Anticipation in stuttering: A theoretical model of the nature of stutter prediction

The fact that some people who stutter have the ability to anticipate a stuttering moment is essential for several theories of stuttering and important for maximum effectiveness of many currently used treatment techniques. The “anticipation effect,” however, is poorly understood despite much investigation into this phenomenon. In the present paper, we combine (1) behavioral evidence from the stuttering-anticipation literature, (2) speech production models, and (3) models of error detection to propose a theoretical model of anticipation. Integrating evidence from theories such as Damasio's Somatic Marker Hypothesis, Levelt's Perceptual Monitoring Theory, Guenther's The Directions Into Velocities of Articulators (DIVA) model, Postma's Covert Repair Hypothesis, among others, our central thesis is that the anticipation of a stuttering moment occurs as an outcome of the interactions between previous learning experiences (i.e., learnt associations between stuttered utterances and any self-experienced or environmental consequence) and error monitoring. Possible neurological mechanisms involved in generating conscious anticipation are also discussed, along with directions for future research. Educational Objectives: The reader will be able to: (a) describe historical theories that explain how PWS may learn to anticipate stuttering; (b) state some traditional sources of evidence of anticipation in stuttering; (c) describe how PWS may be sensitive to the detection of a stuttering; (d) state some of the neural correlates that may underlie anticipation in stuttering; and (e) describe some of the possible utilities of incorporating anticipation into stuttering interventions.