Evaluation and elimination of an avoidance response in a child who stutters: A case study

In this case study, efforts to treat stuttering in a 6-year-old male with cerebral palsy were complicated by frequent replies of “I don't know” that allowed the child to avoid more extensive answers to conversational questions. Following a program of extinction plus differential reinforcement of alternative behavior (DRA), the response “I don't know” was decreased while both speech rate and stuttering increased. Simplified habit reversal (SHR) techniques (controlled breathing) were then applied and resulted in a reduction of stuttering and maintenance of low rates of avoidance. A reversal to baseline resulted in initially high levels of avoidance and low levels of stuttering, with these trends reversing as baseline continued. The SHR treatment for stuttering was then reimplemented and stuttering rates again decreased while avoidance rates remained low, Implications are discussed.     

The experiences of living with a sibling who stutters: a preliminary study

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and (3) discuss the clinical implications of the results with regards to working with children who stutter and their families.     

School-age children's perceptions of a person who stutters

The present study examined the perceptions school-age children have of stutterers. Four groups of fourth and fifth grade students viewed a videotape with either the speaker stuttering or not stuttering while reading a poem. A semantic differential scale of bi-polar adjective pairs was used to rate the speaker on intelligence and personality traits. The current study found that there is a significant difference between school-age children's perceptions of stutterers and nonstutterers with the ratings for the disfluent speaker more negative than the ratings for the fluent speaker. It was found that children did not rate personality and intelligence related traits differently. This information can be used to validate the need for education regarding stuttering for children and those who work with children. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1). identify perceptions of stutterers by a variety of groups; (2). discuss the implications of research on perceptions of stutterers; and (3). compare/contrast children and adults and their perceptions.     

Middle school students' perceptions of a peer who stutters

Little is known about how middle school students perceive a similar-aged peer who stutters. Therefore, the purpose of this study was to examine the influence of stuttering frequency, Likert statement type (affective, behavioral, cognitive), and the gender of the listener on middle school students' perceptions of a peer who stutters. Sixty-four middle school students (10-14 years) individually viewed a video sample of a teen telling a joke at one of four stuttering frequencies (<1%, 5%, 10%, 14%). After the students viewed one of the video samples, they were asked to rate 11 Likert statements that reflected their affective, behavioral, and cognitive perceptions of a peer who stuttered. The results revealed an interaction between stuttering frequency and Likert statement type. Ratings of behavioral statements (speech production characteristics) were significantly more positive for the sample containing <1% stuttering than 10% and 14% stuttering. Ratings for cognitive statements (thought and beliefs) were significantly more positive for the sample containing <1% stuttering than 10% and 14% stuttering. The stuttering frequency of the peer did not significantly influence how students rated affective statements (feelings and emotions). It was also found that male and female middle school students did not significantly differ in their perceptions of a male peer who stutters. Clinical implications are discussed relative to peer teasing, friendship, listener comfort, and social acceptance within a middle school setting for a student who stutters. Future research directions are also discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize how middle school students perceive stuttering; (2) explain how the frequency of stuttering influences middle school students' perceptions of a peer who stutters; and (3) provide clinical implications of the data from this study.     

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP.     

Increasing false recognition rates with confirmatory feedback: a phenomenological analysis

During a simulated witness interrogation, participants were encouraged to confabulate an account consistent with false information concerning a videotaped event. The interviewer verbally affirmed some false responses. Previous research has shown that, a week later, participants often recognize confabulated events that were affirmed by the experimenter as being from the video. What is unclear is whether confirmatory feedback encouraged a change in the mental representation of the confabulated events to fit the original event or confirmation might have merely encouraged a change in beliefs about the event. To further understand the mechanisms that underlie the confirmatory feedback effect, participants were asked to judge the phenomenological experience associated with false recognition.     

Interpreting imaginative play in child psychotherapy: Towards a phenomenological hermeneutic approach

Abstract

Despite renewed interest and technical advances in play therapy with children, its theoretical basis remains weak. A phenomenological hermeneutic approach to play therapy offers a philosophically grounded theoretical understanding of the meaning of children's expressions through imaginative play in a therapeutic context. Drawing upon Gadamer's ontological concept of play and Ricoeur's theory of interpretation, a child's imaginative play is seen as a text that calls for interpretation. The understanding and interpretation of imaginative play in play therapy is illustrated by means of a case vignette of a young physically abused child.     

