Risk factors and assessment methods for screening childhood-onset fluency disorders: a scoping review.
Mayra Maria Oliveira de Lima, Heloísa de Oliveira Dos Anjos, Thaíse Sara Costa Dias and 2 others
Across 11 studies of preschoolers, parental complaint of stuttering was the most frequently identified predictor of persistence, followed by family history, age at onset, and duration.
No screening studies for cluttering in preschoolers were found, and the review captured only two formal screening instruments, both Brazilian.
Key findings
1Parental complaint of stuttering was the most frequently cited predictor of persistence (named in 5 of 11 studies), ahead of family history, age at onset, duration, and high frequency of typical disfluencies (each named in 3 studies).
2No studies screening for or assessing risk factors for cluttering in preschoolers were found in the literature, and the only two formal screening instruments captured by the search were the Brazilian PRGD and IRGD.
3No single risk factor in isolation was considered predictive of persistent stuttering; the presence of at least two predictive factors together was significantly associated with high risk of persistence.
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What it does not show
Only 11 articles were included, and six of the eleven were Brazilian, limiting the geographic and cultural breadth of the evidence base. No studies on cluttering screening in preschoolers were found, so the review cannot speak to that condition at all. Most included studies were at evidence levels III to VII (case-control, cross-sectional, narrative), with no randomised trials or large prospective cohorts. The review's own search missed at least two existing screening instruments (the US CSS-P and a Chilean instrument), so the instrument landscape is understated. No critical appraisal of the included articles was performed, which is standard for scoping reviews but means methodological quality was not formally assessed. The included studies varied widely in sample size (30 to 2,055), age range (2 to 12 years), and assessment approach, making direct comparison difficult. Several included studies relied on parental report without direct clinical confirmation, introducing potential recall and reporting bias.
Declared interests
No funding source and no conflicts of interest were declared.
The easy way to misread this
Do not read the list of 27 risk factors as a validated screening checklist. The review is a map of what 11 mostly Brazilian, mostly lower-level studies have reported; it does not establish which combination of factors reliably predicts persistence, and the two formal instruments it identifies (PRGD, IRGD) are still in early validation stages. Also, the absence of cluttering studies reflects a gap in the literature, not evidence that cluttering does not occur in preschoolers.
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