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How Stuttering Develops: The Multifactorial Dynamic Pathways Theory Journal Review

Emma H. Hinzman

Department of Health and Sciences, Southeastern University

CSDS 3073: Fluency and Voice Disorders

Professor Renovales

February 2, 2023
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How Stuttering Develops: The Multifactorial Dynamic Pathways Theory Journal Review

Technique/Design

This article exists to define stuttering and the Multifactorial Dynamic Pathways Theory.

The evidence and speculations regarding children who stutter and adults who stutter is the major

content given throughout the journal. Topics including the dynamic pathways theory, what

stuttering is from a neurodevelopmental perspective, the motor aspects of stuttering, the language

aspects of stuttering, emotional aspects of stuttering, the central neural aspects of stuttering, and

the Multifactorial Dynamic Pathways Theory and all that it entails.

Population

The population of the studies conducted in the article focused on children who stutter and

adults who stutter with children who do not stutter and adults who do not stutter as the control.

The journal will briefly mention adolescents throughout the paper as this is an important part of

development in regard to stuttering as well. The emphasis of research, however, focuses mostly

on adults and children who do and do not stutter as a comparison.

Results

The journal article provided much evidence and research to support the results regarding

stuttering and the Multifactorial Dynamic Pathways theory, which reveals that stuttering is not

caused by one single thing but by multiple factors. Stuttering can now be classified as a

neurodevelopmental disorder. Some other neurodevelopmental disorders include specific

language impairment, dyslexia, and autism. It is now understood that these neurodevelopmental

disorders emerge in early childhood because of atypical Central Nervous system development,

hence the word developmental in the name of the disorder. The onset for developmental
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stuttering is anywhere from 30 to 48 months and it is estimated that 5 to 8 percent of preschool

children experience stuttering. Onset usually occurs when a child’s linguistic abilities are

expeditiously developing. Stuttering, however, in regards to persistence into adolescence and

adulthood, is 20 percent likely, as it has been found that 80 percent of children who stutter will

grow out of it, with or without therapy. Research shows that only 1 percent of the adult and teen

population worldwide have persistent stuttering. Many theories have hypothesized that parenting

behavior, linguistic processing, and motor deficits cause stuttering. The Multifactorial Dynamic

Pathways Theory, however, does not center around the onset or “course” (Smith, A., & Weber,

C., 2017) of stuttering but on coexisting, significant changes in other cognitive structures and

neural systems in early childhood. This MDP Theory focuses on the fact that there are many

factors that influence stuttering including genetic factors, epigenetic factors, and environmental

factors. Genes are sequences of DNA that exist from the time one is born, and they carry the

information which makes up a person’s traits. The MDP theory says that genes can be a big

influence on stuttering because they provide information that guides development. Epigenetics is

how the behaviors and the internal and external environment can cause changes that affect the

way that genes work, and the MDP theory suggests that this may be what inevitably results in

stuttering. The role of epigenetics and the specific environments and behaviors on stuttering is

not completely understood. However, the journal emphasizes that, although specific language

impairment has a higher heritability factor, the role of epigenetics and the way surrounding

experiences shape and influence the development of the brain, is significant. In reference to

persistent stuttering, it has been noted by the MDP theory that, in adults who stutter, specific

fiber tracts suggest that there is a lack of neural connectivity in the brain. Research has shown
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that aside from some minor differences, shows the left-dominant neural network to be significant

in neural networks to work for fluent speech production as an influential factor.

Conclusions

Stuttering is a neurodevelopmental disorder that results from a lack of connectivity in the

brain and influential factors. The Multifactorial Dynamic Pathways Theory supports this

statement in that these specific factors and neural connections cause stuttering. The theory

suggests that the central nervous system is malfunctioning in generating motor commands that

produce fluent speech. The theory also suggests through supportive evidence that treatment

should be given as early as possible in order for the highest chance of recovery or the most fluent

speech possible. It also recommends that treatment be coupled with “strategies promoting

speech-motor coordination that result in fluent productions” (Smith, A., & Weber, C., 2017).

Areas Needing Further Study

Areas needing further study include multiple topics discussed throughout the journal.

Epigenetics is one area that would benefit from further study. Its role is not completely

understood, and would greatly impact research regarding stuttering and other neurological

disorders or diseases. Next, beneficial future work would be discovering whether the instabilities

in speech motor processes present in the onset of stuttering are foretelling of persistent stuttering.

In addition to these areas, the topic of whether there is a consequential relationship between

activity suggests persistent stuttering. Another topic that could have more research pertaining to

it would be whether or not preschool-aged children who stutter have negative responses to

stuttering before their school-aged years which most but not all research propose. Overall,
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further research pertaining to emotional and temperamental factors in the development of

stuttering would be considerably useful.

Evaluation

One thing that could have benefited the journal article more would be the population size.

A larger sample size of those who do stutter and those who do not stutter, while also including

individual data that would detail data in order to exhibit the true performance of those who do

and do not stutter would be advantageous. The journal did a great job of providing the reader

with all of the information they need to discover more about stuttering and all that it entails while

supplying analogies to support further understanding of the more difficult material to grasp. The

results are provided all throughout the article and not all in one specific category. Comparison

between the results of those children who stutter and do not and adults who stutter and do not

was consistent with displaying throughout the article, while also bringing the results back to the

control group presenting that contrast.

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References

Smith, A., & Weber, C. (2017). How Stuttering Develops: The Multifactorial Dynamic Pathways

Theory. Journal of speech, language, and hearing research : JSLHR, 60(9), 2483–2505.

https://doi.org/10.1044/2017_JSLHR-S-16-0343