Clinical and Sociodemographic Predictors of Parental Perceptions and Confidence in Managing Child Stuttering: a Cross-Sectional Study

Abstract

The main aim of the current study was to identify and analyze the most significant clinical and sociodemographic predictors of parents’ perceptions regarding their child’s stuttering. 139 parents, with at least one child who stutters, completed both the Persian version of the Palin Parent Rating Scale (P-Palin PRS) and a sociodemographic and clinical checklist. To investigate the relationships between scores on the Palin PRS factors and sociodemographic and clinical characteristics, we conducted univariable analyses using Pearson correlation coefficients, independent t-tests, and one-way ANOVA. The study analyzed the P-Palin PRS factors: Impact of Stuttering on the Child, Severity of Stuttering and Impact on the Parents, and Parent’s Knowledge and Confidence in Managing it. Mean scores were 5.37, 3.87, and 5.42, respectively, with correlations ranging from 0.371 to 0.507. Higher stutter severity negatively correlated with Impact on the Child (r=-0.364, P < 0.001). History of speech therapy (ST) failure and family history of speech and language disorders (SLDs) showed lower Impact scores (P = 0.053 and P = 0.057). Severity of Stuttering and Impact on the Parents negatively correlated with stutter severity (r=-0.546, P < 0.001) and positively with parents’ ages. Parent’s Knowledge and Confidence correlated negatively with stutter severity (r=-0.242, P = 0.004) and was lower in those with family history of SLDs (P = 0.008). The high stutter severity, ST failure, and family history of SLDs were associated with lower scores across all PRS factors. In conclusion current study identified key predictors influencing parents’ perceptions of their child’s stuttering, including stutter severity, speech therapy history, and family background.

Introduction

Stuttering is categorized as one of the neurodevelopmental disorders [1, 2]. This disorder is defined by considerable age-inappropriate disruptions in fluency and the time patterning of speech. These problems include broken words (e.g., interjections like “um” and “uh”), sound prolongations (e.g., stretching out sounds, such as “aaaaaple”), repetitions in syllables and/or sounds (e.g., “b-b-b-bill”), and blocks (e.g., noticeable pauses or stoppages in speech) [1]. In a review about the epidemiology of stuttering, which conducted by Yairi and Ambrose, which encompassed over 40 cross-sectional studies, the prevalence of stuttering was found to range from 0.3 to 5.6% [3]. A wide range of studies have found that stuttering may lead to various negative consequences, such as problems in interpersonal and peer relationships, mental health issues (e.g., depression, anxiety, and sleep problems), a decline in academic performance, and impaired self-esteem. All of these factors can contribute to a poor quality of life for affected children [4–6].

Importantly, stuttering in children is not limited to them alone. The significant negative psychosocial impacts faced by parents due to having a child who stutters are well-documented and widely acknowledged [7]. These challenges can manifest in various forms, including emotional distress, increased anxiety, social isolation, and feelings of helplessness. Parents often experience a profound sense of worry and concern about their child’s future, social interactions, and overall well-being, which can significantly affect their own mental health and quality of life [8, 9]. In addition, parents play an essential role in the management of children experiencing stuttering [10, 11]. Accordingly, all evidence-based modules highlight the role of parents in the management and treatment of childhood stuttering [1, 7].

Parents’ interactions and responses to children’s stuttering are crucial aspects to consider [9, 12], despite the absence of a clear link between the onset of childhood stuttering and parental behaviors or attitudes [13]. Parents frequently express uncertainty about how best to support their child and anxiety stemming from their lack of knowledge about stuttering. They also report dissatisfaction with therapy outcomes when they are not actively involved in the therapeutic process [14]. Negative repercussions on the parent-child relationship can occur when children perceive parental attempts to assist during stuttering episodes unfavorably [15]. Furthermore, previous research indicates that chronic stuttering in a child can influence parents’ attitudes, behaviors, and responses [12, 13]. Thus, parental reactions to children’s stuttering can significantly impact its progression or improvement [9, 11, 12, 14, 16]. For instance, failure to modify maternal communication styles following stuttering incidents can hinder stuttering reduction, while changes in parental responses may increase the emotional and physical burden on stuttering children [17]. Additionally, children often react to their stuttering based on their parents’ responses [12], with inappropriate parental reactions typically exacerbating children’s responses [18]. Given these factors, Plexico and Burrus (2012) argue that addressing parents’ needs and concerns is as crucial as addressing those of the child.

To gain a deeper understanding of parents’ perceptions of childhood stuttering in their children, it is essential to identify significant predictors of both negative and positive perceptions among these parents. Previous studies have identified certain clinical and sociodemographic variables such as age at onset of stuttering, gender, time elapsed since onset of stuttering, and familial history of stuttering presence or absence as key predictors of stuttering in children [2, 19, 20]. However, there is a notable gap in research concerning the identification of crucial predictors of parents’ perceptions regarding their child’s stuttering. With this understanding, our study aims to fill this gap by investigating the primary predictors influencing parents’ perceptions of their child’s stuttering. Specifically, we seek to explore how factors such as parental education level, socioeconomic status, severity of stuttering, and the effectiveness of previous therapeutic interventions may impact parents’ attitudes and beliefs about their child’s stuttering. Therefore, the main aim of the current study was to identify and analyze the most significant predictors of parents’ perceptions regarding their child’s stuttering.

Methods

Study Design

The current study was a cross-sectional study conducted in Tehran, Iran, from May 2023 to April 2024. This research received approval from the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences, under the code IR.USWR.REC.1399.260.

Participants

Parents with a child with stuttering were recruited from private speech therapy clinics in Tehran, Iran, as well as from the outpatient wards of rehabilitation centers affiliated with the University of Social Welfare and Rehabilitation Sciences. These centers included Rofeideh Rehabilitation Hospital, Asma Rehabilitation Center, and Nezammafi Rehabilitation Center. Table 1 presented the demographic characteristics of the parents and their children. The mean age of the children was 5.35 years (SD = 1.17), and 74.1% were male. The mean duration of stuttering was 1.85 years (SD = 1.08), and the mean severity of stuttering was 3.34 (SD = 2.02). Among the participants, 44.6% had a history of failure in speech therapy (ST), 33.8% had a family history of speech and language disorders (SLDs), and 60.4% had a family history of stuttering. The mean ages of the mothers and fathers were 33.76 years (SD = 4.27) and 37.73 years (SD = 4.59), respectively.

Table 1.

Demographic characteristics of the participants

	Mean (SD) or n (%)
Child’s age (y)	5.35 (1.17)
Child’s sex
Male	103 (74.1)
Female	36 (25.9)
Age at stuttering onset	3.51 (0.99)
Time since onset of stuttering	1.85 (1.08)
Severity rating score	3.34 (2.02)
History of failure in ST
No	77 (55.4)
Yes	62 (44.6)
Family history of SLDs
No	92 (66.2)
Yes	47 (33.8)
Family history of stutter
No	55 (39.6)
Yes	84 (60.4)
Mother’s age	33.76 (4.27)
Father’s age	37.73 (4.59)
Mother’s education
Non-academic	29 (20.9)
Academic	110 (79.1)
Father’s education
Non-academic	45 (32.4)
Academic	94 (67.6)
Number of children
1	61 (43.9)
2	63 (45.3)
3	15 (10.8)

SD: Standard Deviation; ST: Speech Therapy; SLDs: Speech and Language Disorders

Procedure

The recruitment procedure involved collaboration with speech-language pathologists working at the previously mentioned clinics and centers. These professionals identified potential participants and provided them with detailed information about the study. The diagnosis of stuttering was confirmed using the Persian version of the Stuttering Severity Instrument-Third Edition (SSI-3). Parents who expressed interest in the study participated voluntarily.

