Overview! • • • • • • • • • • • Kurt Eggers Inhibition and attention in stuttering EU symposium on Fluency Disorders Antwerp, 2014 Stuttering, temperament & rationale current research line Working hypotheses Study 1: Factorial temperament structure in CWS Study 2: Temperament dimensions in CWS Study 3: Attentional networks in CWS Study 4: Visual attentional set-shiting in CWS Study 5: Auditory attentional set-shifting in CWS Study 6: Inhibitory control in CWS (a) and AWS (b) Study 7: Exogenous/endogenous response inhibition in CWS Conclusion Q & A Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! The concept of temperament! The concept of temperament! • Rothbart et al. 2001 “constitutionally based, individual differences in reactivity " and self-regulation” individual’s relatively enduring biological make up, influenced over time by heredity, maturation, and experience • Rothbart et al. 2001 “constitutionally based, individual differences in reactivity " and self-regulation” arousability of motor, affective, and sensory response systems Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! The concept of temperament! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! The concept of temperament! • Rothbart et al. 2001 “constitutionally based, individual differences in reactivity " and self-regulation” processes that serve to modulate (increase or decrease) reactivity, including attentional focusing and inhibitory control Conceptualization! Conceptualization! Q & A! Stimulus Somatic Autonomic Cognitive Neuroendocrine Negative reactivity Positive reactivity Effort Self-regulation Conceptualization! Avoidance/Withdrawal Approach Inhibition of approach Attack Orienting attention away Orienting att. towards Working hypothesis! Self-soothing Self-stimulation Seeking comfort Seeking excitement Hypothesis 1! Hypothesis 2! Hypothesis 3! Self-regulation Adapted from Rothbart In Strelau & Angleitner, 1991 Conclusion! Q & A! 1 Rationale current study! Working hypotheses! • Available literature points to ìreactivity and îself-regulation (including attentional regulation & inhibitory control) • Published findings primarily questionnaire-based not unequivocal reflected in actual behavioral patterns? • Goal: in depth insight association temperament-stuttering -large-scale questionnaire-based study -neurocognitive measures (of self-regulation) Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 1: Factorial temperament structure in CWS ! • Instrument: Children’s Behavior Questionnaire (Rothbart et al., 2001) 18 subscales > 233 items; 7-point likert-scale • Participants: n=256 69 CWS / 146 TDC/ 41 CWVN (3;00 - 8;11y) • Criteria: -native Dutch speakers (Flanders) -free of (other) SLH, neurol./psych. problems -CWS: min. 3 % WWD and/or MWR, " min. ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations -CWVN: diagnosed by ENT-specialist Eggers et al., JSLHR, 2009 ① a. CWS and TDC are similar in terms of their overall underlying " temperament structure, as measured by a parental temperament " questionnaire; b. CWS, compared to TDC, are higher in positive and/or negative " reactivity and lower in self-regulation, as measured by a parental " temperament questionnaire. ② Attentional processes (self-regulation), as measured by cognitive " computer tasks, are less efficient in CWS compared to TDC. " ③ Inhibitory control (self-regulation), as measured by cognitive computer " tasks, is less efficient in CWS compared to TDC. Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 1: Factorial temperament structure in CWS ! Activity level Impulsivity Anger/frustration Inhibitory control Approach Low intensity pleasure Attentional focusing Perceptual sensitivity Discomfort Sadness Falling reactivity Shyness Fear Smiling/laughter Extraversion/Surgency High intensity pleasure Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 1: Factorial temperament structure in CWS ! Activity level Impulsivity Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Inhibitory control Approach Low intensity pleasure Conclusion! Q & A! Study 1: Factorial temperament structure in CWS ! Activity level Impulsivity Anger/frustration Inhibitory control Approach Low intensity pleasure Extraversion/Surgency Anger/frustration Hypothesis 3! Extraversion/Surgency Negative affect Negative affect Attentional focusing Perceptual sensitivity Attentional focusing Perceptual sensitivity Discomfort Sadness Discomfort Sadness Falling reactivity Shyness Falling reactivity Shyness Fear Smiling/laughter Fear Smiling/laughter Effortful control High intensity pleasure Conceptualization! Working hypothesis! Factor congruence coëfficients: .86-.97 TDC ≅ CWS ≅ CWVN High intensity pleasure Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! 2 Study 2: Temperament dimensions in CWS ! Study 2: Temperament dimensions in CWS ! • Instrument: Children’s Behavior Questionnaire (Rothbart et al., 2001) • Participants: n=116 58 CWS / 58 TDC (3;04 - 8;11y) matched on age (±2M) & gender • Criteria: -native Duch speakers (Flanders) -free of (other) SLH, neurol./psych. problems -CWS: min. 3 % WWD and/or MWR, " min. ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., JFD, 2010 Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 3: Attentional networks in CWS ! Study 3: Attentional networks in CWS ! • Instrument: Attention Network Test (Fan et al., 2002) • Instrument: Attention Network Test (Fan et al., 2002) • Participants: n=82 41 CWS / 41 CWNS (4;00 – 9;00y) matched on age (±3M) & gender • Criteria: -monolingual Dutch speaking children -normal articulation, language, hearing, & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -CWS: min. 3 % WWD and/or MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., JSLHR, 2012 Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 4: Visual attentional set-shifting! Study 4: Visual attentional set-shifting! • Instrument: Visual set-shifting task (De Sonneville, 2009) • Instrument: Visual set-shifting task (De Sonneville, 2009) • Participants: n=80 40 CWS / 40 CWNS (4;00 – 09;04y) matched on age (±3M) & gender • Criteria: -monolingual Dutch speaking children -normal articulation, language, hearing, & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -CWS: min. 3 % WWD and/or MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., IALP Athens, 2010 Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! 3 Study 5: Auditory attentional set-shifting! Study 5: Auditory attentional set-shifting! • Instrument: Auditory set-shifting task (De Sonneville, 2009) • Instrument: Auditory set-shifting task (De Sonneville, 2009) • Participants: n=32 16 CWS / 16 CWNS (6;04 – 09;09y) matched on age (±3M) & gender • Criteria: -monolingual Finnish speaking children -normal articulation, language, hearing, & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -CWS: min. 3 % WWD and/or MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., submitted Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 6a: Inhibitory control in CWS ! Study 6a: Inhibitory control in CWS ! • Instrument: Go/NoGo task (De Sonneville, 2009) • Instrument: Go/NoGo task (De Sonneville, 2009) • Participants: n=60 30 CWS / 30 CWNS (4;10 – 10;00y) matched on age (±3M) & gender • Criteria: -monolingual Dutch speaking children -normal articulation, language, hearing, & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -CWS: min. 3 % WWD and/or MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., JFD, 2013 Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Study 6b: Inhibitory control in AWS ! Study 7: Exogenous & endogenous RI in CWS ! • Instrument: Go/NoGo task (De Sonneville, 2009) • Instruments: Stop signal task (Verbruggen et al., 2008) Sustained attention task (De Sonneville, 2009) • Participants: n=48 24 AWS / 24 AWNS (27y ± 9M) matched on age (±11M) & gender • Criteria: -monolingual Dutch speaking -normal artic., lang., hear., & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -AWS: min. 3 % WWD-MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W • Participants: n=36 18 CWS / 18 CWNS (7;04 – 10;11y) matched on age (±3M) & gender • Criteria: -monolingual Dutch speaking children -normal articulation, language, hearing, & vision -no reported comorbidity -no sign. group differences on age, SES, IQ, language, simple RT -CWS: min. 3 % WWD and/or MWR, " ≥ ‘mild’ on SSI-3, " sample ≥ 300W from 2 free play situations Eggers et al., submitted Eggers, Logopedie, 2012 Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! 4 Study 7: Exogenous & endogenous RI in CWS ! Study 7: Exogenous & endogenous RI in CWS ! • Instruments: Stop signal task • Instruments: Sustained attention task Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conclusion! Conclusion! ① CWS are ì(N)R and îEC, as measured by CBQ. Findings seem to be corroborated by neurocognitive computerparadigms: ① CWS are ì(N)R and îEC, as measured by CBQ. " • ì(N)R and îEC plays a role in the onset, development, and maintenance of certain behavioral disorders • Possibly a moderator in stress-related situations ② Attentional processes are less efficient in CWS. ③ Inhibition is less efficient in CWS. • Possibly a moderator in conditioning processes Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conclusion! Conclusion! ② Attentional processes are less efficient in CWS. ③ Inhibition is less efficient in CWS. • Attentional orienting plays a significant role in regulating emotional reactivity & distress • Externally triggered vs. internally generated > fronto-basal ganglia circuit > link with emerging etiological models • Less efficient error detection & processing > link to psycholinguistic etiological models/CE-model • Overlap visual & temporal orienting anatomical networks > role in speech motor execution • Lesion studies: perseverative errors • Less efficient emotional regulation > ìemotional arousal in stressful situations • Resource allocation/competition based models Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! 5 Conclusion! ④ Vulnerability vs. disability hypothesis ⑤ Early childhood stuttering onset and development ⑥ Future research directions • Multimethod approach • Temperament interactions • Prospective longitudinal research Thank you for your attention. Q&A Conceptualization! Working hypothesis! Hypothesis 1! Hypothesis 2! Hypothesis 3! Conclusion! Q & A! 6
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