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Finding Their Voice

Translational Health

Nearly 68 million people worldwide stutter. Stuttering can turn something as simple as a conversation or job interview into a nightmarish experience for a person dealing with the disorder. Dr. Farzan Irani of the Texas State Department of Communication Disorders — along with a multi-institutional team of researchers, students and professionals — has spent his career developing intervention programs for people who stutter to help them improve fluency and, more importantly, not allow stuttering to affect their life choices or opportunities.

head outline Illustration with a maze and a "talking" bubble coming out of the heads mouth.

“It is important to note that we all experience moments of disfluency — when we’re anxious, or distracted, or unsure of what we want to say,” explains Irani. “This is fundamentally different from stuttering, and research over the last two decades has shown this more and more.” Stuttering used to be thought of as a psychological disorder causing an individual to be afraid of speaking. However, it is now known that stuttering is neurological in nature and comes from anomalous communication between the speech centers in the brain. This understanding led to the research that Irani is currently pursuing as part of a larger multi-institutional team of researchers under a National Institutes of Health grant. The team is developing a brain-computer interface which will help researchers identify patterns of brain activity before a person stutters. The goal is to develop new, effective practices for what Dr. Irani calls “mental recalibration”: training the brain to follow pathways that promote fluency and avoid those that result in stuttering.

This is fundamentally different from stuttering, and research over the last two decades has shown this more and more.

Dr. farzan Irani

“It is important to note that we all experience moments of disfluency — when we’re anxious, or distracted, or unsure of what we want to say,” explains Irani. “This is fundamentally different from stuttering, and research over the last two decades has shown this more and more.” Stuttering used to be thought of as a psychological disorder causing an individual to be afraid of speaking. However, it is now known that stuttering is neurological in nature and comes from anomalous communication between the speech centers in the brain. This understanding led to the research that Irani is currently pursuing as part of a larger multi-institutional team of researchers under a National Institutes of Health grant. The team is developing a brain-computer interface which will help researchers identify patterns of brain activity before a person stutters. The goal is to develop new, effective practices for what Dr. Irani calls “mental recalibration”: training the brain to follow pathways that promote fluency and avoid those that result in stuttering.

Irani’s efforts are currently focused on identifying moments of true stuttering in speech, as opposed to normal hesitation or misspeaking. To get a baseline sense of each subject’s stuttering severity, he listens to and transcribes video recordings of each subject reading a book passage and having a conversation. For the experimental procedure, subjects read nonsense phrases that are presented on a screen for only a second, in order to trigger a stuttering episode. The subject’s brain activity is monitored via electroencephalography (EEG) throughout the process, so that when Irani identifies a moment of fluency or stuttering, the corresponding brain activity can be categorized and later reviewed. The team is working to create a predictive model that can identify brain activity before someone stutters with at least 90 percent accuracy. Irani says they are close to achieving this goal, with current models able to predict stuttering 85 percent of the time.

68 million people live with stuttering worldwide.

Long-term, the team hopes to incorporate the tools developed in this study into existing interventions. Every summer, Irani hosts the Comprehensive Stuttering Therapy Program (CSTP) — an intensive two-week program aimed at effective long-term management of stuttering. As he describes it, “the goal is not just that a person will take the two-week program and leave fluent, but rather to increase confidence in their speech to the point that they do not have to constantly think about how they are talking.” Hopefully techniques developed under the brain-computer interface study, in conjunction with techniques already employed at the CSTP, will help reduce stuttering severity and improve long-term treatment outcomes by incorporating these neurofeedback “brain training” practices. However, Irani reminds us that this work is on the cutting-edge of both new technologies and stuttering therapy and is “so novel that we don’t yet know where our results may take us.”

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