Late Childhood Essays - Speech Impediments, Language Acquisition

Arch Dis Child 2009; 94:42-46 doi:10.1136/adc.2007.134114 ?Original article ?The effects of bilingualism on stuttering during late childhood + Author Affiliations 1.1 Division of Psychology and Language Sciences, University College London, London, UK 2.2 Department of Language and Communication Science, City University, London, UK 1.Peter Howell, Division of Psychology and Language Sciences, University College London, Gower Street, London WC1E 6BT, UK; [emailprotected] ?Accepted 24 June 2008 ?Published Online First 9 September 2008 Abstract Objectives: To examine stuttering by children speaking an alternative language exclusively (LE) or with English (BIL) and to study onset of stuttering, school performance and recovery rate relative to monolingual speakers who stutter (MONO). Design: Clinical referral sample with supplementary data obtained from speech recordings and interviews. Setting: South-East England, 1999?2007. Participants: Children aged 8?12 plus who stuttered (monolingual and bilingual) and fluent bilingual controls (FB). Main outcome measures: Participants? stuttering history, SATS scores, measures of recovery or persistence of stuttering. Results: 69 (21.8%) of 317 children were bilingual. Of 38 children who used a language other than English at home, 36 (94.7%) stuttered in both languages. Fewer LE (15/38, 39.5%) than BIL (23/38, 60.5%) children stuttered at first referral to clinic, but more children in the fluent control sample were LE (28/38, 73.7%) than BIL (10/38, 26.3%). The association between stuttering and bilingual group (LE/BIL) was significant by 2 test; BIL speakers have more chance of stuttering than LE speakers. Ages at stuttering onset and male/female ratio for LE, BIL and MONO speakers were similar (4 years 9 months, 4 years 10 months and 4 years 3 months, and 4.1:1, 4.75:1 and 4.43:1, respectively). Educational achievement was not affected by bilingualism relative to the MONO and FB groups. The recovery rate for the LE and MONO controls together (55%) was significantly higher by 2 test than for the BIL group (25%). Conclusions: BIL children had an increased risk of stuttering and a lower chance of recovery from stuttering than LE and MONO speakers. Bilingualism has been regarded as a risk factor for stuttering.1 2 However, there is little information about how a second language affects the chances of stuttering onset and of recovery. Consequently, a study was conducted on all referrals for stuttering for children first seen when they were between 8 and 10 years of age who attended clinics that specialized in the diagnosis and treatment of stuttering. Children who used a second language in the pre-school years either (a) exclusively (these learned English at school, termed LE) or (b) along with English in the home (bilingual from birth, termed BIL) were selected. The majority of the children were seen again when they were aged 12 plus. Prevalence rates of stuttering for LE and BIL children as compared with all referrals were examined to determine if a disproportionate number of speakers of a language other than English is referred to stuttering clinics. Checks were made to verify that the LE and BIL children were stuttering by c omparing age at stuttering onset and gender ratio for these speaker groups against monolingual speakers from a referral sample who stuttered (MONO). Early school performance of LE and BIL children who stuttered was compared with that of a MONO group and bilingual children who were fluent (the fluent bilingual group, termed FB). The patterns of onset and recovery in the LE, BIL and MONO groups were compared. METHODS Participants and sub-groups A total of 317 children who stuttered participated. They all (a) started school in the UK at age 4 or 5, (b) first presented at a clinic when aged between 8 and 10 years and (c) lived in the greater London area. Stuttering was confirmed by a specialist speech-language therapist at the clinic. Reported onset of stuttering usually occurs before age 6. The attendance at clinic 2 or more years later is partly due to the time needed to process children in the health system; these are secondary referrals to the specialist clinic and devolved budgets to local area health authorities can cause delay. Recordings were taken to estimate the percentage of stuttered syllables and to allow the stuttering severity instrument measure SSI-33 to be applied (see below for details of how SSI-3 was calculated). When each child was seen initially, all 317 caregivers were asked whether they used a language