Stuttering in adolescence and the risk for dysglycemia in early adulthood.

AIMS: To investigate the association between stuttering during adolescence and the onset of dysglycemia (prediabetes or type 2 diabetes) in early adulthood among men and women. MATERIALS AND METHODS: This cohort study included Maccabi Health Services members assessed for mandatory military service at ages 16-19 during 1990-2019 and followed until 31 December 2020. Stuttering status was recorded in the baseline medical evaluation. Incident cases of dysglycemia were identified systematically using prediabetes and diabetes registries. Cox proportional hazard models were applied for men and women separately, adjusting for sociodemographics and medical status. RESULTS: The study cohort comprised 866,304 individuals (55% men; 0.21% with stuttering) followed for a total of 12,696,250 person-years. During the study period, 7.6% (n = 36,603) of men and 9.0% (n = 34,723) of women were diagnosed with dysglycemia. The mean ages at diagnosis were 34 and 32 years for men and women, respectively. Women with stuttering exhibited the highest dysglycemia incidence rate (102.3 per 10,000 person-years) compared with the other groups (61.4, 69.0, and 51.9 per 10,000 person-years for women without stuttering, men with stuttering, and men without stuttering, respectively). For both men and women, those with stuttering showed an increased risk of being diagnosed with dysglycemia compared with those without (adjusted hazard ratios 1.18 [1.01-1.38] and 1.61 [1.15-2.26], respectively). The associations persisted in extensive sub-analyses. CONCLUSIONS: Stuttering in adolescence is associated with a higher risk of dysglycemia in early adulthood for men and women. Screening and targeted prevention in this population, especially women, may be beneficial.

Self-reported musculoskeletal pain, headache, jaw pain and swallowing dysfunction in a sample of young Saudi adults who stutter.

Objectives: To report the prevalence of musculoskeletal pain, headache, jaw pain and difficulty in swallowing among people who stutter (PWS). METHODS: The cross-sectioal study was conducted from October 3, 2021, to March 21, 2022, after approval from the ethics review committee of King Khalid University, Abha, Saudi Arabia, and comprised adult people who stutter belonging to different regions of Saudi Arabia. They were divided into five groups based on stuttering severity as estimated by Stuttering Severity Instrument-4. Data was collected on musculoskeletal pain in different body areas using a questionnaire.. Data ws analysed using SPSS 22. RESULTS: Of the 101 Arabic-speaking subjects, 63(62.4%) were males and 38(37.6%) were females. The overall mean age was 27±7 years (range: 18-39 years). The largest group was of subjects with moderate severity of stuttering 31(30.6%); 21(68%) males and 10(32%) females. The increase in number of musculoskeletal pain locations was related to the severity of stuttering (p<0.05). The most common musculoskeletal pain sites were the lower back 31(31%), neck 26(26%) and shoulder 26(26%). Frequent headaches and difficulty chewing hard food due to jaw pain were reported by 49(49%) and 22(22%) participants, respectively (p<0.05). Swallowing difficulty was reported by 9(9%) participants (p>0.05). CONCLUSIONS: Widespread chronic musculoskeletal pain of low intensity was found to be common among people who stuttered, and the number of pain locations was positively related to stuttering severity.

Social anxiety disorder in adolescents who stutter: A risk for school refusal.

BACKGROUND: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. METHODS: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. RESULTS: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. CONCLUSIONS: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.

Self-reported impact of developmental stuttering across the lifespan.

AIM: To examine the phenomenology of stuttering across the lifespan in the largest prospective cohort to date. METHOD: Participants aged 7 years and older with a history of developmental stuttering were recruited. Self-reported phenotypic data were collected online including stuttering symptomatology, co-occurring phenotypes, genetic predisposition, factors associated with stuttering severity, and impact on anxiety, education, and employment. RESULTS: A total of 987 participants (852 adults: 590 males, 262 females, mean age 49 years [SD = 17 years 10 months; range = 18-93 years] and 135 children: 97 males, 38 females, mean age 11 years 4 months [SD = 3 years; range = 7-17 years]) were recruited. Stuttering onset occurred at age 3 to 6 years in 64.0%. Blocking (73.2%) was the most frequent phenotype; 75.9% had sought stuttering therapy and 15.5% identified as having recovered. Half (49.9%) reported a family history. There was a significant negative correlation with age for both stuttering frequency and severity in adults. Most were anxious due to stuttering (90.4%) and perceived stuttering as a barrier to education and employment outcomes (80.7%). INTERPRETATION: The frequent persistence of stuttering and the high proportion with a family history suggest that stuttering is a complex trait that does not often resolve, even with therapy. These data provide new insights into the phenotype and prognosis of stuttering, information that is critically needed to encourage the development of more effective speech therapies. WHAT THIS PAPER ADDS: Half of the study cohort had a family history of stuttering. While 75.9% of participants had sought stuttering therapy, only 15.5% identified as having recovered. There was a significant negative correlation between age and stuttering frequency and severity in adults.

Latent Class Analysis Reveals Distinct Groups Based on Executive Function and Socioemotional Traits, Developmental Conditions, and Stuttering: A Population Study.

A growing body of research has reported associations between weaker Executive Functions (EF), the set capacities that are needed to manage and allocate one's cognitive resources during cognitively challenging activities and various neurodevelopmental conditions, including stuttering. The majority of this research has been based on variable-centered approaches, which have the potential to obscure within-population heterogeneity. Person-centered analyses are essential to understanding multifactorial disorders where relationships between indicators have been elusive, such as stuttering. The current study addressed gaps in the literature by using latent class analysis (LCA), a person-centered approach, to identify homogenous subgroups within the National Health Interview Survey (2004-2018) publicly available data set. Using this exploratory approach, we examined the hypothesis that there exist distinct classes (or subgroups) of children based on parent reports of EF, Socioemotional (SE) traits, developmental atypicality, and stuttering. Our analyses revealed distinct subgroups with substantially different likelihoods of parent-reported stuttering behaviors and developmental atypicality. For children with both EF and SE difficulties, the likelihood of parental report of stuttering and atypical development was even higher, in fact this likelihood (of stuttering and not-typically developing) was highest among all subgroups. In contrast, children without difficulties were the least likely to be reported with stuttering or not-typically developing. Our findings are consistent with theoretical frameworks for stuttering, which cite EF as a crucial component in the disorder. Additionally, our findings suggest within-population heterogeneity among children with EF difficulties and, specifically, EF and SE heterogeneity among children who stutter.

Stuttering related and psychosocial predictors of impact of stuttering.

OBJECTIVE: To investigate the psychosocial factors having an impact on persons with a stuttering problem. Methods: The correlation study was conducted from October 2016 to February 2018 at hospitals, speech clinics and educational institutes of Lahore. The sample comprised of young adults aged 16-30 years of either gender with stuttering problem. Data was collected using Stuttering Severity Instrument-4, Social Interaction Anxiety Scale-Urdu, Big Five Measure-20, Overall Assessment of the Speaker's Experience of Stuttering and the Urdu version of the shortened form of the Coping Orientation to Problems Experienced inventory. Data was analysed using SPSS 23. RESULTS: Of the 78 subjects, 66(84.6 %) were males and 12 (15.4 %) were females. There were 21(27%) subjects aged 16-19 years and 57(73%) with age range of 20-30 years. The overall mean age was 21.96±3.89 years. Mean age of onset was 4.59±1.29 years, while gradual onset and progressive stuttering was reported by 74(94.9 %). The Bilingual users 49(63%) reported to have frequent stuttering. Among the 43(55.1%) who had received treatment, 30(38%) received speech therapy and 26(33.3%) reported dissatisfaction. Stuttering severity and social anxiety were significantly positively correlated with all domains of impact of stuttering (p<0.05). Age, and duration were negatively correlated with day-to-day communication (p<0.05) and previous speech treatment showed negative association with impact on general knowledge about stuttering (p<0.05). Avoidance coping strategy had a significant relationship with all domains of impact (p<0.05). CONCLUSIONS: Severity of stuttering and social anxiety were found to have repercussions on people who stuttered, while avoidance coping was practised more to deal with the negative impact on reactions toward stuttering and quality of life.

