Effortful control and adaptive functioning in school-age children who stutter

Abstract

Purpose: Research has shown that children who stutter (CWS) demonstrate poor adaptive functioning, or poor functional, social, and psychological skills, when compared to children who do not stutter (CWNS). Previous work has also shown that preschool CWS demonstrate significantly lower effortful control than CWNS. High effortful control, or the ability to inhibit a dominant response, is predictive of high adaptive functioning in children who are exposed to a range of adversities. The purposes of this study were fourfold: (a) to investigate if the differences between preschool CWS and CWNS in effortful control extended to school-aged children; (b) to determine if effortful control could uniquely explain adaptive functioning after controlling for a diagnosis of stuttering; (c) to investigate whether effortful control was more influential to CWS than to CWNS; and (d) to investigate whether effortful control uniquely explained adaptive functioning in CWS after controlling for stuttering frequency. Methods: Effortful control and seven core areas of adaptive functioning were investigated in 46 school-age CWS and 46 CWNS. Eight independent two tailed t-tests were used to assess whether CWS demonstrated lower effortful control than CWNS and lower adaptive functioning than CWNS in seven adaptive functioning areas: communication competence, peer competence, internalizing behaviors, externalizing behaviors, general anxiety, social anxiety, and depression. Correlation and hierarchical regression analyses were used to examine the extent to which each component of adaptive functioning was related to effortful control when controlling for age, intelligence, parent-child relationship, and stuttering v PUBLIC ABSTRACT Children who stutter often experience negative consequences as a result of stuttering, including poor relationships with their peers, higher psychological behavior problems, and lower communication abilities. Research has shown that the better a child can regulate his or her emotions, the better he or she can cope with difficulties. This is particularly compelling as preschool children who stutter have lower regulation abilities than their peers. However, because 75% of preschool children who stutter will recover, it is unknown whether the subgroup of older school-age children who continue to stutter also have lower abilities in regulation. If they do, they may not have the internal regulation abilities needed to cope with stuttering. Moreover the negative side effects of stuttering may not be due to the stuttering itself, but to diminished regulation abilities. This study investigated whether emotional regulation is more important to social, psychological, and communication abilities than stuttering in school-age children. The results showed that emotional regulation was the most important factor to a child developing positive social and psychological skills, even more important than whether the child stuttered, or even the degree of the stuttering. However, the study also showed that quantity of stuttering also aff...

Cognitive bias and stuttering in adolescence

“…Gunn and colleagues 2014reported that 38% of treatment-seeking aWS in their sample attained at least one diagnosis of an Axis I mental health disorder, with 71% of these classified as anxiety disorders; this is nearly double the current estimates for adolescents in the general population. Further, compared to typically fluent controls (TFC), aWS have been shown to exhibit higher levels of social anxiety (Blood et al, 2001;Erickson & Block, 2013;Hollister, 2015;Mulcahy et al, 2008), trait anxiety Davis et al, 2007;Mulcahy et al, 2008), and state anxiety (Mulcahy et al, 2008), although the severity of anxiety tended to remain within the normal range.…”

“…These psychosocial ramifications of stuttering likely make aWS acutely vulnerable to developing social anxiety. Indeed, several reports comparing aWS to TFC have revealed higher rates of social anxiety (Blood et al, 2001;Erickson & Block, 2013;Hollister, 2015;Mulcahy et al, 2008), state anxiety (Davis et al, 2007;Mulcahy et al, 2008), and general anxiety Gunn et al, 2014) among those who stutter. However, two cohorts of treatmentseeking aWS have demonstrated anxiety rates comparable to TFC on measures of state and trait anxiety (Craig & Hancock, 1996;Hancock et al, 1998) and general anxiety (Messenger, Packman, Onslow, Menzies, & O'Brian, 2015).…”

“…Although this was an unexpected finding (cf. Blood et al, 2001;Erickson & Block, 2013;Hollister, 2015;Mulcahy et al, 2008), it allowed us to examine any unique contribution of stuttering to interpretations above and beyond the influence of social anxiety which, as discussed in the following section, there did not appear to be. An interesting finding related to social anxiety was the significant interacting effect of group and sex on social anxiety scores such that female aWS reported higher levels of social anxiety than male aWS.…”

“…Most of the literature has focused on documenting the degree of social anxiety among adults which has revealed a prevalence ranging from 21 to 60% (Blumgart, Tran, & Craig, 2010;Kraaimaat, Vanryckeghem, & Van Dam-Baggen, 2002;Menzies et al, 2008;Stein, Baird, & Walker, 1996), which is indeed higher than the 12.1% prevalence among the general population (Kessler et al, 2005). Findings from studies examining the prevalence of social anxiety in aWS have been equivocal, though many have shown that they are more likely to experience social anxiety than their non-stuttering peers Blood, Blood, Maloney, Meyer, & Qualls, 2007;Blood et al, 2001;Davis, Shisca, & Howell, 2007;Erickson & Block, 2013;Gunn et al, 2014;Hollister, 2015;Mulcahy et al, 2008).…”

“…There is a growing body of evidence that adults and adolescents who stutter experience heightened levels of social anxiety when compared to their non-stuttering peers (Blood et al, 2001;Blumgart et al, 2010;Erickson & Block, 2013;Hollister, 2015;Kraaimaat et al, 2002;Menzies et al, 2008;Mulcahy et al, 2008;Stein et al, 1996).…”