Subtypes of stuttering determined by latent class analysis in two Swiss epidemiological surveys

Abstract

AimsAssociations between stuttering in childhood and a broad spectrum of risk factors, associated factors and comorbidities were examined in two large epidemiological studies. Subtypes of stuttering were then identified based on latent class analysis (LCA).MethodsData were from two representative Swiss population samples: PsyCoLaus (N = 4,874, age 35–82 years) and the ZInEP Epidemiology Survey (N = 1,500, age 20–41 years). Associations between stuttering and sociodemographic characteristics, familial aggregation, comorbidity and psychosocial risk / associated factors were investigated in both samples. LCAs were conducted on selected items from people in both samples who reported having stuttered in childhood.ResultsInitial analyses linked early anxiety disorders, such as separation anxiety disorder and overanxious disorder, to stuttering (PsyCoLaus). ADHD was associated with stuttering in both datasets. In the analyses of risk / associated factors, dysfunctional parental relationships, inter-parental violence and further childhood adversities were mutual predictors of stuttering. Moreover, comorbidities were seen with hay fever, asthma, eczema and psoriasis (PsyCoLaus). Subsequent LCA identified an unspecific group of persons who self-reported that they stuttered and a group defined by associations with psychosocial adversities (ZINEP, PsyCoLaus) and atopic diseases (PsyCoLaus).ConclusionsThe two subtypes of developmental stuttering have different risk / associated factors and comorbidity patterns. Most of the factors are associated with vulnerability mechanisms that occur early in life and that have also been linked with other neurodevelopmental disorders. Both psychosocial and biological factors appear to be involved in the etiopathogenesis of stuttering.

Associations between stuttering, comorbid conditions and executive function in children: a population-based study

“…The high rates of asthma in CWS in the present study is in agreement with past reports [ 143 , 149 , 151 , 171 ]. In fact, another atopic disease, hay fever, was reported to correlate with an earlier onset of stuttering and chronicity [ 172 ].…”

“…In clinical cohorts, concomitant language, speech, and behavioral disorders (e.g., expressive language, receptive language, articulation, phonology, and ADHD) are commonly reported with stuttering [ 141 , 142 ]. Prior studies also suggest higher rates of socioemotional, psychological distress and anxiety in CWS compared to CWNS [ 126 , 143 – 148 ]. In a study of 2,628 CWS, a majority (62.8%) had comorbid disorders [ 149 ].…”

Prevalence and Therapy Rates for Stuttering, Cluttering, and Developmental Disorders of Speech and Language: Evaluation of German Health Insurance Data

“…As the diagnosis of stuttering could also be related to acquired stuttering, we analyzed in detail the occurrence of comorbidities in the cohorts with speech disorders and the total insured population. For the insurance year 2017, we evaluated the co-occurrence of disorders and comorbidities for which a coexistence with stuttering has previously been reported in the literature, including: anxiety disorders (ICD10 codes F40.x, F41.x, and F93.0) (Iverach et al, 2009); ADHD (F90.x) (Ajdacic-Gross et al, 2018); tic disorders and Tourette syndrome (F95.x) (Ajdacic-Gross et al, 2018); personality disorders (F60.x, F61.x, and F62.x) (Iverach et al, 2009); specific developmental disorders of scholastic skills (F81.x) (Ajdacic-Gross et al, 2018); atopic disorders (J30.1-J30.4, J45.0, L20.x, and J30.1-J30.4) (Ajdacic-Gross et al, 2020); mental retardation (F70-F74); chromosomal anomalies (Q90x-Q99.x); and neurodevelopmental disorders (G40.x, G80.x. G91.x, G93.0, and G93.1) (Neumann et al, 2017).…”

“…These numbers were compared against the prevalences observed among the general insurance population aged 0-19 years for the insurance year 2017. Table 3 shows elevated odds ratios in patients with developmental disorders of speech and language (F80) compared with those for the general population for: atopic dermatitis (L20) (Ajdacic-Gross et al, 2020); phobic disorders (F40, F41, and F93) (Iverach et al, 2009); ADHD (F90) (Ajdacic-Gross et al, 2018); tic disorders and Tourette's syndrome (F95) (Ajdacic-Gross et al, 2018); personality disorders (F60) (Iverach et al, 2009); specific developmental disorders of scholastic skills (F81) (Ajdacic-Gross et al, 2018); intellectual disabilities (F70-F74); chromosomal anomalies (Q90 and Q93); and neurodevelopmental disorders (G40, G80, G91, G93, and G93) (Neumann et al, 2017). Table 4 shows a similar distribution of concomitant disorders and comorbidities among patients with FIGURE 3 | Annual total number (A,C) and the crude annual incidence [in%, (B,D)] of male and female patients in each 1-year age group diagnosed with a disorder of speech and language (A,B), as coded by at least one confirmed ICD-10 diagnosis of developmental disorders of speech and language, stuttering, or cluttering, and those diagnosed with stuttering (C,D) in insurance year 2017; y = years.…”

Hay Fever is Associated with Prevalence, Age of Onset and Persistence of Stuttering

“…. Recently, Ajdacic-Gross et al (2018) identified atopic diseases as factors associated with stuttering which applies more generally to childhood speech disorders Silverberg 2016a, 2016b), ADHD (Buske-Kirschbaum et al 2013;Schans et al 2017;Tsai et al 2013) and other neurodevelopmental disorders. Additional evidence is accruing which shows that psychosocial stressors impact the immune system at an early age (Danese and Lewis 2017) and psychosocial stressors and the immune system impact brain development jointly at critical periods .…”