Speech-motor control and interhemispheric relations in recovered and persistent stuttering.

The neurological basis of stuttering is associated with anomalies of interhemispheric relations and of the neural mechanisms of speech-motor control, specifically those involving the supplementary motor area (SMA). Stuttering typically develops through childhood and adolescence but many children will recover without formal treatment or intervention. The hypothesis that such spontaneous recovery is related to a maturation of the SMA is explored. Four experimental tasks were performed by adults whose stuttering has persisted, adults who reported having stuttered as children, and a control group of adults who reported never having stuttered. A Sequence Reproduction Finger Tapping task (Webster, 1986) and a Bimanual Crank Turning task (Preilowski, 1972) examined the functioning of the SMA, and 2 Divided Visual Field tasks examined asymmetries of hemispheric activation. The overall pattern of results for persistent stutterers compared to nonstutterers was consistent with motor-perceptual anomalies previously reported in the literature. The Bimanual Crank Turning task revealed additionally that the bimanual coordination deficits reported in adults who stutter are kinesthetically based and mediated through anterior callosal systems, including the SMA. Ex-stutterers were similar to nonstutterers in their performance of the motor control tasks, but similar to persistent stutterers in perceptual asymmetries associated with Divided Visual Field tasks. Taken together, the results from the four experimental tasks support the general hypothesis that an anomaly in interhemispheric relations and a deficit in the mechanisms of speech-motor control are each a necessary but not sufficient condition for stuttering and that recovery from childhood stuttering reflects a maturation of the mechanisms of speech-motor control.