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Purpose: The purpose of this study was to examine the impact of self-disclosure and strategies for communication competence on perceptual ratings and performance evaluations of undergraduate students who do and do not stutter by professors who require oral presentations. Method: Two hundred thirty-eight college instructors who require oral presentations in their classes participated in this study. Each participant viewed one video of six possible randomized conditions varying according to the presence and disclosure of stuttering (i.e., fluent, stuttering, stuttering + disclosure) and level of communication competence (i.e., high vs. low). Participants evaluated public speaking performance against a standardized rubric and rated the student along 16 personality traits. Results: Results of separate 2 × 3 analyses of variance revealed that professors perceived a student who disclosed stuttering, compared to the identical video without disclosure, more positively overall. Significant interactions between fluency (i.e., presence vs. absence of stuttering vs. disclosure of stuttering) and communication competence (i.e., high vs. low) were found for overall performance evaluation scores. The video during which the student disclosed stuttering and presented with low communication competence was given a higher score than the identical video without disclosure. Conclusions: Professors respond positively to both strategies for high communication competence and self-disclosure. High communication competence behaviors mitigate positive feedback bias. Disclosure results in improved positive perceptions across levels of communication competence. For students presenting with low communication competence, disclosure may improve evaluation of performance in oral presentations. The greatest perceptual and evaluative benefits were achieved with the combination of the two strategies.

Purpose:The purpose of this study was to examine the perceptual ratings and performance evaluations of students who do and do not stutter by professors who require oral presentations. Additionally, this study sought to investigate the influence of behaviors related to communication competence on perceptual and evaluative ratings.Method:One hundred fifty-eight college instructors who require oral presentations in their classes participated in this study. Participants viewed one video of four possible randomized conditions: (a) presence of stuttering + low communication competence, (b) absence of stuttering + low communication competence, (c) presence of stuttering + high communication competence, and (d) absence of stuttering + high communication competence. Participants evaluated student performance against a standardized rubric and rated the student along 16 personality traits.Results:Results of separate 2 × 2 analyses of variance revealed professors' view and evaluate students presenting with high communication competence more positively overall, regardless as to whether stuttering is present or not. Significant interactions between fluency (i.e., presence vs. absence of stuttering) and communication competence (i.e., high vs. low) were found for negative personality traits, as well as delivery evaluation scores. The video for which the student stuttered and presented with low communication competence was rated more positively than the video for which the student did not stutter and presented with low communication competence.Conclusions:Professors perceive and evaluate students who stutter differently from their nonstuttering peers, and those ratings are moderated by levels of communication competence. High-communication-competence behaviors improved perceptual and evaluation scores; however, in the presence of low-communication-competence behaviors, professors overcorrect in the form of positive feedback bias, which may have negative long-term academic consequences.

Purpose: Self-disclosure describes the act of revealing personal information to another person. To date, researchers in the area of stuttering have primarily demonstrated the utility of self-disclosure through analysis of listener perceptions. This study explores the utility of informative self-disclosure use from the perspectives of adults who stutter with experience using this strategy over time and across contexts. Method: Twelve adults who stutter discussed their self-disclosure experiences in semistructured interviews. Interview transcripts were analyzed using interpretative phenomenological analysis to produce themes reflecting the most salient aspects of self-disclosure experiences. Credibility was achieved through bracketing, investigator triangulation, and member checking. Results: Four superordinate themes reflecting experiences shared by all 12 participants were generated. Each superordinate theme contained two to three corresponding subthemes. The superordinate themes included cognitive relief, self-empowerment, social connection, and personalization. These findings reflect the positive impact of informative self-disclosure use on communication and quality of life. Conclusions: Adults who stutter perceive informative self-disclosure to be an effective strategy that provides various benefits to the speaker, in addition to facilitating positive listener perceptions. Clinicians should encourage clients to self-disclose in an informative and personalized manner, provide opportunities for practice, and support clients in determining when and where it is most beneficial for them to implement this strategy.

School-based guidelines often require that treatment focuses on minimizing or eliminating stuttered speech. The purpose of this study was to examine the benefits of explicit training in communication competencies to children who stutter without targeting stuttered speech. Thirty-seven children (ages 4–16) completed Camp Dream. Speak. Live., an intensive group treatment program which targets the psychosocial needs and communication of children who stutter. Outcome measures included the Overall Assessment of the Speaker's Experience of Stuttering (OASES), the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT), and the Patient Reported Measurement Information System (PROMIS) Pediatric Peer Relationships Short Form (PROMIS Peer Relationships) and Parent Proxy Peer Relationships Short Form (PROMIS Parent Proxy). Pre- and posttreatment public presentations were rated on nine core verbal and nonverbal communication competencies by a neutral observer. Similar to previous studies, participants demonstrated significant improvements in communication attitudes (OASES) and perceived ability to establish peer relationships (PROMIS Peer Relationships), particularly school-aged participants (ages 7–16). Participants also demonstrated significant improvement in eight of the nine communication competencies. Findings suggest that, in addition to the psychosocial gains of programs such as Camp Dream. Speak. Live., children who stutter benefit from explicit training in communication skills, and these gains are not dependent on the presence of stuttered speech.

