ABSTRACT
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.
Subject(s)
Diabetes Mellitus, Type 2 , Prediabetic State , Stuttering , Humans , Female , Male , Adolescent , Adult , Stuttering/epidemiology , Stuttering/etiology , Stuttering/complications , Young Adult , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Risk Factors , Incidence , Prediabetic State/epidemiology , Prediabetic State/complications , Follow-Up Studies , Blood Glucose/analysis , Cohort Studies , PrognosisABSTRACT
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.
Subject(s)
Disorders of Excessive Somnolence , Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Sleep-Wake Transition Disorders , Stuttering , Child , Humans , Middle Aged , Stuttering/complications , Stuttering/epidemiology , Sleep Wake Disorders/complications , Sleep Wake Disorders/epidemiology , SpeechABSTRACT
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.
Subject(s)
Musculoskeletal Pain , Stuttering , Male , Adult , Female , Humans , Young Adult , Stuttering/epidemiology , Self Report , Saudi Arabia/epidemiology , Deglutition , Headache/epidemiologyABSTRACT
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.
Subject(s)
Phobia, Social , Stuttering , Child , Humans , Adolescent , Phobia, Social/epidemiology , Stuttering/diagnosis , Stuttering/epidemiology , Stuttering/etiology , Anxiety/psychology , Anxiety Disorders , StudentsABSTRACT
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.
Subject(s)
Stuttering , Tics , Tourette Syndrome , Humans , Stuttering/complications , Stuttering/epidemiology , Stuttering/diagnosis , Tourette Syndrome/complications , Tourette Syndrome/epidemiology , Tics/complications , Tics/epidemiology , Speech Disorders/diagnosis , SpeechABSTRACT
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.
Subject(s)
Stuttering , Child, Preschool , Humans , Male , Anxiety , Emotions , Portugal/epidemiology , Speech , Stuttering/diagnosis , Stuttering/epidemiology , Stuttering/therapy , FemaleABSTRACT
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.
Subject(s)
Self-Injurious Behavior , Stuttering , Child , Humans , Adolescent , Aged, 80 and over , Longitudinal Studies , Speech , Stuttering/epidemiology , Stuttering/psychology , Prospective Studies , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/psychologyABSTRACT
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.
Subject(s)
Stuttering , Adolescent , Humans , Child , Stuttering/epidemiology , Stuttering/psychology , Depression/epidemiology , Depression/psychology , Anxiety/epidemiology , Anxiety/diagnosis , Anxiety/psychology , Mental HealthABSTRACT
PURPOSE: The aims of this study were to investigate the occurrence of stuttering behavior across time and to evaluate the relationship between stuttering behavior and language ability in children with Down syndrome. METHOD: A national age cohort of Norwegian first graders with Down syndrome (N = 75) participated in the study. Speech samples from a story-retelling task and a picture book dialogue as well as standardized measures of vocabulary, grammar, and nonverbal mental ability were collected at two time points approximately 5 months apart. Stuttering behavior was evaluated through counting stuttering-like disfluencies and stuttering severity ratings. The relationship between stuttering behavior and language ability was investigated through hierarchical regression analysis. RESULTS: The participants had stuttering severity ratings ranging from no stuttering behavior to severe and displayed all types of stuttering-like disfluencies. There were significant relationships between stuttering behavior and language ability at the first time point, whereas the relationships were not significant at the second time point. The stuttering severity ratings were significantly predicted by language ability across time, whereas the frequency of stuttering-like disfluencies was not. CONCLUSIONS: The occurrence of stuttering behavior was high across the measures and time points; however, the relationship between stuttering behavior and language ability varied across these variables. Thus, the nature of the relationship does not seem to follow a strict pattern that can be generalized to all children across time.
Subject(s)
Down Syndrome , Stuttering , Child , Humans , Language , Down Syndrome/epidemiology , Stuttering/epidemiology , Speech , Speech Production MeasurementABSTRACT
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.
Subject(s)
Stuttering , Young Adult , Male , Female , Humans , Adolescent , Adult , Child, Preschool , Stuttering/epidemiology , Stuttering/psychology , Quality of Life , Communication , Language , FearABSTRACT
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.
Subject(s)
Stuttering , Female , Humans , Longevity , Male , Prospective Studies , Self Report , Speech Therapy , Stuttering/epidemiology , Stuttering/therapyABSTRACT
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.
