A Study Investigating the Temperament of SchoolAged Children who Stutter

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A Study Investigating the Temperament of
School-Aged Children who Stutter

• Alison Nicholas, Ehud Yairi, Steve Davis,
  Sarah Mangelsdorf, Frances Cook and Victoria
  Hamilton
• Michael Palin Centre for Stammering Children,
  London, UK
• University of Illinois, USA
• University College London, London, UK

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Outline of the presentation

• Background to the Study
• Study design, participants, methods
• Preliminary Results
• Summary and conclusions

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Temperament and Stuttering

• Recent years, focus placed on the relationship
  between stuttering and temperament (Conture,
  2001 Guitar, 1998).
• No evidence that particular temperament
  characteristics cause stuttering, but proposed
  that temperament may play a role in exacerbating
  and/or maintaining the disorder.

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Temperament of young CWS

• Young CWS, compared with CWNS are
• More active and less able to maintain and shift
  their attention (Embrechts et al, 2000 Karass et
  al, 2006)
• Less distractible (Anderson et al, 2003)
• More impulsive and less able to plan and to
  suppress inappropriate responses (Embrechts et
  al, 2000)

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Temperament of young CWS

• Less adaptable (Embrechts et al, 2000 Anderson
  et al, 2003)
• More reactive to environmental stimuli (Wakaba,
  1998 Karass et al, 2006)
• Less able to regulate their emotions (Karass et
  al 2006)

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Temperament of school-aged CWS

• School-aged CWS rated as more anxious,
  introverted, sensitive, withdrawn, insecure,
  fearful and less likely to take risks than CWNS
• (Fowlie Cooper, 1978 Oyler Ramig, 1995 and
  Oyler, 1996)

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Current Study

• School-aged CWS (10-15 years)
• Temperament questionnaires
• Self-report as well as parent-report

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Current Study

• Research Questions
• Do school-aged CWS differ from CWNS in terms of
  their temperament?
• Are there differences between parent- and
  self-report of childrens temperament?

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Participants

• 14 CWS and 14 CWNS matched by age, gender and
  social background
• Aged between 103 and 149 years
• (CWS Mean age 128 yrs CWNS Mean age129 yrs)
• Each group consisted of 2 girls and 12 boys
• All CWS referred to the MPC for specialist
  assessment

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Participants continued

• CWS confirmed as exhibiting stuttering according
  to multiple criteria (Yairi Ambrose, 1999)
• CWNS were recruited either by the CWS or from
  local schools
• CWNS evaluated to be normally fluent following
  the Yairi and Ambrose (1999) guidelines
• English language and literacy levels sufficient
  for questionnaire completion.

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Temperament Questionnaire

• Early Adolescent Temperament Questionnaire
  Revised (EATQ-R) (Ellis and Rothbart, 2001)
• Parent-report and self-report formats used

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Temperament Dimensions

• Activation control
• Affiliation
• Attention
• Fear
• Frustration
• Surgency/high intensity pleasure

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Temperament Dimensions

• Inhibitory Control
• Perceptual Sensitivity
• Pleasure Sensitivity
• Shyness
• Aggression
• Depressive Mood

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Temperament Questionnaire

• Childs questionnaire 103 statements
• Parents questionnaire 62 statements
• Statements rated using a 5-point rating scale
• 1 almost always untrue
• 5 almost always true

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Analysis

• Multivariate analysis of variance (MANOVA) was
  used to establish differences between the group
  of CWS and the group of CWNS, on each of the
  dimensions on the
• EATQ-R.

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Parent-Report EATQ-R

• Significant differences (pCWS and CWNS

• Attention F (1 ,48 ) 7.17, p0.01
• Inhibitory control F(1, 48) 13.36, p0.001
• Shyness F(1, 48) 6.1, p0.02
• High intensity pleasure F(1, 48) 4.02, p0.05
  

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Parent-Report EATQ-R

• No significant differences found between CWS and
  CWNS
• Activation Affiliation
• Aggression Depressive Mood
• Fear Frustration.

