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156 JCPSLP Volume 14, Number 3 2012 Journal of Clinical Practice in Speech-Language Pathology
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!
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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.
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).
Correspondence to:
Libby Smith
phone: +61 (0)3 9936 6588
email: