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07-08-2012 | Psychology | Article

Model predicts stuttering and fluency in school-age children


Free abstract

MedWire News: Children can be successfully screened for stuttering and fluency using Howell and Davis's risk factor model, particularly when whole-word repetitions are excluded, UK study findings indicate.

In 2011, Howell and Davis developed a model for assessing stuttering prognosis in children aged 8 years, examining seven risk factors: head injury; age at onset of stuttering; family history; handedness; speaking two or more languages in the preschool years; gender; and stuttering severity. Of these, only severity scores on the Stuttering Severity Instrument for Children and Adults, Third Edition (SSI-3) predicted whether children who stutter (CWS) would recover or still stutter when a teenager.

To develop and assess models for screening stuttering, Peter Howell, from University College London, studied stuttering and severity scores from CWS and fluent children aged 8-10 years, with 222 and 103 children, respectively, recruited for the development phase and 272 and 25 children, respectively, recruited for the validation phase.

A series of models were developed for screening and predicting the prognosis of CWS and fluent children, with analyses conducted with whole-word repetitions excluded and included in the SSI-3. The model that excluded whole-word repetitions was tested in children from a range of ages.

The results, reported in the Journal of Fluency Disorders, show that all the models tested achieved a specificity and sensitivity of approximately 80%. For the model using the SSI-3 without whole-repetition, the overall percentage of correct identifications was 81.1%.

Overall classification accuracy was 87.1% and 82.2% when SSI-3 was used with or without whole-word repetition, respectively. The sensitivity in identifying CWS who would recover was 81.3%, and the specificity in finding CWS who persisted with stuttering was 80.9%. These mirror the findings of the previous study.

In the validation study, the model of SSI-3 without whole-word repetition correctly identified 84.4% of fluent children and 88.0% of CWS, some of whom differed in age from those used to develop the model.

Howell concludes: "The findings show that Howell and Davis's (2011) model for predicting risk of stuttering can be successfully adapted to classify fluent children.

"This offers the possibility of it acting as a screening instrument for stuttering with children at the age of school intake. The model is successful at classifying CWS outside the age range for which it was originally developed."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Liam Davenport, MedWire Reporter

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