An Active Inference Account of Stuttering Behavior

Developmental stuttering, or childhood-onset fluency disorder, has been traditionally characterized by the production of speech disfluencies, such as repetitions, prolongations, and blocks. However, the manner, intensity, and overall effects of stuttering vary widely among individuals. Despite extensive scientific inquiry spanning over a century, the complex and seemingly paradoxical nature of stuttering has thwarted attempts at a unified explanation. Active inference, a predictive processing theory of sentient behavior, provides a potential account for understanding the core behaviors and diverse phenomena of stuttering. Stuttering likely arises from disruptions in perception-action cycling that facilitate the fluent sequential production of syllables. More specifically, aberrantly high sensory precision to speech-related predictions may cause the abrupt inhibition of syllable initiation, resulting in the hallmark stuttering ‘block.’ Moreover, active inference elucidates the perplexing contextual variability of stuttering behavior, such as the effects of adaptation, consistency, and distraction. Importantly, this account holds significant clinical implications for stuttering treatment, offering novel avenues for intervention.