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The Client's Perspective on Voluntary Stuttering
Abstract
Purpose:
Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering.
Method:
The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use.
Results:
A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment.
Conclusions:
To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.
... Another strategy that school counselors can employ, with guidance from school-based SLPs, is to pseudo stutter (fake stutter) with the SWS. Pseudo stuttering is often used as a therapeutic tool for persons who stutter to increase acceptance and openness with stuttering and increase self-confidence (Byrd, Gkalitsiou, Donaher, & Stergiou, 2016). When helping professionals pseudo stutter, clients have reported that this experience often strengthens the therapeutic relationship, which can increase the client's motivation, vulnerability, and resilience (Byrd et al., 2016). ...
... Pseudo stuttering is often used as a therapeutic tool for persons who stutter to increase acceptance and openness with stuttering and increase self-confidence (Byrd, Gkalitsiou, Donaher, & Stergiou, 2016). When helping professionals pseudo stutter, clients have reported that this experience often strengthens the therapeutic relationship, which can increase the client's motivation, vulnerability, and resilience (Byrd et al., 2016). Asking permission to pseudo stutter from the SWS is important, and explaining the rationale behind the method helps normalize the experience. ...
Children who stutter may experience challenges in their social and emotional development that can lead to academic struggles in school. School counselors and speech-language pathologists (SLPs) are uniquely positioned to collaborate on school-based interventions to help children who stutter. We review common elements of stuttering in children and provide suggestions for enhanced collaboration between school counselors and SLPs.
... -Voluntary stuttering: Also called pseudo-stuttering, this technique entails deliberate production of overt dysfluencies that resemble stuttering by the client or clinician [123,124]. It is used to provide desensitization to stuttering and reduce fear, negative emotions associated with stuttering, and feeling of loss of control [123,125]. A speech-language pathologist, small group of individuals who stutter and one social robot are involved. ...
This comprehensive survey and review presents stuttering treatment approaches that have been reported in the past 20 years in order to highlight the different characteristics in each intervention. The comprehensive survey presented in this article was conducted according to the PRISMA guidelines to extract articles on stuttering interventions, published between 01/01/2000 and 01/08/2020. 11 formal programs, 9 fluency induction techniques and 7 adjunct therapy approaches were identified through the comprehensive survey and summarized. The most common results were the Lidcombe program and altered auditory feedback techniques. The comprehensive survey and review presented in this article strives to provide knowledge that can help researchers in other areas, such as Human-Robot Interaction (HRI), acquire a preliminary understanding of stuttering interventions and further the field of stuttering interventions with the introduction of technological advancements.
... -Voluntary stuttering: Also called pseudo-stuttering, this technique entails deliberate production of overt dysfluencies that resemble stuttering by the client or clinician [123,124]. It is used to provide desensitization to stuttering and reduce fear, negative emotions associated with stuttering, and feeling of loss of control [123,125]. A speech-language pathologist, small group of individuals who stutter and one social robot are involved. ...
The inclusion of technologies such as telepractice, and virtual reality in the field of communication disorders has transformed the approach to providing healthcare. This research article proposes the employment of similar advanced technology – social robots, by providing a context and scenarios for potential implementation of social robots as supplements to stuttering intervention. The use of social robots has shown potential benefits for all the age group in the field of healthcare. However, such robots have not yet been leveraged to aid people with stuttering. We offer eight scenarios involving social robots that can be adapted for stuttering intervention with children and adults. The scenarios in this article were designed by human–robot interaction (HRI) and stuttering researchers and revised according to feedback from speech-language pathologists (SLPs). The scenarios specify extensive details that are amenable to clinical research. A general overview of stuttering, technologies used in stuttering therapy, and social robots in health care is provided as context for treatment scenarios supported by social robots. We propose that existing stuttering interventions can be enhanced by placing state-of-the-art social robots as tools in the hands of practitioners, caregivers, and clinical scientists.
... Cognitive and affective aspects of the Blank Center programming were targeted during the second half of weekly group sessions and then personalized during weekly individual sessions to elaborate each concept within the context of the clients' life. Topics included client education about stuttering, dispelling myths about stuttering, and discussing the cause of stuttering (e.g., heritability [Frigerio-Domingues & Drayna, 2017]; atypical sensory-motor processing [Chang et al., 2019]; vulnerable linguistic-phonological processing [Byrd et al., 2015;Coalson & Byrd, 2017]), as well as the personal utility of selfdisclosure (Byrd, Croft, et al., 2017;Byrd, McGill, et al., 2017;, voluntary stuttering (Byrd, Gkalitsiou, Donaher, et al., 2016), self-advocacy (Boyle et al., 2016(Boyle et al., , 2017, and participation in mindfulness activities (Boyle, 2011;De Veer et al., 2009 ...
