Journal of Fluency Disorders最新文献

Purpose

This study initiated a program of research that aims to develop a program theory underlying integrated cognitive-behavioural fluency enhancing stuttering treatments for school-age children. This research asks, what in the treatment program works (or does not work), for whom, in what contexts, and why.

Methods

Using a critical realist evaluation approach, seven speech-language pathologists (SLPs) with extensive experience in treating children who stutter were asked about barriers and facilitators of optimal treatment outcomes within the context of the Comprehensive Stuttering Program - School-aged Children (CSP-SC). From these data discrete resource mechanisms, contexts, within child reasoning mechanisms, and outcomes were derived and a preliminary program theory was proposed.

Results

Facilitating and impeding child physiology, treatment and SLP resource mechanisms, family and school contexts, and within-child mechanisms were identified. Facilitating mechanisms included motivation, personality/psychological characteristics, understanding and trust of the treatment process, experience of speaking with less effort, and self-efficacy. Impeding mechanisms included reduced motivation, impeding personality/psychological characteristics, lack of buy-in, and, for some children, a prohibitive cost of effort in using learned strategies.

Conclusion

A preliminary program theory was hypothesized which will be further developed in future analysis of data obtained from children and parents who participated in the CSP-SC at the same centre from which the SLPs came. Subsequent research with new cohorts of SLPs, children, and parents from other treatment programs and centres will be needed to establish the generalizability of the program theory generated in this program of research

Purpose

This study utilized the Chinese and Japanese translations of the Public Opinion Survey of Human Attributes-Stuttering (POSHA–S) and Cluttering (POSHA–Cl) to compare the differences in (a) attitudes towards stuttering versus cluttering in speech-language pathology (SLP) students in either China or Japan, (b) attitudes of SLP students in China versus Japan towards either stuttering or cluttering, and (c) attitudes of Chinese and Japanese students versus international databases for stuttering and cluttering.

Method

The POSHA–S and POSHA–Cl were both administered to 99 SLP students from six universities in China and 352 SLP students from two universities in Japan.

Results

Attitudes toward stuttering were markedly different for Chinese versus Japanese students. Overall, stuttering attitudes were slightly more positive than cluttering attitudes in both countries; however, compared to China, Japanese SLP students attitudes toward stuttering and cluttering were more disimilar. In addition, compared with the international database, the attitudes of Chinese and Japanese SLP students toward self-reactions to both disorders were more positive.

Conclusion

Chinese and Japanese SLP students’ attitudes toward both stuttering and cluttering are likely to be influenced by geography, culture, education, and the “halo effect.” The attitudes of the SLP students in China and Japan are more negative than the attitudes as shown in the global data.

Purpose

This study aims to create a stigma reduction framework for stuttering in the local context of Québec, Canada using the Participative Concept Mapping Approach (PCMA), focusing on both self and societal stigma.

Method

Employing a mixed-methods approach, this study engaged 17 experts—people who stutter, clinicians and health innovation specialists—in PCMA workshops. Via diverse steps, including generation, sorting and rating of ideas in response to the focus prompt, "To effectively address stuttering (self-)stigma, an intervention should…" these sessions led to a framework depicted in visual maps, then refined into actionable principles through qualitative analysis. Mixed-methods data analysis used the open-source R-CMap software to generate visual maps illustrating the relationships among ideas as well as importance and feasibility ratings.

Results

The collaborative workshops identified 95 ideas in response to the focus prompt, reunited in 7 clusters, evolving into 16 principles to mitigate stuttering stigma and self-stigma. At the therapy level, these principles emphasize personalized therapy, thorough assessments, stigma-free therapeutic environment, empowerment, and the importance of group inclusivity and educating the relational circles. Societally, they advocate for initiatives such as improved educational outreach, empathy enhancement, and better representation. This dual approach targets individual experiences and societal views on stuttering, stressing the need for an all-encompassing intervention framework.

Conclusion

The findings demonstrate PCMA's usefulness in crafting local, culturally sensitive, tailored interventions for stigma reduction. The study emphasizes the necessity of holistic approaches that address individual experiences and societal perceptions, offering a model to conduct similar exercises in diverse local settings.

