Prevalence and Therapy Rates for Stuttering, Cluttering, and Developmental Disorders of Speech and Language: Evaluation of German Health Insurance Data

Acknowledging a Stutter Affects the Impression One Makes in a Job Interview

BACKGROUND

People who have a stutter are often viewed negatively by others. Acknowledgement-defined as notifying others up front about characteristics that might lead one to be evaluated negatively-might be an effective impression management strategy for people stigmatized by stuttering. Past research testing this hypothesis, however, has produced inconsistent findings.

AIMS

To assess the effectiveness of acknowledgement by people who stutter as a strategy for eliciting more positive evaluations from others while controlling for possible methodological problems in past research. Participants were expected to be more likely overall to find job applicants without a stutter to be better candidates for a job than those with a stutter. However, it was also hypothesized that this difference would not be significant when candidates with a stutter acknowledged it.

METHODS & PROCEDURES

Participants watched two simulated job interview videos: in one, the applicant had a stutter, and in the other, they did not. For half of the participants, the applicant who stuttered acknowledged the speech dysfluency at the beginning of the job interview. After watching each interview, the participants rated the interviewee.

OUTCOMES & RESULTS

The results revealed the predicted significant interaction between stuttering and acknowledgement: acknowledgement of the stutter led the stuttering job candidate to be evaluated just as positively as the non-stuttering job candidate.

CONCLUSIONS & IMPLICATIONS

This research has implications for the kind of advice practitioners can offer people anticipating interactions (such as job interviews) where they will be evaluated. The findings also potentially widen the range of circumstances in which acknowledgement can be used to counteract the negative impressions people might be biased to form of stigmatized individuals.

WHAT THIS PAPER ADDS

What is already known on the subject Previous research shows that acknowledging a stigmatized identity (and other forms of acknowledgement) upfront before interacting with others in an evaluative context (such as a job interview) can often improve the impression one makes and how one's performance is perceived. However, past research evaluating this strategy in the case of stuttering has produced inconsistent findings. In addition, some past research suggests that acknowledgement might not be effective when the source of stigma is perceptually salient during the interaction. What this paper adds to the existing knowledge The results of this study, designed to control for possible methodological problems in past research, indicate that acknowledgement can in fact be an effective impression management strategy for people who stutter. What are the potential or actual clinical implications of this work? This research has implications for the kind of advice practitioners can offer people anticipating interactions (such as job interviews) where they will be evaluated. In short, it provides a method for trying to reduce the discrimination a person who stutters might face.

Life Impact of Cluttering: The Adult Perspective

INTRODUCTION

Though the research on the quality of life of people who stutter is extensive, there is minimal research on cluttering's life impact. Anecdotal reports from people who clutter1 and their significant others have described some elements of cluttering's impact and advocated for these components to be addressed in treatment. Three formal studies have used semistructured interviews to document cluttering's impact. These non-peer-reviewed studies make important contributions; however, more research is needed to add to this existing information. The current study adds perspectives of adults who clutter related to cluttering's impact upon the specific contexts of work, school, and social situations.

METHOD

In this phenomenological study, 10 adults who clutter participated in a semistructured interview. Through grand tour, mini tour, and example questions, participants were asked to provide their perspective on the life impact of cluttering. Each interview was orthographically transcribed, and transcripts were coded for themes. Triangulation and member checking were conducted to establish reliability and validity of themes.

RESULTS

Results revealed the following themes: Social impact of cluttering leads to avoidance, misunderstanding, and feelings of isolation; cluttering impacts natural tendencies; educational impact of cluttering results in misunderstanding and struggle; occupational impact of cluttering leads to role entrapment and difficulty maintaining employment.

CONCLUSIONS

This study adds perspectives of adults who clutter regarding specific aspects of quality of life such as social isolation, frequent misunderstandings, and negative educational and occupational impact. As more voices are heard within the cluttering community, more support is presented for the importance of understanding the negative life impact cluttering can have. Further understanding of these perspectives adds to the information needed to inform holistic cluttering assessment and treatment.

Adult stuttering prevalence I: Systematic review and identification of stuttering in large populations

PURPOSE

Stuttering epidemiology is reviewed with a primary goal of appraising methods used to identify stuttering in large populations. Secondary goals were to establish a best estimate of adult stuttering prevalence; identify data that could subgroup stuttering based upon childhood versus adult onset and covert versus over behaviour; and conduct a preliminary assessment of the degree to which stuttering features as a co-occurring diagnosis.

METHODS

Systematic review followed PRISMA guidelines. Quality assessment was based on the Joanna Briggs Institute Prevalence Critical Appraisal Tool, with criteria adjusted for appraisal of stuttering.

RESULTS

15 sets of data were assessed for quality, with three meeting criteria for inclusion. These estimated adult stuttering prevalence at 0.67% at age 14-17 years (Taghipour et al., 2013); 0.21% at age 16-20 years (Tsur et al., 2021); and 0.63% when aged over 21 years (Craig et al., 2002).

CONCLUSION

Systematic review indicates adult stuttering prevalence is between 0.6-0.7%. A false positive paradox follows from the low prevalence of stuttering in the general population, creating a need for very high specificity when measuring stuttering in the general population. Failure to achieve high specificity (99.9% is suggested) leads to loss of statistical power due to presence of false positives. A corollary of the false positive paradox is that sensitivity in measurement of stuttering can be relatively low (90% is suggested) before general population estimates of stuttering prevalence are appreciably affected. Despite this relaxation of measurement requirements regarding sensitivity, covert stuttering is likely to have been underestimated. Covert stuttering might be accounted for using data from prospective cohort studies, however such a revision seems unlikely to exceed the widely-accepted 1% adult stuttering prevalence estimate; see Gattie, Lieven & Kluk (2024 this issue) for an estimate at 0.96 %. When used to estimate stuttering prevalence, data reported by Tsur et al. (2021) are outlying, with the relatively low estimate possibly due to origin as military conscript data and/or generalised healthcare screening.

Adult stuttering prevalence II: Recalculation, subgrouping and estimate of stuttering community engagement

PURPOSE

Epidemiological research of stuttering has frequently focused on children, with a relative paucity of population level data specific to adults. Prevalence data for adults are reassessed here, including a breakdown of whether stuttering is overt or covert, and whether onset was in childhood or adulthood. The engagement of adults who stutter with stuttering communities is also estimated.

METHODS

Prevalence calculations were based on data from studies having the strongest designs, following the systematic review of Gattie, Lieven & Kluk (2024, this issue). Original data for engagement with stuttering communities were gathered from English language internet stuttering support groups, a national stuttering charity in the UK and a regional stuttering support group in Manchester, UK.

RESULTS

Adult stuttering prevalence was estimated at 0.96% (95% CI 0.65, 1.44). This can be broken down to 0.63% overt stuttering (95% CI 0.46, 0.79) comprising 0.53% childhood onset and 0.10% adult onset; and 0.33% covert stuttering (95% CI 0.19, 0.58) comprising 0.28% childhood onset and 0.05% adult onset. Covert stuttering will have been overestimated, and may often be very mild. Engagement with stuttering communities was estimated at 0.99% internationally, 0.63% nationally and 1.01% regionally. Actual engagement will have been lower due to attrition and overcounting.

CONCLUSION

The adult stuttering prevalence estimate of 0.96% is consistent with the widely-cited all ages stuttering prevalence estimate of 1%. Of adults who stutter, fewer than 1% engage with stuttering communities.

Improving Stuttering Through Augmented Multisensory Feedback Stimulation

BACKGROUND/OBJECTIVES

Stuttering is a speech disorder involving fluency disruptions like repetitions, prolongations, and blockages, often leading to emotional distress and social withdrawal. Here, we present Augmented Multisensory Feedback Stimulation (AMFS), a novel personalized intervention to improve speech fluency in people who stutter (PWS). AMFS includes a five-day intensive phase aiming at acquiring new skills, plus a reinforcement phase designed to facilitate the transfer of these skills across different contexts and their automatization into effortless behaviors. The concept of our intervention derives from the prediction of the neurocomputational model Directions into Velocities of Articulators (DIVA). The treatment applies dynamic multisensory stimulation to disrupt PWS' maladaptive over-reliance on sensory feedback mechanisms, promoting the emergence of participants' natural voices.

METHODS

Forty-six PWS and a control group, including twenty-four non-stuttering individuals, participated in this study. Stuttering severity and physiological measures, such as heart rate and electromyographic activity, were recorded before and after the intensive phase and during the reinforcement stage in the PWS but only once in the controls.