The effects of self-disclosure on the communicative interaction between a person who stutters and a normally fluent speaker

PurposeThe purpose of this study was to investigate the effects of self-disclosure on the self-perception of stuttering severity, comfort, cognitive effort, and anxiety in a structured conversational interaction with a normally fluent speaker. The benefit of self-disclosure from the perspective of the person who stutters in a self-disclosed and in a non-disclosed condition was also studied. The total syllables produced and percent syllables stuttered were measured in both experimental conditions in order to evaluate the effects on the amount of speech produced and verbal fluency.MethodsTwenty-five adults who stutter were recruited in Philadelphia and New Jersey, through social media, university clinics, and National Stuttering Association (NSA) self-help groups. The participants engaged in a conversational task with a normally fluent speaker (NFS). The cognitive-affective variables (self-perception of stuttering severity, comfort, cognitive effort, anxiety and benefit) were measured using self-report questionnaires completed after each condition. The percent syllables stuttered and total syllables in each condition were also transcribed and analyzed.ResultsFrequency distributions of Likert Scale ratings indicated a slight preference for self-disclosure over non-disclosure, but there was a non-significant difference on the benefit variable for the disclosed and non-disclosed conditions. There were correlations between total syllables produced and percent syllables stuttered and comfort, in the non-disclosed state only. Other findings included non-significant differences for the cognitive-affective variables across conditions.ConclusionFrom the perspective of the person who stutters, self-disclosure at the outset of the communicative interaction did not have a decisive impact on the cognitive-affective or speech variables.     

100 midlife women with eating disorders: a phenomenological analysis of etiology

This study analyzed eating disorder (ED) etiological factors for 100 midlife women ED inpatients, grouped by ED onset age: < 40 and > or = 40 years. Interpretative Phenomenological Analysis classified ED etiological influences into background contributors, immediate triggers, or sustainers. Family-of-origin issues, predominantly parental maltreatment, emerged as important background contributors, but not immediate ED triggers, regardless of onset age. Body image issues were also major background contributors regardless of onset age and further served as immediate ED triggers for many of the younger-onset patients, but not the older-onset patients. Family-of-choice and health issues were unimportant for younger-onset patients but were important ED contributors and triggers for older-onset patients. Emergent etiological differences suggest differential assessment and treatment needs for midlife ED patients based on ED onset age.     

Listener perceptions along a fluency--disfluency continuum: a phenomenological analysis

The purpose of this study was to conduct a phenomenological analysis (a qualitative research method) of unbiased listeners' perceptions to six speech samples across a fluency-disfluency continuum. A sample of 60 individuals heard only one sample chosen from three levels of fluent or three levels of disfluent speech. Listeners were interviewed following the presentation of the speech sample and their comments were analyzed with respect to the perception of the speaker's communicative effectiveness. Communicative effectiveness was supported by three phenomenological categories: speaker attributes, listener attributes, and story attributes. Five theme clusters further supported these categories: speech production, context, speaker identity, listener comfort, and story comprehension. The results showed that listener perceptions within theme clusters varied across the six speech samples. The results also showed that listeners differentially respond to a broad array of information in the speech signal (not simply fluency or disfluency). These findings support Traunmuller's (1994) modulation theory associated with information that can be obtained from the speech signal. Implications for the treatment of stuttering are also discussed. EDUCATIONAL OBJECTIVES: The reader will learn (1) how listeners may have multiple and varying perceptual experiences depending upon where along a fluency-disfluency continuum a speech sample is heard; (2) how perceptual experiences are influenced by speaker, listener, and story attributes; and (3) how phenomenological analysis may expand our understanding of multifactorial issues associated with stuttering.     

Coping with HIV as a chronic illness: A longitudinal analysis of illness appraisals

Illness appraisals are central to understanding how individuals cope with chronic illness. An interpretive phenomenological approach to the analysis of two years of bimonthly stressful event narratives in a sample of 57 HIV?+?gay men revealed five groups that differed on how they appraised HIV and one group of individuals who changed from one type of appraisal to another over the course of the 2-year study. The ways of appraising HIV revealed in this analysis have implications for interventions and for the study of coping with HIV as a chronic illness. The repeated assessment of specific HIV-associated stressful events and a qualitative analytic approach allowed for a more in-depth understanding of the meaning of HIV for the participants. This study suggests that coping interventions may be more powerful if they are tailored to individual appraisals of HIV because different forms of coping are likely to be differentially effective depending on the meaning of HIV in the individual's life.     