The purpose of this study was to examine the benefits of a treatment approach for adults who stutter that focuses on core communication competencies rather than attempt to modify speech fluency. Eleven adults who stutter completed a 12-week treatment program at The Arthur M. Blank Center for Stuttering Education and Research. Pre-and posttreatment measures included (a) self-reported cognitive and affective aspects of stuttering (Overall Assessment of the Speaker's Experience of Stuttering [OASES], Self-Perceived Communication Competence [SPCC], Devereux Adult Resilience Survey [DARS], and Self-Compassion Scale [SCS]) and (b) ratings of 9 core communication competencies by an unfamiliar clinician blind to pre/posttreatment status. Participants reported significant mitigation of the adverse impact of stuttering (OASES) and greater resilience (DARS) after treatment. Participants also demonstrated significant gains in 8 of the 9 clinician-perceived communication competencies. Lower pretreatment stuttering frequencies were not significantly associated with posttreatment gains in clinician-perceived communication competencies. Preliminary findings suggest that, similar to findings for children and adolescents who stutter in previous studies, significant psychosocial and communicative benefit can be obtained for adults who stutter following treatment designed to focus on communication effectiveness rather than fluency, and that these gains are not contingent on the participants' stuttering frequency prior to enrollment.
... Self-compassion could also function as a companion to existing treatment methods, such as voluntary stuttering and self-disclosure. These evidence-based desensitization and stigma reduction techniques, both of which can lead to decreased avoidance and increased positive perceptions Byrd et al., 2017Byrd et al., , 2016, often require adults who stutter to persist through a reportedly difficult adjustment period before the technique becomes effective. For example, in Byrd et al.'s (2016) study, 42% and 30% of participants were uncomfortable or somewhat uncomfortable using voluntary stuttering at first, and one in five participants had never voluntary stuttered outside the room. ...
Purpose
The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter.
Method
Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter.
Results
Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life.
Conclusions
Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.
... Analysis to identify the relation between the case of clients and the most beneficial interventions is required. [62,65,66] Also sensed is a need to emphasize variables such as participant and clinician characteristics, time since onset, and session time (number of sessions per week, minutes per session) during research so that comparative investigation may be feasible. In addition, there may be a high risk of bias in such studies. ...
Stuttering is a speech fluency disorder with varied etiological explanations. It is important to identify symptoms early so that adequate and timely intervention can be delivered with focus on management and recovery. Stuttering, besides affecting speech fluency, might have a number of negative psychosocial consequences for the sufferer that may lead to immense anxiety, besides other symptoms. Therefore, it is thus imperative to include multiple dimensions in the holistic treatment of stuttering. Cognitive behavior therapy and mindfulness equip the client with the skills to manage the problems that occur as a result of stuttering. Since the rate of relapse in this condition is high, the chosen therapeutic paradigm must involve booster sessions over a long term. Periodic, detailed assessment would update the therapist about the barriers in treatment and would help in devising appropriate methods to get rid of these hindrances.
Purpose:
School-age children and adolescents frequently have difficulty developing positive identities around their stuttering. Many students experience both physical and social consequences from stuttering. The great lengths that speakers go to try to hide their stuttering and to speak fluently increase their difficulty. As long as school-age children who stutter try to identify as fluent speakers, they will have difficulty lessening the negative impact of stuttering on their lives. Fortunately, many people who stutter also report positive stuttering experiences. Speech-language pathologists can use these positive experiences to help school-age children grow more comfortable with stuttering. They can also help school-age children reduce some of the speaking effort and social stigma that leads them to try to conceal their stuttering in the first place. To accomplish both these goals, I propose a stutter-affirming therapy.
Method:
This clinical focus article summarizes previous research about identity development in stuttering. I discuss a therapy approach I call stutter-affirming therapy. In elucidating this approach, I discuss practical ways that speech-language pathologists can use to help school-age children develop positive stuttering identities through easier speaking and stuttering. I ground these examples in a case study of a 12-year-old boy who stutters.