Purpose: Research suggests that self-disclosure can improve listeners' perceptions of stuttering; however, it is unknown whether the effectiveness of self-disclosure transcends culture and language. This study examined the clinical utility of self-disclosure in a culturally and linguistically diverse population: Hebrew-speaking people who stutter in Israel.Method: The experimental protocol replicated Byrd, Croft et al. Participants (N = 92 adults in Israel) viewed a video of either a male or female Hebrew-speaking person who simulated stuttering and self-disclosed informatively, apologetically, or not at all. Participants then rated the speaker on ten traits (i.e. friendly, outgoing, intelligent, confident, engaging, distracting, unfriendly, shy, unintelligent, insecure) using a bipolar likert scale.Result: Results indicated that participants rated the speaker who self-disclosed in a neutral and informative manner as significantly more outgoing compared to the speaker who did not self-disclose at all, supporting the results from Byrd, Croft et al. Additionally, the male speaker was rated as significantly more friendly and outgoing than the female speaker.Conclusion: This study suggests that self-disclosing in a neutral and informative manner can improve listeners' perceptions of people who stutter similarly across culture and language.

Speech-language pathologists can identify stuttering in multiple languages,even if they do not speak the language. However, due to differences in languagedevelopment, multilingual speakers have been documented with higherlevels of typical disfluencies in their speech than monolingual speakers. Thesehigher levels of disfluency put multilingual speakers at greater risk of misdiagnosis as individuals who stutter, due to poor understanding of the nature of the manifestation of stuttering in two or more languages and reliance on monolingual-English diagnostic criteria. The purpose of the present systematic review is to explore how stuttering is identified in multilingual speakers who are described as participants who stutter, and whether monolingual English-speaking guidelines were the most commonly used reference for determining the presence of stuttering.

Purpose Given the marked increase in evidence-based information regarding the nature/treatment of stuttering, coupled with the fact that pediatricians tend to be one of the initial points of contact for parents who suspect their preschool-age child may stutter, this study explored pediatricians' (a) accuracy in identifying children who may stutter and (b) likelihood of referring children who present with a profile indicative of stuttering to speech-language pathologists. Method Pediatricians recruited nationally through professional organizations completed a 5- to 7-min online survey that probed stuttering identification and referral practices via responses to experimental case vignettes. Each vignette featured a 4-year-old boy with a family history of stuttering whose mother reported signs of stuttering and manipulation of two factors: stuttering during the pediatrician visit (or not) and negative communication attitude (or not). Results Our findings suggest pediatricians' identification and referral of children who may stutter is largely prompted by observation of overt speech behaviors and/or negative communication attitude. Participants' gender, years in practice, and experience working with children who stutter did not influence likelihood of referral. Conclusions Results indicate pediatricians are less likely to implement a “wait and see” approach with young children who stutter today than in the past. Unlike other common child onset diagnoses, however, parent report of atypical behavior does not yield pediatrician referral to a specialist. Future education and advocacy efforts directed toward pediatricians should emphasize inclusion of factors other than direct observation of stuttering behavior that may warrant referral (e.g., parent report).

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 The purpose of this study is to examine the frequency and type of speech disfluencies (stuttering-like and nonstuttering-like) in bilingual Spanish–English (SE) children who stutter (CWS) to SE children who do not stutter (CWNS) during narrative samples elicited in Spanish and English to provide further diagnostic information for this population and preliminary data toward an expansion of this study. Method Participants included six bilingual SE children (three CWS, three CWNS) ranging in age from 5 years to 7;5 (years;months) and recruited from the surrounding Houston, Texas area. Participants provided a narrative sample in English and Spanish. The frequency of speech disfluencies was tabulated, and mean length of utterance was measured for each sample. Results Results indicate that both talker groups exceed the diagnostic criteria typically used for developmental stuttering. Regardless of the language being spoken, CWS participants had a frequency of stuttering-like speech disfluencies that met or exceeded the diagnostic criteria for developmental stuttering that is based on monolingual English speakers. The CWNS participants varied in meeting the criteria depending on the language being spoken, with one of the three CWNS exceeding the criteria in both languages and one exceeding the criteria for percentage of stuttering-like speech disfluencies in one language. Conclusion Findings from this study contribute to the development of more appropriate diagnostic criteria for bilingual SE-speaking children to aid in the reduction of misdiagnoses of stuttering in this population.

PURPOSE: The primary purpose of this preliminary study was to explore whether a clinician’s use of active listening skills (i.e., client-directed eye gaze and paraphrasing) influenced parents’ perceptions of clinical empathy in a stuttering assessment. A secondary purpose was to determine whether parent age, education, or parent concern predicted perceived clinical empathy. METHOD: Participants (n = 51 parents/guardians of children who stutter) watched two counter-balanced videos of a clinician demonstrating either high or low frequency use of active listening skills during the clinician’s initial assessment with a standardized patient actor portraying a parent of a child who stutters. After each video, parents rated the clinician’s empathy and active listening skills via the Jefferson Scale of Physician Empathy for Observers (JSPEO; Hojat et al., 2017) and the Counselor Activity Self-Efficacy Scales - Modified (Victorino & Hinkle, 2018). Participants then completed a demographic questionnaire and rated their concern about their child’s stuttering. RESULTS: Paired t-tests demonstrated significantly higher ratings of perceived clinical empathy in the high frequency active listening condition compared to the low frequency condition (d = 0.548). Simple linear regression analyses indicated parent age or level of education did not predict perceived clinical empathy. An independent samples t-test indicated that parent concern about stuttering did not predict perceived clinical empathy. CONCLUSIONS: Preliminary findings suggest that the clinician was viewed as significantly more understanding, concerned, and caring (i.e., perceived as empathic) when active listening skills were used. Parents’ ratings of empathy on the JSPEO, based on high levels of active listening by the clinician, were not associated with parents’ ages, education levels, or concern about their children’s stuttering. This may reflect the value of active listening in clinical relationships regardless of variables specific to the recipient (e.g., parent of a child who stutters). Given that parents are more apt to share thoughts and emotions about their child’s communication with clinicians who demonstrate empathic qualities, this preliminary study suggests that the use of active listening skills warrant emphasis in clinical training.

BACKGROUND: Microaggressions are subtle insults, invalidations, or slights that target people due to their association with a marginalized group. Microaggressive experiences have been shown to degrade quality of life and corroborate negative stereotypes towards persons with disabilities. To date, minimal research has been dedicated to exploring microaggressions within adults who stutter. METHODS: Seven adults who stutter participated in semi-structured focus group interviews similar to Keller and Galgay’s (2010) qualitative investigation of microaggressions experienced by adults with a disability. Group interviews were transcribed and analyzed using QSR NVivo software to develop themes and subthemes. RESULTS: Eight major themes were identified within two supraordinate themes: Microaggressive Behavior (patronization, second-class status, perceived helplessness, workplace microaggression, clinical microaggression, denial of privacy) and Perception of Microaggressive Behavior (exoneration of listener, no or minimal microaggressive experience). Although patronization, second-class status, and helplessness were mentioned frequently by multiple participants, exoneration of the listener was the most frequently recurring theme. DISCUSSION: Based on these preliminary focus group interviews, stuttering-based microaggressions broadly resemble ableist microaggressions reported by Keller and Galgay (2010). Interviewees also expressed a reluctance to identify slights related to stuttering as microaggression and often characterized these incidents as unavoidable.

Purpose: During the 2019 Fourth Croatia Clinical Symposium, speech-language pathologists (SLPs), scholars, and researchers from 29 countries discussed speech-language pathology and psychological practices for the management of early and persistent stuttering. This paper documents what those at the Symposium considered to be the key contemporary clinical issues for early and persistent stuttering. Methods: The authors prepared a written record of the discussion of Symposium topics, taking care to ensure that the content of the Symposium was faithfully reproduced in written form. Results: Seven contemporary issues for our field emerged from the Symposium. Conclusion: Effective early intervention is fundamental to proper health care for the disorder. However, as yet, there is no consensus about the timing of early intervention and how it should be managed. Currently, clinical translation is a barrier to evidence-based practice with early stuttering, and proactive strategies were suggested for junior SLPs. Apprehension emerged among some discussants that treatment of early stuttering may cause anxiety. For persistent stuttering, assessment procedures were recommended, as were strategies for dealing with childhood bullying. There was agreement that SLPs are the ideal professionals to provide basic cognitive-behavior therapy for clients with persistent stuttering. Questions were raised about our discipline standards for basic professional preparation programs for stuttering management.

Purpose Although preschool-age children who stutter report more negative attitudes toward communication than their typically fluent peers, few investigations have explored factors that may contribute to the differences observed in communication attitude. The purpose of the present study was to explore whether behavioral characteristics of stuttering severity (frequency, duration, physical concomitants) and time since onset of stuttering predict communication attitude in preschool-age children. Method Fifty-nine preschool-aged children who stutter completed two speaking samples and the KiddyCAT, a self-report assessment of communication attitude. Speech samples were analyzed for stuttering frequency (measured by percentage of stuttered syllables), duration, and presence of physical concomitants. Linear regression models were used to assess if these behavioral measures of stuttering and time since onset of stuttering predicted self-reported communication attitude. Results Results indicate stuttering behavioral measures and time since onset do not predict KiddyCAT scores of preschool-age children who stutter. Conclusions Preliminary data suggest children who have presented with stuttering for a longer period of time are no more likely to report a negative communication attitude than children who have a shorter time since onset. Additionally, in contrast to school-age children who stutter, but similar to adults and adolescents who stutter, communication attitude is not linearly related to stuttering severity in preschool-age children.

Purpose The purpose of this study was to investigate working memory in adults who do (AWS) and do not (AWNS) stutter using a visual N-back task. Processes involved in an N-back task include encoding, storing, rehearsing, inhibition, temporal ordering, and matching. Methods Fifteen AWS (11 males, 4 females; M = 23.27 years, SD = 5.68 years) and 15 AWNS (M = 23.47 years, SD = 6.21 years) were asked to monitor series of images and respond by pressing a “yes” button if the image they viewed was the same as the image one, two, or three trials back. Stimuli included images with phonologically similar (i.e., phonological condition) or phonologically dissimilar (i.e., neutral condition) names. Accuracy and manual reaction time (mRT) were analyzed. Results No difference was found between AWS and AWNS in accuracy. Furthermore, both groups were more accurate and significantly faster in 1- followed by 2- followed by 3-back trials. Finally, AWNS demonstrated faster mRT in the phonological compared to neutral condition, whereas AWS did not. Conclusion Results from this study suggest different processing mechanisms between AWS and AWNS for visually presented phonologically similar stimuli. Specifically, a phonological priming effect occurred in AWNS but not in AWS, potentially due to reduced spreading activation and organization in the mental lexicon of AWS. However, the lack of differences between AWS and AWNS across all N-back levels does not support deficits in AWS in aspects of working memory targeted through a visual N-back task; but, these results are preliminary and additional research is warranted.

Purpose The purpose of this study was to investigate executive control in adults who stutter (AWS) and adults who do not stutter (AWNS) via a nonspeech paradigm, wherein eye movements were monitored (i.e., antisaccade task). Processes involved in an antisaccade task include working memory, attention, and voluntary motor control, but the task primarily provides insight into inhibitory control. Method Seventeen AWS (14 men, three women; M = 23.41 years) and 17 AWNS ( M = 23.29 years) were presented with a combination of prosaccade (i.e., looking toward a target) and antisaccade (i.e., suppress a reflexive saccade toward the target and look in the opposite direction) trials. The distance of the target from the center of the screen was also manipulated (i.e., 5.5 o = short distance and 10.8 o = long distance). Data for accuracy and reaction time of the first accurate saccade were collected and analyzed. Results No difference was found between AWS and AWNS in accuracy or in reaction time. Both groups were more accurate in the prosaccade than the antisaccade trials and in the long compared to the short distance trials. Furthermore, both groups demonstrated longer saccade latencies for long compared to short distances and for antisaccade compared to prosaccade trials. Conclusions Preliminary results do not support deficits in inhibition in AWS during a motorically simple, non–speech-related oculomotor task, but additional research is warranted.

Purpose Previous literature has documented that college professors view hypothetical students who stutter more negatively than their fluent peers. The purpose of the present study was to investigate whether individuals who stutter report they experience more negative perceptions in the college classroom, and the impact of those perceptions on their comfort approaching professors. Methods Two hundred forty-six adults who do and do not stutter, matched for age, participated in this study. Participants were presented with 16 positive and negative personality traits and asked to rate how strongly they believed their professor viewed them along each trait. All participants were asked whether they felt comfortable approaching their professors to discuss their performance. Adults who stutter were asked additional questions to investigate their college experience more comprehensively. Results Adults who stutter reported they experienced significantly more negative perceptions from their professors than adults who do not stutter, and were significantly less likely to feel comfortable approaching their professors. These reported negative perceptions, specifically being perceived as less self-assured, predicted comfort approaching professors to receive performance feedback for adults who stutter. Finally, amongst adults who stutter, perception of how they were evaluated compared to their peers was significantly related to comfort approaching professors. Conclusions Results support that the negative perceptions towards hypothetical students who stutter reported in previous literature are experienced by individuals who stutter, and that these perceptions drive comfort approaching professors for performative feedback. Results suggest professors may increase students’ comfort by clearly outlining equality in evaluation procedures.

The purpose of this follow-up study was to explore the effectiveness of an intensive treatment program—Camp Dream. Speak. Live.—within older, school-age children who stutter. Twenty-three school-age children who stutter (age range: 7–14 years) attended this week-long intensive therapy program for the first time. Outcome measures included Overall Assessment of the Speaker's Experience of Stuttering and the Patient Reported Outcomes Measurement Information System Pediatric Peer Relationships Form. Findings demonstrate significant improvements in quality of life and communication attitudes can be achieved in a short period of time when increasing fluency is not a target.

Clinicians commonly report difficulty determining whether the disfluencies produced by their clients are indicative of stuttering or suggestive of something else, such as cluttering, autism, language impairment, or second language learning. In our clinical decision-making process, we identify features unique to specific speech and/or language disorders. This identification enables differential diagnosis in most cases. But what happens when features appear to overlap and, as a result, compromise our clinical decision making? This article provides information to assist in the differential diagnosis of stuttering, particularly as it pertains to the assessment of children who speak more than one language. It explores similarities in the speech behaviors produced by these speakers, contrasting them with stuttering behaviors in monolingual English speakers.

Non-word repetition is weaker for adults who stutter (AWS) compared to adults who do not stutter (AWNS) as phonological demands increase. However, non-word stimuli used in previous studies varied by length, but did not vary with regard to segmental or metrical complexity. The purpose of the present study was to examine the unique influence of these two distinct types of complexity on non-word repetition in AWS and AWNS via administration of the Test of Phonological Structure (TOPhS). Twenty-four adults (12 AWNS, 12 AWS) repeated 96 non-words within a soundproof booth immediately after auditory presentation. All 96 non-word targets included on the TOPhS were one to four syllables in length and ranked based on segmental complexity (simple, moderate and complex) and metrical complexity (simple, moderate and complex). No main effect of metrical complexity was detected between groups, and no differences in accuracy were observed for non-words with simple or moderate segmental complexity. However, AWS were significantly more likely to produce a phonemic error when repeating words with complex segmental structure than AWNS, irrespective of metrical complexity. Segmental complexity may contribute to the differences in phonological working memory in AWS when controlling for metrical complexity and length.

Previous research employed silent phoneme monitoring tasks to examine differences in phonological encoding in adults who stutter (AWS) compared to adults who do not stutter (AWNS). The primary purp...

Purpose Adults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter. Methods Twenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale ( Richmond & McCroskey, 1997 ). All participants who stutter completed the Overall Assessment of the Speaker’s Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006 ) and speaking samples to measure stuttering frequency. Results Adults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores. Discussion This is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.

