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Language problems at an early age in very preterm (VP) children can have a detrimental effect on other developmental domains and often persist throughout childhood. The aim of this study was to examine the concurrent and predictive validity of an early language parent-report questionnaire for language disorder in VP children from 2 to 10 years of age. In 80 VP children (<32 weeks' gestation) without major disabilities, a parent-questionnaire and formal language assessment, both normed for the general population, were administered at 2 years corrected age (CA). Of these infants, 62 were seen for follow-up formal language assessment at age 4 and 61 were seen at age 10. Sensitivity and specificity values were calculated. The Lexi-list showed acceptable concurrent validity for word production scores obtained at age 2 CA. The predictive validity was good for sentence production and acceptable for word production scores obtained at age 4, and low for language production scores obtained at age 10. A Lexi-list cut-off score of <85 (i.e., <-1 SD) was found optimal. A norm-referenced parent-report questionnaire is a useful, first screening tool in a neonatal follow-up. It not only detected early language disorder at age 2 CA but also proved to be a good predictor for language disorder at age 4. However, it did not predict language disorder at age 10. Formal language assessment at age 4 would therefore be recommended for children with an abnormal parent-report language score at age 2 CA. • A parent-report questionnaire is a useful, first screening tool in neonatal follow-up. • The Lexi-list proved to be a good predictor for language disorder at age 4. • The Lexi-list could not predict language disorder at age 10. [ABSTRACT FROM AUTHOR]

Language is a complex neurodevelopmental phenomenon. Approximately 45% of children born very preterm (VP) show mild-to-severe language problems throughout childhood. Nevertheless, in most hospitals in Europe language functions are not routinely assessed at follow-up. To give clear indications for extensive language assessment in school-aged children born VP, based on routinely assessed intelligence and behavioral problems. Language functions of 63 10-year-old children born VP (<32 weeks' gestation) without major handicaps were compared to their intellectual and executive functions and behavioral problems. Using multiple linear regression analyses, the predictive value of perinatal factors and the association with neurodevelopmental factors of low language were measured. The mean language score was significantly lower than the verbal intelligent quotient (VIQ; mean difference = 6.4, p <.001, d=.48) and the mean vocabulary knowledge (mean difference = 9.3, p <.001, d=.70). Besides, VIQ (β =.649, p =.001) and performance IQ (PIQ; β =.260, p =.035) were significantly associated with language scores. Significant predictors of language scores were number of days of assisted ventilation (β = -.592, p =.015) and mother's vocabulary knowledge (β =.473, p =.014), rather than mother's educational level (β =.139, p =.956). Children born VP had language problems that were not expected from their significantly higher VIQ and vocabulary knowledge. Clinicians assessing these children should be aware of possible language problems, which cannot be detected with a simple vocabulary task. Our findings provide evidence of the need for adequate language assessments by a speech-language pathologist in children born VP, especially in those with VIQ scores in the low average range. • Language scores are worse than verbal IQ and vocabulary in children born VP. • At the same time, language scores are significantly associated with verbal IQ. • Indicating that low average verbal IQ scores should indicate language assessment. • Parent's vocabulary knowledge is stronger predictor than parent's educational level. • Adding speech-language pathologist to multi-disciplinary team of follow-up advised. [ABSTRACT FROM AUTHOR]

A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker's experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus. • A new clinical, evidence-based model to inform children who stutter and their parents, and adult clients about stuttering. • The onset and development of stuttering is visualized in a Figure. • Biological, psychological, and social factors are related to the speaker's experience of stuttering severity and impact. • A hypothetical lifeline casus illustrates the model. [ABSTRACT FROM AUTHOR]

Highlights • Children's self-report on recovery from stuttering should not replace traditional criteria (expert rating and parental report). • Children's self-report needs to be added when considering the status of stuttering. • Future studies on recovery should add self-reports to improve the validity of the stuttering recovery rate estimates. • Clinicians are recommended to take into account children's self-report on stuttering status. Abstract Purpose The first purpose was to define the recovery rate in children who stutter in a clinical sample, adding self-report to validate recovery status. The second purpose was to explore whether children who were judged to be recovered showed subjective experiences that might be interpreted as coping behaviors used to control speech fluency. Methods In this longitudinal study, preschool-age children whose parents consulted a speech-language pathologist about stuttering were followed for 9 years. At follow-up, children's self-reports on stuttering were reported, as well as traditional criteria on recovery (parental and expert judgment). The Overall Assessment of the Speaker's Experience of Stuttering (OASES) was used to collect children's experiences with speaking. Results Eleven of the 15 children (73%) were judged by parents and clinicians to have recovered from stuttering. However, when considering children's self-reports, 9 children (60%) might be considered to have recovered. In addition, 3 children who were judged to be recovered reported experiences with speaking that were uncommon, even compared to children who continued to stutter. Conclusion In this exploratory study of a clinical population , the recovery rate in children that received treatment for stuttering appeared to be comparable to a non-clinical population. Considering self-reports can improve validity of assessing the "recovery rate". Moreover, recovery in children may not be effortless; instead, it may be the result of conscious or unconscious coping behavior. Future studies are recommended to consider self-reports to improve validity of recovery, and to document experiences with speaking to explore effortless, spontaneous fluency versus controlled fluency. [ABSTRACT FROM AUTHOR]

Abstract: This pilot study compared two treatments for stuttering in preschool-age children. Thirty children were randomly assigned to either a Lidcombe Program (LP) treatment or a Demands and Capacities Model (DCM) treatment. Stuttering frequencies and severity ratings were obtained immediately before and after treatment (12 weeks). The stuttering frequencies and severity ratings significantly decreased for both treatment groups. No differences between groups were found. Parents of children in both groups were cooperative in many respects, and there were no differences between them on scales that measured their satisfaction with the two treatments. The findings suggest that randomized controlled trials of LP versus DCM treatments are feasible, and they underline the need for experimental analyses of the two treatments. Educational objectives:: The reader will be able to: (1) describe the principles and methods of Lidcombe treatment for early stuttering; (2) delineate principles and methods of Demands and Capacities Model treatment; and (3) summarize results of an investigation that compared these programs’ relative effects in a pilot study. [Copyright &y& Elsevier]

