Socioecological Determinants of Speech Evaluation and Treatment Among Children Who Stutter.

Purpose: While there is no cure for stuttering, therapy can help children who stutter (CWS) reduce the adverse effects imposed by stuttering. The Individuals with Disabilities Education Act (IDEA) guarantees "special education and related services" at no cost to all children with disabilities. However, a potential interplay of variables may influence service provision for CWS. Therefore, the purpose of this study was to identify some of the determinants of receiving (a) an evaluation and (b) speech-language therapy (SLT) among a nationally representative sample of CWS.

Method: This analysis utilized five waves of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11-a nationally representative sample of children in the United States attending both full-day and part-day kindergarten in 2010-2011, who were followed through the fifth grade. Over 800 parents reported that their child had a problem with stuttering at least once in the panel. Using a socioecological framework, this study sought to identify the individual-, interpersonal-, and community-level determinants of receiving (a) a communication evaluation and (b) SLT among CWS.

Results: Determinants at all three levels were significantly associated with both the likelihood of evaluation and receipt of SLT.

Conclusions: Despite the passage of IDEA over 20 years ago, many CWS are not receiving necessary evaluation and therapy services in school. These shortfalls result from determinants at multiple levels making mitigation more challenging. Identification is the first step in resolving such problems, and it is hoped that this project contributes to this discourse.