Over half of school-age children who stutter (CWS) have sufficient attention deficit/hyperactivity disorder (ADHD) symptoms to warrant referral for clinical evaluation, the results of a US study of parental reports indicates.
"From a clinical perspective, the identification of coexisting ADHD traits in CWS is vitally important because these subgroups of children will require a different type of intervention from those children who present with stuttering alone," explain Joseph Donaher, from the Children's Hospital of Philadelphia in Pennsylvania, and co-authors.
"This suggestion is particularly relevant considering [findings] that the presence of ADHD-like traits can reduce clinical outcomes for people who stutter."
They add: "Conversely, these findings also suggested that clinical outcomes can be enhanced by addressing attention skills prior to implementing speech therapy for CWS. Thus, if clinicians can identify specific ADHD traits that appear problematic for an individual, they may be able to design interventions that account for these weaknesses."
In a retrospective study of 36 CWS, aged between 3.9 and 17.2 years, whose parents were administered the ADHD Rating Scale, 58% met criteria for referral for additional evaluation of ADHD symptoms, at 66% of male and 25% of female participants.
Interestingly, the proportion of children who met the referral criteria decreased from 100% in those aged 3 to 5 years to 33% among those aged 15 to 17 years, the team reports in the Journal of Fluency Disorders.
Four CWS had concomitant diagnoses, including anxiety and post-traumatic stress disorder, Tourette syndrome, and skull fracture, and all met the criteria for referral.
In all, 11% of children had a family history of recovered stuttering, 42% a family history of persistent stuttering, and 8% a history of both persistent and recovered stuttering, while 39% had no family history of stuttering. Referral was significantly associated with both a history of recovered stuttering and concomitant diagnosis.
Bonferroni analysis indicated that there was a strong positive correlation between a reported family history of recovered stuttering and a concomitant diagnosis.
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