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Temperament and Childhood Stuttering: Theory, evidence, and clinical practice

Temperament and Childhood Stuttering: Theory, evidence, and clinical practice
Robin Michael Jones, PhD, CCC-SLP
January 29, 2016
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Learning Outcomes

Dr. Robin Jones:  The learning outcomes for this course are to define temperament and identify approaches that can be used to measure it, describe the role of temperament in theoretical models of stuttering and describe these characteristics in young children who stutter, and describe potential clinical implications of temperament in the treatment of childhood stuttering. 

Purpose

The overall purpose of this is course is to give background on what temperament is, including reactivity and regulation, especially with regard to childhood stuttering.  Empirical evidence will be discussed as well as one theoretical model that implicates temperament and emotion in the onset and development of childhood stuttering.  I will describe some ways to apply this to clinical practice (i.e. how to assess stuttering and how to work with young children who stutter and their families).

There are two key acronyms for this course – “CWS” which is used for children who stutter and “CWNS” which is used for children who do not stutter.

The three articles that will be covered are: 

  • Article 1: Temperament, Speech and Language: An overview (Conture et al., 2013) – This articles reviews different theoretical perspectives on temperament, what it is, what type of aspects make up temperament, and also discusses how temperament may play a role in various speech-language disorders such as stuttering, voice disorders, and SLI, which is helpful to SLPs.  This article could apply to other populations that we work with as well, but those are the three that are highlighted in the article. 
  • Article 2: Temperament Dimensions in Stuttering and Typically Developing Children (Eggers et al., 2010) – This is a great example of an empirical study looking at temperament in young children who stutter. 
  • Article 3: Temperament, Emotion, and Childhood Stuttering (Jones et al., 2014) – This is an article that I wrote with my colleagues that provides a relatively brief overview on temperament and what it is. It also reviews the empirical evidence available at that time on the association between temperament and emotion.  Clinical implications are discussed as well.

Article 1: Temperament, Speech and Language: An Overview
(Conture et al., 2013)

Temperament: Defined

What is temperament?  There are as many different definitions of temperament as there are with stuttering.  Rothbart defines temperament as “individual differences in emotional, motor, and attentional reactivity measured by latency, intensity and recovery of response, and self-regulation processes such as effortful control that modulate reactivity (2007).”  This is how reactive you are to a given situation as well as how well you can cope with or decrease that reactivity.  These tendencies of temperament are biologically based.  They tend to be stable, trait-like aspects of an individual, but are not continually expressed.  Expression will depend on the content of the situation or the environmental condition that the individual is in.  If they are in a very calm situation, that reactive aspect of their temperament probably will not be expressed.  Whereas if they are in a very emotionally challenging situation, then that is when you may see that emotional reactivity being expressed for a given individual. 

Emotion Reactivity and Regulation: Defined

What are reactivity and regulation?  Reactivity is emotional, motoric and attentional reactions.  Regulation is defined as processes that regulate that reactivity.  These include things such as the tendency to approach or withdraw from stimuli and/or directing attention away or towards stimuli.  I have a three and a half-year-old, soon to be four-year-old son.  His name is Arlo.  He does not watch a lot of TV, but when he does, if there is a scary part coming or any kind of conflict, he will cover his eyes or go out of the room.  He will direct his attention away from that.  That is a way for him to regulate his emotions as to not get himself too aroused in that situation. 

How are reactivity and regulation measured?  One way is to look at the latency to respond; how quickly does the response happen?  What is the intensity of the response?  What is the frequency of that response or how often is it happening?  What is the duration of those responses?  Measures can be based on caregiver reports; having the parents report on their child’s positive and negative affect.  Coded behavior observations can also be used to code positive and negative facial expressions or how the child shifts their attention from emotional stimuli to a more neutral stimuli.  Physiological measures, such as sympathetic or parasympathetic nervous system activity, can also be used to measure reactivity and regulation. Sympathetic activity is typically associated with the fight or flight response (e.g. there is an increase in heart rate and sweaty palms).  Parasympathetic activity is more of a calming response.  You “rest and digest.”  The heart rate would decrease in those types of situations. 

Some possible relations between emotional reactivity (arousal) and emotional regulation (coping).   Figure 1 shows a few possible associations between emotion reactivity and regulation. Although this is speculation, it is believed that having a good balance between the two is important.  As Ellen DeGeneres says, “My point is life is about balance, the good and the bad, the highs and the lows, the pina and the colada.”  The thought is that a person who has high reactivity and high regulation (i.e. good ability to cope with that high reactivity) they will have relatively good outcomes.  However, the person who has low reactivity (i.e. is not very reactive) and higher regulation will be associated with less desirable outcomes.


robin michael jones

Robin Michael Jones, PhD, CCC-SLP

Robin M. Jones, PhD,CCC-A/SLP, Assistant Professor, Hearing and Speech Sciences, Vanderbilt University, Nashville, TN 37232.  Jones’s primary research interest relate to childhood stuttering, with a focus on emotional (caregiver report, behavioral and psychophysiological) and linguistic contributions to stuttering as well as empirical assessment and treatment of stuttering.

 
 



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