Introduction: Recent studies conducted with bilingual populations have shown that bilingual children who do not stutter (CWNS) are often less fluent than their monolingual counterparts, which seems to affect the accuracy with which speech-language pathologists (SLPs) identify stuttering in bilinguals. That is, misdiagnosis appears frequently in bilingual children and is more likely to occur with bilingual CWNS (false positives) than with bilingual CWS (false negatives). Methods: The goal of the current study was to gain insight in the extent of this misdiagnosis. Speech samples of 6 Lebanese bilingual CWNS and 2 CWS were rated by Lebanese SLPs in an audio-only and audiovisual presentation mode. SLPs had to identify each child as stuttering or not and subsequently rate on a 6-point scale the stuttering severity for each child. SLPs also provided background information by means of a questionnaire. Results: The results showed that stuttering severity ratings (1) were on average significantly higher for CWS than for CWNS, (2) were for each CWS higher than for all but one of the CWNS, (3) varied significantly among the CWNS but not the CWS, (4) were not affected by the presentation mode, and (5) correlated positively with the percentage of stuttering-like disfluencies (SLD) and the mean number of iterations, but not with the percentage of other disfluencies (OD). Conclusion: Misdiagnosed bilingual CWNS are perceived by the SLPs as having a mild stutter, primarily based on the frequency of their disfluencies, but can be occasionally rated at par with CWS. Further research differentiating the disfluent speech of bilingual children who do and do not stutter is needed to reach a more adequate diagnosis of stuttering.

1.
Bloodstein
O
,
Bernstein Ratner
N
,
Brundage
S
.
A handbook on stuttering
. 7th ed.
Plural Publishing
;
2012
.
2.
Saad Merouwe
S
,
Bertram
R
,
Richa
S
,
Eggers
K
.
Bilinguisme et bégaiement: revue de la littérature et implications sur le diagnostic clinique
.
Glossa
.
2022
;
132
:
67
91
.
3.
Byrd
CT
.
Assessing bilingual children: are their disfluencies indicative of stuttering or the by-product of navigating two languages
.
Semin Speech Lang
.
2018
;
39
(
4
):
324
32
.
4.
Coalson
GA
,
Peña
ED
,
Byrd
CT
.
Description of multilingual participants who stutter
.
J Fluency Disord
.
2013
;
38
(
2
):
141
56
.
5.
Shenker
RC
.
Multilingual children who stutter: clinical issues
.
J Fluency Disord
.
2011
;
36
(
3
):
186
93
.
6.
Tetnowski
JA
,
Richels
C
,
Shenker
R
,
Sisskin
V
,
Wolk
L
.
When the diagnosis is dual
.
Leader
.
2012
;
17
(
2
):
10
3
.
7.
Byrd
CT
,
Bedore
LM
,
Ramos
D
.
The disfluent speech of bilingual Spanish-English children: considerations for differential diagnosis of stuttering
.
Lang Speech Hear Serv Sch
.
2015a
;
46
(
1
):
30
43
.
8.
Eggers
K
,
Van Eerdenbrugh
S
,
Byrd
CT
.
Speech disfluencies in bilingual Yiddish-Dutch speaking children
.
Clin Linguist Phon
.
2020
;
34
(
6
):
576
92
.
9.
Rispoli
M
,
Hadley
P
.
The leading-edge: the significance of sentence disruptions in the development of grammar
.
J Speech Lang Hear Res
.
2001
;
44
(
5
):
1131
43
.
10.
Zackheim
CT
,
Conture
EG
.
Childhood stuttering and speech disfluencies in relation to children’s mean length of utterance: a preliminary study
.
J Fluency Disord
.
2003
;
28
(
2
):
115
41
; quiz 141–2. https://doi.org/10.1016/s0094-730x(03)00007-x.
11.
Ambrose
NG
,
Yairi
E
.
Normative disfluency data for early childhood stuttering
.
J Speech Lang Hear Res
.
1999
;
42
(
4
):
895
909
.
12.
Yairi
E
,
Seery
C
.
Stuttering: foundations and clinical applications
. 3rd ed.
Plural publishing
;
2023
.
13.
Byrd
CT
,
Watson
J
,
Bedore
L
,
Mullis
A
.