Purpose

This study aimed to assess the reliability and validity of the Italian translation of the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales for adults who stutter, as there are no assessment tools currently available in Italy. The UTBAS scales provide a comprehensive stuttering-specific measure of the unhelpful thoughts and beliefs that can be used to screen for indicators of social anxiety in adults who stutter. Additionally, the UTBAS scales also allow the identification of negative thoughts and beliefs that negatively impact speech treatment outcomes.

Method

The translation of the UTBAS scales into Italian (UTBAS-ITA) was completed using the forward-backward translation process and it was administered to 98 adults who stutter (AWS) and 98 adults who do not stutter (AWNS). Both groups were matched for gender and age. We also administered the UTBAS-ITA to 76 AWS a second time within a two-week interval to assess test-retest reliability. Additionally, we administered the State-Trait Anxiety Inventory and the Fear of Negative Evaluation Scale to 20 AWS to assess concurrent validity.

Results

The UTBAS-ITA showed good power of discrimination between AWS and AWNS, high internal validity, high internal consistency, good construct validity, and good test-retest reliability.

Conclusion

Since there is a scarcity of clinical assessment tools for adults who stutter in Italy, the UTBAS-ITA could serve as an assessment tool and outcome measure for clinical and research environments.

Purpose

The Public Opinion Survey of Human Attributes - Stuttering (POSHA-S, St. Louis, 2013) was developed as a standard measure of public attitudes about people who stutter. As with any survey-based methods, threats to validity may occur because of social desirability bias. Using computer mouse-tracking, we were interested in observing changes in cognition that are manifested in intentionality through action by evaluating underlying cognitive processes that drive social judgments of people who stutter.

Methods

Twenty-two women, 1 non-binary person, and 47 men reported using a computer mouse to complete an online, remote, and modified version of the POSHA-S. Responses were categorized as correct/helpful or incorrect/unhelpful relative to each component of the POSHA-S and were used as measures of explicit cognitive processes. Computer-mouse trajectory metrics, including area under the curve (AUC) and reaction time (RT), were used to measure implicit cognitive processes.

Results

Although participants’ explicit responses were significantly more likely to be correct/helpful than incorrect/unhelpful, with endorsement of correct/helpful prompts 77 % of the time, participants also endorsed incorrect/unhelpful prompts more than half (i.e., 52 %) of the time. Familiarity with people who stutter was associated with disagreeing with incorrect/unhelpful prompts. As indicated by greater AUC, participants exhibited significantly more implicit cognitive processes indicating competition when responding “disagree” compared to “agree”, regardless of whether the prompts were correct/helpful or incorrect/unhelpful. Similarly, participants took significantly longer to respond to prompts with "disagree" rather than "agree".

Conclusion

The findings of this study offer evidence of participants reporting cognitive processes that are overall more correct/helpful than incorrect/unhelpful, in their explicit responses to the dichotomous response tasks of the POSHA-S. However, these findings are tempered by evidence of a tendency to agree with statements in the measure and suggest the need for further research to increase understanding of how to measure and improve explicit and implicit cognitive processes related to people who stutter.

Purpose

Previous studies have suggested that allergies, asthma, and sleep problems are prevalent in those who stutter. This study analyzed similar data for a broad age group of adults who stutter (AWS).

Method

Data from the 2012 National Health Interview Survey were analyzed. Adults from 18 to 60 + years of age reported a) to have stuttered, b) to have had any allergy, asthma, or acid reflux, c) to have had insomnia/trouble sleeping and daytime negative consequences, and d) average sleeping hours per day in the past 12 months.

Results

The sample included 320 AWS and 33,043 controls. AWS were at greater odds of respiratory, food, and skin allergies (OR = 2.38, 2.36, and 2.09, respectively), as well as asthma and acid reflux (OR = 2.30 and 2.01, respectively) than controls. AWS were at greater odds of insomnia/trouble sleeping, oversleeping, excessive sleepiness, and fatigue than controls (OR = 2.11, 1.71, 2.67, and 1.81, respectively). The subgroup of AWS with no allergy, asthma, and acid reflux were also at greater odds of insomnia/trouble sleeping and excessive sleepiness than controls (OR = 2.13 and 3.11, respectively). Differences were found in specific age groups: younger/middle-aged AWS reported more allergies, asthma, and acid reflux than controls, while older AWS did not; younger/middle-aged AWS reported more insomnia/trouble sleeping than controls, while older AWS reported more oversleeping.

