Why Early Intervention is Essential in Preschool Age Children Who Stutter: A Systematic Review

Main Article Content

Snijders S Sevenants R Eggers K Van Eerdenbrugh S

Abstract

Background: For long, a wait-and-see approach was implemented for preschool age children who started to stutter. The last two decades, however, research indicated more and more that this is not the most appropriate action. Speech pathologists specialised in stuttering have gained much knowledge about stuttering near onset the past few years. A previous exploratory study showed that primary care professionals have not yet gained all this knowledge.


Aims: The aim of this systematic review was to fill the knowledge gaps of primary care professionals by formulating evidence-based information and to provide them to the primary care professionals.


Methods: To find evidence-based information for the knowledge that the respondents lack, a systematic literature search was conducted on 24 October 2022 in Cochrane, PubMed and Evidence Maps (American Speech-Language-Hearing Association). Systematic reviews and guidelines of the past decade about stuttering in preschool age children were consulted. Relevant information was selected. Resources were developed and fine-tuned by a focus group. Quality assessments were conducted on all included studies by using the Joanna Briggs Institute tools for systematic reviews and the Appraisal of Guidelines for Research and Evaluation (AGREE II) for guidelines. Findings are presented on a poster, flyer, website and video.


Results: Eight systematic reviews and one guideline met the inclusion criteria and were used to create information materials. Findings are that the cause of stuttering is very complex and influenced by multiple factors. Characteristics of stuttering include repetitions, prolongations, and blocks, but stuttering can also affect social and emotional functioning. It is clear that a wait-and-see approach is not the desired approach anymore.


Conclusions: The resources developed in this study can help primary care professionals in identifying stuttering and referring families of young children to a stuttering specialist, to maximize the chance on recovery for the child. A stuttering specialist will decide based on the stuttering characteristics and its development if a family needs advice and active follow-up or if treatment needs to be initiated.

Article Details

How to Cite
S, Snijders et al. Why Early Intervention is Essential in Preschool Age Children Who Stutter: A Systematic Review. Medical Research Archives, [S.l.], v. 11, n. 7.1, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3676>. Date accessed: 15 may 2024. doi: https://doi.org/10.18103/mra.v11i7.1.3676.
Section
Research Articles

References

1. World Health Organization. International statistical classification of diseases and related health problems (11th ed.). 2019. https://icd.who.int/
2. Yairi E, Ambrose N. Epidemiology of stuttering: 21st century advances. Journal of Fluency Disorders. 2013;38(2):66-87.
3. Reilly S, Onslow M, Packman A, Cini E, Conway L, et al. Natural history of stuttering to 4 years of age: A prospective community-based study. Pediatrics. 2013;132(3):460-467.
4. Yairi E, Ambrose NG. Early childhood stuttering I: Persistency and recovery rates. Journal of Speech, Language, and Hearing Research. 1999;42(5):1097-1112.
5. Langevin M, Packman A, Onslow M. Parent perceptions of the impact of stuttering on their preschool age children and themselves. Journal of Communication Disorders.2010;43(5): 407-423.
6. Weidner ME, St. Louis KO, Burgess ME, LeMasters SN. Attitudes toward stuttering of nonstuttering preschool and kindergarten children: A comparison using a standard instrument prototype. Journal of Fluency Disorders. 2015;44:74–87.
7. Langevin M, Packman A, Onslow M. Peer responses to stuttering in the preschool setting. American journal of speech-language pathology. 2009;18(3):264–76.
8. Singer CM, Hessling A, Kelly EM, Singer L, Jones RM. Clinical characteristics associated with stuttering persistence: A meta-analysis. Journal of Speech, Language, and Hearing Research. 2020;15;63(9):2995-3018.
9. Jones M, Onslow M, Packman A, Williams S, Ormond T, Schwarz I, Gebski V. Randomised controlled trial of the Lidcombe programme of early stuttering intervention. BMJ. 2005;22;331(7518):659-664.
10. Chang SE, Garnett EO, Etchell A, Chow HM. Functional and neuroanatomical bases of developmental stuttering: current insights. The Neuroscientist. 2019;25(6):566-582.
11. Chang SE, Zhu DC, Choo AL, Angstadt M. White matter neuroanatomical differences in young children who stutter. Brain. 2015;138(3):694-711.
12. McAllister, J. Behavioural, emotional and social development of children who stutter. Journal of Fluency Disorders. 2016;50:23–32.
13. Briley PM, O’Brien K, Ellis C. Behavioural, emotional, and social well-being in children who stutter: Evidence from the National Health Interview Survey. Journal of Developmental and Physical Disabilities .2019;31:39–53.
14. Blood GW, Blood IM. Bullying in adolescents who stutter: Communicative competence and self-esteem. Contemporary Issues in Communication Science and Disorders. 2004;31(Spring):69–79.
15. Iverach L, O’Brian S, Jones M, Block S, Lincoln M, Harrison E, et al. Prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Journal of Anxiety Disorders. 2009;23(7):928–34.
16. Winters KL, Byrd CT. Pediatrician referral practices for children who stutter. American Journal of Speech-Language Pathology. 2020; 29(3): 1404-1422.
17. Perez H, Stoeckle J. Stuttering: Clinical and research update. Can Fam Physician. 2016;62(6): 479-484.
18. Lees R, Stark C, Baird J, Birse S. Primary care professionals’ knowledge and attitudes on speech disfluency in pre-school children. Child Language Teaching and Therapy. 2000;16(3): 241-254.
19. Child & Family (Kind & Gezin). 2022. https://www.kindengezin.be/nl