Purpose The purpose of this study was to examine the influence of self-disclosure on observers' perceptions of persons who stutter. Method Participants ( N = 173) were randomly assigned to view 2 of 4 possible videos (i.e., male self-disclosure, male no self-disclosure, female self-disclosure, and female no self-disclosure). After viewing both videos, participants completed a survey assessing their perceptions of the speakers. Results Controlling for observer and speaker gender, listeners were more likely to select speakers who self-disclosed their stuttering as more friendly, outgoing, and confident compared with speakers who did not self-disclose. Observers were more likely to select speakers who did not self-disclose as unfriendly and shy compared with speakers who used a self-disclosure statement. Controlling for self-disclosure and observer gender, observers were less likely to choose the female speaker as friendlier, outgoing, and confident compared with the male speaker. Observers also were more likely to select the female speaker as unfriendly, shy, unintelligent, and insecure compared with the male speaker and were more likely to report that they were more distracted when viewing the videos. Conclusion Results lend support to the effectiveness of self-disclosure as a technique that persons who stutter can use to positively influence the perceptions of listeners.

In this study, we investigated the frequency and types of stuttering-like (SLD) and other (OD) disfluencies in 59 typically developing bilingual Yiddish-Dutch (YD) speaking children. Participants were divided in two age categories: 6.01-7.07 and 9.00-10.04-year-olds. All children (1) were successive, bilingual YD speaking, (2) had Yiddish as their dominant language and (3) were sufficiently intelligible in both languages. A conversation sample of at least 300 syllables was collected in each of the two languages. The main findings in this study were (a) the total amount of SLD as well as OD were significantly higher in the non-dominant language. For the SLD, this was mainly caused by the higher frequency of monosyllabic word and syllable repetitions. For the OD, almost all disfluency types seem to have contributed to this. (b) The total amount of OD was significantly higher in the older group of bilingual YD children than in the younger group. This was primarily due to higher frequencies of phrase repetitions, lexical revisions and unfinished words. (c) The monolingual diagnostic guideline of three SLD per 100 words as a means to label stuttering cannot be used in this bilingual population. The majority of the non-stuttering children scored higher than the standard 3% SLD in both languages. In the dominant Yiddish language, 27 children (46%) scored above this percentage, in the non-dominant Dutch language, 46 children (78%).We conclude that bilingual YD-speaking children have a higher frequency of speech disfluencies in comparison to monolingual children. Consequently, monolingual stuttering guidelines cannot be used in this bilingual population.

Purpose The purpose of the present study is to examine whether the academic, clinical, and fluency-related student experiences of professionals who self-identify as having specialized knowledge of fluency disorders differ from those who do not. Method An online survey was developed to identify the academic, clinical, and specific fluency-related experiences professionals had when they were undergraduate and graduate students. The survey was completed by 219 professionals within the field of speech-language pathology (122 self-identified specialists, 97 self-identified non-specialists). Results Considerable overlap was observed in training experiences of self-identified specialists and non-specialists. However, Chi-square analyses revealed a significantly greater proportion of self-identified specialists reported (a) completion of a dedicated course in fluency disorders during undergraduate and graduate curriculum, (b) interaction with five or more fluency clients during clinical practicum, and (c) exposure to specific fluency-related activities such as voluntary stuttering and attendance at a fluency-related support group. Conclusions Findings suggest that despite the degree of overlap between self-identified specialists' and non-specialists' pre-professional training, the quantity and quality of certain experiences may influence future decisions to focus more exclusively on working with persons who stutter.

Stuttering therapy for children, both preschool and school-age, has been offered in a variety of settings and formats, for example in schools, university clinics, outpatient clinics, and private practices. Therapy itself is offered either in a group setting or a one-to-one basis in many of these settings. In recent years, there has been an increase in specialized camps (generally offered in the summer) for children who stutter. Camps for children who stutter vary in duration and offer a combination of group and individual therapy in addition to activities designed to address the affective and cognitive aspects of stuttering and increase overall communicative effectiveness. This paper provides an overview and description of five such camps for children who stutter to help spread awareness and familiarize the listener with the role camps play in helping children who stutter. Preliminary outcome data on the various goals targeted within some of the camps is included; however, that is not the purpose of this paper.

Purpose Best practice for developmental stuttering remains a topic of debate. In the clinical forum following this introduction, four fluency experts balance the evidence and expertise to describe their approach to assessment and treatment.

Purpose We investigated whether outcomes of therapy for persistent developmental stuttering differ in individuals who carry a mutation in one of the known genes associated with stuttering compared to individuals without such mutations. Method We studied outcomes of an intensive fluency shaping-based therapy program in individuals with persistent developmental stuttering. We evaluated a cohort of 51 stuttering individuals with who carried a mutation in either the GNPTAB, GNPTG, NAGPA, or AP4E1 gene. We compared therapy outcomes in these individuals with outcomes in 51 individuals matched for age, gender, and ethnicity, who stutter and underwent the same therapy program, and did not carry a mutation in any of these genes. Fluency pre- and post-therapy was evaluated using blinded observer-based quantitative stuttering dysfluency measures (Dysfluent Words Score, DWS), and by subjects’ self-reported measures of struggle, avoidance and expectancy behavior associated with speaking (Perceptions of Stuttering Inventory, PSI). The difference between pre- and post-therapy fluency scores was taken as the measure of near-term therapy efficacy. Results Comparison of fluency measures showed a strong effect of therapy overall. Mutation carriers achieved significantly less resolution in PSI following therapy, with PSI scores showing significantly less improvement in individuals who carry a mutation (p = 0.0157, RR = 1.75, OR = 2.92) while the group difference in DWS between carriers and non-carriers was statistically not significant in the present study, the trend observed in the results warrants further research focused on this important issue. Conclusions These results suggest stuttering is more resistant to therapy in individuals who carry a mutation in one of the genes known to be associated with stuttering.

