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Pediatrician Referral Practices for Children Who Stutter
Katherine L Winters1, Courtney T Byrd1
1Department of Communication Sciences and Disorders, The University of Texas at Austin.
Insights
Pediatricians are more likely to refer children for stuttering concerns when they observe speech behaviors or negative communication attitudes. Parent concerns alone are less likely to prompt a referral to a speech-language pathologist.
Area of Science:
- Pediatrics
- Speech-Language Pathology
- Child Development
Background:
- Pediatricians are often the first point of contact for concerns about childhood stuttering.
- Increased evidence-based information on stuttering necessitates updated pediatrician practices.
Purpose of the Study:
- To assess pediatricians' accuracy in identifying potential stuttering in preschoolers.
- To evaluate pediatricians' referral likelihood for children exhibiting stuttering indicators.
Main Methods:
- National online survey of pediatricians using case vignettes.
- Vignettes manipulated stuttering presence and communication attitude.
- Data collected on pediatrician identification and referral practices.
Main Results:
- Pediatricians' identification and referral decisions were primarily influenced by observed stuttering behaviors and negative communication attitudes.
- Pediatrician gender, years in practice, and experience with stuttering did not significantly affect referral rates.
Conclusions:
- Pediatricians are less inclined to adopt a 'wait and see' approach for young children who stutter compared to previous practices.
- Parental reports of atypical behavior alone do not consistently lead to specialist referrals, unlike other childhood diagnoses.
- Future education should encourage pediatricians to consider factors beyond direct observation for stuttering referrals, such as parental concerns.
Abstract:
Purpose Given the marked increase in evidence-based information regarding the nature/treatment of stuttering, coupled with the fact that pediatricians tend to be one of the initial points of contact for parents who suspect their preschool-age child may stutter, this study explored pediatricians' (a) accuracy in identifying children who may stutter and (b) likelihood of referring children who present with a profile indicative of stuttering to speech-language pathologists. Method Pediatricians recruited nationally through professional organizations completed a 5- to 7-min online survey that probed stuttering identification and referral practices via responses to experimental case vignettes. Each vignette featured a 4-year-old boy with a family history of stuttering whose mother reported signs of stuttering and manipulation of two factors: stuttering during the pediatrician visit (or not) and negative communication attitude (or not). Results Our findings suggest pediatricians' identification and referral of children who may stutter is largely prompted by observation of overt speech behaviors and/or negative communication attitude. Participants' gender, years in practice, and experience working with children who stutter did not influence likelihood of referral. Conclusions Results indicate pediatricians are less likely to implement a "wait and see" approach with young children who stutter today than in the past. Unlike other common child onset diagnoses, however, parent report of atypical behavior does not yield pediatrician referral to a specialist. Future education and advocacy efforts directed toward pediatricians should emphasize inclusion of factors other than direct observation of stuttering behavior that may warrant referral (e.g., parent report).
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