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Stuttering: Our Current Knowledge, Research Opportunities, and Ways to Address Critical Gaps.
Our understanding of the neurobiological bases of stuttering remains limited, hampering development of effective treatments that are informed by basic science. Stuttering affects more than 5% of all preschool-age children and remains chronic in approximately 1% of adults worldwide. As a condition that affects a most fundamental human ability to engage in fluid and spontaneous verbal communication, stuttering can have substantial psychosocial, occupational, and educational impacts on those who are affected. This article summarizes invited talks and breakout sessions that were held in June 2023 as part of a 2-day workshop sponsored by the US National Institute on Deafness and Other Communication Disorders. The workshop encompassed topics including neurobiology, genetics, speech motor control, cognitive, social, and emotional impacts, and intervention. Updates on current research in these areas were summarized by each speaker, and critical gaps and priorities for future research were raised, and then discussed by participants. Research talks were followed by smaller, moderated breakout sessions intended to elicit diverse perspectives, including on the matter of defining therapeutic targets for stuttering. A major concern that emerged following participant discussion was whether priorities for treatment in older children and adults should focus on targeting core speech symptoms of stuttering, or on embracing effective communication regardless of whether the speaker exhibits overt stuttering. This article concludes with accumulated convergent points endorsed by most attendees on research and clinical priorities that may lead to breakthroughs with substantial potential to contribute to bettering the lives of those living with this complex speech disorder.
A feasibility study of a preventative, transdiagnostic intervention for mental health problems in adolescence: building resilience through socioemotional training (ReSET).
BACKGROUND: Adolescence is a developmental period during which an estimated 75% of mental health problems emerge (Solmi et al. in Mol Psychiat 27:281-295, 2022). This paper reports a feasibility study of a novel indicated, preventative, transdiagnostic, school-based intervention: Building Resilience Through Socioemotional Training (ReSET). The intervention addresses two domains thought to be causally related to mental health problems during adolescence: social relationships and emotion processing. Social relationships were targeted using principles from interpersonal psychotherapy, while emotion processing was targeted using cognitive-emotional training focused on three areas of emotion processing: Emotion perception, emotion regulation and interoception. The aims of this feasibility study were to (i) assess the acceptability of integrating group-based psychotherapy with individual cognitive-emotional training, (ii) evaluate the feasibility of our recruitment measures, and (iii) assess the feasibility of delivering our research measures. METHODS: The feasibility study involved 41 adolescents, aged 12-14, who were randomly assigned to receive the ReSET intervention or their school's usual mental health and wellbeing provision. RESULTS: Qualitative data from intervention participants suggested the programme was experienced as a cohesive intervention, with participants able to draw on a combination of skills. Further, the cognitive-training tasks were received positively (with the exception of the interoception training task). The recruitment and research measures were successfully delivered in the school-based setting, with 97.5% retention of participants from baseline to post-intervention assessment. Qualitative data was overwhelmingly positive regarding the benefits to participants who had completed the intervention. Moreover, there was only limited data missingness. CONCLUSIONS: We conclude that a trial of the ReSET intervention in a school setting is feasible. We discuss the implications of the feasibility study with regard to optimising school-based interventions and adaptations made in preparation for a full-scale randomised controlled trial, now underway.
Disentangling the Component Processes in Complex Planning Impairments Following Ventromedial Prefrontal Lesions.
Damage to the ventromedial prefrontal cortex (vmPFC) in humans disrupts planning abilities in naturalistic settings. However, it is unknown which components of planning are affected in these patients, including selecting the relevant information, simulating future states, or evaluating between these states. To address this question, we leveraged computational paradigms to investigate the role of vmPFC in planning, using the board game task "Four-in-a-Row" (18 lesion patients, 9 female; 30 healthy control participants, 16 female) and the simpler "Two-Step" task measuring model-based reasoning (49 lesion patients, 27 female; 20 healthy control participants, 13 female). Damage to vmPFC disrupted performance in Four-in-a-Row compared with both control lesion patients and healthy age-matched controls. We leveraged a computational framework to assess different component processes of planning in Four-in-a-Row and found that impairments following vmPFC damage included shallower planning depth and a tendency to overlook game-relevant features. In the "Two-Step" task, which involves binary choices across a short future horizon, we found little evidence of planning in all groups and no behavioral differences between groups. Complex yet computationally tractable tasks such as "Four-in-a-Row" offer novel opportunities for characterizing neuropsychological planning impairments, which in vmPFC patients we find are associated with oversights and reduced planning depth.
Craving what you imagine: How sensory mental imagery relates to trait food craving and BMI.