Purpose The purpose of this study was to explore metrical aspects of phonological encoding (i.e., stress and syllable boundary assignment) in adults who do and do not stutter (AWS and AWNS, respectively). Method Participants monitored nonwords for target sounds during silent phoneme monitoring tasks across two distinct experiments. For Experiment 1, the 22 participants (11 AWNS, 11 AWS) silently monitored target phonemes in nonwords with initial stress. For Experiment 2, an additional cohort of 22 participants (11 AWNS, 11 AWS) silently monitored phonemes in nonwords with noninitial stress. Results In Experiment 1, AWNS and AWS silently monitored target phonemes in initial stress stimuli with similar speed and accuracy. In Experiment 2, AWS demonstrated a within-group effect that was not present for AWNS. They required additional time when monitoring phonemes immediately following syllable boundary assignment in stimuli with noninitial stress. There was also a between-groups effect, with AWS exhibiting significantly greater errors identifying phonemes in nonwords with noninitial stress than AWNS. Conclusions Findings suggest metrical properties may affect the time course of phonological encoding in AWS in a manner distinct from AWNS. Specifically, in the absence of initial stress, metrical encoding of the syllable boundary may delay speech planning in AWS and contribute to breakdowns in fluent speech production.

Purpose The purpose of the present study was to enhance our understanding of phonological working memory in adults who stutter through the comparison of nonvocal versus vocal nonword repetition and phoneme elision task performance differences. Method For the vocal nonword repetition condition, participants repeated sets of 4- and 7-syllable nonwords ( n = 12 per set). For the nonvocal nonword repetition condition, participants silently identified each target nonword from a subsequent set of three nonwords. For the vocal phoneme elision condition, participants repeated nonwords with a target phoneme eliminated. For the nonvocal phoneme elision condition, participants silently identified the nonword with the designated target phoneme eliminated from a subsequent set of three nonwords. Results Adults who stutter produced significantly fewer accurate initial productions of 7-syllable nonwords compared to adults who do not stutter. There were no talker group differences for the silent identification of nonwords, but both talker groups required significantly more mean number of attempts to accurately silently identify 7-syllable as compared to 4-syllable nonwords. For the vocal phoneme elision condition, adults who stutter were significantly less accurate than adults who do not stutter in their initial production and required a significantly higher mean number of attempts to accurately produce 7-syllable nonwords with a phoneme eliminated. This talker group difference was also significant for the nonvocal phoneme elision condition for both 4- and 7-syllable nonwords. Conclusion Present findings suggest phonological working memory may contribute to the difficulties persons who stutter have establishing and/or maintaining fluent speech. Educational Objectives : (a) Readers can describe the role of phonological working memory in planning for and execution of speech; (b) readers can describe two experimental tasks for exploring the phonological working memory: nonword repetition and phoneme elision; (c) readers can describe how the nonword repetition and phoneme elision skills of adults who stutter differ from their typically fluent peers.

Background/Aims: Previous studies employing a variety of tasks have demonstrated that adults who stutter (AWS) pre­sent with phonological encoding differences compared to adults who do not stutter (AWNS). The present study examined whether atypical preverbal monitoring also influenced AWS performance during one such paradigm – the silent phoneme monitoring task. Specifically, we investigated whether monitoring latencies for AWS were accelerated after the word’s uniqueness point – the phoneme that isolates the word from all lexical competitors – as observed for AWNS when monitoring internal and external speech. Methods: Twenty adults (10 AWS, 10 AWNS) completed a silent phoneme monitoring task using stimuli which contained either (a) early uniqueness points (EUP), (b) late uniqueness points, or (c) no uniqueness point (NUP). Response latency when identifying word-final phonemes was measured. Results: AWNS exhibited the expected uniqueness point effect when monitoring internal speech; word-final phonemes were accessed more rapidly for words with EUP than NUP. In contrast, AWS did not differ in the phoneme monitoring speed. That is, AWS did not exhibit the expected uniqueness point effects. Conclusion: Findings suggest that inefficient or atypical preverbal monitoring may be present in AWS and support theories that implicate the internal speech monitor as an area of deficit.

Evidence suggests young monolingual children who stutter (CWS) are more disfluent on function than content words, particularly when produced in the initial utterance position. The purpose of the present preliminary study was to investigate whether young bilingual CWS present with this same pattern. The narrative and conversational samples of four bilingual Spanish- and English-speaking CWS were analysed. All four bilingual participants produced significantly more stuttering on function words compared to content words, irrespective of their position in the utterance, in their Spanish narrative and conversational speech samples. Three of the four participants also demonstrated more stuttering on function compared to content words in their narrative speech samples in English, but only one participant produced more stuttering on function than content words in her English conversational sample. These preliminary findings are discussed relative to linguistic planning and language proficiency and their potential contribution to stuttered speech.