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Parent-Report EATQ-R

• CWS scored lower than CWNS on
• Attention
• Inhibitory control
• High intensity pleasure
• CWS scored higher than CWNS on
• Shyness

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Self-Report EATQ-R

• No significant differences were found between
  the self-reports of CWS and CWNS
• Shyness (p 0.09)

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Parent-Report vs Self-Report EATQ-R

• CWS parents vs CWS self
• Significant differences were found between
  parent-report and self-report
• Activation F(1, 37) 4.17 p0.05
• Attention F(1, 37) 4.01, p0.05

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Parent-Report vs Self-Report EATQ-R

• CWNS parents vs CWNS self
• No significant differences were found between
  parent-report and
• self-report

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Attention the capacity to focus attention as
well as to shift attention when desired

• Younger CWS also found to have poorer attention
  control (Embrechts et al, 2000 Anderson et al,
  2003 Karass et al, 2006)
• Attention control may contribute to the
  development and persistence of stuttering

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Attention the capacity to focus attention as
well as to shift attention when desired

• Poor attention control may make it harder for CWS
  to apply the attention required on
  speech-language planning and production ?
• CWS with poor ability to shift attention may find
  it harder to move on or let go from
  disruptions or mistakes in their own speech
  (Conture, Karass et al, 2006)

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Inhibitory Control the capacity to plan, and
to suppress inappropriate responses

• Young CWS also performed less well in inhibitory
  control (Embrechts et al, 2000)
• Inhibitory control may contribute to the
  development and persistence of stuttering

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Shyness behavioral inhibition to novelty and
challenge, especially social

• Supports findings of earlier studies of
  school-aged CWS (Fowlie Cooper, 1978 Oyler,
  1996)
• Younger CWS found to be slower to adapt to
  novelty and such individuals have tendency to be
  shy (Kagan, 1989, 1994)
• Shyness may develop over time, may be linked to
  experience of stuttering and contribute to its
  persistence

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Shyness behavioral inhibition to novelty and
challenge, especially social

• Physiological signs linked to shyness increased
  muscle tension (Guitar, 1998 Kagan et al, 1987)
• Shyness may contribute to development of
  avoidance behaviours?

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High intensity pleasurethe pleasure derived
from activities involving high intensity or
novelty

• No difference found between young CWS and CWNS on
  high intensity pleasure dimension (Embrechts et
  al, 2000)
• Pleasure gained from high intensity/novel
  activities may be more linked to the experience
  of stuttering?

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High intensity pleasurethe pleasure derived
from activities involving high intensity or
novelty

• CWS may attempt to modify their emotions,
  perhaps in an attempt to control their
  stuttering?
• Linked to shyness?

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Parent-report vs Self-report

• Discrepancy between parent and child report of
  temperament but only for CWS
• Are CWS less insightful about their own
  behaviours compared with parents?
• Are parents influenced by negative stereotypes?
• Is parents anxiety about the stuttering
  influencing their interpretations of childrens
  behaviour?

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Summary

• Parents of CWS judged them as
• Having poorer attention control
• Less able to plan and to suppress inappropriate
  responses
• More shy
• Gaining less pleasure from high intensity/novel
  activities

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Summary

• CWS did not rate themselves as being different to
  CWNS on any temperament dimension
• Significant differences found between
  parent-report and self-report for CWS Activation
  and Attention
• No significant differences found between
  parent-report and self-report for CWNS

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What next?

• Continue subject recruitment
• Complete data analysis group and individual
• Comparison between child and parent temperament
• Analysis of temperament over time

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Acknowledgements

• Association for Research into Stammering in
  Childhood
• Islington Primary Care Trust
• Research grant R01 DC 05210 from the USA
  National Institutes Of Health, National
  Institution on Deafness and Other Communication
  Disorders
• Staff at the Michael Palin Centre
• All the parents and children

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Contact Details

• alison.nicholas_at_islingtonpct.nhs.uk