Discussion:
stutter-affirming therapy focuses on conditioning the speaker's reaction to stuttering in ways that move toward and embrace stuttering (stutterphilic reactions) rather than in ways that move away from and reject stuttering (stutterphobic reactions). Speech-language pathologists can help school-age children who stutter foster positive stuttering identities using the three priorities of stutter-affirming therapy. First, reject fluency by reducing stutterphobic and increasing stutterphilic reactions to stuttering. Second, value stuttering by discovering what speakers gain from it. Third, create an environment in which it is easier to stutter through education, advocacy, disclosure, and voluntary stuttering.
Purpose
The purposes of this tutorial are (a) to critically review the ways in which stuttering therapy and research are both constrained by and resistant to ableism and (b) to offer practical suggestions for further interrupting stuttering-related ableism in the discipline of speech-language pathology.
Method
At the beginning of the tutorial, the concept of ableism is introduced and the effects of ableism on people who stutter are discussed. Following an overview of the discipline's current strengths in resisting ableism associated with stuttering, five practical suggestions for further interrupting ableism are provided. To illustrate how these suggestions might be enacted, real and hypothetical clinical and research scenarios are presented throughout. Although this tutorial draws heavily on the experiences of adults who stutter, many of the concepts are also relevant to kids and teens who stutter.
Conclusion
Speech-language pathologists can be change agents in interrupting ableism associated with stuttering and powerful allies to people who stutter.
Previous studies suggest that excessive attention to speech motor control may lead to inappropriate coping behaviors and clinical distress for adults who stutter. However, when combined with psychological-based approaches, such as cognitive behavioral therapy (CBT), it is possible that these behaviors and distress could be effectively alleviated. This study investigated whether group CBT, with a specific focus on decreasing the excessive attention to speech motor control, could reduce stuttering frequency as well as the psychological and behavioral difficulties associated with stuttering. A group CBT training program for adolescents and adults who stutter was conducted over the course of five weeks. Forty-eight adolescents and adults who stutter participated in eleven groups. Changes in stuttering frequency and self-reported outcomes (questionnaire scores) from the baseline (pre-intervention) were investigated immediately post-intervention and six months post-intervention. Results show that stuttering frequency was significantly reduced after interven- tion. Additionally, some questionnaire scores, including those on overall impact of stuttering, social anxiety, and coping behaviors, showed significant improvement both immediately post-intervention and six months post-intervention. Therefore, it is suggested that group CBT focusing on the reduction of excessive attention to speech motor control is effective in reducing stuttering frequency as well as the psychological and behavioral difficulties associated with stuttering.
吃音のある成人では，発話運動制御に過度に注意が向くことが不適切な対処行動を引き起こし，臨床的な困難につながるという仮説があり，認知行動療法などの心理・行動面での支援が効果的であると考えられる。本研究は，発話運動制御に対する過度な注意を弱める認知行動療法が，吃音中核症状頻度，心理・行動面での困難の緩和につながるかを調べることを目的とした。吃音のある成人48名が参加し，介入前・後での吃音頻度（吃音検査法・フリースピーチ; 主要アウトカム）・質問紙得点（副次アウトカム）の変化と，介入6ヶ月後での質問紙得点の変化を調べた。その結果，吃音頻度は，吃音検査法とフリースピーチ共に有意に減少し，一部の質問紙得点は，介入前に比べて介入6ヶ月後でも有意な改善を示していた。発話運動制御に対する過度な注意を弱める認知行動療法は，吃音頻度の減少に加え，長期的な心理・行動面の困難の緩和にもつながり得ると考えられた。
Es wird ein kurzer historischer Überblick über die Therapie des Stotterns gegeben. Anschließend werden die beiden Hauptansätze, die Stottermodifikation und das Fluency Shaping, beschrieben. Auf die Therapie von Kindern, die medikamentöse Behandlung und die Bedeutung von Selbsthilfegruppen wird gesondert eingegangen. Abschließend wird die Effektivität von Stottertherapien diskutiert.
Purpose
Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term “stuttering,” might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of “stuttering” to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders.
Method
One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings.
Results
SLPs were significantly less likely to feel comfortable using the term “stuttering” compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences.
Conclusions
SLPs were significantly less comfortable relaying the diagnosis “stuttering” to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.
