A growing body of research has addressed children’s stuttering attitudes between preschool and upper elementary school. Attitudes among preschoolers and kindergarteners have been reported to be much lower that fifth graders’ attitudes, at which time children’s attitudes seemingly converge with their parents’ attitudes. It has been suggested these observed changes align with children’s social and cognitive development and are resistant to the influence of other variables, such as their culture. The purposes of this study were (a) to extend cultural examinations of children’s stuttering attitudes in a sample of kindergarteners through sixth graders in Bosnia & Herzegovina (B&H), and (b) to compare their attitudes with their parents’ attitudes.
One hundred eighty-six child-parent pairs from B&H completed translated versions of the child and adult
Children’s stuttering attitudes improved with age, with the youngest cohort holding the most negative attitudes. Parents held consistently more positive attitudes than the children overall, but the oldest children’s attitudes were quite similar to the parent group.
Confirming previous research, children’s stuttering attitudes progressively improved with age and approached the attitudes of their parents by fifth and sixth grade.
Universally, negative or misinformed stuttering attitudes abound, which often lead to inaccurate stereotyping and/or stigmatization of people who stutter [
In efforts to broaden epidemiological efforts to be inclusive of younger respondents, Weidner & St. Louis [
The first published study using the
To address that need, Glover, St. Louis, & Weidner [
Results from Glover et al. [
Theories about the emergence of stuttering attitudes in young children intrigued many
Based on its location in the west part of the Balkan Peninsula in southeastern Europe, B&H has been a crossroads of diverse populations dating back to the Neolithic age, which has fostered a rich culture. It currently has a population of over 3.5 million and, despite a turbulent history, has made strides to stabilize its [
Bosnia & Herzegovina emerged as a feasible country in which to replicate the Glover et al. [
The purposes of this study were to examine the differences of stuttering attitudes among children from B&H across different grade levels and compare their attitudes to those of their parents. Bearing on previous research theorizing children’s stuttering attitudes are resistant to culture [
The children filled out the
The
There are a few, but important, differences between the adult and child instruments worth mentioning. First, although they share 28 similar items, the wording is slightly different in order to make the language understandable for child respondents. For example, “genetics” on the adult version is worded “came from their mom or dad when they were born” on the child version. Second, the child version provides respondents with a video example of stuttering (as demonstrated by customized cartoon characters), followed by a definition of stuttering. The absence of a definition on the adult version makes no differences in results [
A previously translated
The second author obtained the permissions for human subject research through the primary and kindergarten school sites. Child-parent pairs were recruited using convenience sampling techniques at various primary schools throughout the city of Tuzla, Bosnia & Herzegovina. The grades were combined into four cohorts to represent children in kindergarten, early, middle, and upper elementary-aged children and their parents.
The second author and a research assistant from the University of Tuzla gave hard copies of the
Descriptive data for items, components, Subscores, and the Overall Stuttering Score (OSS) were analyzed for both the child and parent groups. Within and between group differences for summary scores (i.e., components, Subscores, and OSS) were calculated using independent t-tests. Cohen’s d effect sizes for significant differences were also reported. To account for the number of comparisons and thereby control for Type 1 error, an adjusted significance level of
One-hundred eighty-six nonstuttering children participated in the study. Children with parental consent, gave assent, and who demonstrated the ability to reliably comprehend and respond to the survey questions were included in the study. The latter criterion was determined via a combination of teacher and parental report. Children were not excluded on the basis of sex, socio-economic status, or race. Although stuttering was not an exclusionary criterion, based on parent report, none of the children in the current study stuttered.
Children’s demographic information is summarized in
One parent of each child filled out a questionnaire; therefore, the sample sizes were identical (
Parents’ Overall Stuttering Score was 26, ranging from 23 (parents of third and fourth graders) to 30 (parents of kindergarteners). Stuttering Beliefs and Self Reactions were 35 and 17, respectively. Although parents of kindergarteners consistently held the most positive attitudes, there were no significant differences between the parents based on their children’s age.
With few exceptions, parents consistently held higher stuttering attitudes compared to the child group. Parent vs. child comparisons revealed significant differences relative to OSS (child=3, parent=26,
Comparisons by cohort revealed a clear trend for children’s OSSs steadily approaching those of their parents. For example, the youngest child cohort (i.e., kindergarteners) significantly different from the parents, (youngest child cohort=−6, parent=26,
This study sought to compare the stuttering attitudes of children and their parents from Bosnia & Herzegovina (B&H). Children were grouped into one of four cohorts: kindergarten, early elementary (i.e., first and second graders), middle elementary (third and fourth graders), and upper elementary (i.e., fifth and sixth graders). The children and parents completed respective versions of the
As a whole, the four cohorts held relatively positive attitudes related to the potential of a person who stutters to make friends, make good choices, and have any job as an adult. On the other hand, however, the four cohorts generally held unfavorable attitudes about the traits of people who stutter and had limited knowledge about stuttering causes or how to sensitively react to a person who stutters. Even at the upper elementary level, children maintained stereotypical beliefs that people who stutter are nervous or shy and “unable to talk well.”
