Research findings: * [Guenther](https://www.frontiersin.org/articles/10.3389/fpsyg.2019.03088/full): the primary impairment underlying stuttering behavior is malfunction in the cortico-basal ganglia-thalamocortical (hereafter, cortico-BG) loop that is responsible for initiating speech motor programs * [Alm](https://www.frontiersin.org/articles/10.3389/fpsyg.2019.03088/full#ref4) proposed that the core deficit in persistent developmental stuttering (PDS) is an impaired ability to initiate motor programs * [Webster](https://www.frontiersin.org/articles/10.3389/fpsyg.2019.03088/full#ref124) demonstrates that PWS are particularly impaired in initiating through sequences in the presence of competing tasks. * [Guenther](https://www.newswise.com/articles/stuttering-starts-at-speech-initiation-not-due-to-impaired-motor-skills-asa181) compares speech to a jukebox that plays CDs. The jukebox has two circuits: one that chooses a CD and one that plays the CD. Inside the brain, this corresponds to one circuit initiating the desired speech in the basal ganglia, while another circuit coordinates the muscles needed to generate the speech. **Stuttering stems from the initiation of speech, so only the first of the two circuits is impaired.** In stuttering, the CDs themselves are fine, but the mechanism for choosing them is impaired. * [Research](https://www.sciencedirect.com/science/article/pii/S2468171722000023): Disruptions in the initiation of speech