Stuttering: A multidimensional treatment and evaluation package

A regulated breathing method associated with systematic desensitization and cognitive restructuring was applied to eight adult stutters. Behavioral measures (percentage of stuttered syllable [%SS] and rate of speech) were taken during telephone, interview, and public speaking situations using both obtrusive and unobtrusive conditions. Cognitive and subjective assessment included the Erickson Scale of Communication Attitudes, an irrational beliefs scale, self-efficacy perception, and the percentage of improvement reported by the stutterers. Eight adult nonstutterers were also assessed in identical conditions and compared with the treated subjects in the purpose of a social validation perspective. Results showed that the treatment package significantly reduced stuttering at post-test, and therapeutic gains were maintained at 6 month follow-up study. On the %SS, no significant difference emerged at follow-up between treated stutterers and normals. The multicomponent treatment appears to be a successful treatment for stuttering.     

Communicating by telephone: Views of a group of people with stuttering impairment

A study of the use of and attitudes towards the telephone by persons with stuttering impairment is presented. Data was collected by survey (postal questionnaire). Results indicate that making calls may be more problematic than answering them. Avoidance-like behaviours were more prevalent amongst younger adult stutterers than their older counterparts. Severe stutterers use the telephone least. Many stutterers surveyed see telephoning as being more problematic than ‘face-to-face’ communication and give a range of reasons for this. Telephoning difficulties can have wide ranging effects. Some implications of these findings are discussed.     

Emotional experiences in everyday life: A survey approach

As part of a telephone survey, respondents were asked to report the most recent situation that evoked strong emotional feelings in them and to describe the pattern of their reactions. The majority of the situations reported had evoked negative emotions. Most of the emotion-antecedent events are connected to relationships with family and friends or to work-related situations. Only happiness and anger are reported as relatively pure feeling states; most others are emotion blends, with anger/sadness and sadness/fear occurring most frequently. Facial expression changes as well as heart and muscle symptoms are reported as the most frequent reactions across all emotions, whereas other nonverbal and physiological reactions are more specific for particular emotions. By the use of factor analysis, response patterns across various components of emotional state, including affect control, are explored.The first author gratefully acknowledges support from the Stiftung Volkswagenwerk for a sabbatical leave to the University of California at Berkeley.     

Rate changes in the speech of stutterers after therapy

The fluent speaking rate of nine adult male stutterers was compared before and after stuttering intervention. The subjects, ranging in age from 18 to 37 yr (mean, 25 yr, 3 mo), exhibited mild to severe stuttering prior to treatment. The only rate reduction strategy taught to subjects during intervention was to slow the first phoneme or syllable of sentences spoken. In addition, however, subjects significantly reduced their overall rate as determined by measurements made of their fluent speech at the middle of sentences, as well as overall sentence durations (excepting the first word of utterances). The data from this investigation are interpreted relative to the facilitation/simplification hypothesis.     

COLLEGE WOMEN'S FEARS AND PRECAUTIONARY BEHAVIORS RELATING TO ACQUAINTANCE RAPE AND STRANGER RAPE

Past research on women's fear of rape has focused on women's fears relating to stranger rape, even though most rapes are acquaintance rapes. In this study, 139 undergraduate women completed a questionnaire concerning their fears, precautionary behaviors, and beliefs relating to acquaintance and stranger rape. Women reported being more fearful of rape by strangers than by acquaintances, and they reported engaging in more precautionary behaviors because of fear of stranger rape than of acquaintance rape. When asked to self-generate situations in which they feared rape, they generated more situations in which they feared stranger rape than acquaintance rape. Paradoxically, they estimated that acquaintance rape was more common. Precautionary behaviors were best predicted by level of fear. A history of acquaintance rape had no effect on women's responses. Theoretical and educational implications are discussed.     

Influence of stuttering therapy on clinicians'' disfluencies: Effects of client modeling

This study investigated whether student clinicians working with stutterers subsequently produce more disfluencies than student clinicians providing therapy to clients with other speech and language disorders. Seventeen graduate students working in a 6-wk summer camp setting were divided into two groups: eight who provided treatment for stutterers (group 1) and nine who provided therapy for clients with other communication disorders (group 2). All student clinicians were recorded during spontaneous speaking and oral reading tasks prior to camper arrival and following camper departure. An eight-category classification system was used to determine disfluency types. Findings revealed that Group 1 clinicians significantly decreased their total disfluencies between pre- and post-camp recordings on the spontaneous speaking task. Unexpectedly, this same group also substantially increased part-word repetitions and sound prolongations. The possibilities of incidental learning, reverse modeling, and overidentification with stuttering clients are discussed.     