Identification of stuttering in bilingual Spanish-English speaking children
.
Contemporary Issues in Communication Science and Disorders
.
2015b
;
42
:
72
87
.
14.
Saad Merouwe
S
,
Bertram
R
,
Richa
S
,
Eggers
K
.
Identification of stuttering in bilingual children across two presentation modes
. Presented at:
The joint world congress on stuttering and cluttering
.
Montreal, Canada
;
2022 May 27–30
.
15.
Shaaban
KA
.
Bilingual education in Lebanon
. In:
Cummins
J
,
Corson
D
, editors.
Encyclopedia of Language and Education
.
The Netherlands
:
Kluwer
;
1997
.
Vol. 5
; p.
251
9
.
16.
Thonhauser
I
.
Multilingual education in Lebanon: “Arabinglizi” and other challenges of multilingualism
.
Mediterr J Educ Stud
.
2000
;
6
(
1
):
49
2000
.
17.
Cordes
AK
.
Individual and consensus judgments of disfluency types in the speech of persons who stutter
.
J Speech Lang Hear Res
.
2000
;
43
(
4
):
951
64
.
18.
Runyan
CM
,
Adams
MR
.
Perceptual study of the speech of “successfully therapeutized” stutterers
.
J Fluency Disord
.
1978
;
3
(
1
):
25
39
.
19.
Runyan
CM
,
Adams
MR
.
Unsophisticated judges’ perceptual evaluations of the speech of “successfully treated” stutterers
.
J Fluency Disord
.
1979
;
4
(
1
):
29
38
.
20.
Wendahl
R
,
Cole
J
.
Identification of stuttering during relatively fluent speech
.
J Speech Hear Res
.
1961
;
4
:
281
6
.
21.
Williams
D
,
Kent
L
.
Listener evaluations of speech interruptions
.
J Speech Hear Res
.
1958
;
1
(
2
):
124
31
.
22.
Luper
H
.
Consistency of stuttering in relation to the goal gradient hypothesis
.
J Speech Hear Disord
.
1956
;
21
(
3
):
336
42
.
23.
Martin
RR
,
Haroldson
SK
.
Stuttering and speech naturalness: audio and audiovisual judgments
.
J Speech Hear Res
.
1992
;
35
(
3
):
521
8
.
24.
Panico
J
,
Healey
EC
,
Brouwer
K
,
Susca
M
.
Listener perceptions of stuttering across two presentation modes: a quantitative and qualitative approach
.
J Fluency Disord
.
2005
;
30
(
1
):
65
85
.
25.
Tuthill
C
.
A quantitative study of extensional meaning with special reference to stuttering
.
J Speech Disord
.
1940
;
5
(
2
):
189
91
.
26.
Williams
D
,
Wark
M
,
Minifie
F
.
Ratings of stuttering by audio, visual, and audiovisual cues
.
J Speech Hear Res
.
1963
;
6
:
91
100
.
27.
Mayer
M
.
Frog goes to dinner
.
New York (NY)
:
Dial Books for Young Readers
;
1974
.
28.
Riley
G
.
Stuttering severity instrument for children and adults
. 4th ed.
Austin (TX)
:
Pro Ed, Inc
;
2009
.
29.
Tuller
L
.
Clinical use of parental questionnaires in multilingual contexts
. In:
Armon-Lotem
S
,
Jong
JD
,
Meir
N
, editors.
Assessing multilingual children disentangling bilingualism from language impairment
.
Bristol
:
Multilingual Matters
;
2015
. p.
300
30
.
30.
Hallal
F
,
Khoukaz
J
,
Kouba Hreich
E
,
Messarra
CM
.
Evaluation des troubles du langage dans le contexte plurilingue Libanais: utilisation des scores du “Questionnaire pour Parents d’Enfants Bilingues” (PaBiQ) comme prédicteurs diagnostiques des Troubles du Langage. Evaluation of language disorders in the Lebanese plurilingual context: using the scores of the “Questionnaire for Parents of Bilingual Children” (PaBiQ) as diagnostic predictors of language disorders, Unpublished thesis
.
Saint-Joseph University of Beirut
;
2014
.
31.
