Australian normative data for the Overall Assessment of the Speaker's Experience of Stuttering

People who stutter often report negative impacts on their wellbeing as a result of their chronic fluency disorder. The need for a comprehensive assessment of the wellbeing and experience of stuttering should be a prime consideration when measuring treatment outcomes. One such measure designed to evaluate wellbeing and aspects of the individual's experience of his or her stuttering is the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Normative data for the OASES Adult version (OASES-A; and hereafter referred to simply as the OASES) has begun to be collected over the past 10 years, though none are available for an Australian population. This paper presents Australian normative data for the OASES for 200 adult males and females who stutter, aged between 18 and 85 years. Additionally, the influence of age, sex, and frequency of stuttering on the Australian OASES scores are also presented. No significant relationships between OASES scores were found for sex and age, which is in keeping with the USA original dataset. However, those participants who had more severe stuttering were more likely to have higher negative impacts for 'General Information', Communication in Daily Situations,' and for the overall OASES score. Implications for further research are discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (i) describe the purpose of the Overall Experience of the Speaker's Experience of Stuttering for Adults (OASES), (ii) evaluate the relevance of the OASES to treatment planning and the evaluation of stuttering treatment outcomes in the adult population, and (iii) compare Australian normative dataset with the USA and Dutch normative datasets for the OASES.     

Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life

ObjectiveThis study investigates the association between the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The OASES measures the adverse impact of stuttering on a person's life.DesignParticipants in the present study were 112 persons who stutter from Germany.MethodsAll participants filled in both the NEO-FFI and the OASES questionnaires.ResultsResults revealed a strong positive correlation between the personality trait Neuroticism and scores on the OASES. Moreover, Extraversion was negatively correlated with the OASES scores.ConclusionsThe findings suggest that people with higher Neuroticism and lower Extraversion scores experience a greater impact of stuttering on their daily life. The results underscore the importance of considering personality as a potential moderator or mediator factor in future stuttering research and, potentially, also in treatment.Educational objectives: The reader will learn (a) about the different personality dimensions reflected by the NEO-FFI, (b) why it is important to consider the impact of stuttering on everyday life from the perspective of the people who stutter and (c) how personality is linked to the Overall Assessment of the Speaker's Experience of Stuttering (OASES).     

Fibromyalgie und Leistungseinschränkung

Interdisciplinary guidelines allowed for new quality standards in pain appraisal. Simultaneously, the scientific notion of fibromyalgia changed from a subjectively overvalued malaise to a central disturbance of coping with stress, which is neurobiologically determined. Therefore, in this article a psychosomatics-based guide is given for the socio-medical appraisal of fibromyalgia with reference to the new International Classification for Functioning and Disability (ICF) of the World Health Organization (WHO). As illustration a case study is presented.     

Relative contributions to overall impact of stuttering in adults using the overall assessment of the Speaker’s Experience of Stuttering (OASES)

PurposeComprehensive assessment of stuttering requires consideration of a wide range of behaviors that impact outcomes, and the Overall Assessment of the Speaker’s Experience of Stuttering (OASES) is an assessment tool that accomplishes such. The purpose of this study was to determine how the individual components of the test contribute to the OASES’ impact score.MethodData collected at a university speech-language and hearing clinic from 29 adults were used for a relative weight analysis (RWA). RWA was utilized to determine the relative contributions of the OASES’ subtests to the OASES’ impact score. Confidence intervals for the individual relative weights were calculated for each OASES subtest and significance tests based on bootstrapping with 10,000 replications.ResultsDifferences were present in contributions of the OASES’ subtests to the OASES’ overall impact score, where the following explained a significant amount of variance in the OASES’ impact score: Speaker’s Reactions; Daily Communication; and Quality of Life. However, contribution of the subtest, “General Information”, was not significant.ConclusionThrough examination of relative contributions to the impact of stuttering using the OASES, this project has identified differences in contributors to the overall impact of the disorder of stuttering. This information is beneficial to researchers and clinicians alike in that it gives specific guidance into what determines increased impact in adults who stutter (AWS). Future works should pursue clarification of these differences with an end goal of identifying and overcoming barriers to positive outcomes while also identifying and nurturing facilitators to optimal management.     

Assistive/rehabilitation technology,disability, and service delivery models

The United Nation’s Millennium Development Goals do not explicitly articulate a focus on disability; similar failures in the past resulted in research, policy, and practice that are not generalizable and did not meet the needs of persons with disabilities since they were developed for an “average” population. Academics and professionals in health and other disciplines should have a knowledge base in evidence-based practices that improve well-being and participation of people with disabilities through effective service delivery of assistive technology. Grounded by a theoretical framework that incorporates a multivariate perspective of disability that is acknowledged in the convention on the rights of persons with disabilities and the World Health Organization’s International Classification of Functioning, Disability and Health, we present a review of models of assistive technology service delivery and call for future syntheses of the fragmented evidence base that would permit a comparative effectiveness approach to evaluation.     

