Predictors of Lidcombe Program treatment dropout and outcome for early stuttering

A preliminary investigation of the mental health of parents of young children who stutter

INTRODUCTION

While research has shown that parents of preschool-aged children who stutter (CWS) may be negatively affected by their child's stuttering, few studies have investigated their mental health. If parents of CWS have poor mental health, this may impact stuttering treatment choices, the conduct of treatment, stuttering treatment outcomes, and the development of stuttering treatments.

METHODS

82 parents (74 mothers and 8 fathers) of preschool-aged children who stutter (aged 1-5) were recruited upon application for an assessment for their child. A survey battery extracting quantitative and qualitative information about symptoms of potential depression, anxiety, stress, and psychological distress, as well as the emotional effect of stuttering on parents was administered and the results summarized.

RESULTS

Data from standardised measures revealed similar incidence as normative data for the presence of stress, anxiety or depression (1 in 6 parents) and distress (almost 1 in 5 parents). However, more than half of the participants reported experiencing a negative emotional effect due to their child's stuttering and a large proportion also reported that stuttering influenced their communication with their child.

CONCLUSIONS

Speech-language pathologists (SLPs) should broaden the scope of their duty of care to include the parents of CWS more fully. Parents should be provided with informational counselling or other support services that will help reduce worry and anxiety related to negative emotions.

Contemporary Theories of Stuttering Development

The article presents a theoretical analysis of contemporary models of persistent stuttering development in children and adults at the current period of development of science. The accumulated amount of scientific knowledge suggests that stuttering has a neurological basis: it is associated with disorders in the structure and function of the brain. On this basis, there have been emerged models of stuttering that link the cause of a speech disorder with an unstable speech motor system. Theories and models of stuttering based on cognitive and language processing are likely to be useful in that they have explanatory power in relation to the mechanisms that play an important role in the production of key symptoms of stuttering. Considering that stuttering is a complex disorder, the logical result of this was the proposal of multifactorial models of impaired speech fluency. The presented overview may be useful to psychiatrists, clinical psychologists, speech therapists, teachers, and practitioners interacting with children and adults with stuttering and other speech fluency disorders.

Psychological characteristics of early stuttering

PURPOSE

The purpose of this study was to use psychological measures of pre-schoolers who stutter and their parents to inform causal theory development and influence clinical practices. This was done using data from a substantive clinical cohort of children who received early stuttering treatment.

METHOD

The cohort (N = 427) comprised parents and their children who were treated with the Lidcombe Program, the Westmead Program, and the Oakville Program. The study incorporated demographic information, stuttering severity, and child and parent psychological measures prior to treatment.

RESULT

The cohort revealed nothing unusual about behavioural and emotional functioning, or the temperaments, of pre-school children that would influence treatment, be targeted during treatment, or influence causal theory development. However, a third of parents were experiencing moderate to high life stressors at the time of seeking treatment, and half the parents failed first-stage screening for Anankastic Personality Disorder.

CONCLUSION

The present results are consistent with a number of previous reports that showed that the population of pre-schoolers who stutter have no unusual psychological profiles. Hence, these results suggest that the association between mental health and stuttering later in life is a consequence of the disorder rather than being a part of its cause. The finding of the life stress of parents who seek stuttering treatment for pre-school children has potential clinical importance and warrants further investigation. Further psychological research is required about parents of pre-school children who stutter, because half the parents in the cohort failed the screener for Anankastic Personality Disorder. This is of interest because a previous study associated screening failure for another personality disorder (Impulsive Personality Disorder) with treatment dropout for early childhood stuttering.