Purpose : The purpose of the present study was twofold: (a) to investigate whether the demographic characteristics of the male-to-female transgender person have changed over the past 2 decades given the increased awareness and tolerance of transgender persons in today's society and (b) to determine if there are additional characteristics that may be unique to the transgender clinical profile of today. Method: A 28-question survey (N = 77 respondents in final data corpus) that was developed to address the authors' research questions was distributed via e-mail to various listservs and organizations for trans- gender persons. Results: Male-to-female persons of today, at least in terms of basic demographics, are markedly similar to the profile described almost 2 decades ago relative T

Research has demonstrated children who stutter score significantly lower than children who do not stutter on the Purdue Pegboard Test. Past data also suggest performance on this task may be associated with stuttering frequency (Choo et al., 2016; Mohammadi et al., 2016). The purpose of this study was to explore whether these performance differences and the relationship to stuttering frequency are present in adults who stutter (AWS). Forty-eight participants (AWS = 24, and AWNS = 24) matched for age, gender, education, and handedness completed all four tasks of the Purdue Pegboard Test. There were no significant between group differences and stuttering frequency did not predict performance. These findings suggest previous differences may only be applicable to subgroups and/or that, with development, the manual tasks unique to the Purdue Pegboard Test may not be sensitive enough to reveal differences.

Nonword repetition and phoneme elision represent the combined influence of several speech and language processes. In the present study we investigated nonword repetition and phoneme elision performance in schoolage children who stutter (CWS) and children who do not stutter (CNS). Participants were 14 CWS (mean = 11.7 years, SD = 2.1 years) and age- and sex-matched CNS (mean = 11.8 years, SD = 2.0 years). Each talker group was further subdivided into two age groups: younger (N = 7; 8‐11.5 years) and older (N = 7; 11.6‐15 years). Repeated-measures analyses were conducted on the accuracy and response time (in seconds) data. In nonword repetition, the CWS showed a trend for lower per cent of correct phonemes at the two-syllable level compared with the CNS. In phoneme elision, the younger CWS showed a significantly lower accuracy rate than the older CWS at the two- and three-syllable nonword lengths, while similar differences were not evident between the younger versus older CNS at any of the nonword lengths. No accuracy difference in phoneme elision was noted between the two talker groups. Group differences in speech initiation times were also not evident in either of the tasks. Findings from nonword repetition offer tentative support for difficulties experienced by school-age CWS in phonemic encoding/working memory abilities. Findings from the phoneme elision task suggest a complex pattern of age-dependent performance by the CWS. Comparison of response accuracy and speech initiation times in both the tasks failed to show speed‐accuracy trade-off strategies in either of the groups.

The present study investigated segmentation and rhyme abilities, skills critical for phonological encoding, of children who stutter (CWS) and those who do not (CNS). Participants were 9 CWS (8 males and 1 female, mean age = 11.1, SD = 2.31) in the age range of 7 and 13 years and 9 age and sex matched CNS (mean age = 11.2, SD = 2.19). Participants performed two verbal monitoring tasks, phoneme and rhyme monitoring, in silent naming. Performances in the verbal monitoring tasks were compared to a neutral, nonverbal tone monitoring task. Additionally, the complexity of the phoneme monitoring task was varied such that participants had to monitor for singletons vs. consonant clusters. Repeated measures analysis of the response time data did not reveal significant differences between the groups in the three monitoring tasks. Analysis of the complexity data revealed a trend for slower monitoring of the consonant clusters in the CWS group compared to the CNS. Present findings do not support a deficit in segmentation and rhyme abilities in CWS, although there was some preliminary evidence of segmentation difficulties with increasing phonological complexity of the stimuli. Educational objectives: At the end of this activity the reader will be able to: (a) discuss the literature on phonological encoding skills in children who stutter, (b) describe skills underlying the phonological encoding process, (c) summarize whether or not children who stutter differ from those who do not in segmentation and rhyme abilities, (d) suggest future areas of research in the investigation of segmentation and rhyme monitoring abilities in children who stutter.

Purpose The purpose of this review was to examine the descriptions of multilingual participants provided in stuttering literature to determine how frequently and consistently relevant factors of language profile are reported. Method We conducted a systematic search of published studies that included multilingual participants who stutter and reviewed the level of detail provided regarding language history, function, proficiency, stability, mode, accent, covert speech, and affective factors. Results Twenty-three studies qualified to be included in the systematic review, consisting of 342 different multilingual stuttering participants. Of these 23 studies, the most frequently reported information included language proficiency (70%), history (56%), and function (43%). The specificity of the information used to define these factors was inconsistent. Affect was mentioned in 22% of studies, and language stability, mode, and accent information was included in less than 10% of the studies. Conclusions Results demonstrate that description of multilingual stuttering participants is inadequate and inconsistent. A recommended framework is provided for future studies to facilitate cross-study comparisons and enhance our ability to interpret the manifestation of stuttering in multilingual participants. Educational objectives: The reader will be able to: (a) summarize the current validity of cross-study comparisons in available research of multilingual participants who stutter; (b) describe the range of language factors to be included when providing descriptions of multilingual participants who stutter; (c) discuss the importance of consistency when describing language profiles of multilingual research participants.

Purpose Adults who stutter (AWS) are less accurate in their immediate repetition of novel phonological sequences compared to adults who do not stutter (AWNS). The present study examined whether manipulation of the following two aspects of traditional nonword repetition tasks unmask distinct weaknesses in phonological working memory in AWS: (1) presentation of stimuli with less-frequent stress patterns, and (2) removal of auditory-orthographic cues immediately prior to response. Method Fifty-two participants (26 AWS, 26 AWNS) produced 12 bisyllabic nonwords in the presence of corresponding auditory-orthographic cues (i.e., immediate repetition task), and the absence of auditory-orthographic cues (i.e., short-term recall task). Half of each cohort (13 AWS, 13 AWNS) were exposed to the stimuli with high-frequency trochaic stress, and half (13 AWS, 13 AWNS) were exposed to identical stimuli with lower-frequency iambic stress. Results No differences in immediate repetition accuracy for trochaic or iambic nonwords were observed for either group. However, AWS were less accurate when recalling iambic nonwords than trochaic nonwords in the absence of auditory-orthographic cues. Conclusions Manipulation of two factors which may minimize phonological demand during standard nonword repetition tasks increased the number of errors in AWS compared to AWNS. These findings suggest greater vulnerability in phonological working memory in AWS, even when producing nonwords as short as two syllables.

Purpose The purpose of this study was to investigate the influence of phonetic complexity as measured by the Word Complexity Measure (WCM) on the speed of single-word production in adults who do (AWS, n = 15) and do not stutter (AWNS, n = 15). Method Participants were required to name pictures of high versus low phonetic complexity and balanced for lexical properties. Speech reaction time was recorded from initial presentation of the picture to verbal response of participant for each word type. Accuracy and fluency were manually coded for each production. Results AWS named pictures significantly slower than AWNS, but there were no significant differences observed in response latency when producing word of high versus low phonetic complexity as measured by the WCM. Conclusion Findings corroborate past research of overall slowed picture naming latencies in AWS, compared to AWNS. Findings conflict with data that suggest that the phonetic complexity of words uniquely compromises the speed of production in AWS. The potential interaction between lexical and phonetic factors on single-word production within each group are discussed.

When the challenges of providing speech-language pathology services in school settings intersect with the complexities of meeting the unique needs of students who stutter, clinicians may encounter a variety of ethical issues. This article explores some of the ethical challenges of treating stuttering in school settings by discussing three clinical scenarios. Seedhouse's Ethics Grid is provided as a scaffold to support the critical analysis of school-based stuttering treatment issues. Factors examined include creating and respecting autonomy, serving student needs, doing good and minimizing risks, and telling the truth and keeping promises. In addition, clinical outcomes are considered in terms of their impact on students and family members, clinicians, students with communication disorders other than stuttering, and school personnel. Finally, some of the practical concerns when treating stuttering in school settings are discussed, including the law, codes of practice, wishes of others, as well as the effectiveness and efficiency of actions.

This article analysed the acoustic structure of voiced stop + vowel sequences in a group of persons who stutter (PWS). This phonetic unit was chosen because successful production is highly dependent on the differential tweaking of right-to-left anticipatory coarticulation as a function of stop place. Thus, essential elements of both speech motor planning and execution can be parsimoniously assessed. Five adult PWS read three passages 3 times in a randomised order. These passages contained an overabundance of words beginning with initial [bV], [dV] and [gV] sequences. Digital audio and visual recordings were analysed to first identify fluent and stuttered target words, which were then spectrally analysed to yield locus equation (LE) regression plots. The slope of the LE regression function directly indexes the coarticulatory extent of the vowel's influence on the preceding stop consonant. The PWS revealed LE parameters falling within the normal ranges based on previously documented data obtained from fluent speakers. Theoretical considerations of possible underlying factors responsible for stuttering disfluencies are discussed relevant to these findings.

Researchers have suggested that being bilingual may increase the likelihood of development of stuttering. This suggestion was recently discounted by the data that indicate bilingual children who do not stutter produce an atypically high number of speech disfluencies. Thus, bilingual children are not at increased risk for development of stuttering, but they do appear to be at increased risk for false positive diagnosis of stuttering. This risk may be further increased by persisting public misperception that being bilingual increases the likelihood that the child will develop stuttering. The present study explored whether speech-language pathologists (SLPs) inaccurately classify bilingualism as a risk factor for the onset and persistence of stuttering and what factors uniquely influence their perception of bilingualism as a risk factor. Participants included 207 speech-language pathologists recruited through the American Speech-Language Hearing Association Membership Directory. Participants completed web-based surveys addressing their generalized knowledge of perceived risk factors associated with stuttering including bilingualism. Preliminary results indicate that some, but not all speech-language pathologists view bilingualism as a risk factor. Results further indicate that clinical experiences and personal perspectives significantly contribute to this misperception.

Purpose: The purpose of this study was to investigate whether school-age observer perceptions of children who stutter varied based upon the presence or absence of a self-disclosure statement. The secondary purpose was to determine if school-age observer perceptions were susceptible to the same gender bias observed in adult males versus females who stutter. Method: Observers (N=130) were randomly assigned to view two of four possible videos (i.e., male selfdisclosure, male no self-disclosure, female self-disclosure, and female no self-disclosure). Immediately after viewing both videos, observers completed a survey assessing their perceptions of the speakers. Results: Observers were significantly more likely to select self-disclosure videos as more friendly and they reported being less distracted when they were viewing videos in which the speakers self-disclosed, when controlling for observer and speaker gender. Additionally, when controlling for self-disclosure and observer gender, observers were more likely to choose the female speaker as more friendly and intelligent compared to the male speaker and they were also more likely to select the male speaker as more unfriendly and unintelligent compared to the female speaker. Conclusion: Results from this study lend further support regarding the effectiveness of self-disclosure as a technique that children who stutter can employ in order to positively influence listener perceptions.