1. The 11% cumulative incidence of stuttering in this study was found to be more than twice that previously reported.
2. Stuttering in early childhood was associated with improved language outcomes, and equal to improved psychosocial outcomes compared with non-stuttering children.
Evidence Rating Level: 2 (Good)
Study Rundown: The natural history of stuttering has not been outlined by previous large clinical trials. Therefore, much of the wisdom given to parents about the onset, treatment benefits, and outcomes of children who stutter often lacks an evidence base. This study took a large, prospective cohort of infants and followed their progress to four years of age. Researchers found that 11% of children studied stuttered by age four, more than twice that previously reported. In addition, the study found no significant difference in psychosocial health, including emotional, social and behavioral health. Surprisingly, improvement was seen in language scores and social and school functioning as evaluated by the Clinical Evaluation of Language Fundamentals Preschool-Second Edition (CELF-P2) and the Pediatric Quality of Life Inventory Parent-Proxy Report (PEDS-QL). This study was limited by reliance on parental identification of possible stuttering and potential generalizability was affected by the above average education levels of mothers interviewed in the study. The high incidence of stuttering found in this study emphasizes how potentially common it is among children. However, the positive outcomes are reassuring and raise new questions about the role of stuttering in language and social development.
Relevant Reading: Childhood stuttering: incidence and prevalence
Study Author, Dr. Sheena Reilly, Ph.D., talks to 2 Minute Medicine: Director of Speech Pathology, RCH, Murdoch Children’s Research Institute; and Professor of Speech Pathology, The University of Melbourne Department of Paediatrics at the Royal Children’s Hospital.
“Stuttering onset is relatively common – the cumulative incidence in this study was 11% by 4 years. Parents however can be reassured that developmental stuttering is not associated with poorer outcome (temperament, social-emotional development) in the preschool years at least.
Many children in this community sample had not seen a speech pathologist. Many other reports concern children who had attended for therapy or who had been recruited to the study later, for example from 3 year of age. Our findings emphasize the importance of investigating such issues in community samples and not relying solely on reports on samples of children who come to the attention of speech pathology services.
We need to learn more about recovery, that is when it occurs and how long it takes. But for now parents should watch and wait for up to 12 months before seeking treatment. Of course if parents are worried or the child seems upset then they should seek help earlier.”
In-Depth [prospective cohort study]: This nested study included 1619 infants recruited from the Early Language in Victoria Study (ELVS) who were followed from several months of life for four years. Parents were reminded by letter every four months for 12 months to call if their child displayed features of stuttering. Identified children were then assessed by a speech pathologist and, if diagnosed, followed monthly until stuttering resolution was recognized by both the parents and speech pathologist. Further assessments of language skills of both mother and child as well as behavioral, social and emotional development of the child, occurred at one, two, and four years old. Stuttering was confirmed in 181 (11%) of study participants. In addition, children who stuttered were significantly more likely to perform higher on the CELF-P2, a measure of core language, expressive, and receptive ability, (p < .001), as well as the social functioning (p < .001) and school/preschool aspects (p < .03) of the PEDS-QL when compared to those who did not stutter. No significant score differences were seen on other assessments when comparing children who stuttered and those that did not.
By Laurel Wickberg and Leah H. Carr
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