Characteristics of Attentional Focus of Movement among Adults who Stutter
Main Article Content
Abstract
Certain conditions are known to eliminate stuttering immediately. These conditions are referred to as fluency-inducing conditions, and they infer abnormalities of attentional characteristics among people who stutter. The aims of this study were to elucidate how the motor performance of stutterers is influenced by attentional foci: external focus of attention and internal focus of attention. A typing task involving sequential key pressing was conducted under the external focus and internal focus conditions among 13 adults who stutter and 12 matched control adults who do not stutter. Typing accuracy and typing speed were analyzed. The results revealed that the typing speed was significantly lower under the internal focus condition than the external focus condition in both groups, indicating that internal focus reduces the efficiency of finger movement compared to external focus. Moreover, for adults who stutter, typing accuracy also decreased significantly under the internal focus condition. It is speculated that adults who stutter are more vulnerable to disruptions in motor control under internal focus conditions than adults who do not stutter. The clinical implications of these findings are discussed.
Keywords:
stuttering, focus of attention, finger movement, motor performance
Article Details
How to Cite
MURASE, Shinobu.
Characteristics of Attentional Focus of Movement among Adults who Stutter.
Medical Research Archives, [S.l.], v. 12, n. 7, july 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5627>. Date accessed: 30 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i7.5627.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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https://doi.org/10.4992/jjpsy.85.13235
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https://doi.org/10.3758/s13423-015-0999-9
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19. Rossettini, G, Testa, M., Vicentini, M., & Manganotti, P. (2017). The effect of different attentional focus instructions during finger movement tasks in healthy subjects: An exploratory study (20147). Biomed Re-search International: e2946465:2946465. https://doi.org/10.1155/2017/2946465
20. Heitz, R. P. (2014). The speed-accuracy tradeoff: history, physiology, methodology, and behav-ior. Frontiers in neuroscience, 8, 86875. https://doi.org/10.3389/fnins.2014.00150
21. Zentgraf, K., Lorey, B., Bischoff, M., Zimmermann, K., Stark, R., & Munzert, J. (2009). Neural correlates of attentional focusing during finger movements: A fMRI study. Journal of Motor Behavior, 41(6), 535–541. https://doi.org/10.3200/35-08-091
22. Zimmermann, K. M., Bischoff, M., Lorey, B., Stark, R., Munzert, J., & Zentgraf, K. (2012). Neural correlates of switching attentional focus during finger move¬ments: an fMRI study. Frontiers in psychology, 3, 555. https://doi.org/10.3389/fpsyg.2012.00555
23. Raisbeck, L. D., Diekfuss, J. A., Grooms, D. R., & Schmitz, R. (2020). The effects of attentional focus on brain function during a gross motor task. Journal of Sport Rehabilitation, 29, 441–447
https://doi.org/10.1123/jsr.2018-0026
24. Sakurada, T., Yoshida, M., & Nagai, K. (2022). Indi¬vidual optimal attentional strategy in motor learning tasks characterized by steady-state somatosensory and visual evoked potentials. Frontiers in Human Neuroscience, 15, 784292. https://doi.org/10.3389/fnhum.2021.784292
25. Smits-Bandstra, S. De Nil, L., & Rochon, E. (2006). The transition to increased automaticity during fin-ger sequence learning in adult males who stutter. Journal of Fluency Disorders, 31(1), 22–40.
https://doi.org/10.1016/j.jfludis.2005.11.004
26. Smits-Bandstra, S., & De Nil, L. F. (2007). Sequence skill learning in persons who stutter: Implications for cortico-striato-thalamo-cortical dysfunction. Journal of Fluency Disorders, 32(4), 251–278.
https://doi.org/10.1016/j.jfludis.2007.06.001
27. Kim, K. S., Daliri, A., Flanagan, J. R., & Max, L. (2020). Dissociated development of speech and limb sensorimotor learning in stuttering: Speech au-ditory-motor learning is impaired in both children and adults who stutter. Neuroscience, 451, 1–21. https://doi.org/10.1016/j.neuroscience.2020.10.014
28. Sares, A. G., Deroche, M. L., Shiller, D. M., & Gracco, V. L. (2018). Timing variability of sensorimotor inte-gration during vocalization in individuals who stut-ter. Scientific Reports, 8(1), 16340.
https://doi.org/10.1038/s41598-018-34517-1
29. Cai, S., Beal, D. S., Ghosh, S. S., Tiede, M. K., Guen¬ther, F. H., & Perkell, J. S. (2012). Weak responses to auditory feedback perturbation during articula¬tion in persons who stutter: evidence for abnormal auditory-motor transformation. PloS one, 7(7), e41830.
