Cognitive Flexibility in Preschool Children with and without Stuttering Disorders

Abstract Purpose Multifactorial explanations of developmental stuttering suggest that difficulties in self-regulation and weak attentional flexibility contribute to persisting stuttering. We tested this prediction by examining whether preschool-age children who stutter (CWS) shift their attention less flexibly than children who do not stutter (CWNS) during a modified version of the Dimension Card Change Sort (DCCS), a reliable measure of attention switching for young children. Methods Sixteen CWS (12 males) and 30 children CWNS (11 males) participated in the study. Groups were matched on age (CWS: M  = 49.63, SD  = 10.34, range  = 38–80 months; CWNS: M  = 50.63, SD  = 9.82, range  = 37–74 months), cognitive ability, and language skills. All children completed a computer-based variation of the DCCS, in which they matched on-screen bivalent stimuli to response buttons based on rules that switched mid-task. Results Results showed increased slowing for CWS compared to controls during the postswitch phase, as well as contrasting patterns of speed-accuracy tradeoff for CWS and CWNS as they moved from the preswitch to postswitch phase of the task. Conclusions Group differences in performance suggest that early stuttering may be associated with difficulty shifting attention efficiently and greater concern about errors. Findings are consistent with a growing literature indicating links between weak attentional control and persisting developmental stuttering.