The inclusion criteria were: (1) children who scored eleven or above on the Persian version of the SSI-3; (2) children aged between three years and six years and eleven months; (3) children who spoke Persian; and (4) children who had been stuttering for at least six months. The exclusion criteria included: (1) children with severe speech or language disorders and (2) children diagnosed with attention-deficit/hyperactivity disorder (ADHD).

Through this meticulous process, we ensured that the study participants met the specific requirements necessary to provide relevant and accurate data for our research on childhood stuttering and its management.

The instruments used in the current study included a socio-clinical checklist and the Persian version of the Palin Parent Rating Scales. Before beginning the study, participants were given explicit instructions to meticulously address all the questions posed. The questionnaire was administered within the speech therapy clinic, ensuring a conducive and tranquil environment. Within the clinic, the examiners thoroughly briefed the participants on the details of the scales and offered guidance on how to navigate them effectively. Additionally, the examiners were readily available to provide clarification and support for any potential ambiguities within the questionnaire. Participants were tasked with independently completing the scale, but the examiners remained on standby to address any questions or uncertainties that arose. On average, the entire process took approximately 15 to 20 min per respondent, ensuring a comprehensive yet efficient assessment procedure. This method ensured that the participants fully understood the questionnaire and provided accurate and thoughtful responses.

Measures

Palin Parent Rating Scale

The Palin Parent Rating Scale (Palin PRS) is a structured questionnaire designed for parents of children who stutter. It comprises 19 items organized into three factors. Factor 1, which includes seven items, assesses parents’ perceptions of how significantly stuttering impacts their child. Factor 2, also with seven items, evaluates parents’ views on the severity of their child’s stuttering and its emotional repercussions on the family. Factor 3, consisting of five items, explores parents’ understanding and knowledge of their child’s stuttering [7]. For the Persian version of the scale, exploratory factor analysis demonstrated a high degree of consistency with the original factor structure. No floor or ceiling effects were observed, indicating that the scale’s items were appropriately challenging and discriminative across the range of responses. The three factors of the Persian version of the Palin PRS (P-Palin PRS) exhibited strong internal consistency, with a Cronbach’s alpha of 0.8, and excellent test-retest reliability, with an intraclass correlation coefficient (ICC) of 0.9. These results underscore the reliability and validity of the P-Palin PRS in assessing parents’ perceptions and understanding of their child’s stuttering in the Persian-speaking population [21].

Sociodemographic and Clinical Checklist

In the present study, we developed a self-report checklist to assess various clinical and sociodemographic variables. These variables include age, gender, parents’ ages, severity rating scores, history of failure in speech therapy (ST), family history of speech and language disorders (SLDs), family history of stuttering, mother’s education level, father’s education level, and number of children in the family. This checklist was designed to capture comprehensive information relevant to understanding the factors influencing childhood stuttering and its management within our study population.

Statistical Analysis

In the present study, continuous variables were reported as mean (standard deviation (SD)), while categorical variables were presented as numbers (percentages). To explore the relationships between scores of the Palin Parent Rating Scale (Palin PRS) factors and demographic characteristics, univariable analysis utilized Pearson correlation coefficients, independent t-tests, and one-way ANOVA as appropriate.

Furthermore, multiple linear regression analysis was employed using the backward elimination method, with a removal criterion set at alpha = 0.10, to investigate how demographic characteristics were associated with scores of the Palin PRS factors. Statistical analyses were conducted using SPSS for Windows, version 16.0 (SPSS Inc., Chicago, IL, USA), with the level of significance set at 0.05.

Results

Descriptive Statistics and Correlations of the Palin PRS Factors

Descriptive statistics of the Palin PRS factors and their correlations are presented in Table 2. The mean total weighted score for Factor 1, Factor 2 and Factor 3 were 5.37 (SD = 1.41), 3.87 (SD = 1.55) and 5.42 (SD = 1.24), respectively. There were moderate to strong positive correlations among the Palin PRS factors (r ranging from 0.371 to 0.507).

