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Title: Temperamental characteristics of children with developmental stuttering, from parent questionnaire to neuropsychological paradigms
Other Titles: Temperamentkenmerken van kinderen met ontwikkelingsstotteren, van oudervragenlijsten tot neuropsychologische paradigma's
Authors: Eggers, Kurt
Issue Date: 22-Oct-2012
Abstract: Developmental stuttering is a speech fluency disorder characterized by frequent, involuntary repetitions, prolongations, and/or blocks of sounds, syllables, or words. Often these disruptions are accompanied by secondary behaviors such as struggle, postponement, and avoidance behaviors and frequent indications of an emotional impact. The incidence and prevalence are respectively about 5 and 1%. Stuttering usually starts between 2-to-5 years of age and recovers spontaneously in about 80% of the cases. Current views on the etiology of stuttering emphasize a multifactorial model, combining genetic, neurobiological, behavioral, emotional, and environmental factors. During the last decades several authors emphasized the possible importance of temperamental characteristics for the onset and development of stuttering. Due to the limited amount of studies in this area and the fact they were primarily parent questionnaire-based, several questions with regard to the association between developmental stuttering and temperamental characteristics still remained unanswered. Temperament can be defined as constitutionally based individual differences in reactivity and self-regulation. Reactivity refers to the speed and intensity of motor, cognitive, affective, and autonomic responses. Self-regulation refers to those processes that can modulate reactivity, i.e. facilitate or inhibit.The general aim of this thesis was to gain in depth insight in the relation between temperament and developmental stuttering, including temperamental components of attention and inhibitory control. This general aim was further specified in three main research objectives, as reflected in the different studies. For the first research objective a temperament questionnaire was administered to large groups of children who stutter (CWS) and children who not stutter (CWNS) to detect possible differences. For the second and third research objective, neuropsychological computer tasks were employed to detect possible differences between CWS and CWNS on attentional networks and inhibitory control. The ChildrenÂ’s Behavior Questionnaire was administered to the parents of CWS, CWNS, and children with vocal nodules. Analysis of the underlying factor structure revealed, apart from some minor differences, a congruent factor structure for the three participant groups. Consequent analyses of the factors and scales showed CWS to be higher in negative reactivity and lower in self-regulation, partly determined by higher scale scores for anger/frustration, motor activation, and approach and lower scale scores for inhibitory control and attentional shifting.The following studies always included a group of CWS matched to a group of CWNS. For the second research objective, the Attention Network Test, a combination of a cued reaction time task and a flanker task, was used. Findings revealed a lower efficiency of the orienting network for CWS and a trend towards a lower efficiency of the executive control network.For the third and final research objective, the efficiency of inhibitory control was evaluated by using a Go/NoGo task, a stop signal task, and a sustained attention task. CWS were found to be less able to suppress prepotent response tendencies in those tasks where response inhibition had to be generated endogenously while they performed comparable to CWNS in a task where response control was externally triggered.In conclusion, current studies have shown that CWS, as a group, differ from CWNS on temperamental constellation, more in specific they are higher in negative reactivity and lower in self-regulation. With regard to self-regulation, differences emerged on attentional regulation and inhibitory control. These findings have led to an increased insight in the relation between temperament and developmental stuttering and have laid the foundations for future longitudinal studies. The latter will be necessary to unveil the way of interaction between temperament and developmental stuttering.
Table of Contents: Acknowledgements
Abstract
Korte inhoud
Acronyms and abbreviations
Table of contents
Chapter 1 General introduction
1.1 Motivation for the present research
1.2 Developmental stuttering
1.2.1 Definition
1.2.2 Onset of stuttering
1.2.2.1 Genetics
1.2.2.2 Age and pattern at onset
1.2.2.3 Prevalence and incidence
1.2.2.4 Spontaneous recovery versus chronic stuttering
1.2.2.5 Male-to-female ratio
1.2.3 Stuttering development
1.2.4 Etiological theories
1.2.5 Anatomical correlates of developmental stuttering
1.3 History of psychological research in stuttering
1.4 The concept of temperament
1.4.1 Different perspectives on temperament
1.4.1.1 History of temperament
1.4.1.2 Temperament models
1.4.2 Rothbart’s temperament model
1.4.2.1 Positive and negative reactivity
1.4.2.2 Self-regulation
1.4.2.3 Children’s Behavior Questionnaire
1.4.3 Measurement of temperament
1.4.4 Temperament and development
1.4.2.1 Normal development
1.4.2.2 Temperament and behavioral disorders
1.4.2.3 Temperament and communication disorders
1.5 Temperament and developmental stuttering research
1.5.1 Questionnaire-based findings
1.5.2 Psychophysical and psychophysiological findings
1.5.3 Communication-Emotional model of stuttering
1.6 Research objectives
1.7 Thesis outline

