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The atmosphere in the virtual café is minimalist and serene, with white walls and natural wood furnishings. At a long table, a group of avatars sit opposite one another, talking about the weather - until one of the avatars notices a newcomer.

“We have a new person with us today,” she says to the group. Then, to the newcomer: “Hello and welcome.”

The group looks up. A few avatars smile. Some frown. One impatiently taps his fingers on the tabletop. 

The environment is simulated, but the stress experienced by the participant in the scenario is real, stemming from an innate human need for social connection and acceptance coupled with the fear of negative evaluation. This stress response activates the sympathetic nervous system, causing an increased heart rate and flushed skin, which communication sciences researcher Kim Bauerly measures using electrodes on the fingers of her subject’s hand.

“When we perform a motor activity under social stress - whether it be some sort of sport such as basketball or giving a speech to a big audience - we are more likely to exhibit variability and show more errors in our movement,” said Bauerly, an associate professor in the Department of Communication Sciences and Disorders. “For speech, a heightened social anxiety causes changes in articulatory control that may not be conducive to fluent speech in adults who stutter.  

Bauerly studies the effects of emotion on speech-motor control in adults who stutter using a method that introduces social stress via a virtual reality scenario custom designed by . Her findings provide a rationale for identifying, and reducing, social anxiety as part of treatment to improve fluency.

“Our field has moved away from an old way of fluency intervention, where we train a person to use a different way of speaking to be more fluent,” said Bauerly, whose experience as a person who stutters made her aware of the effects social stress can have on speech-motor control.

“Sometimes those techniques do prove helpful - if a person just wants to be fluent in a situation - but they can't use these skills day in and day out. They never become automatic. And so there's a higher rate of relapse.”

Bauerly's research underscores the value of incorporating Cognitive Behavioral Approaches that focus on modifying dysfunctional emotions, behaviors, and thoughts as part of a treatment plan.

“Our treatment approaches are moving more towards accepting stuttering and acknowledging it and being open about it – and with this comes more confidence in speaking and stuttering,” said Bauerly.

Because anxiety, like confidence, is acquired over time, Bauerly's next study will focus on its root, which is shown to begin in preschool and grow through a sophisticated interaction between temperament and environmental factors that is even further complicated for children who stutter.

"Stuttering makes children stand out, makes them different," said Bauerly. “I am interested in investigating the younger age range to determine what risk factors lead to some children who stutter to develop social anxiety.” 

Dr. Bauerly researches the interplay between emotion and speech-motor control in those who stutter to gain deeper insights into effective treatment strategies. Her current project is funded under an NIH NIDCD R21 Exploratory Grant.