Table 2.

The means and standard deviations of the Palin PRS factors and their correlations (n = 139)

	1	2	3
1 Impact of Stuttering on the Child	1
2 Severity of Stuttering and Impact on the Parents	0.507***	1
3 Parent’s Knowledge and Confidence in Managing it	0.371***	0.440***	1
Observed Range	0.31–7.08	0.71–6.89	1.32–7.54
Mean (SD)	5.37 (1.1)	3.87 (1.55)	5.42 (1.24)

SD: Standard Deviation

***P < 0.001

Univariable Analysis

Impact of Stuttering on the Child

According to the univariable analysis, there was negative correlation between severity of stuttering and score of Impact of Stuttering on the Child (r=-0.364, P < 0.001) (Table 3; Fig. 1). The mean score of Impact of Stuttering on the Child in participants with history of failure in ST was lower than those without history of failure in ST, although this difference was not statistically significant (P = 0.053). A similar result was obtained for participants with family history of SLDs (P = 0.057).

Table 3.

Relationship of the Palin PRS factors with demographic variables

	Impact of Stuttering on the Child		Severity of Stuttering and Impact on the Parents		Parent’s Knowledge and Confidence in Managing it
	Mean (SD) or r	P	Mean (SD) or r	P	Mean (SD) or r	P
Child’s age (y)	0.105	0.220	0.052	0.546	0.108	0.206
Child’s sex		0.329		0.229		0.644
Male	5.45 (1.26)		3.77 (1.48)		5.45 (1.24)
Female	5.14 (1.77)		4.13 (1.73)		5.34 (1.24)
Age at stuttering onset	0.013	0.883	-0.032	0.712	0.006	0.941
Time since onset of stuttering	0.102	0.234	0.085	0.320	0.111	0.193
Severity rating score	-0.364	< 0.001	-0.546	< 0.001	-0.242	0.004
History of failure in speech therapy		0.053		0.005		0.308
No	5.59 (1.22)		4.20 (1.51)		5.52 (1.17)
Yes	5.11 (1.59)		3.46 (1.51)		5.30 (1.32)
Family history of SLDs		0.057		0.498		0.008
No	5.55 (1.23)		3.93 (1.48)		5.64 (1.08)
Yes	5.02 (1.67)		3.74 (1.68)		5.00 (1.41)
Family history of stutter		0.701		0.615		0.434
No	5.43 (1.30)		3.95 (1.53)		5.52 (1.11)
Yes	5.34 (1.48)		3.81 (1.57)		5.36 (1.31)
Mother’s age	0.047	0.582	0.206	0.015	0.092	0.282
Father’s age	-0.023	0.790	0.200	0.018	-0.003	0.974
Mother’s education		0.969		0.657		0.162
Non-academic	5.38 (1.38)		3.98 (1.65)		5.71 (1.29)
Academic	5.37 (1.43)		3.84 (1.53)		5.35 (1.22)
Mother’s education		0.962		0.478		0.917
Non-academic	5.38 (1.42)		3.73 (1.50)		5.44 (1.16)
Academic	5.37 (1.41)		3.93 (1.58)		5.42 (1.27)
Number of children		0.947		0.983		0.560
1	5.42 (1.45)		3.85 (1.60)		5.50 (1.23)
2	5.34 (1.43)		3.86 (1.54)		5.42 (1.23)
3	5.32 (1.26)		3.94 (1.45)		5.11 (1.29)

SD: Standard Deviation; ST: Speech Therapy; SLDs: Speech and Language Disorders; r: Pearson correlation coefficient

Fig. 1.