Purpose:
Voluntary stuttering techniques involve persons who stutter purposefully interjecting disfluencies into their speech. Little research has been conducted on the impact of these techniques on the speech pattern of persons who stutter. The present study examined whether changes in the frequency of voluntary stuttering accompanied changes in stuttering frequency, articulation rate, speech naturalness, and speech effort.
Method:
In total, 12 persons who stutter aged 16-34 years participated. Participants read four 300-syllable passages during a control condition, and three voluntary stuttering conditions that involved attempting to produce purposeful, tension-free repetitions of initial sounds or syllables of a word for two or more repetitions (i.e., bouncing). The three voluntary stuttering conditions included bouncing on 5%, 10%, and 15% of syllables read. Friedman tests and follow-up Wilcoxon signed ranks tests were conducted for the statistical analyses.
Results:
Stuttering frequency, articulation rate, and speech naturalness were significantly different between the voluntary stuttering conditions. Speech effort did not differ between the voluntary stuttering conditions. Stuttering frequency was significantly lower during the three voluntary stuttering conditions compared to the control condition, and speech effort was significantly lower during two of the three voluntary stuttering conditions compared to the control condition.
Conclusions:
Due to changes in articulation rate across the voluntary stuttering conditions, it is difficult to conclude, as has been suggested previously, that voluntary stuttering is the reason for stuttering reductions found when using voluntary stuttering techniques. Additionally, future investigations should examine different types of voluntary stuttering over an extended period of time to determine their impact on stuttering frequency, speech rate, speech naturalness, and speech effort.
INTRODUCTION: Since 1993, the American Speech-Language-Hearing Association neither requires students in training to take a course on stuttering nor have clinical experience working with persons who stutter (PWS). One of the repercussions of this policy noted by Yaruss and Quesal (2002), is that almost one quarter of training programs allow students to graduate without stuttering coursework and nearly two-thirds let students matriculate without any clinical experiences with PWS. It is likely that much of the information many current students receive about stuttering is provided in one or two lectures as part of a series of lifespan courses offered by training programs. Manning (2004) stated that as most speech-language pathologists do not stutter, they may have difficulty empathizing with the clients they are called upon to serve in stuttering therapy. While Manning does not suggest that one needs to be a PWS to help a PWS, he believes that empathy is much easier if one has been through a similar situation. Pseudostuttering (PS) or voluntary stuttering has been used in stuttering therapy as a means of client self-analysis, desensitization, symptom modification, etc. Likewise, PS has helped speech-language pathology (SLP) students understand and empathize with the person who stutters as they attempted PS outside the classroom (Ham, 1990). Klinger (1987) observed that, "If clinicians are to be viewed as a vital link in the treatment of stuttering, then more should be known about clinicians and their own emotional reactions to stutterers and the stuttering situation." The purposes of the present study were to: (a) examine the experiences and feelings of undergraduate SLP students before and after they publicly pseudostuttered in the off-campus community and (b) describe the reactions of the general public to persons who stutter. METHOD: Participants: Forty-four undergraduate students majoring in speech-language pathology at a medium-sized public university in the Mid-Atlantic region of the United States and who were enrolled in a stuttering course participated in this study. The majority of students (86%) had met at least one person who stutters prior to enrolling in the course. Procedures: At the first class meeting, participants completed a questionnaire that queried them about (1) their past and present exposure to persons who stutter, (2) their beliefs about the cause of stuttering; (3) behaviors that constitute stuttering; and (4) suggestions they would give to a listener when speaking with a person who stutters. During that same meeting, students were informed that one of their course learning activities would include a project involving pseudostuttering in an off-campus environment and preparing a written description of their experiences. As part of the course content, students received in-class training on stuttering behaviors and extensive practice in replicating mild and moderate severity levels of stuttering for four weeks prior to engaging in the project. All students worked in pairs and were asked to (a) pseudostutter as realistically as possible in two face-to-face situations with strangers in the off-campus community using mild and moderate levels of stuttering severity; (b) describe their feelings before and after their 'stuttering' experiences; (c) discuss listener reactions to their disfluencies; and (d) submit a written report of their experiences.
