Self-Disclosure and Physiological Responses among Adults who Stutter

Purposes: (1) To explore self-disclosure, physiological and affective responses in easy and difficult speaking situations, (2) to investigate physiological and affective responses in self-disclosure and no self-disclosure speaking contexts, (3) to examine types of self-disclosure statements used along with physiological responses, (4) and to gain an understanding of reasons why and how adults who stutter choose to self-disclose or not self-disclose about their stuttering. Method: Four adults who stutter were randomly assigned to self-disclosure and non self-disclosure speaking contexts. Heart rate, skin conductance, and affective responses were measured during the following focus areas: 1) start baseline, 2) anticipation of the easy speaking situation, 3) the easy speaking situation, 4) anticipation of the difficult speaking situation, 5) the difficult speaking situation, and 6) end baseline. An informational interview to understand the participants’ use of or lack of self-disclosure in their daily lives was then conducted. Results: Skin conductance responses were comparable between self-disclosure and non self-disclosure groups. When it came to the participants’ heart rate (BPM), all but one focus area had a statistically significant difference between the BPM recorded for the self-disclosure group (M=35.88, SD=3.77) compared to the non self-disclosure group (M=49.54, SD=1.54) for the End Baseline; p =0.04 (between-group). Affectively, participants who did not self-disclose reported the same affective responses pre- and post-experiment, while participants who did self-disclose reported different affective responses pre- and post-experiment. Participants also expressed that self-disclosing was dependent on the familiarity of the listener or situation. Also, most participants stated feeling “at ease” or a “pressure” was lifted off when they self-disclosed. Most participants also shared that they self-disclosed as a part of their first interaction with someone or when meeting someone for the first time. Furthermore, when asked about their reactions to engaging in the most difficult and easiest speaking situations most participants were surprised by their feelings. Conclusion: There was not a statistically significant difference in the between-group heart rate and skin conductance results, but there was during the end of the baseline of the BPM measurements. It was also suggested that the anticipation of easy or difficult speaking situations (SC and HR) may be influenced based on familiarity or comfortableness of situation. Participants who did not self-disclose reported the same affective responses pre- and post-experiment, while participants who did self-disclose reported different affective responses pre- and post-experiment. Additionally, the informational interview gave insight into how the participants’ perceived fear of a speaking situation was different than anticipated. The interview provided information about the situations that participants self-disclose most often and how they self-disclose. This study also revealed that self-disclosure is still a valuable tool that can ease conversation for the speaker. These results may help clinicians to inform their therapy by considering multiple variables that contribute to stuttering and how they change depending on the client’s experiences

Outcomes of Telepractice Speech Therapy for an Adult who Covertly Stutters: A Case Study

Purpose: To report on telepractice-based holistic speech-language therapy services to reduce avoidance of stuttering and increase positive self-image as a communicator for an adult who covertly stutters as compared to baseline. Method: A single case study design was employed with baseline, intervention, and maintenance phases completed via telepractice. The participant received bi-weekly speech-language therapy services, including both individual and group sessions. The Overall Assessment of the Speaker’s Experience of Stuttering-Adult (OASES-A) and Stuttering Severity Instrument-4th Edition (SSI-4) assessed the participant’s overt and covert stuttering behaviors at pre-treatment and post-treatment timeframes. Weekly data points of participant’s self-report of avoidance of stuttering during therapy sessions and during the week between therapy sessions as well as researcher calculated frequency of stuttering were measured. Visual inspection was utilized to analyze treatment outcomes. Results: The participant demonstrated a reduction in avoidance of stuttering within sessions as well as the week prior to a session, as compared to baseline. Additionally, the participant presented with an increased percent of words stuttered (%WS) following into maintenance as compared to baseline. Visual inspection of weekly data points of frequency of stuttering and self-report of avoidance appeared to present promising results throughout the intervention phase with potential treatment effects continuing into the maintenance phase. Conclusion: Results of the current study demonstrate preliminary evidence for potential positive outcomes of holistic speech therapy via telepractice for people who covertly stutter

