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Development and Validation of a Research Version of the Overall Assessment of the Speaker’s Experience of Stuttering- Adult (OASES-A-R)

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Purpose Numerous frameworks and definitions have sought to differentiate what behaviors and experiences should be considered as a part of stuttering. Nearly all of these efforts have been based on the perspectives and beliefs of conversational partners and listeners. This outside-in approach to defining stuttering lacks validation from people who live with the condition. Method In this study, 430 adults who stutter participated in a qualitative exploration of the term stuttering. Data were analyzed thematically to determine speakers' perspectives about moment of stuttering and the overall experience of stuttering in their lives. Results To adults who stutter, the term stuttering signifies a constellation of experiences beyond the observable speech disfluency behaviors that are typically defined as stuttering by listeners. Participants reported that the moment of stuttering often begins with a sensation of anticipation, feeling stuck, or losing control. This sensation may lead speakers to react in various ways, including affective, behavioral, and cognitive reactions that can become deeply ingrained as people deal with difficulties in saying what they want to say. These reactions can be associated with adverse impact on people's lives. This interrelated chain of events can be exacerbated by outside environmental factors, such as the reactions of listeners. Discussion Data from this survey provide novel evidence regarding what stuttering means to adults who stutter. These data are used to update the adaptation of the World Health Organization's International Classification of Functioning, Disability and Health as it applies to stuttering (Yaruss & Quesal, 2004) to better account for the complex and individualized phenotype of stuttering and to develop a definition of the experience of stuttering that is based not only on the observations of listeners but also on the impact of stuttering on the lives of adults who stutter.
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The R package ltm has been developed for the analysis of multivariate dichotomous and polytomous data using latent variable models, under the Item Response Theory ap-proach. For dichotomous data the Rasch, the Two-Parameter Logistic, and Birnbaum's Three-Parameter models have been implemented, whereas for polytomous data Seme-jima's Graded Response model is available. Parameter estimates are obtained under marginal maximum likelihood using the Gauss-Hermite quadrature rule. The capabilities and features of the package are illustrated using two real data examples.
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The International Classification of Functioning, Disability and Health (ICF) framework has a pragmatic focus on how impairment impacts the individual's activities and participation. Stuttering is known to impact communication in younger adults but this has not been established in older people who stutter. In this study, emotional reactions to stuttering were investigated in a group 55 years and older who self-reported stuttering since childhood. This was a cross-sectional descriptive design. Twelve participants who self-reported that they still stuttered and in whom stuttering was confirmed, and 14 controls completed the Fear of Negative Evaluation Scale (FNES), The Endler Multi-dimensional Anxiety Scales-Trait (EMAS-T) and The Australian Personal Wellbeing Index (PWA-I). Participants whose stuttering persisted also completed the Overall Assessment of Speakers Experience of Stuttering (OASES). The group who stuttered scored significantly higher on the FNES, with scores in the social phobia range. Responses on the OASES showed that stuttering continues to be a negative experience for this older group. Results for the EMAS-T and PWA-I were within the average range across both participant groups however significant differences existed between the groups in the social evaluative and physical danger domains of the EMAS-T, and the satisfaction with health domain of the PWA-I. Significant fear of negative evaluation, which is the key feature for social anxiety, was found in the group of older people who stuttered with a higher level of trait anxiety in social evaluative domains. The OASES showed that they also reacted to stuttering and communication in daily situations with moderate to severe impact scores which showed that stuttering impacted on speaking activities and by those negative experiences limited communication. Limited communication and restricted participation in the lives of older people have implications for healthy productive ageing and this is discussed.
Article
Purpose: This study uses the Simplified Chinese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A-SC) to examine the stuttering experience of people in China and determine if there are differences between the data collected in China and other countries. Methods: A total of 139 responses to the OASES-A-SC were collected in an online self-help community of people in China who stutter. Descriptive analyses were conducted to obtain the understanding of how stuttering impacts the life experience of people in China who stutter. Comparisons were conducted regarding the groups of gender, highest education, and therapy history. Cross-cultural comparisons among the data collected from China, Australia, the Netherlands, Japan, Sweden, and the USA were also conducted. Results: The data for the OASES-A-SC showed a skewed distribution toward the severe end of the OASES-A impacting scale. About 93.5% participants rated the overall impact of stuttering on their life at and above the "Moderate" category. The mean scores of the General Information, Reaction to Stuttering, and Qualify of Life sections fell in the moderate-to-severe category. Compared with the data in other five countries, the Chinese data were significantly higher in the impact severity level. Conclusion: The results showed that people in China who stutter have more adverse experiences related to stuttering compared with their counterparts in western or developed countries. Higher negative attitudes toward stuttering in China, social stigma against people with disabilities, and the fewer professional supports were discussed to be associated with this more adverse experience. Cultural differences such as a greater power distance and higher collectivism in Chinese culture were considered to be associated with the elevated level of adverse impact of stuttering in China.
