Jan McAllister

The impact of adolescent stuttering on educational and employment outcomes: Evidence from a birth cohort study

PURPOSE In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter. METHOD A secondary analysis of a British birth cohort dataset was used in the study. At age 16, there were 217 cohort members who were reported by their parents to stutter, and 15,694 cohort members with no known history of stuttering or other speech problems. Data were analysed concerning factors associated with report of stuttering at 16, school leaving age, highest qualification, unemployment early in working life, pay at age 23 and 50, and social class of job at age 23 and 50. RESULTS Those who stuttered at 16 were statistically more likely than those who did not stutter to be male, to have poorer cognitive test scores, and to have been bullied. There were no significant effects of stuttering on educational outcomes. For employment outcomes, the only significant association with stuttering concerned socioeconomic status of occupation at 50, with those who had been reported to stutter having lower-status jobs. DISCUSSION These findings fail to support the belief that stuttering has a negative impact on education and employment. The higher likelihood of those who stutter working in lower-status positions may reflect their preference for avoiding occupations perceived to require good spoken communication abilities. Therapeutic implications are discussed. EDUCATIONAL OBJECTIVES The reader will be able to describe (a) prior work on the impact of stuttering on education and employment, (b) some characteristics of the National Child Development Study (NCDS), (c) the effect of stuttering on school leaving age and highest educational qualification in NCDS, (d) the effect of stuttering on employment outcomes in NCDS: unemployment by age 23, pay at 23 and 50, and socioeconomic status of occupation at 23 and 50.

The Impact of Adolescent Stuttering and Other Speech Problems on Psychological Well-Being in Adulthood: Evidence from a Birth Cohort Study.

BACKGROUND Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for. AIMS To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psychological distress and associated symptoms as measured by the Rutter Malaise Inventory. METHOD & PROCEDURES A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses. OUTCOMES & RESULTS In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties. CONCLUSIONS & IMPLICATIONS These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders.

Evaluation and discharge criteria in therapy with adults who stutter: A survey of speech and language therapists

Professional guidelines recommend that the psycho-social implications of living with a stutter should be assessed, and that therapy should target the emotional and cognitive aspects of living with a stutter (Taylor-Goh, ). Very little evidence exists about how speech and language therapists (SLTs) evaluate success of therapy or determine discharge criteria. The aim of the research reported here, which was part of a larger study of current SLT practice among clinicians working with adults who stutter, was to discover how SLTs (1) evaluate success in therapy and (2) determine whether to discharge a client who stutters. A postal self-administered questionnaire was distributed to SLTs (n = 342) who work in Britain with adults who stutter. A response rate of 77.5% was achieved. Content analysis was used to analyse open ended questions about evaluation and discharge criteria. Many therapists adopt practice in line with recommendations from the literature, but some SLTs do not report that they use outcome measures to evaluate their practice, or suggest that they sometimes adopt inappropriate discharge criteria. Other SLTs use novel methods to assist with evaluation.

Stuttering, alcohol consumption and smoking

PURPOSE Limited research has been published regarding the association between stuttering and substance use. An earlier study provided no evidence for such an association, but the authors called for further research to be conducted using a community sample. The present study used data from a community sample to investigate whether an association between stuttering and alcohol consumption or regular smoking exists in late adolescence and adulthood. METHODS Regression analyses were carried out on data from a birth cohort study, the National Child Development Study (NCDS), whose initial cohort included 18,558 participants who have since been followed up until age 55. In the analyses, the main predictor variable was parent-reported stuttering at age 16. Parental socio-economic group, cohort members sex and childhood behavioural problems were also included. The outcome variables related to alcohol consumption and smoking habits at ages 16, 23, 33, 41, 46, 50 and 55. RESULTS No significant association was found between stuttering and alcohol consumption or stuttering and smoking at any of the ages. It was speculated that the absence of significant associations might be due to avoidance of social situations on the part of many of the participants who stutter, or adoption of alternative coping strategies. CONCLUSION Because of the association between anxiety and substance use, individuals who stutter and are anxious might be found to drink or smoke excessively, but as a group, people who stutter are not more likely than those who do not to have high levels of consumption of alcohol or nicotine.

Spontaneous recovery of writing after stroke: A case study of the first 100 days

Background: This paper describes a corpus of spontaneous text produced by the first author, an experienced writer, in the 100 days following a CVA. The corpus begins with highly disordered texts replete with neologistic jargon written soon after onset and continues during the period of recovery. By the end of the corpus, language had returned to pre-morbid levels. Aims: The main aim of the paper is to present a detailed longitudinal investigation of the process of recovery from jargon agraphia. In addition, patterns of preservation and deficit will be highlighted, and inferences about the origins of the neologisms, perseverations, and paragrammatisms in the samples will be attempted, although the latter must necessarily be speculative, given the limitations associated with spontaneous writing samples. Main Contribution: The case is relatively unusual compared with other cases in the literature in that it focuses on the spontaneous writing of an individual who wrote extensively in his professional and private life prior to his illness, and who made a complete recovery from the linguistic consequences of the CVA. Conclusions: Early texts in the corpus were disordered at various linguistic levels, but features of typography and other non-alphabetic characteristics were preserved. Findings largely parallel those reported in other case studies.

Cognitive bias modification for social anxiety in adults who stutter: a feasibility study of a randomised controlled trial

Objective To determine the feasibility and acceptability of a computerised treatment for social anxiety disorder for adults who stutter including identification of recruitment, retention and completion rates, large cost drivers and selection of most appropriate outcome measure(s) to inform the design of a future definitive trial. Design Two-group parallel design (treatment vs placebo), double-blinded feasibility study. Participants: 31 adults who stutter. Intervention Attention training via an online probe detection task in which the stimuli were images of faces displaying neutral and disgusted expressions. Main outcome measures Psychological measures: Structured Clinical Interview Global Assessment of Functioning score; Liebowitz Social Anxiety Scale; Social Phobia and Anxiety Inventory; State-Trait Anxiety Inventory; Unhelpful Thoughts and Beliefs about Stuttering. Speech fluency: percent syllables stuttered. Economic evaluation: resource use questionnaire; EuroQol three-dimension questionnaire. Acceptability: Likert Scale questionnaire of experience of trial, acceptability of the intervention and randomisation procedure. Results Feasibility of recruitment strategy was demonstrated. Participant feedback indicated that the intervention and definitive trial, including randomisation, would be acceptable to adults who stutter. Of the 31 participants who were randomised, 25 provided data at all three data collection points. Conclusions The feasibility study informed components of the intervention. Modifications to the design are needed before a definitive trial can be undertaken. Trial registration number I SRCTN55065978; Post-results.

Birth weight and stuttering: Evidence from three birth cohorts.

PURPOSE Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. METHODS Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mothers level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. RESULTS None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. CONCLUSION Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering.