Skip to main content

Latent Class Analysis Reveals Distinct Groups Based on Executive Function and Socioemotional Traits, Developmental Conditions, and Stuttering: A Population Study

Abstract

A growing body of research has reported associations between weaker Executive Functions (EF), the set capacities that are needed to manage and allocate one’s cognitive resources during cognitively challenging activities and various neurodevelopmental conditions, including stuttering. The majority of this research has been based on variable-centered approaches, which have the potential to obscure within-population heterogeneity. Person-centered analyses are essential to understanding multifactorial disorders where relationships between indicators have been elusive, such as stuttering. The current study addressed gaps in the literature by using latent class analysis (LCA), a person-centered approach, to identify homogenous subgroups within the National Health Interview Survey (2004–2018) publicly available data set. Using this exploratory approach, we examined the hypothesis that there exist distinct classes (or subgroups) of children based on parent reports of EF, Socioemotional (SE) traits, developmental atypicality, and stuttering. Our analyses revealed distinct subgroups with substantially different likelihoods of parent-reported stuttering behaviors and developmental atypicality. For children with both EF and SE difficulties, the likelihood of parental report of stuttering and atypical development was even higher, in fact this likelihood (of stuttering and not-typically developing) was highest among all subgroups. In contrast, children without difficulties were the least likely to be reported with stuttering or not-typically developing. Our findings are consistent with theoretical frameworks for stuttering, which cite EF as a crucial component in the disorder. Additionally, our findings suggest within-population heterogeneity among children with EF difficulties and, specifically, EF and SE heterogeneity among children who stutter.

This is a preview of subscription content, access via your institution.

Notes

  1. Preliminary analyses suggested that participant’s sex was minimally associated with parent report of stuttering (rSpearman = -0.054). In addition, LCAs with participant sex included as an indicator evidenced convergence issues and fit more poorly than the corresponding LCAs without sex (see Appendix A). Participant’s sex was therefore not included in our final LCAs.

References

  1. Carlson SM, Wang TS (2007) Inhibitory control and emotion regulation in preschool children. Cogn Dev 22(4):489–510

    Article  Google Scholar 

  2. Diamond A (2013) Executive functions. Annu Rev Psychol 64:135–168

    PubMed  Article  Google Scholar 

  3. Carlson SM (2005) Developmentally sensitive measures of executive function in preschool children. Dev Neuropsychol 28(2):595–616

    PubMed  Article  Google Scholar 

  4. Diamond A, Lee K (2011) Interventions shown to aid executive function development in children 4 to 12 years old. Science 333(6045):959–964

    PubMed  PubMed Central  Article  Google Scholar 

  5. Corbett BA, Constantine LJ, Hendren R, Rocke D, Ozonoff S (2009) Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Res 166(2–3):210–222

    PubMed  PubMed Central  Article  Google Scholar 

  6. Ofoe LC, Anderson JD, Ntourou K (2018) Short-term memory, inhibition, and attention in developmental stuttering: a meta-analysis. J Speech Lang Heart Res 61(7):1626–1648

    Article  Google Scholar 

  7. Ozonoff S, Jensen J (1999) Brief report: specific executive function profiles in three neurodevelopmental disorders. J Autism Dev Disord 29(2):171–177

    PubMed  Article  Google Scholar 

  8. Walden TA, Frankel CB, Buhr AP, Johnson KN, Conture EG, Karrass JM (2012) Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering. J Abnorm Child Psychol 40(4):633–644

    PubMed  PubMed Central  Article  Google Scholar 

  9. Postma A, Kolk H (1993) The covert repair hypothesis prearticulatory repair processes in normal and stuttered disfluencies. J Speech Lang Hear Res 36(3):472–487

    Article  Google Scholar 

  10. Vasic N, Wijnen F (2005) Stuttering as a monitoring deficit. In: Hartsuiker RJ, Bastiaanse R, Postma A, Wijnen F (eds) Phonological encoding and monitoring in normal and pathological speech. Psychology Press, Hove, pp 226–247