Article
Background: Prior research has shown that stuttering is a complex and individualized condition. The Overall Assessment of the Speaker's Experience of Stuttering (OASES; Yaruss & Quesal, 2016) is a well-researched tool that measures the impact of stuttering on an individual's life. This study has used the Polish version of the OASES to examine the experience of stuttering among Polish people who stutter. Method: The original, English version of the OASES was translated into Polish. Reliability and validity for the Polish version were evaluated. Comparisons were made between samples from Poland and the United States for all of the sections and for the overall results of the OASES-S, OASES-T, and OASES-A. To explore the structure of the stuttering experience, a factor structure of the OASES was conducted. Results: Like other versions of the OASES, the OASES-Polish (OASES-PL) demonstrated good reliability and validity. Cross-cultural comparisons have shown that Polish school-age children had significantly lower knowledge and awareness of stuttering than children in the United States (USA). Factor analysis further revealed that the structure of the experience of stuttering is similar across all age groups, but the importance of the particular aspects of stuttering varies at different stages of life. Conclusion: The OASES-PL is a reliable and valid instrument for measuring the impact of stuttering on Polish people who stutter and can therefore be used as a clinical tool. Polish results were relatively similar to those from the USA, though there were subtle cross-cultural differences that are worthy of further exploration. Educational objectives: After reading the article, the participant will be able: (1) to describe the diverse experiences of Polish people who stutter at different ages, (2) to explain the importance of quality of life analysis in diagnosis and speech therapy with people who stutter, and (3) to explain the breadth of the stuttering phenomenon among Polish individuals who stutter.
Article
For children who stutter (CWS), there is good evidence of the benefits of treatment for pre-school age, but an evidence gap for elementary school age. Here we report on the effectiveness of a fluency shaping treatment for 6- to 9-year-old children. The main treatment component is the reinforcement of soft voice onsets. An intensive in-patient group treatment phase lasts 6 days, followed by a 6-month maintenance phase with 3 in-patient weekend group refresher courses. Child and a parent participate together in various treatment activities. In this controlled intervention study (waitlist control, intention-to-treat design) assessments were performed before treatment (T1), 4 weeks after the intensive phase (T2), at the end of the maintenance phase (T3), and 1 year later (T4). Participants were 119 children (108 boys, 11 girls, age 5.5‑10.4 years). Control conditions included a subgroup with delayed treatment (N=25) as well as the assessment of complexity of utterances, inter-rater reliability, and speech naturalness. From before treatment to 1-year follow-up, percent stuttered syllables and OASES-S ( Overall Assessment of the Speaker’s Experience with Stuttering - School-age ) scores decreased with large effect size. Speech naturalness improved during this period but did not reach the level of non-stuttering children. Complexity of utterances increased during the intensive phase, but only temporarily. Twenty children (16.8%, including dropouts) showed no demonstrable treatment benefit. Fluency shaping treatment can be effectively applied to young school children. It is assumed that parental support, group therapy, intensive treatment, and regular exercises at home are essential.
Article
Purpose The aim of this cross-sectional study was to explore the impact and experience of stuttering, and attitude to communication for female and male teenagers who stutter (TWS) in comparison with teenagers with no stutter (TWNS). Methods The Swedish version of the Overall Assessment of the Speaker’s Experience of Stuttering (OASES-T-S), was administered to 56 TWS, 13 -17 years old (26 females, 30 males). An adapted version of OASES, Attitude to Speech and Communication (ASC), was administered to 233 TWNS. The impact scores were analyzed in relation to sex in TWS and TWNS. Results Female TWS reported that stuttering had a greater impact on their life than it did on male TWS (on average 0.5 higher impact scores; Hedges’ g = 0.87). The differences did not seem to be caused by differences in severity of overt stuttering symptoms. Female and male TWS particularly differed on items related to difficulties in day-to-day communication and affective/behavioral reactions to stuttering. Such sex differences were not as pronounced among TWNS, suggesting that teenage women may be more vulnerable to the negative impact of stuttering than men the same age. Conclusion Female teenagers report more negative experiences and a greater tendency to use avoidance strategies than male teenagers.
Article
This article reviews the book The Basics of Item Response Theory Using R by Baker and Kim (2017). It describes the structure and goals of the book, provides an overview of each chapter, and concludes with general comments. Both strengths and limitations of the book are discussed.