RESULTS

The results showed a significant reduction in stuttering severity at the end of the intensive phase, which was maintained during the reinforcement training. Crucially, worse performance was found in PWS than in the controls at baseline but not after the intervention. In the PWS, physiological signals showed a reduction in activity during the training phases compared to baseline.

CONCLUSIONS

Our findings show that AMFS provides a promising approach to enhancing speech fluency. Future studies should clarify the mechanisms underlying such intervention and assess whether effects persist after the treatment conclusion.

Self-inefficacy's impact on well-being indices in students self-identifying with cluttering characteristics

INTRODUCTION

Cluttering, a fluency disorder characterized by fast and irregular speech patterns, receives relatively limited research attention. Consequently, the association between cluttering and measures of well-being remains unexplored. In contrast, stuttering, another fluency disorder, has been associated with anxiety and depression. The present study examines whether an individual's experience of cluttering characteristics is related to alterations in both positive and negative measures of well-being. To achieve this, we assessed the relationship between Self-Identified Cluttering Characteristics (SICC) and measures of well-being in a sizeable sample of 1201 university students. Our main objective was to explore the potential impact of self-inefficacy on the association between SICC and well-being.

METHODS

Consistent with prior research, participants identified themselves as having cluttering characteristics (SICC) or no-cluttering characteristics (SINCC) based on a verbal and written explanation of the disorder. They also completed questionnaires on psychological well-being indices and self-inefficacy.

RESULTS

In total, 276 respondents identified themselves as having cluttering characteristics. In regression models, both SICC and self-inefficacy were predictive of greater negative well-being, increased depressive symptoms, and heightened psychosomatic symptoms. Interestingly, ADHD diagnosis was associated with less negative well-being. Positive well-being indicators (positive future orientation and subjective happiness) were solely predicted by self-inefficacy. Supporting these findings, supplementary regressions including only 56 SICC participants who reported being treated for cluttering yielded similar results. Utilizing Hayes's PROCESS computational procedures to test moderation revealed that self-inefficacy significantly moderated the association between SICC and negative well-being (depressive symptoms) as well as the association between SICC and positive well-being (positive future orientation).

CONCLUSIONS

The findings underscore alterations in well-being among individuals who identify themselves as experiencing cluttering characteristics. Primarily, heightened negative well-being was noted in those with SICC, yet individual self-inefficacy reports mitigated this effect. Overall, SICC exacerbates negative well-being rather than diminishing positive well-being. These findings point to the importance of integrating mental health assessment and intervention into clinical practice for individuals with cluttering symptoms and the potential benefits of interventions targeting self-inefficacy to improve overall well-being in this population.

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.

Knowns and unknowns about the neurobiology of stuttering

Stuttering occurs in early childhood during a dynamic phase of brain and behavioral development. The latest studies examining children at ages close to this critical developmental period have identified early brain alterations that are most likely linked to stuttering, while spontaneous recovery appears related to increased inter-area connectivity. By contrast, therapy-driven improvement in adults is associated with a functional reorganization within and beyond the speech network. The etiology of stuttering, however, remains enigmatic. This Unsolved Mystery highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering.

Effectiveness of Stuttering Modification Treatment in School-Age Children Who Stutter: A Randomized Clinical Trial

PURPOSE

This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter.

METHOD

Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7-11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker's Experience of Stuttering-School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity.

RESULTS

At 3 months postrandomization, the mean score changes of the OASES-S differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants).

CONCLUSIONS

The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24207864.

Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews

PURPOSE

For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness.

METHOD

Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis.

RESULTS

Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall.

CONCLUSIONS

For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24168201.

There is more to cluttering than meets the eye: The prevalence of cluttering and association with psychological well-being indices in an undergraduate sample

BACKGROUND

Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech delivery rate along with disfluencies that are frequent but are not judged to be stuttering. Data on cluttering prevalence in the general population are scarce, as well as its association with psychological well-being indices, such as anxiety, and depressive symptoms.

AIMS

To estimate cluttering prevalence among undergraduates, as well as its relationship with psychological and well-being indicators.

METHODS & PROCEDURES

To address these issues, a large sample (n = 1582) of undergraduates completed a questionnaire that provided a lay definition of cluttering and were asked to identify themselves as clutterers (SI-Clut), as well as to indicate the presence of several psychological and mental well-being indices.

