Is stammering associated with adverse mental health outcomes?
In light of Mental Health Awareness Week 2020, PhD student Ria Bernard discusses links between stammering and mental health outcomes.
When we talk about children who stammer, there is often an assumption that these children are ‘highly anxious’, ‘nervous’ individuals. Despite the fact that much work has been done to raise awareness about the causes and characteristics of stammering, which affects around 8%[1] of children, there is a commonly held view that children who stammer are just more anxious than other children.
When I talk about my PhD research, colleagues and education professionals have looked puzzled, with some asserting that surely it is obvious that children who stammer are more anxious than non-stammering children. During my clinical practice, I worked with a number of children who stammer and found that each child differed in how their stammer affected their confidence, self-esteem and social participation. I wouldn’t have said that all of them presented with heightened anxiety – something which isn’t surprising given that children who stammer are not a homogenous group. But to what extent are such commonly held assumptions around stammering supported by high quality research studies?
My PhD research aims to evaluate whether children who stammer are at increased risk of anxiety and depression compared with their non-stammering peers. Rooted in the context of preventative healthcare, we hope to examine whether variables, such as sex, age, family history of mental health, socio-economic group and bullying victimisation, affect any association between stammering and anxiety/depression in children and young people. By identifying potential risk factors related to clinical levels of anxiety and depression in this population, there would be scope to influence policy around early, multi-disciplinary intervention.
Recent research has shown an increase in the prevalence of mental health disorders amongst non-stammering, typically developing children and young people. Given the impact of stammering on spoken fluency in a world where verbal communication is paramount to participation, it seems reasonable that these children will face additional challenges in getting their message across effectively. Challenges which could lead to increased anxiety about speaking and/or social situations. But does this mean that they are more at risk of clinical levels of anxiety and depression?
There has been much research into the association between stammering and anxiety in the adult population; with a systematic review of the literature indicating that adults who stammer present with elevated anxiety[2]. However, the literature is unclear regarding anxiety levels amongst children and young people who stammer. While some studies have found that children and adolescents who stammer obtain higher scores on anxiety measures than non-stammering children[3][4], other studies have not concluded that young people who stammer present with elevated anxiety[5][6].
In an effort to address some of these issues, I’m keen to hear from children and young people who stammer as part of my latest research study.
For this project, we are inviting children who stammer and their families to take part in a short online questionnaire, which will explore participants’ experiences of mental health and bullying. We are keen to ensure our sample of children is as representative as possible, so if you know anyone who stammers between 8 – 13 years of age who may be interested in taking part, it would be great to hear from you.
Ria is a PhD student at UCL. Her research is funded by Action for Stammering Children Charity and the ESRC.
[1] Yairi, E., & Ambrose, N., 2013. Epidemiology of stuttering: 21st century advances. Journal of Fluency Disorders, 38: 66 – 87.
[2] Craig, A., & Tran, Y, 2014. Trait and social anxiety in adults with chronic stuttering: conclusions following meta-analysis. Journal of Fluency Disorders, 40: 35-43.
[3] Blood, G. W., Blood, I. M., Maloney, K., Meyer, C., and Qualls, C. D., 2007. Anxiety levels in adolescents who stutter. Journal of Communication Disorders, 40: 452 – 469.
[4] Davis, S., Shisca, D., & Howell, P., 2007. Anxiety in speakers who persist and recover from stuttering. Journal of Communication Disorders, 40: 398 – 417.
[5] Smith, K. A., Iverach, L., O’Brian, S., and Mensah, F., Kefalianos, E., Hearne, A., and Reilly, S., 2017. Anxiety in 11-year old children who stutter: findings from a prospective longitudinal community sample. Journal of Speech, Language and Hearing Research, 1 – 12.
[6] Craig, A., & Hancock, K., 1996. Anxiety in children and young adolescents who stutter. Australian Journal of Human Communication Disorders, 24.