Rhythmic game could help stutter in children: Montreal researchers

A rhythmic game on a tablet could help children struggling with stuttering, Montreal researchers have found.

In a previous study, the same team demonstrated that the same intervention could help children with ADHD improve their attention and inhibitory control.

This time, Simone Falk, psychology professor, at the Université de Montréal and her colleagues wanted to find out whether rhythmic training could benefit children who stutter.

“Advances in neuroscience have led us to a better understanding of why people potentially stutter, and one reason is that people who stutter have a difference in the temporal management of speech,” she explained.

To perform well in the rhythmic game, the researchers explained, children must demonstrate a high degree of control in order to tap the screen only when appropriate, in accordance with the rhythm or tempo of the game.

Players tap in time with the music to construct a virtual building, with progress linked to their performance. For example, when they tap with perfect regularity for eight beats, they achieve 100 per cent accuracy, which contributes to their overall score. When the score reaches a certain threshold, a new floor is added to the virtual building. The goal is to complete construction within a set time limit.

This small “proof of concept” study was conducted with 21 French-speaking Quebec children aged nine to 12 who had a stuttering problem but no other language disorders, since this is the age at which stuttering is likely to become permanent. They were randomly asked to participate for three weeks in either the rhythmic game or a non-rhythmic control game.

The authors report that only participants who underwent training in the rhythmic game showed moderate improvements in rhythmic synchronization, interference control, oromotor performance (the mechanical functioning of the mouth), and reduction in stuttering after training.

The authors point out that similar improvements had been observed in patients with Parkinson’s disease. It is therefore possible, they say, that rhythm-based training may “strengthen the temporal framework that underlies both manual coordination and speech motor coordination.”

Almost all of the improvements correlated with the amount of training—in other words, the more the children played, the more they improved. Improvements were measured after 300 minutes of play. In addition, gains in verbal fluency were associated with improved rhythmic performance.

“This study provides preliminary evidence that rhythm-based training can improve cognitive and linguistic outcomes in preadolescents who stutter,” the study authors write.

The effect was not very large and the group was small, Falk admitted, “but the trend was the right one.” The researchers found that children who participated in the game made 24 per cent fewer errors when speaking than before.

Speaking quickly, she noted, “is an act of extreme motor coordination because there are so many muscles to move when pronouncing a single syllable.”

“It requires such fine coordination between the muscles, tongue, jaw, and movement of everything in our articulators, so it requires very precise timing,” she explained. “Stuttering stems from small inaccuracies in this timing, which seem to be innate.”

The data generated by this study are consistent “with previous findings on the same training and outcome measures provided to populations with ADHD and autism who have inhibition control disorders,” the authors write.

In the case of stuttering, they continue, “some data indicate that inhibitory control may be weaker than in people who do not stutter. Given the high number of comorbidities between stuttering and ADHD, ”it is possible that some pre-adolescent stutterers may be at risk for weaker inhibitory control.”

Consistent with this idea and previous findings with other neurodevelopmental groups, some of the participants in the rhythmic game “who had lower initial scores showed greater improvements after playing the game,” the Montreal researchers point out.

The findings of this study were published in the journal Annals of the New York Academy of Sciences.

–This report by La Presse Canadienne was translated by CityNews