In examination of the children by cohort, important differences emerged, thus upholding our first hypothesis that children’s attitudes would steadily increase with age. The Self Reaction, Beliefs, and Overall Stuttering Scores increased across all four cohorts, with OSS improving 4 units between kindergarten and early elementary, 7 units between early and middle elementary, and 10 units between middle and upper elementary. That the youngest cohort held the worst attitudes overall is not surprising. In fact, it upholds previous stuttering research which suggested cognitive and social development may explain attitudinal differences between younger and older children [
Overall, parents held better attitudes than the children in each of the cohorts; however, those differences were more pronounced between the parents and youngest children. Significant differences existed between the parent and kindergarteners for Overall Stuttering Score (kindergarteners=−6, parents=26,
This study is a replication of Glover et al. [
It should be explained that children in the B&H kindergarten cohort also include, by American classifications, preschool-aged children. Therefore, the mean age in the American preschool and kindergarten groups combined was similar to the B&H kindergarten sample (i.e., 5.18 years and 5.21 years, respectively). In addition, the American sample did not include sixth grade children, thus slightly elevating the mean age of the oldest cohort in the B&H group (American=10.5 years, B&H=11.6 years). Despite lower attitudes overall, the B&H children showed a similar upward trajectory of attitudes with age. American children’s attitudes converged with their parents at a slightly younger age (i.e., fourth and fifth grade), opposed to similar attitudes among B&H parents and sixth graders. In a study of Turkish children and their families, Özdemir and colleagues [
Stuttering attitudes of neither the American nor B&H parent groups were influenced by the age of their children. Unlike the child groups in which the American children held slightly better attitudes, attitudes between American and B&H parents were comparable for OSS (American=25, B&H=26), Self Reactions (American=8, B&H=17), and Beliefs (American=42, B&H=35). That American children - but not American parents - held slightly elevated attitudes compared to the respective B&H groups is unclear. Results such as these should continue to be investigated with additional diverse samples to further examine whether or not children’s stuttering attitudes are generally higher in some cultures.
Although these results reflect a robust sample of children from B&H and their families, the sample is restricted to one geographic region of B&H. This is particularly important, given B&H is comprised of three distinct regions characterized by differences in spoken dialect and religious practices, even though small differences were observed among them for adults [
At this time, this and previous studies uphold the notion that children’s stuttering attitudes improve in conjunction with their social and cognitive [
The continued expansion of this line of research will not only contribute to epidemiological advancements in this area but will help to identify populations at “high risk” for holding misinformed or negative attitudes, so that appropriate and swift attitudinal improvement efforts can take place. Based on this and previous research, it seems that preschool and kindergarten aged children are among those at “high risk” for negative stuttering attitudes, thus potentially warrant priority in educational efforts to mitigate negative stuttering attitudes. Weidner et al. [