    Google Scholar 

  11. Rhoades BL, Greenberg MT, Lanza ST, Blair C (2011) Demographic and familial predictors of early executive function development: contribution of a person-centered perspective. J Exp Child Psychol 108(3):638–662

    PubMed  Article  Google Scholar 

  12. Laursen B, Hoff E (2006) Person-centered and variable-centered approaches to longitudinal data. Merrill-Palmer Q 52:377–389

    Article  Google Scholar 

  13. Lanza ST, Collins LM, Lemmon DR, Schafer JL (2007) PROC LCA: a SAS procedure for latent class analysis. Struct Equ Model 14(4):671–694. https://doi.org/10.1080/10705510701575602

    Article  Google Scholar 

  14. Nylund-Gibson K, Masyn KE (2016) Covariates and mixture modeling: results of a simulation study exploring the impact of misspecified effects on class enumeration. Struct Equ Model 23(6):782–797

    Article  Google Scholar 

  15. Stern HS, Arcus D, Kagan J, Rubin DB, Snidman N (1995) Using mixture models in temperament research. Int J Behav Dev 18:407–423

    Article  Google Scholar 

  16. Lanza ST, Flaherty BP, Collins LM (2003) Latent class and latent transition models. In: Schinka JA, Velicer WF (eds) Handbook of psychology, vol 2. Research methods in psychology. Wiley, Hoboken, pp 663–685

    Google Scholar 

  17. Cloitre M, Garvert DW, Weiss B, Carlson EB, Bryant RA (2014) Distinguishing PTSD, Complex PTSD, and borderline personality disorder: a latent class analysis. Eur J Psychotraumatol 5:1–10

    Article  Google Scholar 

  18. Jang Y, Park NS, Chiriboga DA, Kim MT (2017) Latent profiles of acculturation and their implications for health: a study with Asian Americans in central Texas. Asian Am J Psychol 8(3):200–208

    PubMed  PubMed Central  Article  Google Scholar 

  19. Ajdacic-Gross V, Bechtiger L, Rodgers S, Müller M, Kawohl W, von Känel R, Strippoli MPF (2018) Subtypes of stuttering determined by latent class analysis in two Swiss epidemiological surveys. PLoS ONE 13(8):e0198450

    PubMed  PubMed Central  Article  Google Scholar 

  20. Gathercole SE, Pickering SJ, Ambridge B, Wearing H (2004) The structure of working memory from 4 to 15 years of age. Dev Psychol 40(2):177

    PubMed  Article  Google Scholar 

  21. Jacob R, Parkinson J (2015) The potential for school-based interventions that target executive function to improve academic achievement: a review. Rev Educ Res 85(4):512–552

    Article  Google Scholar 

  22. Müller U, Jacques S, Brocki K, Zelazo PD (2009) The executive functions of language in preschool children. In: Winsler A, Fernyhough C, Montero I (eds) Private speech, executive functioning, and the development of verbal self-regulation. Cambridge University Press, Cambridge, pp 53–68

    Chapter  Google Scholar 

  23. Mulder H, Verhagen J, Van der Ven SH, Slot PL, Leseman PP (2017) Early executive function at age two predicts emergent mathematics and literacy at age five. Front Psychol 8:1706

    PubMed  PubMed Central  Article  Google Scholar 

  24. Bull R, Lee K (2014) Executive functioning and mathematics achievement. Child Dev Perspect 8(1):36–41

    Article  Google Scholar 

  25. Yates T, Ostrosky MM, Cheatham GA, Fettig A, Shaffer L, Santos RM (2008) Research synthesis on screening and assessing social-emotional competence. The Center on the Social and Emotional Foundations for Early Learning

  26. Ferrier DE, Bassett HH, Denham SA (2014) Relations between executive function and emotionality in preschoolers: exploring a transitive cognition–emotion linkage. Front Psychol 5:487

    PubMed  PubMed Central  Article  Google Scholar 

  27. Kopp CB (1989) Regulation of distress and negative emotions: a developmental view. Dev Psychol 25(3):343

    Article  Google Scholar 

  28. Hughes C, Ensor R (2011) Individual differences in growth in executive function across the transition to school predict externalizing and internalizing behaviors and self-perceived academic success at 6 years of age. J Exp Child Psychol 108(3):663–676