Correlations between severity of stuttering and weighted scores of the Palin PRS factors. Note. High-weighted scores indicate better state. Note. Correlation coefficients of 0.1–0.3, 0.3–0.5, and > 0.5 were classified as low, medium, and high correlation, respectively

Severity of Stuttering and Impact on the Parents

As presented in Table 3, there was negative correlation between severity of stuttering and score of Severity of Stuttering and Impact on the Parents (r=-0.546, P < 0.001). The mean score of Severity of Stuttering and Impact on the Parents in participants with history of failure in ST was significantly lower than those without history of failure in ST (P = 0.005). There were significant positive correlations between score of Severity of Stuttering and Impact on the Parents and mother’s age (r = 0.206, P = 0.015) and father’s age (r = 0.200, P = 0.018).

Parent’s Knowledge and Confidence in Managing it

There was negative correlation between severity of stuttering and score of Parent’s Knowledge and Confidence in Managing it (r=-0.242, P = 0.004). The mean score of Parent’s Knowledge and Confidence in Managing it in participants with family history of SLDs was significantly lower than those without family history of SLDs (P = 0.008) (Table 3).

Multivariable Analysis

Impact of Stuttering on the Child

According to the multiple linear regression analysis using backward elimination method (alpha for removal of 0.10), high severity of stuttering, having history of failure in ST, and family history of SLDs were associated with lower score of Impact of Stuttering on the Child (P < 0.001, P = 0.094, P = 0.075, respectively). The model R² was 0.169, indicating that 16.9% of the variance in the score of Impact of Stuttering on the Child was explained by these variables (Table 4).

Table 4.

Relationship of the Palin PRS factors with demographic variables

	b	95% CI for b	β	P	R 2
Impact of Stuttering on the Child					0.169
Severity rating score	-0.23	[-0.34 to -0.12]	-0.33	< 0.001
History of failure in ST	-0.38	[-0.82 to 0.07]	-0.13	0.094
Family history of SLDs	-0.42	[-0.88 to 0.04]	-0.14	0.075
Severity of Stuttering and Impact on the Parents					0.350
Severity rating score	-0.42	[-0.52 to -0.31]	-0.54	< 0.001
History of failure in ST	-0.56	[-0.98 to -0.13]	-0.18	0.011
Parent’s Knowledge and Confidence in Managing it					0.154
Severity rating score	-0.15	[-0.25 to -0.05]	-0.24	0.004
Family history of SLDs	-0.55	[-0.97 to -0.14]	-0.21	0.009
Mother’s age	0.07	[-0.01 to 0.14]	0.24	0.056
Father’s age	-0.06	[-0.12 to 0.01]	-0.21	0.088
Academic mother’s education	-0.54	[-1.03 to -0.05]	-0.18	0.032

b: unstandardized coefficient; β: standardized coefficient; CI: Confidence Interval; ST: Speech Therapy; SLDs: Speech and Language Disorders

Severity of Stuttering and Impact on the Parents

As presented in Table 4, high severity of stuttering and having history of failure in ST were associated with lower score of Severity of Stuttering and Impact on the Parents (P < 0.001 and P = 0.011, respectively). The model R² was 0.350.

Parent’s Knowledge and Confidence in Managing it

As presented in Table 4, high severity of stuttering, having family history of SLDs, low mother’s age, high father’s age, and high education of mother were associated with lower score of Severity of Stuttering and Impact on the Parents (P = 0.004, P = 0.009, P = 0.056, P = 0.088, and P = 0.032, respectively).

Discussion

The current study aimed to predict parents’ perceptions about their child who stutters (Impact of Stuttering on the Child, Severity of Stuttering and Impact on the Parents, and Parent’s Knowledge and Confidence in Managing it) based on sociodemographic and clinical variables in an Iranian sample. We found various results, which are presented separately.

First, we found significant correlations among the Palin PRS factors (mentioned parents’ perceptions). Specifically, Impact of Stuttering on the Child showed a significant correlation with Severity of Stuttering and Impact on the Parents, as well as with Parent’s Knowledge and Confidence in Managing it. Additionally, Severity of Stuttering and Impact on the Parents had a significant correlation with Parent’s Knowledge and Confidence in Managing it. These results are consistent with the original paper on the development of the Palin PRS, which demonstrated that these factors are interrelated [7]. These associations are highly related to Palin Parent-Child Interaction Therapy (Palin PCI), an evidence-based treatment approach [22]. In Palin PCI, speech therapists focus on improving children’s self-efficacy and providing parents with a broader understanding of their child’s stuttering [23]. In fact, parents learn to monitor their child’s stuttering rate and provide emotional support. These concepts align with the Palin PRS perspective, which considers these elements interconnected. Thus, the associations we found between the Palin PRS factors can be interpreted in the context of Palin PCI [24].

Second, the study revealed a significant negative correlation between stuttering severity and the “Impact of Stuttering on the Child” subscale. Children with a history of speech therapy (ST) failure and those with a family history of speech and language disorders (SLDs) exhibited lower Impact scores, though these differences were not statistically significant. These results suggest that as stuttering severity increases, the negative impact on children’s emotional and social well-being becomes more pronounced. This may manifest as reduced confidence in speaking situations, heightened anxiety, and overall unhappiness [25]. A history of unsuccessful therapy might contribute to feelings of frustration and a sense of hopelessness in both the child and the parents, potentially exacerbating the perceived impact. Similarly, a family history of SLDs could heighten awareness and concern about the child’s stuttering, affecting how parents perceive and respond to the child’s condition [13, 18]. These factors underscore the complex interplay between clinical and familial influences on the perception of stuttering’s impact on children.

Third, the current study found a significant negative correlation between stuttering severity and the “Severity of Stuttering and Impact on the Parents” subscale. Additionally, participants with a history of failure in ST had significantly lower scores on this subscale compared to those without such a history. There were also significant positive correlations between the subscale scores and the ages of the mother and father. These findings suggest that as the severity of the child’s stuttering increases, parents perceive a greater negative impact on both their child’s speech and the family’s overall well-being. A history of unsuccessful therapy likely amplifies parental concerns and anxiety, as repeated failures can lead to feelings of helplessness and increased stress. Older parents might have more life experience and possibly more resources or coping strategies to manage the challenges posed by their child’s stuttering, which could explain the positive correlation with parental age. This complex interaction highlights the significant emotional and psychological burden that stuttering can place on families, particularly when effective treatment is elusive.

Comparing with previous studies, our findings align with research indicating that higher stuttering severity correlates with increased negative impacts on both the child and the family [26, 27]. Similar to previous findings, our study shows that a history of unsuccessful speech therapy exacerbates parental concerns and stress regarding their child’s stuttering [28, 29]. The positive correlation between parental age and perceptions of stuttering’s impact on the family echoes previous research suggesting that older parents may possess more coping resources or experience to manage the challenges associated with their child’s stuttering [10, 11, 30, 31]. These comparisons underscore the consistent burden that stuttering places on families across various contexts and emphasize the need for effective interventions and support mechanisms tailored to diverse familial circumstances.

The study revealed a negative correlation between the severity of stuttering and the “Parent’s Knowledge and Confidence in Managing it” subscale. Additionally, participants with a family history of speech and language disorders had significantly lower scores on this subscale compared to those without such a history. These findings suggest that as the severity of a child’s stuttering increases, parents feel less knowledgeable and less confident in managing the condition. This may be because more severe stuttering presents greater challenges, making parents feel overwhelmed and less equipped to handle the situation effectively. Furthermore, a family history of SLDs might contribute to feelings of helplessness or inadequacy, as parents might have witnessed similar struggles within their family and feel less optimistic about managing their child’s stuttering. This underscores the need for targeted support and education for parents, particularly those facing more severe cases of stuttering or with a family history of SLDs, to enhance their confidence and efficacy in managing their child’s speech difficulties. The study’s findings on the negative correlation between stuttering severity and parental knowledge and confidence in managing it align with previous research in the field. For example previous studies found that parents of children with more severe stuttering reported lower levels of confidence in managing their child’s speech disorder [11, 32]. Additionally, studies indicated that parents of children with severe stuttering often feel less equipped to handle the associated challenges, which can exacerbate their stress and anxiety [11, 33]. The significant impact of a family history of speech and language disorders on parental confidence and knowledge has also been documented. Literature reported that parents with a family history of stuttering often experience increased anxiety and feelings of helplessness, likely due to past experiences and expectations shaped by previous family members’ struggles with SLDs [33–35]. This family history factor can contribute to a lower perceived ability to manage the child’s condition effectively, as seen in the current study.