OUTCOMES & RESULTS

A total of 276 respondents (23%) self-identified as clutterers (now or in the past), with 55.1% of those being male. Only 56 respondents (3.5% of the total sample; about 21% of SI-Clut) reported having received speech therapy for cluttering. Relative to students self-identifying as non-clutterers, self-identification of cluttering was associated with higher levels of psychosomatic symptoms, depressive symptoms and stress, indicating a tendency toward internalizing psychopathology, along with lower self-esteem, and lower subjective happiness.

CONCLUSIONS & IMPLICATIONS

The current findings point to the high prevalence of students self-identifying as clutterers, along with a significant link between cluttering and mental distress. Therefore, it is important to increase public awareness of cluttering, its diagnosis and treatment. From the clinical perspective, the elevated levels of somatic complaints, anxiety and depression may represent internalizing psychopathology, associated with more covert rather than overt symptomatology. Such symptom manifestation calls for special attention from the speech-language pathologists providing cluttering therapy, using designated well-being or mental health screening tools. Although data on standard cluttering treatment are limited, it should be customized to the client's unique difficulties. Speech-language pathologists' understanding of cluttering, which includes both speech characteristics as well as psychological and social aspects of well-being, may assist them in implementing effective treatments.

WHAT THIS PAPER ADDS

What is already known on the subject Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech rate, along with various disfluencies and articulatory imprecision. It may co-occur with other disorders, such as learning disabilities, and attention-deficit/hyperactivity disorder. Data on cluttering prevalence and its association with psychological well-being indices, such as anxiety and depression, are limited. What this paper adds to existing knowledge A total of 276 undergraduates (23%) self-identified as clutterers, of whom 55.1% were males. A total of 56 respondents (3.5% of the total sample, and about 21% of undergraduates self-identified as clutterers) reported having received speech therapy for cluttering. Psychosomatic symptoms, depressive symptoms and stress levels were higher among these students, suggesting a tendency toward internalizing psychopathology, along with a lower sense of self-esteem and subjective happiness. What are the potential or actual clinical implications of this work? The high prevalence of students self-identifying as clutterers, along with the low percentage of respondents who received speech therapy for cluttering, emphasize the need to raise public awareness of the problem, its diagnosis and treatment (Reichel et al., 2010). The association between cluttering and mental distress requires speech-language pathologists to be aware that cluttering may have covert symptomatology, similar to stuttering, which should be addressed in therapy.

Stuttering Behavior in a National Age Cohort of Norwegian First-Graders With Down Syndrome

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.

Stuttering interventions for children, adolescents, and adults: a systematic review as a part of clinical guidelines

INTRODUCTION

Stuttering may have a holistic effect on the quality of life of a person who stutters by limiting participation in social situations, resulting in feelings of isolation and frustration, leading to difficulties in education and employment and increasing the likelihood of mental health problems. Even young children who stutter may have negative experiences of speaking. Therefore, it is important to treat stuttering behavior effectively in both children and adults. The purpose of this paper was to systematically review group and case studies about the effectiveness of behavioral stuttering interventions to provide evidence-based guidelines for clinicians.

METHODS

Systematic data retrieval was conducted in four electronic databases (PsycINFO, CINAHL, PubMed, Cochrane). The assessment of search results was conducted according to predetermined inclusion and exclusion criteria by two independent judges. The methodological quality of each paper was assessed using strict criteria to include only high-quality research.

RESULTS

The search revealed 2293 results, and 38 papers (systematic reviews N=3, group design studies N=21 and case studies N=14) with acceptable methodological quality were included. The data show that there is most evidence about the treatment of early childhood stuttering, very little evidence about school-aged children and some evidence about adults. The most convincing evidence is about the Lidcombe Program in the treatment of young children who stutter, but also other methods have promising evidence. Our data imply that in the treatment of adults who stutter, holistic treatments may influence speech fluency and overall experience of stuttering behavior. Speech restructuring treatments may have a positive effect on overt characteristics of stuttering, but not on covert stuttering behavior.

CONCLUSIONS

The results of this review agree with earlier reviews about the treatment of young children. However, due to different inclusion criteria, this review also shows the benefits of holistic treatment approaches with adults and adolescents.

Cognitive disorders in childhood epilepsy: a comparative longitudinal study using administrative healthcare data

OBJECTIVE

The study aimed to assess the risk of cognitive impairment in patients with epilepsy, the impact of age of epilepsy onset on cognition and the temporal relationship of epilepsy onset and intellectual impairment.

