Caregiver Predictions of Their 3- to 6-Year-Old Child Who Stutters' Communication Attitude

Abstract

Purpose: Caregivers share critical insight during their child's stuttering evaluation; yet, there have been no empirical studies evaluating whether caregivers provide similar accounts of their 3- to 6-year-old child's communication attitude compared to their child's self-report. This study examined caregiver- and child-reported communication attitude and assessed potential moderators of more comparable caregiver and child ratings (i.e., caregiver confidence, caregiver–child conflict, observer-rated stuttering severity). Method: One hundred thirteen children who stutter ages 3 through 6 years and a primary caregiver were recruited from clinical settings across the United States. Children completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT) and three speaking samples, which were recorded to assess observer-rated stuttering severity using the Stuttering Severity Instrument–Fourth Edition. Caregivers predicted their child's communication attitude (C-KiddyCAT) and provided a confidence rating for their prediction. Caregivers also rated caregiver–child conflict using the Child–Parent Relationship Scale–Short Form (CPRS-SF). Multiple regression was used to (a) evaluate whether caregiver C-KiddyCAT scores predicted child KiddyCAT scores and (b) assess potential moderators of the relationship between C-KiddyCAT and KiddyCAT scores. Results: Caregiver ratings of their child's communication attitude (C-KiddyCAT) predicted child communication attitude ratings (KiddyCAT). A significant interaction between caregiver–child conflict (CPRS-SF) and caregiver ratings of their child's communication attitude (C-KiddyCAT) suggested caregiver–child conflict changed the underlying relationship between C-KiddyCAT and KiddyCAT scores, such that low conflict resulted in more similar C-KiddyCAT and KiddyCAT scores. Neither caregiver confidence nor observer-rated stuttering severity influenced the relationship between C-KiddyCAT and KiddyCAT scores. Conclusions: Although many caregivers predicted communication attitude ratings that closely aligned with their child's report, some caregiver–child dyads provided divergent ratings. Clinicians should interpret caregiver predictions of their child's communication attitude within the context of their full evaluation and the caregiver–child relationship. Assessing both self-reported communication attitude and caregiver predictions of their child's communication attitude provides a meaningful starting point to counseling caregivers about cognitive components of stuttering for preschool- and kindergarten-age children who stutter.