The effects of self-disclosure and non self-disclosure of stuttering on listeners' perceptions of a person who stutters

The aim of this study was to examine listener perceptions of an adult male person who stutters (PWS) who did or did not disclose his stuttering. Ninety adults who do not stutter individually viewed one of three videotaped monologues produced by a male speaker with severe stuttering. In one monologue, 30 listeners heard the speaker disclose stuttering at the beginning and in another monologue, 30 listeners heard the speaker disclose stuttering at the end. A third group of 30 listeners viewed a monologue where no disclosure of stuttering occurred. After listeners viewed a monologue, they were asked to rate a set of six Likert scale statements and answer three open-ended questions. The results showed that only one of six Likert statements was significantly different across the three conditions. The only statement that was different was that the speaker was perceived to be significantly more friendly when disclosing stuttering at the end of the monologue than when not disclosing stuttering. There were no significant differences between the percentage of positive and negative comments made by listeners across the three conditions. Listeners' comments to each open-ended question showed they were comfortable listening to stuttering with or without disclosure and slightly more than half of the listeners believed their perceptions of the speaker did not change when he disclosed stuttering. The results also showed that the speaker who disclosed stuttering at the beginning of the monologue received significantly more positive listener comments than when he disclosed stuttering at the end of the monologue. Results are discussed relative to comparisons with the study, the clinical relevance of acknowledging stuttering as a component of treatment, and future research on the self-disclosure of stuttering. Educational objectives: The reader will be able to: (1) describe how different groups of listeners perceive and respond to two conditions of self-disclosure of stuttering and one condition involving non self-disclosure of stuttering; (2) summarize the range of listener responses to and benefits of self-disclosure of stuttering; and (3) describe the value of self-disclosure of stuttering for the listener and the speaker.     

Being a non-drinking student: An interpretative phenomenological analysis

Recent research suggests that safer student alcohol consumption might be assisted by understanding how social occasions are managed by non-drinkers. In-depth, semi-structured interviews with five 19 – 22 year old non-drinking English undergraduates were subjected to interpretative phenomenological analysis. We present five inter-linked themes: ‘living with challenges to non-drinking’; ‘seeing what goes on in drinking environments’; ‘dealing with conversations about non-drinking (making excuses vs. coming out)’; ‘knowing which friends care about you’; and ‘the importance of minimising “legroom” for peer pressure’. Participants felt under persistent peer scrutiny (as a form of peer pressure) and could feel alienated in drinking environments. Talking about non-drinking was characterised by whether to ‘come out’ (as a non-drinker) or ‘fake it’ (e.g. ‘I’m on antibiotics’). Loyal friendships were reported as particularly important in this context. The decision not to drink was experienced as providing a successful buffer to peer pressure for former drinkers. Our findings unsettle traditional health promotion campaigns which advocate moderate drinking among students without always suggesting how it might be most successfully accomplished and offer tentative guidance on how non-drinking during specific social occasions might be managed more successfully. Findings are discussed in relation to extant literature and future research directions are suggested.     

Thematic moment analysis: A didactic application of a procedure for phenomenological analysis of narrative data

Abstract

Following in the theoretical and methodological roots of the ‘Duquesne school,’ this work presents a procedure for the phenomenological analysis of narrative data. After describing its ‘approach,’ this work lays out the procedure for ‘thematic moment analysis’ using the work of Giorgi as a point of reference. Idiographic results of single datum of being afraid are presented along with the steps through which this ‘idiographic thematic narrative’ was developed. Procedures for arriving at ‘comparative analysis’ of more than one piece of data are presented and distinguished from claims of generality sought by works drawing on larger data pools. Finally, this work discusses issues of internal and external validity both specifically in regards to the ‘thematic moments’ procedure and in terms of phenomenological research in general.     

