Department of Communication Sciences and Disorders, The University of Texas at Austin.
Am J Speech Lang Pathol. 2020 Aug 4;29(3):1404-1422. doi: 10.1044/2020_AJSLP-19-00058. Epub 2020 May 28.
Purpose Given the marked increase in evidence-based information regarding the nature/treatment of stuttering, coupled with the fact that pediatricians tend to be one of the initial points of contact for parents who suspect their preschool-age child may stutter, this study explored pediatricians' (a) accuracy in identifying children who may stutter and (b) likelihood of referring children who present with a profile indicative of stuttering to speech-language pathologists. Method Pediatricians recruited nationally through professional organizations completed a 5- to 7-min online survey that probed stuttering identification and referral practices via responses to experimental case vignettes. Each vignette featured a 4-year-old boy with a family history of stuttering whose mother reported signs of stuttering and manipulation of two factors: stuttering during the pediatrician visit (or not) and negative communication attitude (or not). Results Our findings suggest pediatricians' identification and referral of children who may stutter is largely prompted by observation of overt speech behaviors and/or negative communication attitude. Participants' gender, years in practice, and experience working with children who stutter did not influence likelihood of referral. Conclusions Results indicate pediatricians are less likely to implement a "wait and see" approach with young children who stutter today than in the past. Unlike other common child onset diagnoses, however, parent report of atypical behavior does not yield pediatrician referral to a specialist. Future education and advocacy efforts directed toward pediatricians should emphasize inclusion of factors other than direct observation of stuttering behavior that may warrant referral (e.g., parent report).
目的 鉴于有关口吃的性质/治疗的循证信息明显增加，而且儿科医生往往是怀疑学龄前儿童可能口吃的父母最初联系的人之一，本研究探讨了儿科医生（a）识别可能口吃的儿童的准确性，以及（b）将表现出口吃特征的儿童转介给言语语言病理学家的可能性。 方法 通过专业组织在全国范围内招募儿科医生，他们通过对实验案例描述的回答来完成 5 到 7 分钟的在线调查，以探究口吃识别和转介实践。每个案例描述都有一个 4 岁的男孩，他有口吃的家族史，他的母亲报告有口吃的迹象，并操纵了两个因素：儿科医生就诊期间口吃（或不口吃）和负面沟通态度（或不）。 结果 我们的研究结果表明，儿科医生对口吃儿童的识别和转介主要是由观察明显的言语行为和/或负面沟通态度引起的。参与者的性别、从业年限以及与口吃儿童合作的经验并没有影响转介的可能性。 结论 结果表明，与过去相比，儿科医生今天更不可能对患有口吃的幼儿采取“观望”的方法。然而，与其他常见的儿童起病诊断不同，父母报告的异常行为并不会导致儿科医生将其转介给专家。未来针对儿科医生的教育和宣传工作应强调纳入可能需要转介的其他因素（例如，父母的报告），而不仅仅是直接观察口吃行为。
