Project Summary Stuttering is a complex, neurodevelopmental communication disorder that originates in early childhood during a period of significant speech, language, and social cognitive development (2-6 years). In addition to disruptions in speech fluency, persons who stutter report psychosocial consequences of the disorder, including negative attitudes toward communication and increased rates of anxiety and depression. Children as young as two years old are acutely aware of and negatively impacted by their stuttering. Preschool-age children who stutter report significantly more negative communication attitudes than their typically fluent peers, with group differences increasing in kindergarten and first grade. Research examining the nature and progression of psychosocial and emotional contributions to stuttering in the 5-10% of young children who stutter in the United States is limited. Two studies explored whether stuttering severity, age, and time since onset contribute to communication attitude, with results indicating none of these predictors influence negative communication attitude in young children. Parent perception of their child influences a child’s self-concept during early childhood (ages 3-6 years), when children develop cognitive and affective perspective taking skills. If a parent reports discomfort with their child’s stuttering diagnosis and perceives that their child views their communication less positively, this may uniquely influence the child’s report of their communication attitude. We hypothesize parent perception of their child’s communication attitude and the child’s cognitive and affective perspective taking skills influence a child’s reported communication attitude. To test this hypothesis, we propose three specific aims. In Aim 1, we assess parent perception of their child’s communication attitude in young children who do and do not stutter. In this aim, we use a standardized self-report scale that has demonstrated differences in communication attitudes between children who do and do not stutter and an adapted version of this scale to measure parent perception. In Aims 2 and 3, we examine the influence of cognitive and affective perspective taking on parent-child communication attitude agreement for children who do and do not stutter. These aims incorporate experimental measures of cognitive perspective taking (the ability to make inferences about others’ thoughts) and affective perspective taking (the ability to make inferences about others’ feelings). All aims include relevant moderators that may uniquely contribute to the influence of parent perception or perspective taking on communication attitude. Analyses will include linear regression, causal inference, and non-parametric methods. This proposal is responsive to NIDCD’s priority areas 2 and 3 and therefore is relevant to public health, as the intended aims will 1) identify cognitive and environmental factors associated with negative communication attitudes observed in childhood stuttering, and, 2) inform assessment and treatment for children who stutter ages 3-6 years, an understudied population.

Project Narrative Children who stutter as young as 2-3 years old are aware of their stuttering, exhibit negative reactions to their stuttering, and report more negative communication attitudes than their typically fluent peers. Interestingly, longer time since onset of stuttering and greater stuttering severity are not associated with more negative communication attitudes; therefore, the proposed research study will evaluate novel contributions – namely, parent perception and child perspective taking ability – to communication attitudes of children who do and do not stutter ages 3 years 0 months to 6 years 11 months. If negative communication attitude is more likely to be present in children with cognitive and/or affective perspective taking skills or whose parents perceive them to hold negative communication attitudes, this will provide more evidence for addressing parent reactions to stuttering in treatment.