Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering.

ABSTRACT

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.