Coping styles and personality: a biometric analysis

Previous research suggests that coping styles are modestly heritable and that this genetic influence is shared in large part with genetic influences on personality. To test this hypothesis, we estimated the heritable basis of the Coping Inventory for Stressful Situations in a sample of 91 monozygotic and 80 dizygotic twin pairs. Task-oriented, emotion-oriented, and social diversion coping styles were modestly heritable (h(2)=.17 to .20), whereas the use of distraction appeared to be influenced solely by environmental factors. Multivariate analyses showed that genetic contributions to coping styles were, at best, only modestly related to genetic contributions to personality (r=-.03 to .35). Environmental contributions to personality were unrelated to environmental factors in coping style. These results suggest that coping style is not merely a manifestation of basic personality traits but does support the possibility that the genetic factors in personality influences have a modest influence on an individual's preferred coping style or strength (e.g., rigidity vs flexibility).     

Coping and care-related stress in parents of a child with autism spectrum disorder

Background and Objectives: Parenting a child with Autism Spectrum Disorder (ASD) is challenging and can result in elevated levels of parenting stress. This study investigated the relationship between parent-ratings of their child’s ASD symptoms and two conceptually different measures of parenting stress: One specific to the ASD context and the other a general stress measure applicable to the broader caregiving context. Additionally, the influence of coping style on the relationship between child’s ASD symptoms and parenting stress was investigated.

Design and Methods: Using an internet survey, parents (N?=?178) caring for a child with ASD reported on coping strategies, completed two measures of parenting stress, and assessed their child’s ASD symptoms.

Results: Parenting stress increased with severity of the child’s ASD symptoms, but the strength of this relationship depended on whether a general or disorder-specific measure of parenting stress was used. Regression analyses indicated that some coping strategies moderated the impact of ASD symptom severity on the parent’s care-related stress, but moderation depended on how stress was conceptualized.

Conclusion: This study reinforces the importance of identifying the coping strategies of parents of children with developmental disorders, and highlights the consequences of using different conceptual approaches to measure parenting stress.     

Worlds within worlds: a strategy for using interpretative phenomenological analysis with focus groups

There is increasing interest in applying interpretative phenomenological analysis (IPA) to focus group data and in developing appropriate strategies for doing so. These strategies should exploit the unique features of focus groups, which provide a rich canvas of experiences not seen in individual interviews, while remaining true to the personal, phenomenological perspective of IPA. We present a four-stage approach with specific group focused analytical strategies: looking for “groupness,” clustering reoccurring group interactions, identifying interactional relationships, and incorporating group elements into an analysis. These stages are illustrated with worked examples developed while working with data from focus groups of women with gynaecological cancer discussing a yoga intervention, and explain how these can enrich our understanding of participants’ lived experiences. This approach demonstrates a suggested framework for developing IPA themes from focus group data by analysing and interpreting the group setting. We discuss links to psychological concepts, potential applications and limitations. This empirically based methodology is presented as a practical guide for other researchers grappling with this type of data.     

Quality of life research: a case for combining photo-elicitation with interpretative phenomenological analysis

In this article, we provide practical and theoretical discussion of the use of two complementary research methods to explore quality of life. We present a case example of the use of photo-elicitation alongside interpretative phenomenological analysis and use examples from our research with people living with paraplegia and chronic pain to demonstrate how these methods can be combined to provide a participant-led understanding of quality of life. This discussion includes consideration of practical and ethical issues relevant to others wishing to combine these research methods. Furthermore, we highlight some of the potential practical and therapeutic opportunities provided by the approach through an illustration of how photographs work to enhance self-reflection and promote hermeneutic sense making.     

解释现象学分析在中国的运用：系统评价及指南

作为一种质性研究方法, 解释现象学分析在心理学及社会科学的其他领域中逐渐兴起。目前在中国, 运用解释现象学分析的研究质量参差不齐, 对这些研究进行系统评价, 可以为将来的研究提供指导。通过对中英文数据库的检索及筛选, 最终纳入49篇期刊文章。根据Smith (2011)为解释现象学分析提出的4个标准对这些文章进行评价, 结果显示, 26篇研究明确提及了解释现象学的理论原则, 33篇文章的资料收集及分析过程清晰透明, 大部分研究(n = 40)条理清晰、言之成理, 但只有约1/4的研究(n = 13)提供了足够强的证据来支持其提取出来的主题。只有4篇全部达到质量标准, 11篇基本达到标准, 大部分文章没有达到标准。最后, 本研究尝试提出一份解释现象学分析的使用指南, 供将来的研究参考。