Department of Hearing and Speech Sciences, University of Maryland, College Park.
Am J Speech Lang Pathol. 2022 Sep 7;31(5):2061-2077. doi: 10.1044/2022_AJSLP-21-00209. Epub 2022 Sep 1.
Most therapy programs for young children who stutter (CWS) involve caregiver counseling and adjustment of caregiver behavior to maximize opportunities for the child to be more fluent. One component sometimes included as a recommended adjustment is a reduction in caregiver question asking, as question asking is hypothesized to increase language formulation demands on the child. However, there is limited research to guide clinician advisement to caregivers that has controlled for numerous potential confounding factors, including utterance length and grammaticality, that may impact potential stressors on children. Our aim was to assess whether there was an empirical basis for such recommendations by comparing disfluency profiles of answers to questions and nonanswer utterances produced by children during spontaneous play with parents and examiners.
We analyzed fluency and structural properties as well as pragmatic function of 15,782 utterances from language samples produced by 32 CWS and 32 children who do not stutter (CWNS) who were between 28 and 50 months of age. CWS and CWNS were matched on gender and age within 4 months and were matched as closely as possible on maternal education.
For utterances produced by CWS, answers to adult questions were significantly likely to contain stuttering-like disfluencies than other utterance types, and this was still true after controlling for utterance length and grammaticality. In contrast, for utterances produced by CWNS, answers to questions were significantly likely to be disfluent than other utterance types after controlling for length and grammaticality.
Given the current findings, some prior research, and the documented potential benefits in language development for adult question asking of children, we do not believe that clinicians need to recommend changes to typical question-asking behavior by caregivers of CWS.
大多数针对口吃儿童(CWS)的治疗计划都包括照顾者咨询和调整照顾者行为,以最大限度地增加孩子更流利的机会。有时作为推荐调整的一个组成部分是减少照顾者的问题询问,因为问题询问被假设会增加孩子语言表达的需求。然而,很少有研究可以指导临床医生向照顾者提供建议,这些研究还需要控制许多潜在的混杂因素,包括话语长度和语法正确性,这些因素可能会对儿童造成潜在的压力。我们的目的是通过比较儿童在与父母和检查者进行自发游戏时回答问题和非回答话语的不流畅特征,来评估这种建议是否有实证依据。
我们分析了 32 名口吃儿童(CWS)和 32 名不口吃儿童(CWNS)的语言样本中的流畅性和结构特征以及语用功能,这些儿童年龄在 28 至 50 个月之间。CWS 和 CWNS 在性别和年龄上在 4 个月内进行匹配,并在尽可能接近的情况下根据母亲的教育程度进行匹配。
对于 CWS 产生的话语,回答成人问题的话语比其他话语类型更有可能包含口吃样的不流畅性,即使在控制了话语长度和语法正确性后也是如此。相比之下,对于 CWNS 产生的话语,在控制了长度和语法正确性后,回答问题的话语比其他话语类型更有可能不流畅。
鉴于目前的研究结果、一些先前的研究以及记录的成人询问对儿童语言发展的潜在益处,我们认为临床医生不需要建议 CWS 的照顾者改变典型的询问行为。