The number of words children produce (expressive vocabulary) and understand (receptive vocabulary) changes rapidly during early development, partially due to genetic factors. Here, we performed a meta–genome-wide association study of vocabulary acquisition and investigated polygenic overlap with literacy, cognition, developmental phenotypes, and neurodevelopmental conditions, including attention-deficit/hyperactivity disorder (ADHD). We studied 37,913 parent-reported vocabulary size measures (English, Dutch, Danish) for 17,298 children of European descent. Meta-analyses were performed for early-phase expressive (infancy, 15–18 months), late-phase expressive (toddlerhood, 24–38 months), and late-phase receptive (toddlerhood, 24–38 months) vocabulary. Subsequently, we estimated single nucleotide polymorphism–based heritability (SNP- h 2 ) and genetic correlations (r g) and modeled underlying factor structures with multivariate models. Early-life vocabulary size was modestly heritable (SNP- h 2 = 0.08–0.24). Genetic overlap between infant expressive and toddler receptive vocabulary was negligible (r g = 0.07), although each measure was moderately related to toddler expressive vocabulary (r g = 0.69 and r g = 0.67, respectively), suggesting a multifactorial genetic architecture. Both infant and toddler expressive vocabulary were genetically linked to literacy (e.g., spelling: r g = 0.58 and r g = 0.79, respectively), underlining genetic similarity. However, a genetic association of early-life vocabulary with educational attainment and intelligence emerged only during toddlerhood (e.g., receptive vocabulary and intelligence: r g = 0.36). Increased ADHD risk was genetically associated with larger infant expressive vocabulary (r g = 0.23). Multivariate genetic models in the ALSPAC (Avon Longitudinal Study of Parents and Children) cohort confirmed this finding for ADHD symptoms (e.g., at age 13; r g = 0.54) but showed that the association effect reversed for toddler receptive vocabulary (r g = −0.74), highlighting developmental heterogeneity. The genetic architecture of early-life vocabulary changes during development, shaping polygenic association patterns with later-life ADHD, literacy, and cognition-related traits. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to evaluate the incremental cost–effectiveness and cost–utility of the Lidcombe Program (LP) compared with treatment based on the Demands and Capacities Model (RESTART-DCM) for preschool children who stutter. Method A cost–effectiveness and cost–utility analysis were carried out alongside a Randomized Clinical Trial (the RESTART-study). In total, 199 children in 20 speech clinics participated. Outcome measures included the number needed to treat, based on the percentage of children who did not stutter at 18 months, and Health-related Quality of Life (EQ-VAS and HUI3) at 3, 6, 12 and 18 months. Health-related Quality of Life scores were used to calculate quality adjusted life years (V-QALYs for the EQ-VAS and U-QALYs for the HUI3). Direct and indirect costs were measured by cost questionnaires. Missing data were multiply imputed. Percentages of children who did not stutter in both groups were compared by a chi-square test. Between-group differences in mean QALYs and costs, as well as cost effectiveness and cost–utility ratios, were evaluated by applying bootstrapping techniques. Results After 18 months, health outcomes were slightly better in the LP group, although only the difference in V-QALYs was statistical significant (0.018; 95% CI: 0.008 to 0.027) with a small effect size (Cohen's d = 0.17). Mean costs for the LP group were significantly higher compared to the RESTART-DCM group (€3199 versus €3032), again with a small effect size (Cohen's d = 0.14). The incremental cost–effectiveness ratio was €3360 for one additional child who did not stutter with the LP, and the estimated cost–utility ratios were €10,413 (extra cost per extra V-QALY) and €18,617 (extra cost per extra U-QALY). The results indicated a high probability that the LP is cost-effective compared to RESTART-DCM treatment given a threshold for willingness-to-pay of €20,000 per QALY. Conclusions Differences in effects and costs between the LP and RESTART-DCM treatment were small. Cost–effectiveness and cost–utility ratios were in favor of the LP. The LP is considered a good alternative to RESTART-DCM treatment in Dutch primary care. [ABSTRACT FROM AUTHOR]

Background Stuttering can have a negative impact on many aspects of a speaker's life. Comprehensive assessment must therefore examine a range of experiences in order to reflect the overall impact of the disorder. Purpose This study evaluated the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering – School-age (OASES-S; Yaruss & Quesal, 2010 ), which examines the impact of stuttering on the lives of children ages 7–12. Method The OASES-S was translated to Dutch (OASES-S-D) using a forward/backward translation process. Participants were 101 Dutch-speaking children who stutter (ages 7–12) who were recruited by speech-language therapists throughout the Netherlands. All participants completed the OASES-S-D, the Children's Attitudes about Talking-Dutch, a self-assessment of severity, a clinical assessment of severity, and a speech satisfaction rating. A control group of 51 children who do not stutter also completed the OASES-S-D to determine whether the tool could differentiate between children who stutter and children who do not stutter. Results All sections of the OASES-S-D except section I surpassed a Cronbach's alpha of 0.70, indicating good internal consistency and reliability. Comparisons between the OASES-S-D and other tools revealed moderate to high associations. The OASES-S-D was able to discriminate between children who stutter and children who do not stutter and between participants with different levels of stuttering severity. Discussion The OASES-S-D appears to be a reliable and valid measure that can be used to assess the impact of stuttering on 7- to 12-year old Dutch-speaking children who stutter. Educational Objectives: The reader will be able to: (a) describe the purpose of the OASES-S-D measurement tool; (b) summarize the translation process used in creating the OASES-S-D; (c) summarize the aspects of stuttering measured in the different sections of the OASES-S-D; (d) describe with what measurement tools the validity of the OASES-S-D was investigated; and (e) describe the differences between the American-English version and Dutch translation of the OASES-S. [ABSTRACT FROM AUTHOR]

