title: Re-emergence of childhood stuttering in Parkinson's disease: a hypothesis.
abstract: OBJECTIVE
  To characterize speech patterns in patients with Parkinson's disease (PD) who have a history of childhood stuttering.
  
  
  BACKGROUND
  Childhood stuttering usually resolves, but it re-emerges in some patients after stroke or other brain disorders. This phenomenon of recurrent stuttering has not been characterized in childhood stutterers who later develop PD.
  
  
  METHODS
  Twelve patients with a history of childhood stuttering that remitted and subsequently recurred were included in the study. A structured interview was administered to seven patients, and six were able to answer questions about childhood stuttering. The Johnson Severity Scale (JSS) (range 0-7) and a Situation Avoidance Scale (SAS) were used to rate stuttering severity (range 0-15) and avoidance (range 0-15).
  
  
  RESULTS
  The mean age at onset of childhood stuttering was 6.2 years (range 5-10); the mean latency from the onset of childhood stuttering to adult stuttering was 46.1 years; and the stuttering recurred on average 5.9 years (range 0-21) after the onset of PD. The stuttering characteristics in childhood and adulthood included repetitions of sounds and syllables at the beginnings of words, blocks and interjections, physical tension, and a worsening of symptoms with stress. The patients rated themselves as having mild-to-moderate childhood stuttering by the JSS (mean 3.0, range 2-4) and mild-to-moderate stuttering and avoidance by the SAS (mean stuttering score 5.3, range 3-7; mean avoidance score 4.2, range 3-6). There was no apparent association between the severity of childhood stuttering and the severity of PD, but those patients who had higher Unified Parkinson's Disease Rating Scale scores tended to have more and worse symptoms of stuttering.
  
  
  CONCLUSIONS
  Our patients provide evidence for the hypothesis that childhood stuttering may re-emerge in adulthood with the onset of PD.
authors.affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: J
authors.initials: J
authors.lastname: Shahed
authors.forename: J
authors.initials: J
authors.lastname: Jankovic
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology; D012008:Recurrence; D012720:Severity of Illness Index; D013342:Stuttering / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology