School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Western Australia, Australia.
School of Psychology, Curtin University, Western Australia, Australia.
J Fluency Disord. 2019 Mar;59:80-90. doi: 10.1016/j.jfludis.2018.11.002. Epub 2018 Nov 15.
This study described the proportion of children who stutter who exhibit Attention Deficit Hyperactivity Disorder (ADHD) symptoms, manifesting in inattentive and hyperactive/impulsive behaviours. Children who stutter with these challenging behaviours may not respond as quickly and successfully to stuttering treatment. A preliminary exploration of differences in treatment responsiveness for children with and without ADHD symptoms was undertaken.
Participants were 185 preschool children who stutter who had completed stuttering therapy within 3 months prior to study commencement. Differences between groups of children who stutter with and without elevated ADHD symptoms were investigated, in terms of pre-treatment stuttering features (stuttering severity and typography), demographic variables (age at onset, time between onset and commencement of therapy, family history and sex) and treatment data (post-treatment stuttering severity and number of sessions to achieve discharge criteria).
One-half (50%) of participants exhibited elevated ADHD symptoms. These children required 25% more clinical intervention time to achieve successful fluency outcomes than children without elevated ADHD symptoms. Findings suggest that more ADHD symptoms, increased pre-treatment stuttering severity, and male sex were associated with poorer responsiveness to stuttering treatment.
The large proportion of children exhibiting elevated ADHD symptoms, and the increase in clinical contact time required in this subgroup to achieve successful fluency outcomes, is suggestive of the need for clinicians to tailor stuttering intervention to address these concomitant behaviour challenges. Findings support the use of careful caseload management strategies to account for individual differences between children, and strengthen prognostic information available to parents and clinicians.
本研究描述了表现出注意力缺陷多动障碍（ADHD）症状的口吃儿童的比例，这些症状表现为注意力不集中和多动/冲动行为。具有这些挑战性行为的口吃儿童可能无法像没有 ADHD 症状的儿童那样快速和成功地对口吃治疗做出反应。本文初步探讨了具有和不具有 ADHD 症状的儿童在治疗反应上的差异。
参与者是 185 名学龄前口吃儿童，他们在研究开始前 3 个月内完成了口吃治疗。研究调查了具有和不具有 ADHD 症状的口吃儿童之间的差异，包括治疗前的口吃特征（口吃严重程度和类型）、人口统计学变量（发病年龄、发病与开始治疗之间的时间、家族史和性别）和治疗数据（治疗后口吃严重程度和达到出院标准的治疗次数）。
一半（50%）的参与者表现出 ADHD 症状升高。这些儿童需要 25%的临床干预时间来实现成功的流畅性结果，而没有 ADHD 症状升高的儿童则需要较少的时间。研究结果表明，更多的 ADHD 症状、更高的治疗前口吃严重程度和男性与对口吃治疗的反应较差相关。
表现出 ADHD 症状升高的儿童比例较大，以及该亚组需要增加临床接触时间才能实现成功的流畅性结果，这表明临床医生需要对口吃干预进行调整，以解决这些伴随的行为挑战。研究结果支持使用谨慎的病例管理策略来考虑儿童之间的个体差异，并为家长和临床医生提供更有力的预后信息。