Abstract: Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual''s speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual''s coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants. Learning outcomes: Readers will be able to: (1) Understand how the Wilson and Cleary (1995) model of quality of life could be applied to comprehensively assess the quality of life in adults who stutter, (2) describe how health related quality of life is impaired in adults who stutter, (3) mention affected domains of functioning that are related to health related quality of life impairment in adults who stutter, (4) describe the relationship between stuttering severity, functioning, coping and health related quality of life in adults who stutter, (5) describe differences in stuttering severity, coping style, functioning and health related quality of life between adults who stutter who have registered for therapy and adults who stutter who have not. [Copyright &y& Elsevier]

The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules. The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters. A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice. • We considered mental health and early stuttering. • We considered the early signs of mental health issues. • A distinguished scholar, master clinicians, and delegates discussed the matter. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study is to compare the health-related quality of life (HrQoL) of preschool children who stutter (CWS) and a reference population of children who do not stutter, and to evaluate the association between stuttering severity and HrQoL. Methods Baseline data were used from 197 children participating in a multicenter Randomized Clinical Trial in the Netherlands. Information on stuttering severity and time since onset (TSO) of stuttering was obtained from the baseline evaluation by speech- and language therapists. Stuttering severity was measured using the SSI-3. HrQoL was assessed using proxy versions of two Child Health Questionnaires (ITQOL-97 and CHQ-PF28), the Health Utility Index 3 (HUI3) and the EuroQoL EQ-VAS (EQ-VAS). Results While the outcomes on the EQ-VAS and the HUI3 showed that the HrQoL of CWS is slightly poorer than that of the Dutch reference population, results on the different dimensions of the CHQ-instruments did not reveal any difference in scores between stuttering children and reference groups. Within the group of CWS, two ITQOL-97 and four CHQ-PF28 scales showed statistically different scores for children in different SSI stuttering severity or TSO categories. However, the effect sizes showed that these differences were so small that they could be considered negligible. Conclusion The results of this study do not reveal a diminished HrQoL for preschool CWS. Future research should include a larger cohort of children with severe stuttering, study the longitudinal course of HrQoL and incorporate additional parameters such as the characteristics of the child and his environment. Educational objectives: The reader will be able to: (a) summarize the current evidence base on HrQoL in people who stutter; (b) describe the HrQoL of preschool CWS on different HrQoL measures; (c) describe the relationship between stuttering severity and HrQoL in preschool CWS. [ABSTRACT FROM AUTHOR]

• Perspectives about anxiety-related mental health issues with persistent stuttering. • Perspectives about when to begin early intervention for stuttering. • Perspectives about the issue of early intervention and anxiety. During the 2019 Fourth Croatia Clinical Symposium, speech-language pathologists (SLPs), scholars, and researchers from 29 countries discussed speech-language pathology and psychological practices for the management of early and persistent stuttering. This paper documents what those at the Symposium considered to be the key contemporary clinical issues for early and persistent stuttering. The authors prepared a written record of the discussion of Symposium topics, taking care to ensure that the content of the Symposium was faithfully reproduced in written form. Seven contemporary issues for our field emerged from the Symposium. Effective early intervention is fundamental to proper health care for the disorder. However, as yet, there is no consensus about the timing of early intervention and how it should be managed. Currently, clinical translation is a barrier to evidence-based practice with early stuttering, and proactive strategies were suggested for junior SLPs. Apprehension emerged among some discussants that treatment of early stuttering may cause anxiety. For persistent stuttering, assessment procedures were recommended, as were strategies for dealing with childhood bullying. There was agreement that SLPs are the ideal professionals to provide basic cognitive-behavior therapy for clients with persistent stuttering. Questions were raised about our discipline standards for basic professional preparation programs for stuttering management. [ABSTRACT FROM AUTHOR]

• Techniques for late spontaneous recovery from stuttering clustered into six strategies. • The strategies reflect components of established treatments and naïve explanations. • Causal attributions of recovery clustered into three implicit theories about recovery. • Knowledge about strategies and implicit theories may help to improve treatment. (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies. [ABSTRACT FROM AUTHOR]