Stuttering is a developmental communication disorder that affects approximately one in 20 preschoolers; it typically begins between the ages of 2 and 5 years. Of the preschool children who experience stuttering, approximately 25% will develop a persistent stuttering problem. Because most preschoolers who begin to stutter will recover, parents are typically told to wait-and-see. However, this is not the best course of action for children who are likely to persist and who would most benefit from immediate treatment. It is critical that these children are identified and receive appropriate treatment to reduce the likelihood that stuttering will become a chronic lifelong disorder. Persistent stuttering in older children and adults can have dramatically negative consequences for the individual's educational, employment, and social opportunities. The goal of this project is to improve our ability to predict persistence or recovery from stuttering when children are 4 and 5- years-old. We will use a variety of physiological and behavioral tests to determine which factors are most important in contributing to persistent stuttering. It is generally agreed among researchers that important factors contributing to the development of persistent stuttering include motor, language, and emotional components. It is also widely accepted that the importance of these components varies among individual children who stutter. Therefore our approach to the problem of predicting risk of persistent stuttering is to find the variables that can be entered ino an equation to predict each child's risk. Examples of these variables include speech motor coordination, linguistic proficiency, and emotional reactivity. A better understanding of the factors producing stuttering in early childhood will allow us then to determine what critical components need to be assessed to predict persistence of stuttering. Another goal of our project is to develop a battery of clinical tests that can be used by the clinician to assess risk or persistent stuttering in preschoolers. This clinical battery would include tests such as standardized language tests, speech motor skill tests, and questionnaires used to assess the child's temperament. If the clinician determines, on the basis of this battery, that the child is likely to persist, he/she can design a treatment program suited to that child's specific needs. For example, a stuttering child who is weak in language proficiency and strongly emotionally reactive to his or her own stuttering would most likely benefit from a different treatment strategy compared to a child with immature speech motor skills and high linguistic proficiency.
This project is directly relevant to the mission of NIDCD due to its focus on improving the ability to effectively diagnose children who are most likely to have chronic communication disorder, identifying the most beneficial treatment strategy for each individual, and equipping clinicians with additional tools to serve children who stutter and their families.
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