Instructions to focus upon or distract from internal cues during exposure treatment of agoraphobic avoidance

Instructions to focus upon feared somatic sensations were compared to instructions to engage in distracting tasks, while practising in vivo exposure to feared agoraphobic situations. Thirty individuals assigned a primary diagnosis of Panic Disorder with moderate to severe Agoraphobia were assigned randomly to one of the two treatment conditions. Assessments were conducted pre, post and 6 months following treatment completion, using subjective, behavioral and clinician-rated measures of change. Composite outcome criteria indicated a trend for distracted exposure to yield a higher percentage of improvement than focused exposure, at post assessment. However, focused exposure group members improved to a greater extent over the follow-up interval than members of the distracted group. These trends were relatively weak, given the absence of significant group by time interactions in terms of individual variable analyses. The results were discussed with reference to the role of distraction in fear reduction.     

Hearing your voice through bone and air: Implications for explanations of stuttering behavior from studies of normal speakers

Cherry and Sayers (1956) reported that stutterers have problems dealing with sound fed back to the ears through bone. Their experimental support for this claim is reexamined. It is shown that their technique does not produce the same bone-conducted feedback as produced by the speaker while speaking. Their results are reinterpreted as showing that stutterers have problems when speaking in the presence of low frequency sound because of its masking properties, rather than because the sound originates in bone-conducted feedback.     

Perceptual study of the speech of “successfully therapeutized” stutterers

The purpose of this investigation was to determine if the fluent speech of “successfully therapeutized” stutterers and a group of partially treated stutterers was perceptually different from the fluent speech of normal speaking subjects. Tape recorded speech samples of treated stutterers were obtained from leading exponents of (1) Van Riperian, (2) metronome-conditioned speech retraining, (3) delayed auditory feedback, (4) operant conditioning, (5) precision fluency shaping, and (6) “holistic” therapy programs. All forms of disfluency were edited out of these tapes. The remaining samples were then paired with matched fluent samples of normal talkers and presented to a group of 20 sophisticated judges. The judges were instructed to select from each paired speech sample presented to them the one produced by the stuttering subject. The results of the analyses of variance for correct identification of the stutterers showed that the partially treated stutterers, as well as each group of therapeutized stutterers, were identified at levels significantly above chance. This meant that the fluent speech of the partially and successfully treated stutterers was perceptibly different from the utterances of the normal speakers sampled. In addition, the analyses of variance also revealed that all stuttering groups had a significant severity factor. This finding indicated there was a significant difference between the severity subgroup in all the samples investigated. These results were discussed in terms of their clinical implications.     

Attitude and personality characteristics of older stutterers

Attitude and personality characteristics of 29 stutterers (19 male, 10 female) aged 52–82 yr were assessed using five questionnaires. Results indicate that, while the older stutterers score approximately the same as young adult stutterers on scales assessing approach and performance behaviors, the large majority of older stutterers perceive their stuttering as less handicapping than when they were young adults. Self-perceived personality characteristics of the older stutterers were similar to a group of older nonstutterers. While a few of the subjects had experienced some degree of success as a result of treatment later in life, the majority of the subjects did not currently desire treatment.     

Effectiveness of a DAF conditioning program for adolescent and adult stutterers

The effectiveness of a 90-hr treatment program with 27 adolescent and adult stutterers was studied. The treatment, conversational rate control therapy, consisted of a conditioning program that employed DAF to establish slow stutter-free speech that was subsequently increased in speed to a normal rate. Stimulus control was then generalized to the everyday environment. Recordings of easy and difficult speaking situations were made before and after treatment. Stuttering was substantially reduced for all clients in the clinic and in everyday speaking situations.     

Real and virtual classrooms can trigger the same levels of stuttering severity ratings and anxiety in school-age children and adolescents who stutter

PurposeMany school-age children and adolescents who stutter experience the fear of public speaking. Treatment implications include the need to address this problem. However, it is not always possible to train repeatedly in front of a real audience. The present study aimed to assess the relevance of using a virtual classroom in clinical practice with school-age children and adolescents who stutter.MethodsTen children and adolescents who stutter (aged 9–17 years old) had to speak in three different situations: in front of a real audience, in front of a virtual class and in an empty virtual apartment using a head-mounted display. We aimed to assess whether the self-rated levels of anxiety while speaking in front of a virtual audience reflect the levels of anxiety reported while speaking in front of a live audience, and if the stuttering level while speaking to a virtual class reflects the stuttering level while speaking in real conditions.ResultsResults show that the real audience creates higher anticipatory anxiety than the virtual class. However, both the self-reported anxiety levels and the stuttering severity ratings when talking in front of a virtual class did not differ from those observed when talking to a real audience, and were significantly higher than when talking in an empty virtual apartment.ConclusionOur results support the feasibility and relevance of using a virtual classroom to expose school-age children and adolescents who stutter to a feared situation during cognitive behavioral therapy targeting the fear of public speaking.     

Measurement and comparison of anxiety levels of parents of stuttering, articulatory defective, and normal-speaking children

This study was conducted to determine whether or not parents of stutterers are generally more anxious than parents of nonstutterers. In addition, the situational anxiety attendant upon the viewing of their own children was compared with that of parents of articulatory defective and normal-speaking children. Seven sets of parents of stutterers, articulatory defective, and normal speaking children (N = 42) were administered the A-Trait measure of the Self-Evaluation Questionnaire (Spielberger et al., 1965) before and after viewing videotapes of their own chilg and a child of each of the two other groups. Results indicating that parents of stuttering children exhibit more situational anxiety than parents in either of the other two groups are discussed in terms of their clinical implications.     