Conclusions

Findings on younger and middle-aged AWS are similar to previous ones on children and adolescents who stutter. Differences regarding younger/middle-aged and older AWS could be consequence of environmental variables.

Purpose

The purpose of this study was to investigate the emotional and stuttering experience of adults who stutter (AWS) in everyday life, and how that experience may be shaped by personal (i.e., trait social anxiety) and situational factors (i.e., social partner reaction, communication channel type, social closeness, stuttering knowledge).

Method

AWS completed ecological momentary assessments on their smartphones multiple times a day for up to three weeks. Data (n = 62) were analyzed with multilevel models to determine how situational factors and trait social anxiety influence the Negative Affect (NA), Positive Affect (PA), and self-reported stuttering severity of AWS.

Results

Results indicated that having high (vs. low) trait social anxiety was associated with a tendency to experience high NA, low PA, and high self-reported stuttering severity among AWS. A range of situational factors significantly influenced the within-person variation of NA, PA, and self-reported stuttering severity in everyday life. In addition, interacting with distant social partners relative to being alone heightened NA, and the effect was more prominent among AWS with high (vs. low) trait social anxiety.

Conclusions

Overall, the findings suggest that the variation of affects and stuttering severity among AWS can be partly accounted for by factors from both the situational and personal levels. Clinicians should be aware of the low PA experienced by AWS who have high (vs low) trait social anxiety in everyday life.

Background

The Overall Assessment of the Speaker’s Experience of Stuttering for Adults (OASES-A; Yaruss & Quesal, 2016) is a widely used measurement tool designed to evaluate the adverse impact associated with stuttering. Items examine general perceptions of stuttering, personal reactions to stuttering, functional communication difficulties, and consequences for quality of life. This paper presents a shortened research version of the OASES-A response form (OASES-A-R) that can be used by researchers in scientific studies involving adults who stutter that reflect the Section and Total Scores of the original OASES-A using fewer items.

Method

Previously collected OASES-A data (N = 315) were analyzed via graded response modeling to identify discrimination values of each OASES-A item in measuring each OASES-A Section Total Score. Items with the highest discrimination and items judged by expert clinicians to be more important in measuring adverse impact (N = 27) were used to create a shortened OASES-A-R. The shortened OASES-A-R response form was then validated and compared to the full OASES-A response form in an independent sample (N = 156).

Results

The shortened 25-item OASES-A-R response form demonstrated very high and positive correlations with the full OASES-A response form. Similarly, each OASES-A-R Section demonstrated high internal reliability coefficients similar to those of the OASES-A.

Discussion

The resulting 25-item OASES-A-R response form provides a reflection of the speaker’s experience of stuttering as measured by the original 100-item OASES-A that is suitable for use in certain research studies of adults who stutter. Clinical use is not recommended, as the full OASES-A provides additional insights about a client’s experience of stuttering that are necessary for effective treatment planning and intervention.

Stuttering poses challenges to social, occupational, and educational aspects of life. Traditional behavioral therapies can be helpful but effects are often limited. Pharmaceutical treatments have been explored but there are no FDA-approved treatments for stuttering. Interest has grown in the potential use of classic psychedelics, including psilocybin and LSD, which have shown effectiveness in treating disorders with similar symptoms (e.g., anxiety, depression, PTSD). The potential effects of psychedelics on stuttering have not been explored. We conducted a preliminary investigation of self-identified stutterers who report their experiences taking classic psychedelics on the online messaging forum, Reddit. We qualitatively analyzed 114 publicly available posts, extracting meaningful units and assigning descriptor codes inductively. We then deductively organized responses into an established framework of psychedelics which includes behavioral, emotional, cognitive, belief-based, and social effects. These effects were subsequently grouped under organizing themes (positive, negative, neutral). Descriptive statistics revealed that the majority of users (74.0%) reported positive overall short-term effects particularly related to behavioral and emotional change (e.g., reduced stuttering and anxiety), but negative (9.6%), mixed (positive and negative; 4.8%), and neutral overall experiences (11.6%) were also reported. The results support the possibility that psychedelics may impact stuttering, but caution must be applied in their interpretation given the entirely uncontrolled research setting and potential adverse health effects of psychedelics as reported elsewhere. While these results do not encourage the use of psychedelics by stutterers, they suggest that future work could examine the impact of psychedelics on stuttering under supervised and in clinically controlled settings.