https://doi.org/10.1371/journal.pone.0041830
30. Cai, S., Beal, D. S., Ghosh, S. S., Guenther, F. H., & Perkell, J. S. (2014). Impaired timing adjustments in response to time-varying auditory perturbation dur¬ing connected speech production in persons who stut¬ter. Brain and language, 129, 24-29. https://doi.org/10.1016/j.bandl.2014.01.002
31. Kim, K. S., Daliri, A., Flanagan, J. R., & Max, L. (2020). Dissociated development of speech and limb sensorimotor learning in stuttering: Speech au-ditory-motor learning is impaired in both children and adults who stutter. Neuroscience, 451, 1-21. https://doi.org/10.1016/j.neuroscience.2020.10.014
32. Tanaka, M., Ohyagi, Y., Kawajiri, M., Taniwaki, T., Tobimatsu, S., Furuya, H., & Kira, J. (2005). A patient with focal dystonia induced by golf and presenting a decrease in activity of cerebral motor cortex on task. Rinsho Shinkeigaku=Clinical Neurology, 45(4), 304-307.
https://europepmc.org/article/med/15912799
33. Kadota, H., Nakajima, Y., Miyazaki, M., Sekiguchi, H., Kohno, Y., Amako, M., & Sakai, N. (2010). An fMRI study of musicians with focal dystonia during tapping tasks. Journal of neurology, 257, 1092-1098.
https://doi.org/10.1007/s00415-010-5468-9
34. Chen, M., Summers, R.L.S., Prudente, C.N., Goding, G.S., Samargia-Grivette, S., Ludlow, C.L., Kimberley, T.J.（2020）Transcranial magnetic stimulation and functional magnet resonance imaging evaluation of adductor spasmodic dysphonia during phonation. Brain Stimulation, 13 (3), 908-915.
https://doi.org/10.1016/j.brs.2020.03.003
35. Parr, J. V., Gallicchio, G., Canales-Johnson, A., Uiga, L., & Wood, G. (2023). Cortical, muscular, and ki-netic activity underpinning attentional focus strate-gies during visuomotor control. Psychophysiology, 60(6), e14249.
https://doi.org/10.1111/psyp.14249
36. Lohse, K. R., Sherwood, D. E., & Healy, A. F. (2011). Neuromuscular effects of shifting the focus of atten-tion in a simple force production task. Journal of Mo¬tor Behavior, 43(2), 173–184. https://doi.org/10.1080/00222895.2011.555436
37. Lohse, K. R., & Sherwood, D. E. (2012). Thinking about muscles: The neuromuscular effects of atten-tional focus on accuracy and fatigue. Acta Psycho-logica, 140(3), 236–245. https://doi.org/10.1016/j.actpsy.2012.05.009
38. Lisman, A. L., & Sadagopan, N. (2013). Focus of at¬tention and speech motor performance. Journal of Communication Disorders, 46(3), 281-293. https://doi.org/10.1016/j.jcomdis.2013.02.002
https://doi.org/10.1016/j.jfludis.2020.105766
2. Kohmäscher, A., Primaßin, A., Heiler, S., Avelar, P. D. C., Franken, M. C., & Heim, S. (2023). Effectiveness of stuttering modification treatment in school-age children who stutter: A randomized clinical trial. Journal. of Speech, Language, and Hearing Research, 66(11), 4191–4205.
https://doi.org/10.1044/2023_JSLHR-23-00224
3. Tasko, S. M., McClean, M. D., & Runyan, C. M. (2007). Speech motor correlates of treatment-re-lated changes in stuttering severity and speech nat-uralness. Journal of Communication Disorders, 40(1), 42–65.
https://dx.doi.org/10.1016/j.jcomdis.2006.04.002
4. Bloodstein, O., Ratner, N. B., & Brundage, S. B. (2021). A handbook on stuttering. Plural Publishing.
5. Hesse, T. (2022). Overview of conditions that imme-diately reduce stuttering and a unifying account for their effect. Preprints 2022, 2022070132. https://doi.org/10.20944/pre-prints202207.0132.v1
6. Wulf, G., Höß, M., & Prinz, W. (1998). Instructions for motor learning: Differential effects of internal versus external focus of attention. Journal of Motor Behavior, 30(2), 169–179.