    PubMed  Article  Google Scholar 

  29. Rhoades BL, Greenberg MT, Domitrovich CE (2009) The contribution of inhibitory control to preschoolers’ social–emotional competence. J Appl Dev Psychol 30(3):310–320

    Article  Google Scholar 

  30. Spinrad TL, Eisenberg N, Cumberland A, Fabes RA, Valiente C, Shepard SA, Guthrie IK (2006) Relation of emotion-related regulation to children’s social competence: a longitudinal study. Emotion 6(3):498

    PubMed  PubMed Central  Article  Google Scholar 

  31. Fleming CB, Harachi TW, Cortes RC, Abbott RD, Catalano RF (2004) Level and change in reading scores and attention problems during elementary school as predictors of problem behavior in middle school. J Emot Behav Disord 12(3):130–144

    Article  Google Scholar 

  32. Raaijmakers MA, Smidts DP, Sergeant JA, Maassen GH, Posthumus JA, Van Engeland H, Matthys W (2008) Executive functions in preschool children with aggressive behavior: impairments in inhibitory control. J Abnorm Child Psychol 36(7):1097

    PubMed  Article  Google Scholar 

  33. Vuontela V, Carlson S, Troberg AM, Fontell T, Simola P, Saarinen S, Aronen ET (2013) Working memory, attention, inhibition, and their relation to adaptive functioning and behavioral/emotional symptoms in school-aged children. Child Psychiatry Hum Dev 44(1):105–122

    PubMed  Article  Google Scholar 

  34. Yairi E, Ambrose NG, Niermann R (1993) The early months of stuttering: a developmental study. J Speech Lang Hear Res 36(3):521–528

    Article  Google Scholar 

  35. Bloodstein O, Bernstein-Ratner N (2008) A handbook on stuttering, 6th edn. Thomson-Delmar, New York

    Google Scholar 

  36. Yairi E, Ambrose NG (1999) Early childhood stuttering I: persistency and recovery rates. J Speech Lang Hear Res 42(5):1097–1112

    PubMed  Article  Google Scholar 

  37. Yairi E, Ambrose NG, Paden EP, Throneburg RN (1996) Predictive factors of persistence and recovery: pathways of childhood stuttering. J Commun Disord 29(1):51–77

    PubMed  Article  Google Scholar 

  38. Blood GW, Blood IM (2007) Preliminary study of self-reported experience of physical aggression and bullying of boys who stutter: relation to increased anxiety. Percept Mot Skills 104(3_suppl):1060–1066

    PubMed  Article  Google Scholar 

  39. Blood GW, Ridenour VJ Jr, Qualls CD, Hammer CS (2003) Co-occurring disorders in children who stutter. J Commun Disord 36(6):427–448

    PubMed  Article  Google Scholar 

  40. Langevin M, Packman A, Onslow M (2009) Peer responses to stuttering in the preschool setting. Am J Speech-Lang Pathol 18:264

    PubMed  Article  Google Scholar 

  41. Blood GW, Blood IM, Tramontana GM, Sylvia AJ, Boyle MP, Motzko GR (2011) Self-reported experience of bullying of students who stutter: relations with life satisfaction, life orientation, and self-esteem. Percept Mot Skills 113(2):353–364

    PubMed  Article  Google Scholar 

  42. Blumgart E, Tran Y, Craig A (2010) An investigation into the personal financial costs associated with stuttering. J FluenDisord 35(3):203–215

    Google Scholar 

  43. Craig A, Blumgart E, Tran Y (2009) The impact of stuttering on the quality of life in adults who stutter. J FluenDisord 34(2):61–71

    Google Scholar 

  44. Davis S, Howell P, Cooke F (2002) Sociodynamic relationships between children who stutter and their non-stuttering classmates. J Child Psychol Psychiatry 43(7):939–947

    PubMed  PubMed Central  Article  Google Scholar 

  45. Iverach L, Jones M, McLellan LF, Lyneham HJ, Menzies RG, Onslow M, Rapee RM (2016) Prevalence of anxiety disorders among children who stutter. J FluenDisord 49:13–28

