Hannah Stewart, Julia Manning, Tepanta Fossett, Ph.D.

Comparing the effectiveness of transcranial direct current stimulation (tDCS) and cognitive behavioral therapy (CBT) in increasing speech fluency in adults who stutter

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Abstract:

Stuttering is a speech disorder that frequently impairs a speaker's ability to speak fluently and naturally. Stuttering is characterized by the repetition of sounds, syllables, or words; prolonging of sounds; and blocks—interruptions in speech. A person who stutters is fully aware of what they want to say but struggles to deliver it in a natural manner (National Institute on Deafness and Other Communication Disorders, 2018).  Currently, researchers believe that a variety of factors, including genetics, language development, the environment, and changes in brain structure and function, are responsible for stuttering.  Together, these elements may have an impact on a stutterer's speech (Causes of Stuttering, n.d.). Stuttering might have causes other than underlying diseases, such as nervousness or a history of the condition in the family (National Institute on Deafness and Other Communication Disorders, 2018).  Direct electrical currents are used in transcranial direct current stimulation (tDCS), a non-invasive, painless brain stimulation procedure, used to stimulate areas of the brain (Chesters et al., 2018). Transcranial direct current stimulation has been used as a treatment method for stuttering because it has been shown to be effective at reducing stuttering in adults compared with behavioral therapies (Chesters et al., 2017).  Transcranial direct current stimulation treatment is typically administered to the left inferior frontal cortex (Chesters et al., 2018). Transcranial direct current stimulation treatment encourages neuroplastic changes in the brain circuits leading to long-lasting fluency increases, which is why this method is used to treat stuttering (Chesters et al., 2018). Cognitive behavior therapy (CBT) has also been used to treat stuttering (Gupta et al., 2019).  CBT is a multidisciplinary approach that focuses on the behavioral, cognitive, and emotional elements of stuttering (Gupta et al., 2019).  According to Gupta et al., (2019) CBT is used as a treatment method for individuals who stutter since it has been shown to be the most successful long-term strategy. This study seeks to compare the effectiveness of transcranial direct current stimulation to cognitive behavioral therapy in reducing stuttering behaviors.

Participants in this between-subjects research design study will be 100 adults who stutter. They will be randomly assigned to two groups; one group will receive tDCS and the other group will receive cognitive behavior therapy. The participants of the study will receive a questionnaire prior to receiving treatment, to describe the impact of their fluency disorder on their daily life. Participants of both groups will read a 250-word passage aloud while fluency behaviors are recorded. Measures of speech behavior will be the frequency and duration of disfluencies. It is hypothesized that tDCS will reduce the frequency and duration of speech disfluencies more than CBT. The findings will have an impact on developing an effective treatment strategy for stutterers. 

References

Causes of Stuttering. (n.d.). National Stuttering Association. https://westutter.org/causes-of-stuttering/

Chesters, J., Möttönen, R., & Watkins, K. E. (2018). Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter. Brain, 141(4),1161–1171. https://doi.org/10.1093/brain/awy011

Chesters, J., Watkins, K. E., & Möttönen, R. (2017). Investigating the feasibility of using transcranial direct current stimulation to enhance fluency in people who stutter. Brain and Language, 164, 68–76. https://doi.org/10.1016/j.bandl.2016.10.003

Gupta, A., Mongia, M., Vijay, A., & Sadhu, R. (2019). Management of stuttering using cognitive behavior therapy and mindfulness meditation. Industrial Psychiatry Journal, 28(1), 4. https://doi.org/10.4103/ipj.ipj_18_19

National Institute on Deafness and Other Communication Disorders. (2018, June 11). Stuttering. NIDCD. https://www.nidcd.nih.gov/health/stuttering
Technologies, C. F. (n.d.). Transcranial Direct Current Stimulation for Stuttering. Casa Futura Technologies. Retrieved March 27, 2023, from https://casafuturatech.com/transcranial-direct-current-stimulation/