Humphrey
BD
.
Judgments of disfluency in a familiar versus an unfamiliar language
. In:
Packmann
A
,
Meltzer
A
,
Peters
HFM
, editors.
Theory, research and therapy. Proceedings of the fourth world congress on fluency disorders: 424–427
.
Nijmegen, the Netherlands
:
Nijmegen University Press
;
2004
.
32.
Van Borsel
J
,
Medeiros de Britto Pereira
M
.
Assessment of stuttering in a familiar versus an unfamiliar language
.
J Fluency Disord
.
2005
;
30
(
2
):
109
24
.
33.
Van Borsel
J
,
Leahy
MM
,
Pereira
MB
.
Judging stuttering in an unfamiliar language: the importance of closeness to the native language
.
Clin Linguist Phon
.
2008
;
22
(
1
):
59
67
.
34.
Olness
G
.
Structural assessment of narratives: some issues and illustrative data
.
Clinical aphasiology conference
.
Ghent, Belgium
;
2006
. [Paper presentation] https://aphasiology.pitt.edu/id/eprint/1750.
35.
Bedore
LM
,
Fiestas
CE
,
Peña
ED
,
Nagy
VJ
.
Cross-language comparisons of maze use in Spanish and English in functionally monolingual and bilingual children
.
Bilingualism
.
2006
;
9
(
3
):
233
47
.
36.
Suen
HK
,
Ary
D
.
Analyzing quantitative behavioral observation data
.
Mahwah (NJ)
:
Erlbaum
;
1989
. https://doi.org/10:4324/9781315801827.
37.
Boey
RA
,
Wuyts
FL
,
Van de Heyning
PH
,
De Bodt
MS
,
Heylen
L
.
Characteristics of stuttering-like disfluencies in Dutch-speaking children
.
J Fluency Disord
.
2007
;
32
(
4
):
310
29
.
38.
Leclercq
AL
,
Suaire
P
,
Moyse
A
.
Beyond stuttering: speech disfluencies in normally fluent French-speaking children at age 4
.
Clin Linguist Phon
.
2018
;
32
(
2
):
166
79
.
39.
Pellowski
MW
,
Conture
EG
.
Characteristics of speech disfluency and stuttering behaviors in 3- and 4-year-old children
.
J Speech Lang Hear Res
.
2002
;
45
(
1
):
20
34
.
40.
Tumanova
V
,
Conture
EG
,
Lambert
EW
,
Walden
TA
.
Speech disfluencies of preschool-age children who do and do not stutter
.
J Commun Disord
.
2014
;
49
:
25
41
.
41.
Rousseau
I
,
Onslow
M
,
Packman
A
,
Jones
M
.
Comparisons of audio and audiovisual measures of stuttering frequency and severity in preschool-age children
.
Am J Speech Lang Pathol
.
2008
;
17
(
2
):
173
8
.
42.
Susca
E
,
Healey
E
.
Perceptions of simulated stuttering and fluency
.
J Speech Lang Hear R
.
2001
;
30
:
159
65
.
43.
Hegde
M
,
Hartman
DE
.
Factors affecting judgments of fluency: I. interjections
.
J Fluency Disord
.
1979a
;
4
:
1
11
.
44.
Hegde
M
,
Hartman
DE
.
Factors affecting judgments of fluency: II. word repetitions
.
J Fluency Disord
.
1979b
;
4
(
1
):
13
22
.
45.
Karimi
H
,
Jones
M
,
O’Brian
S
,
Onslow
M
.
Clinician percent syllables stuttered, clinician severity ratings and speaker severity ratings: are they interchangeable
.
Int J Lang Commun Disord
.
2014
;
49
(
3
):
364
8
.
46.
Huffman
ES
,
Perkins
WH
.
Dysfluency characteristics identified by listeners as “stuttering” and “stutterer”
.
J Commun Disord
.
1974
;
7
(
1
):
89
96
.
47.
Rincon
C
,
Johnson
KN
,
Byrd
C
.
An introductory examination of speech disfluencies in Spanish: English bilingual children who do and do not stutter during narratives
.
Perspect ASHA Spec Interest Groups
.
2020
;
5
(
1
):
131
41
.
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