How Stuttering Develops: The Multifactorial Dynamic Pathways Theory
Publication: Journal of Speech, Language, and Hearing Research
Volume 60, Number 9
Pages 2483-2505
Abstract
Purpose
We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory.
Method
We review evidence related to how stuttering develops, including genetic/epigenetic factors; motor, linguistic, and emotional features; and advances in neuroimaging studies. We update evidence for our earlier claim: Although stuttering ultimately reflects impairment in speech sensorimotor processes, its course over the life span is strongly conditioned by linguistic and emotional factors.
Results
Our current account places primary emphasis on the dynamic developmental context in which stuttering emerges and follows its course during the preschool years. Rapid changes in many neurobehavioral systems are ongoing, and critical interactions among these systems likely play a major role in determining persistence of or recovery from stuttering.
Conclusion
Stuttering, or childhood onset fluency disorder (Diagnostic and Statistical Manual of Mental Disorders, 5th edition; American Psychiatric Association [APA], 2013), is a neurodevelopmental disorder that begins when neural networks supporting speech, language, and emotional functions are rapidly developing. The multifactorial dynamic pathways theory motivates experimental and clinical work to determine the specific factors that contribute to each child's pathway to the diagnosis of stuttering and those most likely to promote recovery.
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Information & Authors
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Published In
Journal of Speech, Language, and Hearing Research
Volume 60 • Number 9 • September 2017
Pages: 2483-2505
PubMed: 28837728
Copyright
Copyright © 2017 American Speech-Language-Hearing Association.
History
- Received: Aug 30, 2016
- Revised: Feb 21, 2017
- Accepted: Apr 19, 2017
- Published in issue: Sep 18, 2017
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