This study assessed emotional and speech-language contributions to childhood stuttering. A dual diathesis-stressor framework guided this study, in which both linguistic requirements and skills, and emotion and its regulation, are hypothesized to contribute to stuttering. The language diathesis consists of expressive and receptive language skills. The emotion diathesis consists of proclivities to emotional reactivity and regulation of emotion, and the emotion stressor consists of experimentally manipulated emotional inductions prior to narrative speaking tasks. Preschool-age children who do and do not stutter were exposed to three emotion-producing overheard conversations-neutral, positive, and angry. Emotion and emotion-regulatory behaviors were coded while participants listened to each conversation and while telling a story after each overheard conversation. Instances of stuttering during each story were counted. Although there was no main effect of conversation type, results indicated that stuttering in preschool-age children is influenced by emotion and language diatheses, as well as coping strategies and situational emotional stressors. Findings support the dual diathesis-stressor model of stuttering.
Unlabelled:
The purpose of this investigation was to understand, from the perspective of the speaker, how seven adults have been able to successfully manage their stuttering. Individual experiences were obtained across the three temporal stages (past, transitional, and current). Recurring themes were identified across participants in order to develop an essential structure of the phenomena at each stage. The ability to make the transition from unsuccessful to successful management of stuttering was associated with six recurring themes of: (1) support, (2) successful therapy, (3) self therapy and behavioral change, (4) cognitive change, (5) utilization of personal experience, and (6) high levels of motivation/determination. Six recurring themes associated with past experiences, when stuttering was unsuccessfully managed, included: (1) gradual awareness, (2) negative reactions of listeners, (3) negative emotions, (4) restrictive lifestyle, (5) avoidance, and (6) inadequate therapy. The five recurring themes identified for the current situation where stuttering continues to be successfully managed were: (1) continued management, (2) self acceptance and fear reduction, (3) unrestricted interactions, (4) sense of freedom, (5) and optimism.
Educational objectives:
The reader will be able to: (1) describe, from the prospective of a select group of adults who stutter, the recurring themes associated with both unsuccessful and successful management of stuttering, (2) explain the recurring themes associated with how this group of seven adults achieved successful management of their stuttering, and (3) discuss the basic rationale and procedures associated with phenomenological analysis.
This survey investigated the effect of 'pseudostuttering' experiences on self-perceptions of 29 female, graduate students enrolled in a graduate seminar in stuttering while in a programme of study to become professional speech language pathologists.
Perceptions of self prior to, and immediately after, participation in five scripted telephone calls that contained pseudostuttering were measured via a 25-item semantic differential scale.
Participants perceived themselves as significantly more (p < 0.002) withdrawn, tense, avoiding, afraid, introverted, nervous, self-conscious, anxious, quiet, inflexible, fearful, shy, careless, hesitant, uncooperative, dull, passive, unpleasant, insecure, unfriendly, guarded, and reticent after their pseudostuttering telephone call experiences.
Findings suggests that the pseudostuttering experiences have an impact on self-perceptions and that the experience of 'adopting the disability of a person who stutters' may provide insight as to the social and emotional impact of communicative failure. It is suggested that pseudostuttering exercises may be a valuable teaching tool for the graduate students, especially for those who do not stutter.
Purpose:
The authors of this quasi-experimental design study explored the effect of an educational documentary video that presented factual and emotional aspects of stuttering on changing attitudes toward stuttering of preservice trainees and in-service public school teachers in Kuwait.
Method:
Participants were 99 preservice trainees (48 control, 51 experimental) and 103 in-service teachers (49 control, 54 experimental). All participants completed 22 items from the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S; St. Louis, 2005; translated into Arabic) and 17 additional items pre and post treatment. Participants in the experimental group viewed the awareness video.
Results:
Pretreatment comparisons confirmed that the control and experimental groups did not differ on their attitudes toward stuttering. As predicted, the posttreatment ratings for the control group were not different from the pretreatment ratings. A significant shift in attitudes (mostly in a positive direction) from pre to post treatment was observed for the experimental group of preservice trainees but not for the experimental group of in-service teachers. Interpretation of the difference in outcomes for the experimental preservice group as compared to the experimental in-service group is confounded by gender differences across groups.
Conclusion:
The authors of this study demonstrated that it is possible to positively modify preservice trainees' attitudes of people who stutter by using an educational documentary video.