    Google Scholar 

  46. Klein JF, Hood SB (2004) The impact of stuttering on employment opportunities and job performance. J Fluency Disord 29(4):255–273

    PubMed  Article  Google Scholar 

  47. Messenger M, Onslow M, Packman A, Menzies R (2004) Social anxiety in stuttering: measuring negative social expectancies. J FluenDisord 29(3):201–212

    Google Scholar 

  48. Rees DI, Sabia JJ (2014) The kid’s speech: The effect of stuttering on human capital acquisition. Econ Educ Rev 38:76–88

    Article  Google Scholar 

  49. Koushik S, Shenker R, Onslow M (2009) Follow-up of 6–10-year-old stuttering children after Lidcombe program treatment: a phase I trial. J FluenDisord 34(4):279–290

    Google Scholar 

  50. Jansson-Verkasalo E, Eggers K, Aro K, De Nil LF, Van den Bergh BR (2012) Auditory attention shifting in children who stutter. In: Proceedings of the European Symposium on Fluency Disorders

  51. Daneman M (1991) Working memory as a predictor of verbal fluency. J Psychol Res 20(6):445–464

    Article  Google Scholar 

  52. Engelhardt PE, McMullon ME, Corley M (2019) Individual differences in the production of disfluency: a latent variable analysis of memory ability and verbal intelligence. Q J ExpPsychol 72(5):1084–1101

    Google Scholar 

  53. Spencer C, Weber-Fox C (2014) Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering. J FluenDisord 41:32–46

    Google Scholar 

  54. Nejati V, Pouretemad HR, Bahrami H (2013) Attention training in rehabilitation of children with developmental stuttering. NeuroRehabilitation 32(2):297–303

    PubMed  Article  Google Scholar 

  55. Oyoun HA, El Dessouky H, Shohdi S, Fawzy A (2010) Assessment of working memory in normal children and children who stutter. J Am Sci 6(11):562–566

    Google Scholar 

  56. Smith KA, Iverach L, O’Brian S, Kefalianos E, Reilly S (2014) Anxiety of children and adolescents who stutter: a review. J FluenDisord 40:22–34

    Google Scholar 

  57. Blood GW, Blood IM (2016) Long-term consequences of childhood bullying in adults who stutter: social anxiety, fear of negative evaluation, self-esteem, and satisfaction with life. J FluenDisord 50:72–84

    Google Scholar 

  58. Arnold HS, Conture EG, Key APF, Walden T (2011) Emotional reactivity, regulation and childhood stuttering: a behavioral and electrophysiological study. J Commun Disord 44(3):276–293

    PubMed  Article  Google Scholar 

  59. McClelland MM, Cameron CE, Wanless SB, Murray A, Saracho O, Spodek B (2007) Executive function, behavioral self-regulation, and social-emotional competence. ContempPerspectSoc Learn Early Child Educ 1:113–137

    Google Scholar 

  60. Russell BS, Lee JO, Spieker S, Oxford ML (2016) Parenting and preschool self-regulation as predictors of social emotional competence in 1st grade. J Res Child Educ 30(2):153–169

    PubMed  PubMed Central  Article  Google Scholar 

  61. Espy KA, Sheffield TD, Wiebe SA, Clark CA, Moehr MJ (2011) Executive control and dimensions of problem behaviors in preschool children. J Child Psychol Psychiatry 52(1):33–46

    PubMed  PubMed Central  Article  Google Scholar 

  62. Gooch D, Thompson P, Nash HM, Snowling MJ, Hulme C (2016) The development of executive function and language skills in the early school years. J Child Psychol Psychiatry 57(2):180–187

    PubMed  Article  Google Scholar 

  63. Henry LA, Messer DJ, Nash G (2012) Executive functioning in children with specific language impairment. J Child Psychol Psychiatry 53(1):37–45

    PubMed  Article  Google Scholar 

  64. Sinzig J, Morsch D, Bruning N, Schmidt MH, Lehmkuhl G (2008) Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms. Child Adolesc Psychiatry Ment Health 2(1):4