Multimodal nonvocal nonword matching in adults who stutter

Significant data suggest that phonological working memory (PWM) is impaired in adults who stutter (e.g., Byrd, McGill, Usler, 2015; Byrd, Sheng, Bernstein Ratner, Gkalitsiou, 2015; Byrd, Vallely, Anderson, & Sussman, 2012; McGill, Sussman, Byrd, 2016). Some researchers have argued that the differences observed are driven by deficits in auditory processing as opposed to a core deficit in PWM (Hampton & Weber-Fox, 2008). This exclusive focus on auditory processing does not take into account results from studies that demonstrate PWM deficits in persons who stutter when auditory stimuli are not employed (e.g., McGill et al., 2016; Weber-Fox, Spencer, Spruill & Smith, 2004). No study has investigated PWM in persons who do and do not stutter on tasks that directly compare visual to auditory input performance differences. The purpose of this dissertation was to investigate PWM in adults who do and do not stutter using multimodal nonvocal nonword conditions including visual to visual, visual to auditory, and auditory to visual tasks. Data were coded for accuracy, manual reaction time, and error type. Analyses were conducted to evaluate the relationship between talker group, manual reaction time, accuracy, error types, and speed-accuracy tradeoff within and across conditions. Adults who stutter, compared to adults who do not stutter, demonstrated significantly decreased accuracy and increased manual reaction time on all nonvocal nonword conditions. Additionally, adults who stutter were significantly more likely to select a substitution foil compared to an accurate response than adults who do not stutter. Finally, neither adults who stutter nor adults who do not stutter demonstrated a speed-accuracy tradeoff. Results from the present study do not support the auditory exclusive argument posited in previous research. Regardless of input modality, PWM appears to be uniquely impaired for adults who stutter compared to adults who do not stutter.Communication Sciences and Disorder

Cross-Language Transfer in Intervention with Bilingual Adults Who Stutter: Two Case Studies

The purposes of this study are 1) to examine the effectiveness of bilingual stuttering intervention in two sequential Spanish-English bilingual individuals who stutter 2) to evaluate the degree of cross-language transfer in an AB-single-subject design model of intervention

Teaching health science students during COVID-19: Cross-hemisphere reflections

Efforts to mitigate the spread of the COVID-19 virus based on recommendations from government agencies across the world, such as physical distancing requirements, propelled university and college training programs into virtual learning environments in 2020. This unprecedented and largely unplanned shift to online/remote learning has led to novel pedagogical experiences for instructors, particularly those teaching in the field of health sciences, which typically rely on in-person and hands-on training to prepare students for their careers. Our manuscript aims to answer the research question, “What are the cross-cultural experiences of university instructors teaching students studying health sciences during a global pandemic?” The three authors of this manuscript are lecturers in higher education who teach in the health science programmes in different parts of the world (i.e., Australia, Pacific Northwest USA, Southwest USA). A reflective scholarship of teaching and learning method, collective autoethnographies, was used to examine the online/remote teaching experiences of the authors. Four shared themes emerged from our qualitative coding and reflective discussions, with our experiences highlighting the importance of human connection and comparisons to pre-pandemic teaching practice. Our reflections have implications for pedagogy and course design and highlight the limited support available for educators teaching during stressful times as we continue remote learning. These cross-cultural teaching experiences in health sciences provide important insights into cross-hemisphere discussions about teaching in a post-COVID world

Stuttering Accommodations in Professional Environments: The Intersectionality between Multiculturalism, Multilingualism, Stigma, Disability Identity and Rights

Stuttering is a fluency disorder that disrupts the forward flow of speech (Guitar, 2014). People who stutter (PWS) have been falsely represented in the media and negatively perceived by the general public (Boyle, 2011; Williams, 2015). This public stigma, including cultural and linguistic differences, contributes to the development of self-stigma (Dean & Medina, 2020; Gerlach et al., 2018; Plexico et al., 2019). Stuttering public stigma also leads to decreased earnings and opportunities in the workplace and higher education discrimination (Gerlach et al., 2018; Klein & Hood, 2014). Consequently, there has yet to exist a research study that considers the intersectionality between multilingualism, multiculturalism, race, gender, and SES background and how these identities and backgrounds influence the type of disability stigma and negative perceptions of PWS. This study will consist of ten PWS who will participate in a 60-minute phenomenological semi-structured interview conducted via Zoom. This phenomenological approach will facilitate an interview space where there’s decreased interviewer bias as the participant can speak from their lived experience and answer in their own words (Roulston, 2010). Results from this study will be analyzed via a thematic analysis utilizing in vivo coding. This data analysis method will allow for the participants’ direct interview responses to be amplified and provide meaning to the study’s data (Manning, 2017). Furthermore, the findings of this research will enable a greater understanding of how these experiences influence PWS\u27s willingness to pursue disability accommodations in professional environments, degree of advocacy skills, accommodation and rights knowledge, and perception of disability status

From Grapheme to Phonological Output: Performance of Adults Who Stutter on a Word Jumble Task

Purpose The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task. Method Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT). Results Adults who stutter attempted to solve fewer word jumble stimuli than adults who do not stutter at the 4-letter, 5-letter, and 6-letter lengths. Additionally, adults who stutter were significantly less accurate solving word jumble tasks at the 4-letter, 5-letter, and 6-letter lengths compared to adults who do not stutter. At the longest word length (6-letter), SRT was significantly slower for the adults who stutter than the fluent controls. Conclusion Results of the current study lend further support to the notion that differences in various aspects of phonological processing, including vision-to-sound conversions, sub-vocal stimulus manipulation, and/or lexical access are compromised in adults who stutter

Evaluating the Efficacy of Telepractice Speech Therapy for an Adult Who Covertly Stutters

The aim of this case study is to evaluate the efficacy of telepractice speech therapy sessions using a holistic therapeutic approach (e.g. stuttering modification, avoidance reduction, acceptance and commitment therapy) to reduce avoidance of stuttering and increase positive self-image as a communicator for an adult who covertly stutters as compared to baseline. The current study utilizes an ABM single-subject experimental design (SSED) format (baseline [A], intervention [B] and maintenance [M]). Measures of the participant’s baseline attitudes toward their stutter were taken using the Overall Assessment of the Speaker’s Experience of Stuttering - Adult Version (OASES-A) and percent of words stuttered (%WS) prior to the start of intervention. The participant received bi-weekly speech therapy sessions over the course of 9 weeks, including both a 1-hour individual therapy session and a 1-hour group therapy session. During the intervention phase, weekly data points of frequency of stuttering (%WS out of a 300- word conversational sample) and self-report of avoidance using a Likert scale were collected. The intervention phase has been completed and the participant is currently in the maintenance phase. Data collection and analysis will be completed by mid-July. Data will be analyzed via visual inspection to observe any possible effects of intervention

Participation in Camp Dream. Speak. Live: Affective and Cognitive Outcomes for Children who Stutter

Objective: The purpose of this study was to explore the influence of participation in Camp Dream. Speak. Live., an intensive therapy program, on the communication attitudes, peer relationships and quality of life of children who stutter. Method: Participants were 23 children who stutter (n=5 females; n=18 males; age range 4–14 years) who attended a weeklong intensive therapy program that was exclusively developed to address the affective and cognitive components of stuttering. Outcome measures included the KiddyCAT Communication Attitude Test for Preschool and Kindergarten Children who Stutter, the Overall Assessment of the Speaker’s Experience of Stuttering (OASES), and the Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric Peer Relationships Form. Parents of children who participated in the program completed online parent proxy versions of the Kiddy-CAT, OASES, and PROMIS approximately one month after their child’s participation in Camp Dream. Speak. Live. concluded. Results: Results suggest that participation in Camp Dream. Speak. Live. led to significant increases in the child’s communication attitude, the child’s perception of his/her ability to make friends, and also significantly reduced the impact of stuttering on the child’s overall quality of life. Additionally, parents of children who participated in Camp Dream. Speak. Live. reported they observed positive increases in their child’s perception of his/her own ability to make friends as well as significant decreases in their child’s perspective of the impact of stuttering on his/her overall quality of life. Conclusion: Results support the notion that significant improvements in communication attitude as well as significant reductions in the impact of stuttering on overall quality of life can be achieved in a short period of time

A Preliminary Comparison of In-Person and Telepractice Evaluations of Stuttering.

Purpose The purpose of this study was to compare in-person and telepractice evaluations of stuttering with adult participants. The research questions were as follows: Is an evaluation for stuttering via telepractice equivalent to an in-person evaluation in terms of (a) duration of individual evaluation tasks and overall length of the evaluation, (b) clinical outcomes across evaluating clinicians, and (c) participant experience? Method Participants were 14 adults who stutter (males = 11; age range: 20-68) who were simultaneously assessed via telepractice and in-person. Comprehensive evaluations included analysis of the speaker\u27s stuttering, evaluation of the speaker\u27s perceptions and attitudes about stuttering, and language testing. Evaluations were administered by either an in-person clinician or a telepractice clinician but were simultaneously scored by both clinicians. Participants were randomly assigned to the in-person-led assessment condition or the telepractice-led assessment condition. Results No statistically significant differences were found between the in-person and telepractice-led evaluations in terms of overall evaluation task duration, evaluation clinical outcomes, or participants\u27 reported experiences. That is, telepractice evaluations for stuttering in adults may be an equivalent option to in-person evaluations. Conclusions Results of this preliminary study indicate that telepractice evaluations of stuttering may be comparable to in-person evaluations in terms of duration, clinical outcomes, and participant experiences. The current study supports the notion that telepractice evaluations may be a viable option for adult clients who stutter. Clinical considerations and future directions for research are discussed