Awareness of stuttering in Japanese children aged 3-7 years.

BACKGROUND: Boey et al. (2009) devised a questionnaire for measuring children's awareness of stuttering and showed that even very young children were often aware of their stuttering. There has been no replication of studies using Boey et al.'s parent-reported questionnaire. The aim of this study was to test whether using Boey et al.'s seven questions, developed for a Dutch speaking population could be effective for measuring the awareness of stuttering in Japanese children. METHODS: Participants were 54 children who stutter (CWS) aged 3-7 years. Parents answered seven questions about their child's awareness of stuttering according to the questions developed Boey et al. RESULTS: Parental-reported observations of the child responses citing at least one awareness incident were 76%. The percentage of stuttering children with awareness of their own speech difficulties, according to chronological age, were as follows: 70% at age 3 years; 67% at age 4 years; 75% at age 5 years; 81% at age 6 years; and 90% at age 7 years. CONCLUSIONS: We found that even at age 3 years, many CWS were already aware of their stuttering. The similarity of the data with the seminal study by Boey et al. suggests that the question-based assessment is reproducible even in a country with a different spoken language. The seven questions in Boey et al. are useful for evaluating whether children's awareness of stuttering could contribute to a clinical decision as well as stuttering severity.

A cross-sectional analysis of the effects of everyday life situations on stuttering and associated physical features.

OBJECTIVE: To explore the effects that everyday situations of varying stress/anxiety have on stammering. METHODS: The cross-sectional study was conducted in the first six months of 2018 at Central Park Medical College Lahore, and comprised people with stammer. The subjects were categorised into two groups on the basis of severity of symptoms assessed using the fluency severity rating scale. Group A had subjects with mild to moderate stammer, while Group B had those with moderate to severe stammer. An 8-point Likert scale was employed to evaluate responses towards 33 questions of which 30 were situation-based while 3 focussed on physical fitness, blinking and body jerks. SPSS 23 was used for data analysis. RESULTS: Of the 56 subjects, there were 26(46.4%) in Group A, and 30(53.5%) in Group B. Higher degree of blinking and body jerks were found in Group B (p<0.05 each). CONCLUSION: Subjects with severe stammer had more body jerks and blinking compared to those with mild to moderate condition.

Beyond stuttering: Speech disfluencies in normally fluent French-speaking children at age 4.

The aim of this study was to establish normative data on the speech disfluencies of normally fluent French-speaking children at age 4, an age at which stuttering has begun in 95% of children who stutter (Yairi & Ambrose, 2013). Fifty monolingual French-speaking children who do not stutter participated in the study. Analyses of a conversational speech sample comprising 250-550 words revealed an average of 10% total disfluencies, 2% stuttering-like disfluencies and around 8% non-stuttered disfluencies. Possible explanations for these high speech disfluency frequencies are discussed, including explanations linked to French in particular. The results shed light on the importance of normative data specific to each language.

Stuttering: Clinical and research update.

OBJECTIVE: To provide an update on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. QUALITY OF EVIDENCE: The MEDLINE and Cochrane databases were searched for past and recent studies on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Most recommendations are based on small studies, limited-quality evidence, or consensus. MAIN MESSAGE: Stuttering is a speech disorder, common in persons of all ages, that affects normal fluency and time patterning of speech. Stuttering has been associated with differences in brain anatomy, functioning, and dopamine regulation thought to be due to genetic causes. Attention to making a correct diagnosis or referral in children is important because there is growing consensus that early intervention with speech therapy for children who stutter is critical. For adults, stuttering can be associated with substantial psychosocial morbidity including social anxiety and low quality of life. Pharmacologic treatment has received attention in recent years, but clinical evidence is limited. The mainstay of treatment for children and adults remains speech therapy. CONCLUSION: A growing body of research has attempted to uncover the pathophysiology of stuttering. Referral for speech therapy remains the best option for children and adults.

Methylphenidate and stuttering.

Methylphenidate (MPH) is a piperidine similar to amphetamines, and is indicated for attention deficit hyperactivity disorder. Studies concerning stuttering occurring with MPH are contradictory. We investigated the association between MPH and stuttering. We analysed reports in the World Health Organization global individual case safety reports database, Vigibase, up to 31 December 2018, with the MedDRA preferred term "dysphemia" and the lower level terms "stutter" and "stuttering". The association between exposure to MPH and occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (RORs) were calculated with 95% confidence intervals (CIs). In total, 2975 cases of dysphemia were reported, of which 46 reports were associated with MPH. For the Preferred Term "dysphemia", the ROR was 7.3 (95% CI: 5.4-9.8). With the Lower Level Term "stuttering", 584 cases were registered in the database of which 17 involved MPH. The ROR was 13.9 (95% CI: 8.6-22.5). This study found a signal for stuttering with MPH.

Incidence of developmental speech dysfluencies in individuals with Parkinson's disease.

OBJECTIVE: The aim of this study was to investigate the incidence of developmental speech dysfluencies in individuals with Parkinson's disease (PD). BACKGROUND: The possible relationship between PD and dysfluencies such as stuttering has engaged researchers for many years. However, whether there is a higher-than-expected incidence of reported childhood stuttering in adults with a diagnosis of PD is unknown. PARTICIPANTS AND METHODS: A questionnaire including items regarding present and former speech difficulties was answered by 280 individuals with PD. RESULTS: The total number of persons who reported that they had stuttered (often or sometimes) before the age of 10 years was 11, corresponding to 3.9%. The number of persons who reported unusually fast speech before the age of 10 years was 17, corresponding to 6.1%. The reported incidence of childhood stuttering in this group was consequently not higher than that in previously published reports on childhood stuttering (approx. 5%). The frequency of unusually fast speech was notable, but the lack of a control group made it difficult to conclude on the significance of that finding. CONCLUSION: Although no direct comparison between self-reported incidences of childhood dysfluencies and published incidence figures regarding childhood stuttering can be made, different possible relationships between speech dysfluency and basal ganglia dysfunction are discussed.

Risk of sleep problems in a clinical sample of children who stutter.

PURPOSE: Previous studies have shown increased prevalence of sleep problems among people who stutter. However, there is a lack of knowledge about what these sleep problems may specifically be. METHOD: Fifty children who stutter (CWS) from 6;0 to 12;9 years of age and 50 age- and gender-matched controls participated in this study. Parents did not report coexisting conditions, excepting stuttering and/or sleep problems. Sleep problems were investigated using a standardized questionnaire answered by parents. The questionnaire shows cut-off scores to identify the risk of sleep problems as a whole and on each one of the six subscales (i.e., disorders of initiating and maintaining sleep; sleep breathing disorders; disorders of arousal; sleep-wake transition disorders; disorders of excessive somnolence; and sleep hyperhidrosis). Scores above the cut-off are suggestive of sleep problems. RESULTS: Twenty-one CWS scored higher than the cut-off on the sleep questionnaire compared to only two controls (p < 0.00001). Specifically, CWS scored higher than controls in disorders of initiating and maintaining sleep, sleep-wake transition disorders (especially jerking, sleep talking, and bruxism), and disorders of excessive somnolence (p < 0.0083, corrected for multiple comparisons). DISCUSSION: Compared to controls, CWS are at greater risk for sleep problems, which are not consequences of coexisting disorders. Present findings confirm and expand current knowledge about sleep problems in CWS. Directionality possibilities and clinical implications are discussed.

Allergies, asthma, and sleep problems in adults who stutter.

