Children who stutter face greater challenges managing their behavior and emotions

Children who stutter often face greater challenges managing their behavior and emotions than other children, researchers have found, offering new insight into how to help these children in a more holistic way.

"Our findings indicate that young children who stutter are more apt to be emotionally aroused, less able to settle down once aroused and less able to control their attention and emotion during everyday stressful or challenging situations," Vanderbilt University psychologist Tedra Walden, a co-author of the research, said.

"Stuttering, as it continues, can impact a child's academic, emotional, social and vocational potential and development. Therefore, if we know more about how emotions influence stuttering and then use this information to more effectively treat early childhood stuttering, we should be in a better position to decrease the long-term negative effects of stuttering in children as they get older," she continued.

"We have long thought emotional development influenced childhood stuttering; however, until such findings as ours, we've lacked data to support such beliefs," Edward G. Conture, a co-author of the research and director of graduate studies in the Vanderbilt Department of Hearing and Speech Sciences, said. "These new findings tell us that when parents tell clinicians, for example, that excitement increases their child's stuttering, clinicians should try to see how and when certain emotional states increase or maintain the child's stuttering. Clinicians need to pay more attention to what parents observe about what impacts their child's stuttering."

In addition to Walden and Conture, the research team included Vanderbilt researchers Jan Karrass, first author of the research, Corrin Graham, Hayley Arnold, Kia Hartfield and Krista Schwenk. The research is in press at the Journal of Communication Disorders and is available online now at www.sciencedirect.com/science/journal/00219924.

The researchers were interested in understanding the relationship between how children who stutter are affected by and handle emotional stimulation, as well as their ability to control their attention during everyday situations.

To examine this relationship, the researchers used a standardized test of emotions, surveying the parents of 65 3- to 5-year-old children who stutter and 56 children of the same age who do not. The parents filled out a 100-question survey designed to determine how the children react to emotional events and how well they are able to control these emotions. The children participated in two laboratory tests to gauge their language use and speech abilities to ensure that the only speech-language difference between children who do and do not stutter, at least for this study, was restricted to stuttering.

The researchers found three primary differences between young children who stutter and those who do not. The children who stutter were more emotionally aroused by everyday stressful or challenging situations than their non-stuttering peers. It took these children a longer time to settle back down once they had become aroused. And, the children who stuttered were less able to control their attention and were more likely to become fixated on a distraction than the children who do not stutter.

The authors also found that the degree to which children who stutter are able to regulate their emotions, combined with how strongly they react to upsetting or exciting situations, played a role in the frequency, duration and severity of instances of stuttering.

"We have here something of a 'chicken or egg' question, that is, is there a causal relationship between their emotional, behavioral and attention issues and stuttering, or are those two situations just happening at the same time?" Walden said. "Our findings seem to indicate that kids with behavioral and emotional issues are at greater risk of stuttering, that not all aspects of their emotional reactions can be blamed on stuttering, and some of these reactions may pre-date the onset of stuttering and actually contribute to its onset and development."

"Parents of children known or suspected to be stuttering should not read these findings to suggest that they raise their children in a hermetically sealed jar. Their children should be allowed the full range of emotions and experiences of any other typically developing child," Conture said. "However, if the child consistently and routinely reacts to things such as everyday changes in activities or routine to a greater degree and longer than expected - especially if such reactions seem more usual than unusual and appear related to changes in the child's stuttering - the parent should consider discussing this with a health professional, preferably someone with experience assessing and treating childhood stuttering."

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