Article
Purpose: To explore the process of change and role of resilience following an integrated group intervention for children who stutter (CWS). Method: Using an exploratory multiple case study design, this research sought to identify the most significant changes perceived by seven participants following therapy, the mechanisms of change, and the role of resilience in the process of change. Quantitative measurements of resilience were combined with qualitative analysis of semi-structured interviews. Results: Thematic analysis of qualitative data showed that cognitive and emotional change was a key driver for therapeutic change, enabled by the shared experience of the group and a positive therapeutic environment. These changes were generalised into clients' real-world experiences, facilitated by their support network. Quantitative data demonstrated a statistically reliable positive change in overall Resiliency scores for four participants and reduced impact of stuttering scores on OASES-S for all participants, maintained at 12 month follow-up. Conclusions: This study demonstrates the importance of adopting an integrated approach in therapy for CWS, which incorporates Cognitive Behavioural Therapy (CBT) as a key component, to facilitate change and build resilience. These results are unique to this cohort of CWS and further investigation into the use of CBT and the process of change may be warranted. Educational objectives: The reader will be able to (1) describe the integrated intervention used in this study (2) define the most significant change following therapy for the participants involved (3) summarise the key factors that facilitated change during the therapy process (as perceived by the participants).
Article
Unlabelled: This study explored the impact of the stuttering disorder on perceived quality of life, with emphasis on the individual's relationship with their partner or spouse. Specifically, the purposes were: (a) to investigate what personal experiences and themes exist for both members of a couple dyad when one member of the couple stutters and (b) to examine whether the partners have different experiences with respect to the impact of stuttering on their lives. A mixed method research design was used. Participant dyads (adults who stutter and their fluent life partner) each completed one semi-structured qualitative interview and two questionnaires: the Overall Assessment of Speakers' Experience of Stuttering (OASES), and the Medical Short Form 36 (SF-36). Interviews were analysed qualitatively and significant themes evaluated. Quantitative results of the OASES and SF-36 were analysed, and scores correlated to determine the strength of any clinically significant relationships. Results indicated that people who stutter and their fluent partners reported similar experiences in reactions to stuttering and perceived difficulties in communication. However, no relationship was seen between the two groups in perceived impact on quality of life. Qualitative results indicated that the participants shared life experiences including reactions to stuttering, treatment undertaken and support. Such findings lend support to a broad-based clinical programme for adults who stutter that includes the fluent partner as an agent of change in their treatment. Findings also support the utilisation of qualitative and quantitative research techniques to elucidate relevant psychosocial life themes and experiences for those who live with a stutter. Educational objectives: The reader will be able to: (a) identify the life themes associated with having a partner who stutters; (b) identify the perceived impact of stuttering for adults who stutter compared to their partners; and (c) discuss the clinical implications of the results with regards to working with adults who stutter.
Article
Objective: This study investigates the association between the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The OASES measures the adverse impact of stuttering on a person's life. Design: Participants in the present study were 112 persons who stutter from Germany. Methods: All participants filled in both the NEO-FFI and the OASES questionnaires. Results: Results revealed a strong positive correlation between the personality trait Neuroticism and scores on the OASES. Moreover, Extraversion was negatively correlated with the OASES scores. Conclusions: The findings suggest that people with higher Neuroticism and lower Extraversion scores experience a greater impact of stuttering on their daily life. The results underscore the importance of considering personality as a potential moderator or mediator factor in future stuttering research and, potentially, also in treatment. Educational objectives: The reader will learn (a) about the different personality dimensions reflected by the NEO-FFI, (b) why it is important to consider the impact of stuttering on everyday life from the perspective of the people who stutter and (c) how personality is linked to the Overall Assessment of the Speaker's Experience of Stuttering (OASES).
Article
The World Health Organization (WHO) recently presented a multidimensional classification scheme for describing health status and the experience of disablement. This new framework, the International Classification of Functioning, Disability, and Health (ICF; WHO, 2001), is a revision of WHO's prior framework for describing the consequences of disorders, the International Classification of Impairments, Disabilities, and Handicaps (ICIDH; WHO, 1980). In previous papers, Yaruss had shown how the original ICIDH could be adapted to describe the consequences of stuttering at several levels that are relevant to the communication and life experiences of the person who stutters. The current manuscript presents an update of the Yaruss (1998) model that accounts for the new structure of the ICF. A comparison of the WHO's ICIDH and ICF frameworks is presented, followed by an analysis of how the ICF can be adapted to describe the speaker's experience of the stuttering disorder. Emphasis is placed on the fact that stuttering involves more than just observable behaviors. Specifically, the speaker's experience of stuttering can involve negative affective, behavioral, and cognitive reactions (both from the speaker and the environment), as well as significant limitations in the speaker's ability to participate in daily activities and a negative impact on the speaker's overall quality of life. LEARNING OUTCOMES: As a result of reading this manuscript, participants, willgain an understanding of the updates to the World Health Organization's original International Classification of Impairments, Disabilities, and Handicaps that are seen in the International Classification of Functioning, Disability, and Health understand how the ICF can be applied to the study of stuttering recognize that health conditions such as stuttering are affected by both internal and external factors, and can involve more than just observable behaviors that are seen on the surface.
Overall assessment of the speaker’s experience of stuttering (OASES): Documenting multiple outcomes in stuttering treatment
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