Mental imagery (MI), particularly visual imagery, is thought to play a key role in inducing food cravings, yet its relationship with trait food craving and adiposity remains underexplored. This study investigated how MI for multiple senses is related to the individual food craving trait and BMI. Experiment 1, conducted with a cohort of 291 individuals, used a partial Plymouth Sensory Imagery Questionnaire (PSI-Q) and the Food Craving Inventory. Experiment 2 expanded on this with a large sample (n = 1371) collected across NZ, the United Kingdom, and the United States, incorporating a full PSI-Q with an additional food dimension, the Spontaneous Use of Imagery Scale, as well as the Food Craving Questionnaire-Trait. Across both studies, weak positive correlations emerged between the vividness of olfactory MI scores and trait food craving. In Experiment 2, the vividness scores associated with Smell, Taste, Food, Sensation, and Feel were weakly correlated with the trait food craving measure. Interestingly, an individual's spontaneous use of visual MI, measured with the Spontaneous Use of Imagery Scale, was indirectly linked to BMI, mediated by an individual's food craving trait. These findings provide novel insights into the role of sensory MI in habitual food cravings and adiposity, while at the same time highlighting methodological gaps in current approaches to measuring individual sensory MI.
Understanding disrupted motivation in Parkinson's disease through a value-based decision-making lens
Neurobehavioural disturbances such as loss of motivation have profound effects on the lives of many people living with Parkinson's disease (PD), as well as other brain disorders. The field of decision-making neuroscience, underpinned by a plethora of work across species, provides an important framework within which to investigate apathy in clinical populations. Here we review how changes in a number of different processes underlying value-based decision making may lead to the common phenotype of apathy in PD. The application of computational models to probe both behaviour and neurophysiology show promise in elucidating these cognitive processes crucial for motivated behaviour. However, observations from the clinical management of PD demand an expanded view of this relationship, which we aim to delineate. Ultimately, effective treatment of apathy may depend on identifying the pattern in which decision making and related mechanisms have been disrupted in individuals living with PD.
Technology Matters: Online Support and Intervention (OSI) for child anxiety problems - an example of the journey from research to practice.
Childhood anxiety problems are prevalent and impairing, yet many children are unable to access evidence-based treatment (i.e. cognitive behavioural therapy, CBT). Digitally augmented psychological interventions represent one way to help increase access to CBT for children with mental health problems, as these interventions can substantially reduce the amount of therapist time required to deliver the intervention, as well as bringing a range of other potential advantages for therapists and families. Online Support and Intervention (OSI) is an example of a brief digitally augmented, therapist-supported, parent-led CBT intervention for child anxiety problems that is now being commissioned and delivered in child mental health services. This article outlines the journey of OSI from research to implementation into routine clinical practice and highlights key considerations for translating digitally augmented mental health interventions into routine care in child mental health services.
Animal camouflage: Sculpting with light.
The three-dimensional nanostructure of butterfly and moth wing scales produces directional reflections that are impossible with an artist's brush. Here, we compare the visual effects used by a moth that masquerades as a dead leaf with those of computer graphics.
Disrupted visual attention relates to cognitive development in infants with Neurofibromatosis Type 1.
BACKGROUND: Neurofibromatosis Type 1 is a genetic condition diagnosed in infancy that substantially increases the likelihood of a child experiencing cognitive and developmental difficulties, including Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Children with NF1 show clear differences in attention, but whether these differences emerge in early development and how they relate to broader difficulties with cognitive and learning skills is unclear. To address this question requires longitudinal prospective studies from infancy, where the relation between domains of visual attention (including exogenous and endogenous shifting) and cognitive development can be mapped over time. METHODS: We report data from 28 infants with NF1 tested longitudinally at 5, 10 and 14 months compared to cohorts of 29 typical likelihood infants (with no history of NF1 or ASD and/or ADHD), and 123 infants with a family history of ASD and/or ADHD. We used an eyetracking battery to measure both exogenous and endogenous control of visual attention. RESULTS: Infants with NF1 demonstrated intact social orienting, but slower development of endogenous visual foraging. This slower development presented as prolonged engagement with a salient stimulus in a static display relative to typically developing infants. In terms of exogenous attention shifting, NF1 infants showed faster saccadic reaction times than typical likelihood infants. However, the NF1 group demonstrated a slower developmental improvement from 5 to 14 months of age. Individual differences in foraging and saccade times were concurrently related to visual reception abilities within the full infant cohort (NF1, typical likelihood and those with a family history of ASD/ADHD). CONCLUSIONS: Our results provide preliminary evidence that alterations in saccadic reaction time and visual foraging may contribute to learning difficulties in infants with NF1.