The response of lay persons to pseudostuttering in approximately 200 spontaneous communication situations were reported and evaluated by 24 graduate students in an advanced class in fluency disorders. The students each spent a day as a “stutterer” in all speech contacts. They summarized their pseudostuttering efforts, the perceived auditor reactions, and their own feelings, in each situation. Results indicated that most lay reactions to any stuttering behavior were, at best, neutral or characterized by obvious changes in behavior. Many reactions were overtly and strongly negative. Student reactions were consistently ones of anxiety, fear, the desire to avoid, frustration, and irritation. Feelings of anger and humiliation were common. Discussion of results points out the value of pseudostuttering experience in clinician training, the possible importance of attitude and adjustment consideration in management of clients who stutter, and the apparent failure of (and need for) our profession to educate the lay public about communicative disorders.
Students' perceptions of simulating stuttering in public were obtained in order to quantify students' increased understanding of stuttering. 34 women and 2 men (M age=30.0 yr., SD=9.0) majoring in communication disorders participated. All were graduate students enrolled in their first class in fluency disorders. None had previous experience with individuals who stuttered. Participants completed a questionnaire before and after the experiment and discussed these experiences with the group. Responses to 39 questions using a 5-pt. Likert-type scale were analyzed for students' preparation, feelings, attitudes, and perception of listeners' reactions. Participants recounted both positive and negative experiences gaining understanding of and empathy for people who stutter, changing erroneous perceptions and broadening perspective of the disorder. Participants reported that the roundtable discussion contributed to their learning. Assigning students to simulate stuttering in public and participate in a follow-up discussion is an effective evidence-based teaching practice.
This paper presents fluency disorders in three types of stuttering syndromes with etiological considerations. The syndromes consist of affective, behavioral and cognitive components useful for fluency assessment and establishment of therapy goals with adolescents who stutter. The ultimate goal of the treatment program is a feeling of fluency control rather than actual fluency. A therapy process for fluency disordered adolescents is suggested which outlines four stages with goals and objectives for each stage. Behavior techniques for eliciting a feeling of fluency control are also included. Finally, a case history illustrates the therapy process for an adolescent with a fluency disorder.
Nineteen adults who stutter participated in a 3-week intensive stuttering modification treatment program (the Successful Stuttering Management Program [SSMP]). A series of 14 fluency and affective-based measures were assessed before treatment, immediately after treatment, and 6 months after treatment. Measures included stuttering frequency; the Stuttering Severity Instrument for Children and Adults, Third Edition (SSI-3); a self-rating of stuttering severity; the Perceptions of Stuttering Inventory (PSI); the Locus of Control of Behavior Scale; the Beck Depression Inventory; the Multicomponent Anxiety Inventory IV (MCAI-IV); and the State-Trait Anxiety Inventory. Statistically significant improvements were observed on 4 of the total 14 measures immediately following treatment and on 4 measures at 6 months posttreatment. Statistically significant improvements observed immediately posttreatment included scores on the SSI and the Struggle, Avoidance, and Expectancy subscales of the PSI. Sustained statistically significant improvements at 6 months posttreatment were observed only on client-reported perceptions of stuttering (the Avoidance and Expectancy subscales of the PSI) and 2 specific affective functioning measures (the Psychic and Somatic Anxiety subscales of the MCAI-IV). The SSMP generated some anxiolytic effects but was ineffective in producing durable reductions of core stuttering behaviors, such as stuttering frequency and severity. The discussion focuses on the strengths, weaknesses, and durability of the SSMP treatment approach.
Unlabelled:
This paper describes a new instrument for evaluating the experience of the stuttering disorder from the perspective of individuals who stutter. Based on the World Health Organization's International Classification of Functioning, Disability, and Health [World Health Organization (2001). The International Classification of Functioning, Disability, & Health. Geneva: World Health Organization], the Overall Assessment of the Speaker's Experience of Stuttering (OASES) collects information about the totality of the stuttering disorder, including: (a) general perspectives about stuttering, (b) affective, behavioral, and cognitive reactions to stuttering, (c) functional communication difficulties, and (d) impact of stuttering on the speaker's quality of life. This paper summarizes scale development, reliability and validity assessment, and scoring procedures so clinicians and researchers can use the OASES to add to the available evidence about the outcomes of a variety of treatment approaches for adults who stutter.
Educational objectives:
As a result of this activity, participants will be able to: (1) identify key issues related to the documentation of treatment outcomes in stuttering; (2) discuss the components of the international classification of functioning, disability, and health as they relate to the documentation of stuttering treatment outcomes; (3) evaluate and use a new measurement instrument for assessing the outcomes of stuttering treatment from the perspective of the person who stutters.
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