20. Yairi E, Carrico DM. Early childhood stuttering: Paediatricians’ attitudes and practices. American Journal of Speech-Language Pathology. 1992;1(3):54-62.
21. Pertijs, MAJ, Oonk, LC, Beer, de JJA, Bunschoten, EM, Bast, EJEG, Ormondt, van J, Rosenbrand, CJGM, Bezemer, M, Wijngaarden, van LJ, Kalter, EJ, Veenendaal, van H. Evidence-based Richtlijn Stotteren bij kinderen, adolescenten en volwassenen. Nederlandse Vereniging voor Logopedie en Foniatrie, Woerden. 2014.
22. Nederlandse Vereniging voor Logopedie en Foniatrie. Richtlijn stotteren bij kinderen, adolescenten en volwassenen. 2020. https://www.nvlf.nl/kennis/inhoudelijke-richtlijnen/
23. Joanna Briggs Institute tools. 2022. https://jbi.global/critical-appraisal-tools
24. AGREE Next Steps Consortium. Appraisal of Guidelines for Research & Evaluation (AGREE) II Instrument. https://www.agreetrust.org/
25. Cebam. 2022. https://www.cebam.be/
26. Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. The state of the art in non‐pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness. International journal of language & communication disorders. 2015;50(5):676-718.
27. Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. Health Technol Assess. 2016;20(2):1-302,v-vi.
28. Bernard R, Hofslundsengen H, Frazier Norbury C. Anxiety and depression symptoms in children and adolescents who stutter: A systematic review and meta-analysis. Journal of Speech, Language, and Hearing Research. 2022;65(2):624-44.
29. Brignell A, Krahe M, Downes M, Kefalianos E, Reilly S, Morgan AT. A systematic review of interventions for adults who stutter. Journal of Fluency Disorders. 2020;64:105766.
30. Johnson M, Baxter S, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E. The state of the art in non‐pharmacological interventions for developmental stuttering. Part 2: qualitative evidence synthesis of views and experiences. International Journal of Language & Communication Disorders. 2016;51(1):3-17.
31. Nye C, Vanryckeghem M, Schwartz JB, Herder C, TurnerIII HM, Howard C. Behavioural stuttering interventions for children and adolescents: A systematic review and meta-analysis. Journal of Speech, Language and Hearing Research. 2013;56(3):921-932.
32. Sjøstrand Å, Kefalianos E, Hofslundsengen H, Guttormsen LS, Kirmess M, Lervåg A, Hulme C, Bottegaard Næss KA. Non-pharmacological interventions for stuttering in children six years and younger. Cochrane Database Syst Rev. 2021;9(9):CD013489.
33. Sugathan N, Maruthy, S. Predictive factors for persistence and recovery of stuttering in children: A systematic review. International Journal of Speech-Language Pathology. 2021;23(4):359-371.
34. Van Beijsterveldt CE, Felsenfeld S, Boomsma DI. Bivariate genetic analyses of stuttering and nonfluency in a large sample of 5-year-old twins. Journal of Speech, Language, and Hearing Research. 2010;53(3):609–19.
35. Bloodstein O, Ratner NB. A handbook on stuttering. Clifton Park, NY: Thomson/Delmar Learning; 2008.
36. Dworzynski K, Remington A, Rijsdijk Frühling, Howell P, Plomin R. Genetic etiology in cases of recovered and persistent stuttering in an unselected, longitudinal sample of Young Twins. American Journal of Speech-Language Pathology. 2007;16(2):169–78.
37. Fagnani C, Fibiger S, Skytthe A, Hjelmborg JV. Heritability and environmental effects for self-reported periods with stuttering: A twin study from Denmark. Logopedics Phoniatrics Vocology. 2010;36(3):114–20.
38. Frigerio Domingues CE, Grainger K, Cheng H, Moretti-Ferreira D, Riazuddin S, Drayna D. Are variants in sex hormone metabolizing genes associated with stuttering? Brain and Language. 2019;191:28–30.
39. Kang C, Riazuddin S, Mundorff J, Krasnewich D, Friedman P, Mullikin JC, et al. Mutations in the lysosomal enzyme–targeting pathway and persistent stuttering. New England Journal of Medicine. 2010;362(8):677–85.
40. Packman A. Theory and therapy in stuttering: A complex relationship. Journal of Fluency Disorders. 2012;37(4):225-33.