Clinical Characteristics Associated with Stuttering Persistence: A Meta-Analysis
Singer, Cara Michelle
Approximately 80% of young children who begin stuttering fall below diagnostic thresholds of stuttering (i.e., exhibit recovery) within four to five years of onset. To investigate characteristics that may differentiate children who recover from stuttering (recovered) and children who persist in stuttering (persistent), multiple prospective cohort studies have been conducted. Clinical characteristics (e.g., sex, age at onset, family history of stuttering, stuttering severity and speech-language ability) have been explored as potential risk factors of stuttering persistence with varying results. The present study employed a meta-analytic approach to conduct a systematic review and quantitative assimilation of all available data on clinical characteristics associated with stuttering persistence. Thirty-nine reports (11 studies) met eligibility criteria for the present study. Results indicated that persistent children, compared to recovered children, were more likely to be male and have a family history of stuttering. Further, persistent children exhibited a later onset of stuttering, a higher rate of stuttering-like disfluency, lower speech-sound accuracy, and lower receptive and expressive language than recovered children. High heterogeneity was found across models for individual types of stuttering-like disfluencies, a family history of recovered and persistent stuttering, expressive and receptive vocabulary, negative reactivity and surgency, which indicates that more data is required to determine their potential relation to stuttering persistence. No differences were found for stuttering severity, non-stuttering-like disfluencies, language analysis measures, and effortful control. The findings from the present study represent the highest level of evidence for potential clinical risk factors of stuttering persistence to date and further the understanding of the nature of persistent stuttering. The inclusion of these clinical characteristics in an empirically-based initial evaluation of stuttering in young children will provide valuable diagnostic data that will aid speech-language pathologists in making treatment decisions. Future studies may consider investigating whether the presence of multiple risk factors confers increased risk for persistence (i.e., cumulative risk) as well as whether there are risk factors that confer greater risk than others.