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Acknowledgements We want to extend our thanks to all the speech pathologists who referred their clients to the study – we couldn’t have done it without you! References Beal, D. S., Gracco, V. L., Lafaille, S. J., & De Nil, L. F. (2007). Voxel-based morphometry of auditory and speech-related cortex in stutterers. Neuroreport , 18 (12), 1257–1260. Brown, S., Ingham, R. J., Ingham, J. C., Laird, A. R., & Fox, P. T. (2005). Stuttered and fluent speech production: An ALE meta-analysis of functional neuroimaging studies. Human Brain Mapping , 25 (1), 105–117. Chang, S. E., Erickson, K. I., Ambrose, N. G., Hasegawa-Johnson, M. A., & Ludlow, C. L. (2008). Brain anatomy differences in childhood stuttering. NeuroImage , 39 (3), 1333–1344. Cykowski, M. D., Fox, P. T., Ingham, R. J., Ingham, J. C., & Robin, D. A. (2010). A study of the reproducibility and etiology of diffusion anisotropy differences in developmental stuttering: A potential role for impaired myelination. NeuroImage , 52 (4), 1495–1504. Foundas, A. L., Bollich, A. M., Corey, D. M., Hurley, M., & Heilman, K. M. (2001). Anomalous anatomy of speech- language areas in adults with persistent developmental stuttering. Neurology , 57 (2), 207–215. Fox, P. T., Ingham, R. J., Ingham, J. C., Hirsch, T. B., Downs, J. H., Martin, C., … Lancaster, J. L. (1996). A PET study of the neural systems of stuttering. Nature , 382 (6587), 158–162. Neumann, K., Euler, H. A., von Gudenberg, A. W., Giraud, A. L., Lanfermann, H., Gall, V., & Preibisch, C. (2003). The nature and treatment of stuttering as revealed by fMRI: A within- and between-group comparison. Journal of Fluency Disorders , 28 (4), 381–410. Preibisch, C., Neumann, K., Raab, P., Euler, H. A., von Gudenberg, A. W., Lanfermann, H., & Giraud, A. L. (2003). Evidence for compensation for stuttering by the right frontal operculum. NeuroImage , 20 (2), 1356–1364. Sommer, M., Koch, M. A., Paulus, W., Weiller, C., & Buchel, C. (2002). Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet , 360 (9330), 380–383. Watkins, K., Gadian, D. G., & Vargha-Khadem, F. (1999). Functional and structural brain abnormalities associated with a genetic disorder of speech and language. American Journal of Human Genetics , 65 (5), 1215–1221. Watkins, K., Smith, S. M., Davis, S., & Howell, P. (2008). Structural and functional abnormalities of the motor system in developmental stuttering. Brain , 131 , 50–59. Yakovlev, P., & Lecours, A. (1967). The myelogenetic cycles of regional maturation of the brain. In A. Minkowski: (Ed.), Regional development of the brain in early life (pp. 3–70). Oxford: Blackwell. Libby Smith is a PhD student in the Childhood Communication Research Unit at the Murdoch Childrens Research Institute and The University of Melbourne. She has a Bachelor of Arts/Bachelor of Science and a Master of Arts (Neurolinguistics).

children as young as possible in our current project, we hope to gain a better understanding of the neurological markers of stuttering present in the early years. Our research During the last three years Libby Smith (PhD student) has been working with Professor Sheena Reilly and Dr Angela Morgan from the Murdoch Childrens Research Institute at the Royal Children’s Hospital in Melbourne and Dr Alan Connelly from the Brain Research Institute to investigate brain activation and brain structure in children who stutter. The specific aims of this project are to describe differences between children who stutter and typical speakers in three areas: • brain activation during speech • brain anatomy of the speech areas • white matter fibre pathways that connect different regions involved in speech motor processing. The data collection phase of this project is now complete. Participants (15 children who stutter and a control group of 18 children with typical speech) attended two appoint­ ments. The first involved speech, language, and IQ screening to accurately determine the presence or absence of stuttering and ensure the children had no concomitant speech, language, or cognitive issues. The second appointment was the MRI scanning session where a series of functional and structural MRI images were acquired. Strengths and challenges We found that most children enjoyed having a brain scan because they could keep some pictures of their brain to take home and show their friends and they were able to bring a DVD to watch while most of the pictures were being taken. Nonetheless, scanning young children has presented us with significant challenges. It is important to make sure the children understand the task they are required to perform during the functional imaging scan. For this study, children were required to listen to short sentences through earphones, and then either listen only, or repeat the sentence out loud, according to the instructions. The children rehearsed the task using practice items outside the scanner before the session. Each picture took somewhere between 2 minutes and 8 minutes to acquire. During this time the children needed to keep their head extremely still, otherwise the images would be “blurred”. They could “have a wriggle” between pictures, but the whole session could take up to 1 hour. These factors placed limitations on the age of children who could participate. While it would have been interesting to include children from the age of 3 or 4 when they first begin to stutter, most children this young would not be able to cope with the demands of the task or to stay still for the required amount of time. In this study we included children aged between 5 and 10 years. Most children find it easier to keep still when they are watching a DVD; however, some children will have difficulty lying still regardless. Up to 25% of our data was discarded in the end due to excessive movement. What’s next We are now in the process of analysing the data and are looking forward to seeing the results. While this is a small study in neuroimaging terms, it signifies an exciting step in the quest to unlock the mysteries of the stuttering brain. We also hope the results will contribute to advancing the long-term goal of developing treatments that consider the underlying mechanisms of developmental stuttering rather than simply addressing the symptoms.

Correspondence to: Libby Smith

phone: +61 (0)3 9936 6588 email: libby.smith@mcri.edu.au

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JCPSLP Volume 14, Number 3 2012

Journal of Clinical Practice in Speech-Language Pathology