In addition to the promising results of the current study, several limitations were identified. Firstly, its cross-sectional design restricted the ability to capture dynamic changes and long-term trends in parental perceptions of stuttering over time. Future studies employing longitudinal methodologies would provide a more comprehensive understanding of how these perceptions evolve and are influenced by various factors over the course of treatment and development. Secondly, while the Palin Parent Rating Scale (PRS) used in this study encompasses three primary aspects of parental perception, clinical experience suggests there may be additional dimensions that could impact parents’ views of their child’s stuttering. Future research could explore and integrate these potentially overlooked aspects to provide a more nuanced assessment. Thirdly, the study’s sample size may have limited its ability to detect more subtle differences in parental perceptions across varying severities of stuttering. Larger sample sizes, stratified by severity, would enhance the study’s statistical power and allow for more robust comparisons.

Moving forward, future research could also benefit from exploring the influence of cultural factors on parental perceptions of stuttering, as these may vary significantly across different populations. Moreover, developing interventions aimed at enhancing parental understanding and coping strategies could help mitigate the impact of stuttering on both children and families. Additionally, incorporating qualitative methods such as interviews or focus groups could provide deeper insights into the subjective experiences and needs of parents, complementing the quantitative findings from scales like the Palin PRS. Addressing these limitations and pursuing these directions could contribute to more effective support and intervention strategies for families dealing with childhood stuttering.

Conclusion

The study explored parents’ perceptions of children who stutter using the Palin Parent Rating Scale (PRS), focusing on Impact of Stuttering on the Child, Severity of Stuttering and Impact on the Parents, and Parent’s Knowledge and Confidence in Managing it, in an Iranian context. Significant correlations were found among these factors, highlighting the interconnected nature of parental perceptions regarding stuttering severity and its impact on both children and families. Parents of children with more severe stuttering reported greater emotional and practical challenges, suggesting a need for targeted interventions to enhance parental support and coping strategies. Health policy makers and clinicians should consider integrating family-centered approaches into stuttering interventions, providing comprehensive support that addresses both clinical and emotional aspects of stuttering management.

Abbreviations

Palin PRS

Palin Parent Rating Scale

SD

Standard Deviation

CI

Confidence Interval

ST

Speech Therapy

SLDs

Speech and Language Disorders

Author Contributions

Study concept and design: EBB, SM, MF. Acquisition, analysis, or interpretation of data: SM, MF. Drafting of the manuscript: EBB, MF, SM. Critical revision of the manuscript for important intellectual content: AD, MF. Statistical analysis: SM, MF. Obtained funding: Not Applicable. Administrative, technical, or material support: EBB, MF. Study supervision: MF. All authors read and approved the final manuscript.

Funding

This research did not receive funding from any specific grant agency in the public, commercial, or not-for-profit sectors.

Data Availability

The datasets utilized and/or analyzed during the current study are accessible from the corresponding author upon reasonable request.

Declarations

Ethics Approval and Consent to Participate

Ethical approval for this study was granted by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (Ethical Code IR.USWR.REC.1399.260). Prior to participation, informed consent was obtained from all parents involved in the study, ensuring their voluntary involvement and understanding of the research procedures.

Consent for Publication

Not applicable.

Competing Interests

The authors declare that they have no competing interests.