Attentional regulation in young twins with probable stuttering, high nonfluency, and typical fluency

Using a sample of 20,445 Dutch twins, this study examined the relationship between speech fluency and attentional regulation in children. A secondary objective was to identify etiological overlap between nonfluency and poor attention using fluency-discordant twin pairs.

Three fluency groups were created at age 5 using a parent questionnaire: (a) probable stuttering (PS; N=826; 4.0%), highly nonfluent (HNF; N=547; 2.7%), and typically fluent (TF; N=19,072; 93%). Multiple scales assessing attention, primarily self-regulation/inhibition, were obtained from both parents when children were ages 5 and 7 and from teachers when children were age 7.

When compared with the TF controls, both the PS and HNF children received higher (i.e., more problematic) scores on parental attention ratings at both ages (p<.002). Effect sizes were moderate for both groups. Teacher and parent ratings were generally comparable. The discordant co-twin analyses suggested that nonfluency and attention were influenced by potentially overlapping genetic and shared environmental factors.

The liability to express both high nonfluency and problems with self-regulation/inhibition may arise from a common set of pathogenic mechanisms. This supports emerging models of stuttering, which propose that poor fluency may be part of a broader network of impaired self-regulatory processes.