Mean
Child versus parent means for
Demographic information of children, reported by parents, organized by the four cohorts (Columns 1–4) and combined (Column 5) as well as parents’ demographic information (Column 6)
Demographic variable | Kindergarten | 1st & 2nd grades | 3rd & 4th grades | 5th & 6th grades | Children all | Parents all |
---|---|---|---|---|---|---|
Column | 1 | 2 | 3 | 4 | 5 | 6 |
| ||||||
Number | 61 | 46 | 39 | 40 | 186 | 186 |
| ||||||
Descriptors | ||||||
Age (yr) | 5.2 | 7.5 | 9.5 | 11.6 | 8.1 | 38.4 |
Education (yr) | — | — | — | — | — | 14.2 |
Male | 38% | 50% | 49% | 38% | 44% | 18% |
Female | 62% | 50% | 51% | 62% | 56% | 82% |
Multilingual | 11% | 33% | 41% | 70% | 41% | 52% |
≥1 Sibling | 54% | 74% | 74% | 80% | 49% | — |
Regular daycare | 75% | 4% | 0% | 0% | 49% | — |
Regular school | 0% | 100% | 100% | 100% | 75% | — |
| ||||||
Identification | ||||||
Obese | 3% | 2% | 8% | 13% | 7% | 6% |
Wheelchair | 0% | 0% | 0% | 0% | 0% | 0% |
Stuttering | 0% | 0% | 0% | 0% | 0% | 0% |
Intelligent | — | — | — | — | — | 17% |
Left handed | — | — | — | — | — | 3% |
| ||||||
No persons known… | ||||||
Obese | 33% | 20% | 3% | 13% | 17% | 8% |
Wheelchair | 75% | 52% | 56% | 40% | 56% | 40% |
Stuttering (parent report) | 54% | 56% | 36% | 38% | 46% | 21% |
Intelligent | — | — | — | — | — | 2% |
Left handed | — | — | — | — | — | 5% |
| ||||||
Health & abilities (−100 – +100) | ||||||
Physical health | 92 | 95 | 81 | 94 | 90 | 65 |
Mental health | 95 | 99 | 86 | 99 | 95 | 84 |
Ability to learn | 96 | 97 | 87 | 94 | 72 | 78 |
Ability to speak | 84 | 93 | 86 | 95 | 90 | 88 |
| ||||||
Life priorities | ||||||
Be safe/secure | — | — | — | — | — | 88 |
Be free | — | — | — | — | — | 69 |
Spend time alone | — | — | — | — | — | 27 |
Attend social events | — | — | — | — | — | 18 |
Imagine new things | — | — | — | — | — | 31 |
Help less fortunate | — | — | — | — | — | 70 |
Have exciting experiences | — | — | — | — | — | −34 |
Practice my religion | — | — | — | — | — | 46 |
Earn money | — | — | — | — | — | 76 |
Do job/duty | — | — | — | — | — | 91 |
Get things done | — | — | — | — | — | 89 |
Solve big problems | — | — | — | — | — | 82 |
| ||||||
Impression | ||||||
Obese | — | — | — | — | — | 3 |
Wheelchair | — | — | — | — | — | 41 |
Stuttering | — | — | — | — | — | 26 |
| ||||||
Want/have | ||||||
Obese | — | — | — | — | — | −72 |
Wheelchair | — | — | — | — | — | −70 |
Stuttering | — | — | — | — | — | −59 |
| ||||||
Amount known | ||||||
Obese | — | — | — | — | — | 14 |
Wheelchair | — | — | — | — | — | −2 |
Stuttering | — | — | — | — | — | −9 |
Children ( |
Parents ( |
t-Test Values | t-Test Proba-bility | Cohen’s | |
---|---|---|---|---|---|
Overall stuttering score | 3 (21.9) | 26 (19.3) | −12.04 | <0.00001 | 1.114 |
Beliefs | 19 (27.3) | 35 (27.3) | −6.87 | <0.00001 | 0.586 |
Traits/personality | 1 (55.2) | 39 (67.6) | −4.89 | <0.00001 | 0.616 |
Helped from | 19 (40.0) | −1 (44.9) | 1.32 | 0.187 | 0.470 |
Potential | 64 (47.2) | 72 (31.6) | −3.05 | 0.002 | 0.199 |
Self reactions | −13 (23.9) | 17 (24.9) | −12.66 | <0.00001 | 1.229 |
Accommodating/helping | 33 (40.4) | 54 (31.9) | −7.01 | <0.00001 | 0.577 |
Social distance/sympathy | 7 (45.7) | 35 (38.8) | −6.30 | <0.00001 | 0.661 |
Obesity/wheelchair use | −40 (23.3) | −14 (32.4) | −9.96 | <0.00001 | 0.921 |
Kindergarten | 1st & 2nd grades | 3rd & 4th grades | 5th & 6th grades | Children all | Parents all | |
---|---|---|---|---|---|---|
Column | 1 | 2 | 3 | 4 | 5 | 6 |
| ||||||
Overall stuttering score | −6 | −2 | 9 | 19 | 3 | 26 |
| ||||||
Beliefs: about children who stutter | 11 | 14 | 26 | 34 | 19 | 35 |
| ||||||
Traits/personality | −16 | −5 | 6 | 30 | 1 | 39 |