Chapter 2 Factorial temperament structure of stuttering, voice-disordered, and typically developing children
2.1 Introduction
2.2 Method
2.2.1 Participants
2.2.2 Detection instrument for stuttering
2.2.3 Temperament questionnaire
2.2.4 Procedure
2.2.5 Data analysis
2.3 Results
2.3.1 Dutch CBQ scale reliabilities
2.3.2 Structure of Dutch CBQ scales
2.3.2.1 Factor structure of typically developing children
2.3.2.2 Factor structure of children who stutter
2.3.2.3 Factor structure of children with vocal nodules
2.3.3 Factor congruence coefficients
2.4 Discussion
2.4.1 Dutch CBQ scale reliabilities
2.4.2 Structure of temperament
2.4.3 Congruence of temperament structure
2.5 Conclusion

Chapter 3 Temperament dimensions in stuttering and typically developing
children
3.1 Introduction
3.1.1 The concept of temperament
3.1.2 Temperament as a moderator in the development of behavioral disorders
3.1.3 Temperament and developmental stuttering
3.2 Method
3.2.1 Participants
3.2.2 Temperament questionnaire
3.2.3 Procedure
3.2.4 Data analysis
3.3 Results
3.3.1 Overall group differences
3.3.2 Relationship with therapy duration
3.3.3 Relationship with stuttering severity
3.4 Discussion
3.4.1 Group differences in composite temperament factor scores
3.4.2 Group differences in individual temperament scales
3.4.2.1 CWS scored higher on anger/frustration, approach, and motor activation
3.4.2.2 CWS scored lower on inhibitory control and attentional shifting
3.4.3 Relationship with therapy duration and stuttering severity
3.4.4 Implications for the role of temperament in developmental stuttering
3.4.5 Caveats and suggestions for future research
3.5 Conclusion

Chapter 4 Efficiency of attentional networks in children who stutter
4.1 Introduction
4.2 Method
4.2.1 Participants
4.2.2 Materials
4.2.2.1 Baseline Speed Task
4.2.2.2 Attention Network Test
4.2.3 Procedure
4.3 Results
4.3.1 Between-group differences in RT and error percentages
4.3.2 Changes in mean RT and error rates over the three experimental blocks
4.3.3 Between-group differences in attentional networks
4.4 Discussion
4.4.1 Between-group differences in RT and error percentages
4.4.2 Changes in mean RT and error rates over the three experimental blocks
4.4.3 Between-group differences in attentional networks
4.4.4 Additional considerations
4.5 Conclusion

Chapter 5 Inhibitory control in children who stutter
5.1 Introduction
5.2 Method
5.2.1 Participants
5.2.2 Materials
5.2.2.1 Baseline Speed Task
5.2.2.2 Experimental task: Go/NoGo Task
5.2.3 Procedure
5.3 Results
5.4 Discussion
5.4.1 CWS, as a group, exhibited a less controlled response style
5.4.2 Theoretical implications for the development of stuttering
5.4.3 Possible clinical implications
5.4.4 Caveats, limitations and suggestions for future research
5.5 Conclusion


Chapter 6 Endogenously and exogenously triggered response inhibition
6.1 Introduction
6.2 Method
6.2.1 Participants
6.2.2 Materials
6.2.2.1 Baseline Speed Task
6.2.2.2 Measure of exogenously triggered response inhibition: Stop Signal Task
6.2.2.3 Measure of endogenously generated response inhibition: Sustained Attention Task
6.2.3 Procedure
6.3 Results
6.4 Discussion
6.4.1 CWS and CWNS were equally efficient in exogenously triggered response inhibtion
6.4.2 CWS were less efficient in endogenously generated response inhibition
6.4.3 Possible implication for the role of the basal ganglia in developmental stuttering
6.4.4 Additional considerations and suggestions for future research
6.5 Conclusion

Chapter 7 General conclusions and future research directions
7.1 General discussion of research findings
7.1.1 CWS are higher in negative reactivity and lower in self-regulation, as measured by a parental temperament questionnaire
7.1.2 Attention processes, as measured by a cognitive computer task, arenless efficient in CWS
7.1.3 Inhibition, as measured by cognitive computer tasks, is less efficient in CWS
7.1.4 Vulnerability or disability hypothesis
7.1.5 Temperament characteristics and early childhood stuttering onset and development
7.1.6 Additional considerations

7.2 Future research directions
7.2.1 Multimethod approach
7.2.2 Temperament interactions
7.2.3 Prospective longitudinal research
7.3 General conclusion

References
Curriculum vitae
List of publications
ISBN: 9789090271859
Publication status: accepted
KU Leuven publication type: TH
Appears in Collections:Health Psychology
Faculty of Medicine - miscellaneous

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