METHODS

This longitudinal study analyzed birth cohorts and followed-up children born 2005-2007 up to the age of ten using administrative healthcare data of about 8.9 million members insured by the statutory health insurance "BARMER" in Germany. We compared prevalence of cognitive impairment (ICD-code F7*) in children with epilepsy (ICD-code G40) to controls, and calculated relative risks by age groups at onset of epilepsy and assessed differences in relation to the temporal sequence of the diagnoses.

RESULTS

Of the 142,563 pre-pubertal children included in the analysis, 2728 (1.9%) had an epilepsy diagnosis within the first 10 years of life. 17.4% (475/2728) of children with epilepsy had a diagnosis of cognitive impairment compared to 1.7% (2309/139835) in controls. The relative risk for cognitive impairment compared to age-matched controls was 10.5 (95% CI 9.6, 11.6) and was highest in epilepsy cases with seizure manifestation within the first 2 years of life compared to older children. The prevalence of cognitive impairment before epilepsy diagnosis was slightly increased compared to controls, while it was increased by a factor of nine in children diagnosed with cognitive impairment in the year of onset of epilepsy or afterwards.

CONCLUSIONS

Pre-pubertal children with epilepsy have a ten-fold higher risk for intellectual impairment compared to age-matched controls. This risk inversely correlates with the age of epilepsy manifestation. Cognitive impairment was diagnosed after epilepsy manifestation in the majority of patients.

The disabling nature of hope in discovering a biological explanation of stuttering

Discovering developmental stuttering's biological explanation has been an enduring concern. Novel advances in genomics and neuroscience are making it possible to isolate and pinpoint genetic and brain differences implicated in stuttering. This is giving rise to a hope that, in the future, dysfluency could be better managed if stuttering's biological basis could be better understood. Concurrent to this, there is another hope rising: a hope of a future where differing fluencies would not be viewed through a reductive lens of biology and associated pathologies. The central aim of this paper is to edge out ethical implications of novel research into stuttering's biological explanation. In doing so, the paper proposes to look beyond the bifurcation sketched by the medical and social model of disability. The paper demonstrates how the scientific hope of discovering stuttering's biological explanation acts as an accessory of disablement due to the language of 'lack' and 'deficit' employed in reporting scientific findings and proposes participatory research with people who stutter as an antidote to manage this disablement.

Dyscalculia and dyslexia in Chinese children with idiopathic epilepsy: different patterns of prevalence, comorbidity and gender differences

Objective

The present study aimed to examine the prevalence of dyscalculia, dyslexia, and their comorbidity rates in a large population‐based sample of children with idiopathic epilepsy (N = 2282) and a comparison sample of typically developing schoolchildren (N = 2371).

Methods

Both groups of children were screened using an arithmetic fluency test for dyscalculia and a reading fluency test for dyslexia. Their comorbidity rates were assessed. The prevalence rates of dyscalculia, dyslexia, comorbidity, and isolated dyscalculia/dyslexia (ie, participants with comorbid dyslexia and dyscalculia were excluded) were analyzed.

Results

In both −1.5 SD and −1 SD cutoff criterion, the prevalence rates were about two times higher in children with idiopathic epilepsy than in other schoolchildren; the prevalence rates of isolated dyslexia were higher in children with idiopathic epilepsy than in other schoolchildren (−1 SD: 10.9% vs 8.6%; −1.5 SD: 6.5% vs 4.7%). Meanwhile, comorbidity rates of dyscalculia and dyslexia were higher in children with idiopathic epilepsy than in other schoolchildren (32.7% vs 26.6%; 38.3% vs 23.5%, respectively). Overall, patterns of prevalence rates were different for children with idiopathic epilepsy and schoolchildren, in which children with idiopathic epilepsy had a higher prevalence rate of dyscalculia than dyslexia, while schoolchildren had a higher prevalence of dyslexia than dyscalculia, regardless of cutoff criteria. Interestingly, gender differences in the prevalence rates of all types of learning disabilities were found in schoolchildren, but there were only gender differences in the prevalence rates of dyslexia in children with idiopathic epilepsy.

Significance

The results highlight the vulnerability of children with idiopathic epilepsy for learning disabilities and a differential pattern of gender differences in dyslexia. Moreover, different patterns of prevalence rates suggest that children with idiopathic epilepsy and schoolchildren are more prone to different types of learning disabilities. The findings suggest needs for special interventions of learning disabilities for children with idiopathic epilepsy.