Future-Oriented Positive Mental Imagery Reduces Anxiety for Exposure to Public Speaking

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.     

Some correlates of stuttering severity judgments

Thirteen adult male stutterers recorded the Amplifier Passage on high-quality audiotape. One sentence from each recording was paired with one sentence from each of the remaining 12 recordings. The resulting 78 sentence pairs were presented to eight speech-language pathologists who were asked to judge which stutterer in each pair was more severe and to rate the confidence of each of these judgements. The confidence ratings were analyzed by means of the individual differences model of multidimensional scaling. The results suggested that reading rate and the number of intrasentence pauses were important parameters in determining the severity of stuttering.     

A rapid method of eliminating stuttering by a regulated breathing approach

The Habit Reversal Procedure for eliminating nervous habits was applied to the problem of stuttering. In the new procedure the speaker interrupted his speech at moments of actual or anticipated stuttering and at natural pause points, and resumed speaking immediately after breathing deeply during the pause. In addition to this regularized pausing and breathing, the program included other factors such as formulation of one's thoughts prior to speaking, identification of stutter-prone situations, identification of mannerisms associated with stuttering, speaking for short durations when tense or nervous, daily breathing exercises, relaxation procedures for anxiety, immediate display of improved speaking, and enlisting family support for progress. Fourteen stutterers were given training in the program during a single counseling session of about two hours duration. The next day, the average number of stuttering episodes decreased by 94 per cent, by 97 per cent at the end of one month, and by 99 per cent during the extended follow-up. Each of the clients was improved by at least 93 per cent. The new procedure appears to be more rapid and effective than alternative procedures.     

Clinician attitudes toward stuttering in the United States and Great Britain: A cross-cultural study

The attitudes toward stutterers and stuttering of 702 speech-language clinicians in the United States and Great Britain were studied. Three hundred seventy-one clinicians from six states in the U.S. and 331 clinicians from England and Wales completed the Clinician Attitudes Toward Stuttering (CATS) Inventory. Results of the study were analyzed in terms of differences and similarities in attitudes between the two groups with respect to the etiology of stuttering, early intervention, the effectiveness of stuttering therapies, various therapy techniques, stutterers and their personality, parents of stutterers, clinicians, and reactions of others to stutterers.     

The speech production abilities of stutterers: Recent, ongoing, and future research

Recent and ongoing research into the speech production abilities of stutterers has followed four disparate paths. First, there have been objective studies of physiologic, aerodynamic, and acoustic parameters of stutterers' habitual speech patterns and the patterns they display while speaking in the presence of such novel stimuli as DAF or masking. Second, investigators have undertaken the fiberoptic examination of stutterers' larynges during fluent and stuttered utterances. Third, there have been studies of the speed with which stutterers start and terminate voicing independent of the act of speaking. Finally, there have been investigations of possible perceptible differences between the fluency of stutterers and normal speakers. Each of these four types of research is examined. Tentative conclusions are drawn, and directions for future theorizing and experimentation are suggested.     

Are Female Stalkers More Violent Than Male Stalkers? Understanding Gender Differences in Stalking Violence Using Contemporary Sociocultural Beliefs

This study investigated gender differences in the perpetration of stalking violence and how sociocultural beliefs may account for these differences/similarities. A sample of 293 Australian undergraduate and postgraduate students classified as relational stalkers completed a self-report questionnaire assessing violence perpetration (no/moderate/severe violence) and sociocultural beliefs (justifications for relational violence; assessments of target fear). Female relational stalkers perpetrated elevated rates of moderate violence; however, there were no gender differences for severe violence. Both male and female relational stalkers were more supportive of justifications for female-perpetrated relational violence than male-perpetrated relational violence. Violent male relational stalkers were more likely to believe they caused fear/harm than their female counterparts. These findings are interpreted in the context of sociocultural beliefs that view male-to-female violence as more unacceptable and harmful than female-to-male violence.     

Frequency and comorbidity of social phobia and social fears in adolescents.

This report presents findings on the frequency, comorbidity and psychosocial impairment of social phobia and social fears among 1035 adolescents, aged 12-17 years. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Social phobia and other psychiatric disorders were coded based on DSM-IV criteria using the computerized Munich version of the Composite International Diagnostic Interview. Seventeen (1.6%) of the adolescents met the DSM-IV criteria for social phobia sometimes in their life. More girls than boys received the diagnosis of social phobia and the frequency of the disorder increased with age. The lifetime frequency of social fears were much higher than that of social phobia. The most common types of feared social situations were fear of doing something in front of other people, followed by public speaking. Social phobia comorbid highly with depressive disorders, somatoform disorders and substance use disorders. Despite the high level of psychosocial impairment experienced by cases with social phobia and those with any social fears, only a small portion of them did receive professional help.