    PubMed  PubMed Central  Article  Google Scholar 

  65. Gioia GA, Isquith PK, Kenworthy L, Barton RM (2002) Profiles of everyday executive function in acquired and developmental disorders. Child Neuropsychol 8(2):121–137

    PubMed  Article  Google Scholar 

  66. Bagdi A, Vacca J (2005) Supporting early childhood social-emotional well being: the building blocks for early learning and school success. Early ChildhEduc J 33(3):145–150

    Article  Google Scholar 

  67. Hummer TA, Kronenberger WG, Wang Y, Dunn DW, Mosier KM, Kalnin AJ, Mathews VP (2011) Executive functioning characteristics associated with ADHD comorbidity in adolescents with disruptive behavior disorders. J Abnorm Child Psychol 39(1):11–19

    PubMed  Article  Google Scholar 

  68. Semrud-Clikeman M, Walkowiak J, Wilkinson A, Butcher B (2010) Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. J Autism Dev Disord 40(8):1017–1027

    PubMed  Article  Google Scholar 

  69. Oosterlaan J, Scheres A, Sergeant JA (2005) Which executive functioning deficits are associated with AD/HD, ODD/CD and comorbid AD/HD+ ODD/CD? J Abnorm Child Psychol 33(1):69–85

    PubMed  Article  Google Scholar 

  70. Gioia GA, Espy KA, Isquith PK Behavior rating inventory of executive function preschool version (BRIEF-P)

  71. Centers for Disease Control and Prevention. About the National Health Interview Survey (2019) https://www.cdc.gov/nchs/nhis/about_nhis.htm. Accessed 29 July 2020

  72. Halle TG, Hair EC, Wandner LD, Chien NC (2012) Profiles of school readiness among four-year-old head start children. Early Child Res Q 27(4):613–626

    Article  Google Scholar 

  73. Hipp JR, Bauer DJ (2006) Local solutions in the estimation of growth mixture models. Psychol Methods 11:36–53

    PubMed  Article  Google Scholar 

  74. Masyn KE (2013) Latent class analysis and finite mixture modeling. In: Little TD (ed) The Oxford handbook of quantitative methods vol. 2: Statistical analysis. Oxford University Press, New York, pp 551–611

    Google Scholar 

  75. Nylund-Gibson K, Choi AY (2018) Ten frequently asked questions about latent class analysis. Transl Issues PsycholSci 4(4):440–461

    Article  Google Scholar 

  76. DiStefano C, Kamphaus RW (2006) Investigating subtypes of child development: a comparison of cluster analysis and latent class cluster analysis in typology Creation. EducPsycholMeas 5:778–794

    Google Scholar 

  77. Rudolph KD, Conley CS (2005) The socioemotional costs and benefits of social-evaluative concerns: do girls care too much? J Pers 73(1):115–138

    PubMed  PubMed Central  Article  Google Scholar 

  78. Denham S, Mason T, Caverly S, Schmidt M, Hackney R, Caswell C, DeMulder E (2001) Preschoolers at play: co-socialisers of emotional and social competence. Int J Behav Dev 25(4):290–301

    Article  Google Scholar 

  79. Brody LR (2000) The socialization of gender differences in emotional expression: display rules, infant temperament, and differentiation. Gender Emot 2(11):122–137

    Google Scholar 

  80. Grissom NM, Reyes TM (2019) Let’s call the whole thing off: evaluating gender and sex differences in executive function. Neuropsychopharmacology 44(1):86–96

    PubMed  Article  Google Scholar 

  81. Briley PM, Ellis C Jr (2018) The coexistence of disabling conditions in children who stutter: evidence from the National Health Interview Survey. J Speech Lang Hear Res 61(12):2895–2905

    PubMed  Article  Google Scholar 

  82. Felsenfeld S, van Beijsterveldt CEM, Boomsma DI (2010) Attentional regulation in young twins with probable stuttering, high nonfluency, and typical fluency. J Speech Lang Hear Res 53(5):1147–1166. https://doi.org/10.1044/1092-4388