https://doi.org/10.1080/00222899809601334
7. Wulf, G. (2013). Attentional focus and motor learn¬ing: A review of 15 years. International Review of Sport and Exercise Psychology, 6(1), 77–104. https://doi.org/10.1080/1750984X.2012.723728
8. McNevin, N. H., Shea, C. H., & Wulf, G. (2003). In-creasing the distance of an external focus of atten-tion enhances learning. Psychological Research, 67, 22–29. https://doi.org/10.1007/s00426-002-0093-6
9. Rong-Na, A., Mori, K., & Sakai, N. (2015). Latency analysis of speech shadowing reveals processing differences in Japanese adults who do and do not stutter. Japan Journal of Logopedics and Phoniatrics, 56(4), 326–334. https://doi.org/10.5112/jjlp.56.326
10. Ozawa E., Hara Y., Suzuki N., et al. (2013). Stand-ardized test for stuttering second edition. Tokyo: Gakuensha
11. Okubo, M., Suzuki, H., & Nicholls, M. E. (2014). A Japanese version of the FLANDERS handedness questionnaire. Shinrigaku Kenkyu: Japanese Journal of Psychology, 85(5), 474–481.
https://doi.org/10.4992/jjpsy.85.13235
12. Wulf, G., Lauterbach, B., & Toole, T. (1999). The learning advantages of an external focus of atten-tion in golf. Research quarterly for exercise and sport, 70(2), 120-126. https://doi.org/10.1080/02701367.1999.10608029
13. Wulf, G., & Prinz, W. (2001). Directing attention to movement effects enhances learning: A re-view. Psychonomic bulletin & review, 8(4), 648-660. https://doi.org/10.3758/BF03196201
14. Wulf, G., & Lewthwaite, R. (2016). Optimizing per¬formance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learn¬ing. Psychonomic bulletin & review, 23, 1382-1414.
https://doi.org/10.3758/s13423-015-0999-9
15. Pompa, D., Carson, H. J., Beato, M., di Fronso, S., & Bertollo, M. (2024). Attentional focus effects on lower-limb muscular strength in athletes: A system-atic review. Journal of Strength & Conditioning Re-search, 38(2), 419–434. https://doi.org/10.1519/JSC.0000000000004714
16. Schücker, L., Hagemann, N., Strauss, B., & Völker, K. (2009). The effect of attentional focus on running economy. Journal of sports sciences, 27(12), 1241-1248. https://doi.org/10.1080/02640410903150467
17. Ziv, G., Meckel, Y., Lidor, R., & Rotstein, A. (2012). The effects of external and internal focus of atten-tion on physiological responses during run-ning. Journal of Human Sport and Exercise, 7(3), 608-616. https://www.redalyc.org/pdf/3010/301025319001.pdf
18. Skammer, S., Halvorson, J., & Becker, J. (2023). Us-ing an external focus of attention for gait retraining in runners: A case report. Physiotherapy Theory and Practice, 39(5), 1083-1094. https://doi.org/10.1080/09593985.2022.2035032
19. Rossettini, G, Testa, M., Vicentini, M., & Manganotti, P. (2017). The effect of different attentional focus instructions during finger movement tasks in healthy subjects: An exploratory study (20147). Biomed Re-search International: e2946465:2946465. https://doi.org/10.1155/2017/2946465
20. Heitz, R. P. (2014). The speed-accuracy tradeoff: history, physiology, methodology, and behav-ior. Frontiers in neuroscience, 8, 86875. https://doi.org/10.3389/fnins.2014.00150
21. Zentgraf, K., Lorey, B., Bischoff, M., Zimmermann, K., Stark, R., & Munzert, J. (2009). Neural correlates of attentional focusing during finger movements: A fMRI study. Journal of Motor Behavior, 41(6), 535–541. https://doi.org/10.3200/35-08-091
22. Zimmermann, K. M., Bischoff, M., Lorey, B., Stark, R., Munzert, J., & Zentgraf, K. (2012). Neural correlates of switching attentional focus during finger move¬ments: an fMRI study. Frontiers in psychology, 3, 555. https://doi.org/10.3389/fpsyg.2012.00555
23. Raisbeck, L. D., Diekfuss, J. A., Grooms, D. R., & Schmitz, R. (2020). The effects of attentional focus on brain function during a gross motor task. Journal of Sport Rehabilitation, 29, 441–447
https://doi.org/10.1123/jsr.2018-0026
24. Sakurada, T., Yoshida, M., & Nagai, K. (2022). Indi¬vidual optimal attentional strategy in motor learning tasks characterized by steady-state somatosensory and visual evoked potentials. Frontiers in Human Neuroscience, 15, 784292. https://doi.org/10.3389/fnhum.2021.784292
25. Smits-Bandstra, S. De Nil, L., & Rochon, E. (2006). The transition to increased automaticity during fin-ger sequence learning in adult males who stutter. Journal of Fluency Disorders, 31(1), 22–40.
https://doi.org/10.1016/j.jfludis.2005.11.004
26. Smits-Bandstra, S., & De Nil, L. F. (2007). Sequence skill learning in persons who stutter: Implications for cortico-striato-thalamo-cortical dysfunction. Journal of Fluency Disorders, 32(4), 251–278.
https://doi.org/10.1016/j.jfludis.2007.06.001
27. Kim, K. S., Daliri, A., Flanagan, J. R., & Max, L. (2020). Dissociated development of speech and limb sensorimotor learning in stuttering: Speech au-ditory-motor learning is impaired in both children and adults who stutter. Neuroscience, 451, 1–21. https://doi.org/10.1016/j.neuroscience.2020.10.014
28. Sares, A. G., Deroche, M. L., Shiller, D. M., & Gracco, V. L. (2018). Timing variability of sensorimotor inte-gration during vocalization in individuals who stut-ter. Scientific Reports, 8(1), 16340.
https://doi.org/10.1038/s41598-018-34517-1
29. Cai, S., Beal, D. S., Ghosh, S. S., Tiede, M. K., Guen¬ther, F. H., & Perkell, J. S. (2012). Weak responses to auditory feedback perturbation during articula¬tion in persons who stutter: evidence for abnormal auditory-motor transformation. PloS one, 7(7), e41830.
https://doi.org/10.1371/journal.pone.0041830
30. Cai, S., Beal, D. S., Ghosh, S. S., Guenther, F. H., & Perkell, J. S. (2014). Impaired timing adjustments in response to time-varying auditory perturbation dur¬ing connected speech production in persons who stut¬ter. Brain and language, 129, 24-29. https://doi.org/10.1016/j.bandl.2014.01.002
31. Kim, K. S., Daliri, A., Flanagan, J. R., & Max, L. (2020). Dissociated development of speech and limb sensorimotor learning in stuttering: Speech au-ditory-motor learning is impaired in both children and adults who stutter. Neuroscience, 451, 1-21. https://doi.org/10.1016/j.neuroscience.2020.10.014
32. Tanaka, M., Ohyagi, Y., Kawajiri, M., Taniwaki, T., Tobimatsu, S., Furuya, H., & Kira, J. (2005). A patient with focal dystonia induced by golf and presenting a decrease in activity of cerebral motor cortex on task. Rinsho Shinkeigaku=Clinical Neurology, 45(4), 304-307.
https://europepmc.org/article/med/15912799
33. Kadota, H., Nakajima, Y., Miyazaki, M., Sekiguchi, H., Kohno, Y., Amako, M., & Sakai, N. (2010). An fMRI study of musicians with focal dystonia during tapping tasks. Journal of neurology, 257, 1092-1098.
https://doi.org/10.1007/s00415-010-5468-9
34. Chen, M., Summers, R.L.S., Prudente, C.N., Goding, G.S., Samargia-Grivette, S., Ludlow, C.L., Kimberley, T.J.（2020）Transcranial magnetic stimulation and functional magnet resonance imaging evaluation of adductor spasmodic dysphonia during phonation. Brain Stimulation, 13 (3), 908-915.
https://doi.org/10.1016/j.brs.2020.03.003
35. Parr, J. V., Gallicchio, G., Canales-Johnson, A., Uiga, L., & Wood, G. (2023). Cortical, muscular, and ki-netic activity underpinning attentional focus strate-gies during visuomotor control. Psychophysiology, 60(6), e14249.
https://doi.org/10.1111/psyp.14249
36. Lohse, K. R., Sherwood, D. E., & Healy, A. F. (2011). Neuromuscular effects of shifting the focus of atten-tion in a simple force production task. Journal of Mo¬tor Behavior, 43(2), 173–184. https://doi.org/10.1080/00222895.2011.555436
37. Lohse, K. R., & Sherwood, D. E. (2012). Thinking about muscles: The neuromuscular effects of atten-tional focus on accuracy and fatigue. Acta Psycho-logica, 140(3), 236–245. https://doi.org/10.1016/j.actpsy.2012.05.009
38. Lisman, A. L., & Sadagopan, N. (2013). Focus of at¬tention and speech motor performance. Journal of Communication Disorders, 46(3), 281-293. https://doi.org/10.1016/j.jcomdis.2013.02.002