Clinician should be aware that one purpose of determining factors associated with stuttering is to relieve parents’ guilt.

• Clinician should explore child’s early health history and events surrounding onset of stuttering.

• Clinician should be aware that one purpose of determining factors associated with stuttering is to relieve parents’ guilt.

• T/F Brain function and structure influence each other so that these categories are not actually separate influences on neural activity for speech.

TRUE

T/F - there are brain function differences in people who stutter

TRUE

brain function differences in people who stutter

• Overactivity in _____ hemisphere in areas homologous to speech areas in _____ hemisphere

• Absence of activity or reduced activity in ______ areas used to monitor one’s own speech output

• High levels of abnormal activity in ________

• Supplementary motor area (SMA) more active than in controls, especially during stuttered speech. Related to overactivation in _______ ______

• Overactivity in right hemisphere in areas homologous to speech areas in left hemisphere

• Absence of activity or reduced activity in auditory areas used to monitor one’s own speech output

• High levels of abnormal activity in cerebellum

• Supplementary motor area (SMA) more active than in controls, especially during stuttered speech. Related to overactivation in basal ganglia

brain function differences in people who stutter

• _____ in both hemisphere areas used for using sensory and motor information for planning sequential movements.

• The above is related to findings of less dense white matter tracts used for connecting ______ and _______ areas.

• Underactivity in both hemisphere areas used for using sensory and motor information for planning sequential movements.

• The above is related to findings of less dense white matter tracts used for connecting planning and sensorimotor areas.

brain structure differences in people who stutter

• Reduced volume of gray matter around _____ area

• Reduced volume of gray matter in bilateral ______ lobe areas related to auditory perception

• Persistent stuttering associated with less dense ______ matter tracts connecting areas for phonological representation of sounds to motor execution areas

• Reduced volume of gray matter around Broca area

• Reduced volume of gray matter in bilateral temporal lobe areas related to auditory perception

• Persistent stuttering associated with less dense white matter tracts connecting areas for phonological representation of sounds to motor execution areas

brain structure differences in people who stutter

• The superior longitudinal fasciculus is often less dense in the ____ hemispheres of stutterers.
  
  

• This is a ______ pathway between sensory integration and motor planning areas.

• The superior longitudinal fasciculus is often less dense in the left hemispheres of stutterers.
  
  

• This is a bidirectional pathway between sensory integration and motor planning areas.

brain structure differences in people who stutter

• After therapy, ____-brain overactivations are reduced; ____-brain speech, language, and auditory areas are more activated.

T/F - Two years after therapy, some right-brain overactivation has returned.

• After therapy, right-brain overactivations are reduced; left-brain speech, language, and auditory areas are more activated.

• TRUE - Two years after therapy, some right-brain overactivation has returned. - clinical application: stutterers may need to return to therapy

• A number of neuroscientists have developed models of stuttering based on the notion of ____ _____ circuit dysfunction.

basal ganglia

• The _____ _____ may play an important role in stuttering in the cortico-basal ganglia-thalamocortical loop.

• This loop provides timing signals to the ______ motor area (SMA) of the cortex to initiate motor programs for speech.

• The basal ganglia may play an important role in stuttering in the cortico-basal ganglia-thalamocortical loop.
  
  

• This loop provides timing signals to the supplementary motor area (SMA) of the cortex to initiate motor programs for speech.

brain structure differences in people who stutter

• Widespread _____ matter connectivity deficits in children who stutter (in left-hemisphere areas linking premotor, motor, and auditory systems).

• These deficits also affected _______ and cortical-subcortical communications.

• Resting brain scans showed widespread anomalies in connections between resting networks and those associated with speech motor control, a______, executive function, p______, and emotion.

• Widespread white matter connectivity deficits in children who stutter (in left-hemisphere areas linking premotor, motor, and auditory systems).

• These deficits also affected interhemispheric and cortical-subcortical communications.
  
  

• Resting brain scans showed widespread anomalies in connections between resting networks and those associated with speech motor control, attention, executive function, perception, and emotion.

T/F - Clear evidence that differences are seen in children, not just in adults who have been stuttering for years.

TRUE

• Lack of myelination in white matter tracts suggests potential for interference from “noise” from _____ and _______ overload.

• Lack of myelination in white matter tracts suggests potential for interference from “noise” from emotion and language overload.

JUST READ

• poorly connected areas in the brain, couples with the vast changes that the brain undergoes during development explain why stuttering is so variable and often co-occurs with other disorders.

• Evidence that treatment changes ______ function
  
  

• May suggest that treatments restore effective sensory-motor control of speech
  
  

• Research needed on brain changes that accompany effective versus ineffective treatments

neurological