A multi-informant investigation of risk and protective factors underlying the development of stuttering’s adverse impact on children - Stuttering is most often associated with observable disruptions to the flow of speech, yet living with this condition can negatively impact an individual’s psychosocial development, academic and vocational achievement, and overall quality of life. We do not know how the adverse impact of stuttering (AIS) develops in children who stutter because we have not identified the individual and environmental factors that place some children at greater risk for developing adverse impact or protective factors that mitigate this risk. This knowledge gap impedes timely intervention and the potential to prevent potentially life-altering consequences of stuttering. This project proposes a multifactorial, longitudinal paradigm to capture the dynamic progression of AIS over development in children who stutter. Aim 1 will document the presence or emergence of theoretically and empirically grounded factors related to the development of AIS. Guided by strong preliminary data, we hypothesize that risk factors will portend or contribute to greater adverse impact in some children who stutter, while protective factors will mitigate this risk in other children. Aim 2 provides a comprehensive window into the development of AIS by capturing environmental factors through a multi-informant approach. Parents are an integral part of their child’s support network and may play a key role in shaping a child’s attitudes toward stuttering and communication. Aim 2a cohesively profiles parents’ experiences with stuttering including parent-child relationship dynamics, parent perceptions of stuttering, and any burdens a parent shoulders in managing their child’s stuttering. Speech-language pathologists (SLPs) can help mitigate and prevent AIS, yet children who stutter are often poorly served in speech therapy because SLPs may be uncertain how to assess and treat AIS. Aim 2b will create profiles from factors measuring an SLP’s clinical competency and their therapeutic alliance with a child who stutters. Environmental factors revealed in Aim 2 will inform counseling, education, and training components of speech therapy to reduce the impact that stuttering may have on parents and children who stutter. Finally, Aim 3 will identify additive, multiplicative, and mitigating effects of individual and environmental factors to inform the progression of AIS in individual children who stutter and reveal developmental profile patterns across children who stutter. Understanding consequential combinations of factors and developmental profiles will allow us to identify a child at risk for AIS so we can intervene sooner. Findings from this project will inform the development of AIS and advance targeted intervention and strength-based prevention approaches to mitigate the life-long negative consequences of stuttering and improve the lives of children who stutter.
