Unicomb Rachael, Kefalianos Elaina, Reilly Sheena, Cook Fallon, Morgan Angela
Discipline of Speech Pathology, The University of Newcastle, Australia.
Department of Audiology and Speech Pathology, The University of Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
J Commun Disord. 2020 Feb 13;84:105976. doi: 10.1016/j.jcomdis.2020.105976.
Stuttering and speech sound disorder may co-occur during early childhood, although the exact rate of comorbidity in a community-cohort sample remains unknown. In isolation, both disorders have the potential for long-term negative effects. Comorbidity rates of 16%-46% reported in previous studies were based on parent report, speech-language therapist surveys, case file audits or direct observation studies from clinical samples. Rigorous methodology utilising a prospective, longitudinal community-cohort design is required to support these previous findings.
First, to identify the proportion of children with comorbid stuttering and speech sound disorder at 4 years of age drawn from a community-cohort study. Second, to compare demographic and clinical features of this comorbid diagnosis group compared to children with no diagnosis of either disorder, or those with either disorder in isolation.
METHODS & PROCEDURES: Participants were drawn from a prospective, longitudinal community cohort study (the Early Language in Victoria Study) at 4 years of age (n = 1607). Demographic and clinical features for comparison were theoretically driven and included: gender, birth history, feeding status, speech and language status, family history of communication difficulties, maternal education, maternal vocabulary, maternal mental health and socioeconomic status.
OUTCOMES & RESULTS: Of the 160 children diagnosed with stuttering between 2 and 4 years of age, 6.88 % (n = 11) also had a speech sound disorder. Given the small sample size and number of comparisons performed, there was insufficient evidence to rule out that group differences observed were not simply due to chance.
CONCLUSIONS & IMPLICATIONS: The prevalence of comorbid stuttering and speech sound disorder was lower in a community cohort compared to that reported in clinical studies. Higher rates reported in clinical samples may be due to increased parental help-seeking behaviour when the two disorders co-occur. Subsequently, these children may present to clinics more frequently. Accurate representation of prevalence allows for population specific research on best practice assessment and intervention. Currently little is known about how best to manage this caseload, therefore more research is required in this area, including the determination of prognostic variables to provide efficient and effective management.
口吃和语音障碍可能在幼儿期同时出现，尽管社区队列样本中的确切共病率尚不清楚。单独来看，这两种障碍都有可能产生长期负面影响。先前研究报告的共病率在16%至46%之间，这些研究基于家长报告、言语治疗师调查、病例档案审核或临床样本的直接观察研究。需要采用前瞻性、纵向社区队列设计的严谨方法来支持这些先前的研究结果。
第一，确定社区队列研究中4岁时患有口吃和语音障碍共病的儿童比例。第二，将这一共病诊断组的人口统计学和临床特征与未诊断出任何一种障碍的儿童，或仅患有其中一种障碍的儿童进行比较。
参与者来自一项前瞻性、纵向社区队列研究（维多利亚早期语言研究），年龄为4岁（n = 1607）。用于比较的人口统计学和临床特征是理论驱动的，包括：性别、出生史、喂养状况、言语和语言状况、沟通困难家族史、母亲教育程度、母亲词汇量、母亲心理健康状况和社会经济地位。
在2至4岁被诊断为口吃的160名儿童中，6.88%（n = 11）也患有语音障碍。鉴于样本量小且进行了大量比较，没有足够的证据排除观察到的组间差异不是单纯由偶然因素导致的可能性。
与临床研究报告的情况相比，社区队列中口吃和语音障碍共病的患病率较低。临床样本中报告的较高患病率可能是由于两种障碍同时出现时家长寻求帮助的行为增加。随后，这些儿童可能更频繁地前往诊所就诊。患病率的准确呈现有助于针对特定人群开展关于最佳实践评估和干预的研究。目前对于如何最好地管理这一病例数量知之甚少，因此该领域需要更多研究，包括确定预后变量以提供高效有效的管理。
