A New Framework for Understanding Stuttering: The Dual Premotor Model

Per A. Alm

An explanatory model is proposed: the dual premotor systems theory of stuttering. A core premise is that the timing of speech motor segments may be cued by either of two parallel premotor systems, the lateral and the medial. Stuttering is suggested to be related to impaired "go-signals" from the medial system (including the basal ganglia). Recent findings suggest the possibility that impaired input from the motor cortex to the basal ganglia might be an important factor, leaving the basal ganglia out of control and subject to disproportionate strong emotional influence from the limbic system. Most fluency inducing conditions are proposed to shift speech timing from the medial to the lateral system.

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