    Article  PubMed  Google Scholar 

  83. Ntourou K, Conture EG, Walden TA (2013) Emotional reactivity and regulation in preschool-age children who stutter. J FluenDisord 38(3):260–274

    Google Scholar 

  84. Blood GW, Blood IM, Tellis GM, Gabel RM (2003) A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter. J FluenDisord 28(2):143–159

    Google Scholar 

  85. Andrews C, O’Brian S, Onslow M, Packman A, Menzies R, Lowe R (2016) Phase II trial of a syllable-timed speech treatment for school-age children who stutter. J FluenDisord 48:44–55

    Google Scholar 

  86. Alm PA, Risberg J (2007) Stuttering in adults: the acoustic startle response, temperamental traits, and biological factors. J Commun Disord 40(1):1–41

    PubMed  Article  Google Scholar 

  87. Baker L, Cantwell DP (1982) Psychiatric disorder in children with different types of communication disorders. J Commun Disord 15(2):113–126

    PubMed  Article  Google Scholar 

  88. Briley PM, O’Brien K, Ellis C (2019) Behavioral, emotional, and social well-being in children who stutter: evidence from the National Health Interview Survey. J Dev Phys Disabil 31(1):39–53

    Article  Google Scholar 

  89. Iverach L, Rapee RM (2014) Social anxiety disorder and stuttering: Current status and future directions. J FluenDisord 40:69–82

    Google Scholar 

  90. McAllister J, Collier J, Shepstone L (2012) The impact of adolescent stuttering on educational and employment outcomes: evidence from a birth cohort study. J FluenDisord 37(2):106–121

    Google Scholar 

  91. Karniol R (1995) Stuttering, language, and cognition: a review and a model of stuttering as suprasegmental sentence plan alignment (SPA). Psychol Bull 117(1):104

    PubMed  Article  Google Scholar 

  92. Ratner N, Wijnen F (2007) The vicious cycle: Linguistic encoding, self-monitoring and stuttering. Paper presented at the Proceedings of the Fifth World Congress of Fluency Disorders, Dublin, Ireland

  93. Vasic N, Wijnen F (2001) Stuttering and speech monitoring. Paper presented at the Proceedings of DISS 2001, Edinburgh, United Kingdom

  94. Howell P (2007) A model of serial order problems in fluent, stuttered and agrammatic speech. Hum Mov Sci 26(5):728–741

    PubMed  PubMed Central  Article  Google Scholar 

  95. Howell P, Au-Yeung J (2002) The EXPLAN theory of fluency control applied to the diagnosis of stuttering. Amst Stud Theory Hist Linguist SciSer 4:75–94

    Google Scholar 

  96. Engelhardt PE, Corley M, Nigg JT, Ferreira F (2010) The role of inhibition in the production of disfluencies. Mem Cognit 38(5):617–628

    PubMed  PubMed Central  Article  Google Scholar 

  97. Karrass J, Walden TA, Conture EG, Graham CG, Arnold HS, Hartfield KN, Schwenk KA (2006) Relation of emotional reactivity and regulation to childhood stuttering. J Commun Disord 39(6):402–423

    PubMed  PubMed Central  Article  Google Scholar 

  98. Druce T, Debney S, Byrt T (1997) Evaluation of an intensive treatment program for stuttering in young children. J Fluency Disorders 22(3):169–186

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sara Ashley Smith.

Ethics declarations

Conflict of interest

No potential conflict of interest.

Ethical Approval

Secondary data analysis of publicly available data set, the National Health Interview Survey (2004–2018).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix A

Appendix A

See Table 5 and 6.

Table 5 Model fit statistics for latent class solution with participant’s sex as an indicator
Table 6 Correlations among latent class indicators, group, and developmental status

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smith, S.A., Choo, A.L. & Foster, M.E. Latent Class Analysis Reveals Distinct Groups Based on Executive Function and Socioemotional Traits, Developmental Conditions, and Stuttering: A Population Study. Child Psychiatry Hum Dev 53, 684–700 (2022). https://doi.org/10.1007/s10578-021-01160-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-021-01160-3

Keywords

  • Latent profile analysis
  • Children
  • Executive function
  • Emotion regulation
  • Stuttering