PURPOSE: Previous studies have suggested that allergies, asthma, and sleep problems are prevalent in those who stutter. This study analyzed similar data for a broad age group of adults who stutter (AWS). METHOD: Data from the 2012 National Health Interview Survey were analyzed. Adults from 18 to 60 + years of age reported a) to have stuttered, b) to have had any allergy, asthma, or acid reflux, c) to have had insomnia/trouble sleeping and daytime negative consequences, and d) average sleeping hours per day in the past 12 months. RESULTS: The sample included 320 AWS and 33,043 controls. AWS were at greater odds of respiratory, food, and skin allergies (OR = 2.38, 2.36, and 2.09, respectively), as well as asthma and acid reflux (OR = 2.30 and 2.01, respectively) than controls. AWS were at greater odds of insomnia/trouble sleeping, oversleeping, excessive sleepiness, and fatigue than controls (OR = 2.11, 1.71, 2.67, and 1.81, respectively). The subgroup of AWS with no allergy, asthma, and acid reflux were also at greater odds of insomnia/trouble sleeping and excessive sleepiness than controls (OR = 2.13 and 3.11, respectively). Differences were found in specific age groups: younger/middle-aged AWS reported more allergies, asthma, and acid reflux than controls, while older AWS did not; younger/middle-aged AWS reported more insomnia/trouble sleeping than controls, while older AWS reported more oversleeping. CONCLUSIONS: Findings on younger and middle-aged AWS are similar to previous ones on children and adolescents who stutter. Differences regarding younger/middle-aged and older AWS could be consequence of environmental variables.

The impact of adolescent stuttering and other speech problems on psychological well-being in adulthood: evidence from a birth cohort study.

BACKGROUND: Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for. AIMS: To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psychological distress and associated symptoms as measured by the Rutter Malaise Inventory. METHOD & PROCEDURES: A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses. OUTCOMES & RESULTS: In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties. CONCLUSIONS & IMPLICATIONS: These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders.

[Stuttering in Children: Review and Referral Criteria]. / Disfluências e Gaguez: Revisão e Critérios de Referenciação.

Stuttering is a speech fluency disorder, in which people know perfectly well the message they want to convey, even though their speech is characterized by changes in rhythm, repetitions, prolongations, pauses and blocks, and may also be associated with states of anxiety or emotional tension. Up to one in every six children, typically between two and five years old, experience a period of transitory speech disfluency, with usual spontaneous recovery before reaching school age, with a prevalence rate of stuttering of up to 1% of the adult population, and a higher incidence rate in males (4:1). In Portugal, it is estimated that stuttering affects around 100 thousand people, acquiring importance due to its frequency and association with lower self-esteem, anxiety and social isolation, with negative impact on people's ability to communicate and on their well-being and social interactions. The aim of this article is to highlight the complexity of the diagnostic and therapeutic approach of stuttering in pediatrics, with a particular focus on differentiating between normal speech disfluencies and childhood-onset fluency disorder (stuttering) and referral criteria, in order to raise awareness and facilitate early detection of these cases.

A gaguez é uma perturbação da comunicação a nível da fluência em que a pessoa sabe claramente a mensagem que quer transmitir, mas o seu discurso é caracterizado por alterações do ritmo, repetições, prolongamentos, pausas e bloqueios, podendo ainda associar-se a quadros de ansiedade ou tensão emocional. Até uma em cada seis crianças, tipicamente entre os dois e os cinco anos, experienciam um período de disfluência transitória, com habitual recuperação espontânea até à idade escolar, verificando-se uma prevalência de gaguez em até 1% da população adulta, com maior incidência no sexo masculino (4:1). Em Portugal, é estimado que a gaguez afete cerca de 100 mil pessoas, adquirindo particular importância pela sua frequência e associação a redução da autoestima, ansiedade e isolamento social com impacto na capacidade de comunicação do indivíduo e no seu bem-estar e interações sociais. Este artigo tem como objectivo alertar para a complexidade da abordagem diagnóstica e terapêutica em idade pediátrica, com particular incidência na diferenciação entre disfluências normais da fala e perturbação da fluência com início na infância (gaguez) e critérios de referenciação, pretendendo consciencializar e facilitar a deteção e orientação precoce destes casos.

Factors Associated With Symptoms of Anxiety and Depression in Children Who Stutter.

PURPOSE: Children and adolescents who stutter may be at risk of elevated anxiety and depression symptoms, although studies have indicated variability in reported internalizing symptoms in this population. This study considers the association between anxiety and depression symptoms and stuttering, as well as child, family, and contextual factors that may affect this association. METHOD: Thirty-five school-age children who stutter completed the Revised Children's Anxiety and Depression Scale-Short Version. We fitted regression models to examine the association between anxiety and depression symptoms with bullying, stuttering severity, family history of adverse mental health, and age in children who stutter. RESULTS: Family history of adverse mental health was found to significantly predict anxiety and depression scores. Age also predicted depression scores, with older children reporting higher scores. CONCLUSIONS: Family history of adverse mental health is associated with higher self-reported internalizing symptoms in children who stutter. The interaction between child, family, and contextual factors may change with age, and this requires further exploration in larger, longitudinal studies. The association between bullying and anxiety scores indicates the importance of anti-bullying initiatives in promoting psychosocial development in school-age children who stutter. This study also highlights the contribution of known risk factors for mental health, such as family history, to variability in symptom reporting.

The Association Between Atypical Speech Development and Adolescent Self-Harm.

BACKGROUND: Adolescent self-harm is a major public health issue internationally. Various factors associated with adolescent self-harm have been identified, including being bullied and experiencing mental health problems. Stuttering and speech sound disorder are associated with both of these factors. It was hypothesized that both stuttering and speech sound disorder would be associated with self-harm. This is the first study to explore the relationship between communication disorders and adolescent self-harm. METHOD: Secondary analysis of a large, longitudinal, prospective, community sample, the Avon Longitudinal Study of Parents and Children, was carried out. Clinicians identified children who stuttered or exhibited speech sound disorder at the age of 8 years. When the cohort members were 16 years old, they were asked to complete a questionnaire about self-harm. Multinomial logistic regression was used to examine the associations between stuttering and speech sound disorder and the self-harm outcomes, adjusting for other relevant factors. RESULTS: Of 3,824 participants with data for both speech status and self-harm, 94 (2.5%; 95% confidence interval [CI; 2.0, 3.0]) stuttered at 8 years of age and 127 (3.3%; 95% CI [2.8, 3.9]) displayed speech sound disorder. Speech sound disorder at the age of 8 years was associated with self-harm with suicidal intent in both unadjusted and adjusted models. Differences between the adjusted and unadjusted models were small, suggesting that speech sound disorder is largely an independent risk factor for self-harm with suicidal intent. Stuttering at the age of 8 years was not associated with adolescent self-harm, and there was no association between speech sound disorder and self-harm without suicidal intent. CONCLUSION: Compared with individuals without speech sound disorder, adolescents with speech sound disorder at the age of 8 years have twice the risk of reporting self-harm with suicidal intent, even when other important predictors are taken into account. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22573030.

Developmental stuttering, physical concomitants associated with stuttering, and Tourette syndrome: A scoping review.

BACKGROUND AND PURPOSE: Developmental stuttering and Tourette syndrome (TS) are common neurodevelopmental disorders. Although disfluencies may co-occur in TS, their type and frequency do not always represent pure stuttering. Conversely, core symptoms of stuttering may be accompanied by physical concomitants (PCs) that can be confused for tics. This scoping review aimed to explore the similarities and differences between stuttering and tics in terms of epidemiology, comorbidities, phenomenology, evolution, physiopathology, and treatment. We also described the nature of PCs in stuttering and disfluencies in TS. METHODS: A literature search on Medline, Embase and PsycInfo was executed in March 2022. From 426 studies screened, 122 were included in the review (a majority being narrative reviews and case reports). RESULTS: TS and stuttering have several epidemiological, phenomenological, comorbidity, and management similarities suggesting shared risk factors and physiopathology (involving the basal ganglia and their connections with speech and motor control cortical regions). PCs in stuttering commonly involve the face (eyelids, jaw/mouth/lip movements) and sometimes the head, trunk and limbs. PCs can be present from early stages of stuttering and vary over time and within individuals. The function of PCs is unknown. Some individuals with TS have a distinct disfluency pattern, composed of a majority of typical disfluencies (mostly between-word disfluencies), and a mix of cluttering-like behaviors, complex phonic tics (e.g. speech-blocking tics, echolalia, palilalia), and rarely, atypical disfluencies. CONCLUSION: Future investigations are warranted to better understand the complex relationships between tics and stuttering and address the management of disfluencies in TS and PCs in stuttering.