Subject(s)
Neurodevelopmental Disorders , Stuttering , Child , Executive Function , Humans , Latent Class Analysis , Research Design , Stuttering/epidemiologyABSTRACT
Purpose The purpose of this study is to investigate how epidemiological and clinical factors collectively predict whether a preschooler who is stuttering will persist or recover and to provide guidance on how clinicians can use these factors to evaluate a child's risk for stuttering persistence. Method We collected epidemiological and clinical measures from 52 preschoolers (M = 54.4 months, SD = 6.7 months; 38 boys and 14 girls) diagnosed as stuttering. We then followed these children longitudinally to document whether they eventually recovered or persisted in stuttering. Risk factors found to be significantly associated with stuttering persistence were used to build single and multiple variable predictive statistical models. Finally, we assessed each model's prediction capabilities by recording how accurate a model was in predicting a child's stuttering outcome-persisting or recovered. Results We found that a positive family history of stuttering, poorer performance on a standardized articulation/phonological assessment, higher frequency of stuttering-like disfluencies during spontaneous speech, and lower accuracy on a nonword repetition task were all significantly associated with an increased probability of persistence. The interaction between family history of stuttering and nonword repetition performance was also significant. The full multiple regression model incorporating all these risk factors resulted in the best fitting model with the highest predictive accuracy and lowest error rate. Conclusions For the first time, we show how multiple risk factors collectively predict the probability of stuttering persistence in 3- to 5-year-old preschool children who stutter. Using the full combination of risk factors to assess preschoolers who stutter yielded more accurate predictions of persistence compared to sparser models. A better understanding of the factors that underlie stuttering persistence will yield insight into the underpinnings of chronic stuttering and will help identify etiological targets for novel treatment approaches.
Subject(s)
Stuttering , Attention , Child, Preschool , Female , Humans , Male , Risk Factors , Speech , Speech Production Measurement , Stuttering/epidemiologySubject(s)
Stuttering , Humans , Speech , Speech Therapy , Stuttering/diagnosis , Stuttering/epidemiology , Stuttering/therapyABSTRACT
PURPOSE: Evidence of a linkage between neurodevelopmental stuttering and sleep difficulties has been suggested in studies involving children and adolescents. To further examine the relationship between stuttering and sleep, the current study explored both hours of sleep and insomnia in a longitudinal sample of adolescents and young adults living with stuttering. METHOD: The data for this study came from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative survey study following 13,564 US respondents over the course of 20 years. In each of the five survey waves, respondents noted their average hours of sleep. In addition, Wave IV, respondents indicated whether they suffered from insomnia (i.e., difficulty falling or staying asleep). Respondents who indicated stuttering at ages 18-26 (Wave III) and 24-32 (Wave IV) are considered as those with persistent stuttering-the focus of this analysis. Regression analysis assessed the association between stuttering, hours of sleep and insomnia controlling for sex, age, race, education and other demographic characteristics. RESULTS: The sample included 261 participants (1.7% of total respondents) who identified themselves as people who stutter, comprised of 169 males and 92 females. Compared to their fluent counterparts, individuals who stutter reported to sleep, on average, 20 min less per night. Additionally, 15% of those who stutter reported difficulties falling or staying asleep almost every day or every day, which is twice as likely as controls. Results were robust to demographic characteristics and co-occurring conditions. CONCLUSIONS: Speech-language pathologists should be aware of the association between stuttering and insomnia, as well as the lower average hours of sleep among adolescents and young adults who stutter. The possibility that lower sleep duration and insomnia may affect stuttering daily variability and impair improvement from stuttering are discussed.
Subject(s)
Sleep Initiation and Maintenance Disorders , Stuttering , Adolescent , Adult , Child , Female , Humans , Longitudinal Studies , Male , Sleep , Sleep Initiation and Maintenance Disorders/epidemiology , Stuttering/epidemiology , Surveys and Questionnaires , Young AdultABSTRACT
PURPOSE: This study aimed to identify cases of developmental stuttering and associated comorbidities in de-identified electronic health records (EHRs) at Vanderbilt University Medical Center, and, in turn, build and test a stuttering prediction model. METHODS: A multi-step process including a keyword search of medical notes, a text-mining algorithm, and manual review was employed to identify stuttering cases in the EHR. Confirmed cases were compared to matched controls in a phenotype code (phecode) enrichment analysis to reveal conditions associated with stuttering (i.e., comorbidities). These associated phenotypes were used as proxy variables to phenotypically predict stuttering in subjects within the EHR that were not otherwise identifiable using the multi-step identification process described above. RESULTS: The multi-step process resulted in the manually reviewed identification of 1,143 stuttering cases in the EHR. Highly enriched phecodes included codes related to childhood onset fluency disorder, adult-onset fluency disorder, hearing loss, sleep disorders, atopy, a multitude of codes for infections, neurological deficits, and body weight. These phecodes were used as variables to create a phenome risk classifier (PheRC) prediction model to identify additional high likelihood stuttering cases. The PheRC prediction model resulted in a positive predictive value of 83 %. CONCLUSIONS: This study demonstrates the feasibility of using EHRs in the study of stuttering and found phenotypic associations. The creation of the PheRC has the potential to enable future studies of stuttering using existing EHR data, including investigations into the genetic etiology.
Subject(s)
Stuttering , Algorithms , Child , Comorbidity , Electronic Health Records , Humans , Phenotype , Stuttering/diagnosis , Stuttering/epidemiologyABSTRACT
PURPOSE: To investigate the association between stuttering in adolescence and incident type 2 diabetes in young adulthood. METHODS: This nationwide population-based study included 2 193 855 adolescents of age 16 to 20 years who were assessed for military service between 1980 and 2013. Diagnoses of stuttering in adolescence were confirmed by a speech-language pathologist. Diabetes status for each individual as of December 31, 2016, was determined by linkage to the Israeli National Diabetes Registry. Relationships were analyzed using regression models adjusted for socioeconomic variables, cognitive performance, coexisting morbidities, and adolescent body mass index. RESULTS: Analysis was stratified by sex (Pinteraction = 0.035). Of the 4443 (0.4%) adolescent men with stuttering, 162 (3.7%) developed type 2 diabetes, compared with 25 678 (2.1%) men without stuttering (adjusted odds ratio [OR] 1.3; 95% CI, 1.1-1.6). This relationship persisted when unaffected brothers of men with stuttering were used as the reference group (adjusted OR = 1.5; 95% CI, 1.01-2.2), or when the analysis included only adolescents with unimpaired health at baseline (adjusted OR = 1.4; 95% CI, 1.1-1.7). The association was stronger in later birth cohorts, with an adjusted OR of 2.4 (1.4-4.1) for cases of type 2 diabetes before age 40. Of the 503 (0.1%) adolescent women with stuttering 7 (1.4%) developed type 2 diabetes, compared with 10 139 (1.1%) women without stuttering (OR = 2.03; 95% CI, 0.48-2.20). CONCLUSIONS: Adolescent stuttering is associated with an increased risk for early-onset type 2 diabetes among men.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Stuttering/epidemiology , Adolescent , Cohort Studies , Diabetes Mellitus, Type 2/etiology , Female , Humans , Incidence , Israel/epidemiology , Male , Registries , Risk Factors , Stuttering/complications , Young AdultABSTRACT
This study assessed the prevalence of childhood stuttering in adults with dyslexia (AWD) and the prevalence of dyslexia in adults who stutter (AWS). In addition, the linguistic profiles of 50 AWD, 30 AWS and 84 neurotypical adults were measured. We found that 17 out of 50 AWD (34 %) reported stuttering during childhood compared to 1 % of the neurotypical population. This was moderated by the severity of dyslexia: People with mild dyslexia showed a lower prevalence rate (15 %) of childhood stuttering than those with severe dyslexia (47 %). In addition, we observed that 50 % of the AWS (n = 30) fulfilled the diagnostic criteria of dyslexia, even though they had never been diagnosed as dyslexic. Compared to neurotypical adults, phonological working memory, awareness, and retrieval were similarly reduced in AWS and AWD. The findings supports the view that stuttering and dyslexia may share a phonological deficit.
Subject(s)
Dyslexia , Stuttering , Adult , Dyslexia/complications , Dyslexia/epidemiology , Humans , Linguistics , Memory, Short-Term , Phonetics , Stuttering/complications , Stuttering/epidemiologyABSTRACT
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.
Subject(s)
Stuttering , Child , Child, Preschool , Humans , Infant, Newborn , Japan/epidemiology , Parents , Speech , Speech Disorders , Stuttering/diagnosis , Stuttering/epidemiologyABSTRACT
PURPOSE: The purpose of this study was to investigate the relationship between depressive symptoms and suicidal ideation and living with stuttering while accounting for time, sex, and health-related confounders. METHOD: The data for this study come from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative survey study that has followed 13,564 respondents over the course of 14 years. Responses to the question "Do you have a problem with stuttering or stammering?" at two time points were used to establish stuttering and non-stuttering groups. Regression analysis, propensity score matching, and structural equation modeling were used. RESULTS: Compared to their fluent counterparts, males and females reported significantly elevated symptoms of depression. Although symptoms of depression among males who stutter were stable over time, depressive symptoms among females who stutter increased with age. Compared to males who do not stutter, males who stutter were significantly more likely to report feelings of suicidal ideation. There were no differences in suicidal ideation between females who do and do not stutter. CONCLUSIONS: Speech-language pathologists should be aware of the associations between stuttering and depressive symptoms, as well as the increased risk for suicidal ideation among males who stutter. Clinicians should be knowledgeable about symptoms of depression and suicidal ideation and be familiar with processes to refer as needed.