Blame (at fault) |
8 | 52 | 89 | 89 | 53 | 62 |
Nervous |
−7 | −7 | 9 | 0 | −2 | 77 |
Shy |
−24 | −9 | −56 | 9 | −20 | −23 |
Something bad |
−2 | 17 | 52 | 74 | 30 | — |
Can talk well | −57 | −78 | −65 | −20 | −57 | — |
| ||||||
Help from | 12 | 17 | 24 | 27 | 19 | −1 |
SLP | 70 | 83 | 100 | 90 | 84 | 98 |
Stutterers | 5 | 12 | −14 | −11 | −1 | −47 |
Parent | 43 | 61 | 89 | 90 | 67 | — |
Doctor |
−70 | −87 | −78 | −62 | −74 | −52 |
| ||||||
Cause | −6 | −17 | 7 | −4 | −6 | 30 |
Genetic | 3 | −19 | −60 | −29 | −22 | 6 |
Learning |
−32 | −42 | −9 | 6 | −23 | 74 |
Something bad |
−38 | −14 | 3 | −32 | −22 | — |
Fright |
— | — | — | — | — | −56 |
Act of God |
12 | 11 | 12 | 0 | 9 | 10 |
Virus/disease (germs) |
14 | 0 | 68 | 50 | 28 | 54 |
Ghost/demon/spirit (invisible) |
5 | −40 | 26 | −21 | −8 | 94 |
| ||||||
Potential | 54 | 60 | 68 | 82 | 64 | 72 |
Make friends | 87 | 78 | 100 | 85 | 87 | 100 |
Normal life (do same things as others) | 22 | 52 | 33 | 75 | 43 | 98 |
Do any job (any job as adult) | 50 | 65 | 68 | 88 | 65 | 51 |
Job requiring good judgment (can make good choices) | 58 | 45 | 71 | 83 | 62 | 40 |
| ||||||
Self Reactions: to children who stutter | −23 | −18 | −8 | 4 | −13 | 17 |
| ||||||
Accommodating/helping | 5 | 34 | 47 | 60 | 33 | 54 |
Ignore | 15 | 78 | 79 | 85 | 59 | 96 |
Me (I should help) | 7 | 64 | 49 | 35 | 35 | −36 |
Finish words |
−19 | −22 | 15 | 45 | 1 | 57 |
Say “slow down” |
−41 | 4 | −6 | 32 | −7 | 20 |
Joke (laugh) |
64 | 83 | 100 | 85 | 81 | 88 |
Hide |
2 | −2 | 46 | 79 | 26 | 96 |
| ||||||
Social distance/sympathy | 10 | −14 | 6 | 28 | 7 | 35 |
Comfortable (fun to play with) | 60 | 51 | 87 | 73 | 65 | 88 |
Bothered |
38 | 65 | 85 | 95 | 67 | |
Pity (Feel sorry for them) |
15 |
78 |
89 |
67 |
57 |
82 |
Impatient |
— | — | — | — | — | 96 |
Patient | 43 | 96 | 95 | 90 | 77 | — |
Doctor |
18 | −61 | 5 | 30 | −2 | 72 |
Teacher |
3 | −74 | −57 | −20 | −33 | — |
Neighbor |
−3 | −52 | −24 | 35 | −12 | 68 |
Friend |
−18 | −78 | −59 | −13 | −41 | — |
Parent |
−13 | −78 | −84 | −26 | −47 | — |
Brother or sister |
−21 | −78 | −56 | −3 | −38 | −22 |
Myself |
−15 | −65 | −74 | −49 | −47 | −33 |
Preference | 19 | 31 | 65 | 58 | 40 | — |
Impression | — | — | — | — | — | 26 |
Want to stutter | — | — | — | — | — | −59 |
| ||||||
Knowledge/experience (experience) | −85 | −73 | −78 | −76 | −79 | −42 |
Amount known | — | — | — | — | — | −9 |
Persons known | — | — | — | — | — | −88 |
Source: personal | — | — | — | — | — | −27 |
Informant | −95 | −96 | −91 | −93 | −94 | — |
Child | −77 | −55 | −69 | −62 | −67 | — |
| ||||||
Knowledge source | — | — | — | — | — | 20 |
TV/radio | — | — | — | — | — | 40 |
— | — | — | — | — | 38 | |
Internet | — | — | — | — | — | 31 |
School | — | — | — | — | — | 8 |
Specialists | — | — | — | — | — | −17 |
| ||||||
Obesity/wheelchair | −41 | −38 | −44 | −37 | −40 | −14 |
| ||||||
Preference | −9 | −16 | −30 | −29 | −20 | — |
Obesity | −14 | −7 | 17 | 32 | 4 | — |
Wheelchair | −4 | −25 | −77 | −89 | −43 | — |
| ||||||
Experience | −74 | −60 | −57 | −46 | −61 | — |
Obesity | −55 | −38 | −25 | −19 | −37 | — |
Wheelchair | −92 | −81 | −90 | −72 | −85 | — |
| ||||||
Impression | — | — | — | — | — | 22 |
Obese | — | — | — | — | — | 3 |
Wheelchair | — | — | — | — | — | 41 |
| ||||||
Want/have | — | — | — | — | — | −71 |
Obese | — | — | — | — | — | −72 |
Wheelchair | — | — | — | — | — | −70 |
| ||||||
Amount known | — | — | — | — | — | 6 |
Obese | — | — | — | — | — | 14 |
Wheelchair | — | — | — | — | — | −2 |
Mean ratings inverted so that higher scores reflect more accurate, sensitive attitudes;
Ratings for “Pity (Feel sorry for)” are not inverted for the