Secondary conditions in children with disabilities: spina bifida as a case example

This paper examines the concept of secondary conditions and its application in studies of childhood disability focusing on children with spina bifida as a representative group. The "International Classification of Functioning, Disability and Health" (World Health Organization, Geneva, 2001) provides a classification of body function/structure, activities, participation and the environment to document dimensions of human functioning in context. The ICF is of value in the study of secondary conditions in two ways: as a conceptual framework for defining impairments, activity limitations and participation restrictions, and the mediating role of the environment in their expression; and as a taxonomy for coding these dimensions of disability. The ICF can yield a profile of a child's difficulties, and documentation of environmental barriers experienced by that child. Research studies with children and adolescents with spina bifida reveal that physical and mental impairments and limitations in performing activities and participating in communal life are experienced as secondary conditions. The significance of secondary conditions is that they are preventable. Identifying the mechanisms associated with their manifestation is thus an important priority for the development of effective prevention programs.     

Reprint of: technology and the evolution of clinical methods for stuttering

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.Educational objectives: The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families.     

The effects of actors vocal exercises for relaxation on fluency: A preliminary study

PurposeTo determine the efficacy of treatment based on Kristin Linklater’s technique for vocal preparation for performance for use with people who stutter.MethodA protocol for a treatment for stuttering involving breathing exercises, relaxation techniques, and focus on awareness was designed by the first author from Linklater’s published exercises in her book Freeing the Natural Voice (2006). Four adults who stutter participated in a 12-week, single-case reversal design study. Treatment efficacy was determined by baseline and post-treatment measures on the OASES, self-report naturalness, tension and severity scale, and percentage of stuttering-like disfluency (SLD). Qualitative measures included a daily tension and practice log, a program completion questionnaire, and accounts from the clinicians administering the treatment protocol.ResultsThree of four participants scored lower on the OASES post-treatment, suggesting that the impact of stuttering on their daily lives had decreased. All four experienced a reduction in the number of SLD counted throughout treatment sessions compared to baseline data.ConclusionA treatment for stuttering based on Linklater’s work including regulation of breathing, relaxation, and awareness of breath may be effective in improving fluency and decreasing the impact of stuttering and warrants further study.     

Preliminary study of self-perceived communication competence amongst adults who do and do not stutter

PurposeAdults 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.MethodsTwenty-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.ResultsAdults 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.DiscussionThis 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.     

Technology and the evolution of clinical methods for stuttering

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.Educational objectives: The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families.     

The role of psychological processes in estimates of stuttering severity

Purpose

To examine the associations of trait anxiety (STAI), social anxiety (SIAS), depression (BDI-II), and personality features (ADP-IV) with three measures of stuttering severity: %SS, Stuttering Severity, Instrument, and the Overall Assessment of the Speaker's Experience of Stuttering.

Method

Fifty adults with a history of stuttering served as participants. Participant scores on trait, anxiety, social anxiety, depression, and personality features were entered into a regression analysis, with the criterion variables (DVs) being: %SS, SSI-3, OASES total score. In order to explore the OASES, further, each of the four OASES subscales were also examined. A separate regression was conducted for, each dependent variable.

Results

The OASES total score model was significant (p < .0001) and revealed that social anxiety and, trait anxiety were the only significant predictors, with medium effect sizes noted for both variables. In contrast, percent syllables stuttered and the SSI were not significantly associated with psychological, variables, suggesting that anxiety may not always be related to overt indicators of stuttering. Depression and personality dysfunction were not significantly associated with any measure of, stuttering severity.

Conclusion

Anxiety in the form of social and trait anxiety are significantly associated with stuttering, severity as indicated by the OASES. Traditional procedures for assigning severity ratings to individuals, who stutter based on percent syllables stuttered and the Stuttering Severity Instrument are not, significantly related to psychological processes central to the stuttering experience. Depression and, personality characteristics do not meaningfully account for stuttering.Educational objectives: The reader will be able to: (a) differentiate forms of anxiety that are likely to be associated with stuttering (b) understand the importance of determining features of stuttering that go beyond the obvious, surface characteristics of stuttering frequency, and (c) discuss the important clinical and theoretical implications for understanding the degree of psychological dysfunction that is likely to be characteristic of those who stutter.     

Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering

The treatment components that contribute to and account for successful therapeutic outcomes for people who stutter are not well understood and are debated by many. The purpose of this phenomenological study was to describe in detail the underlying factors that contribute to a successful or unsuccessful therapeutic interaction between clients and their clinicians. Twenty-eight participants, 19 men and 9 women, who had received from 6 months to more than 12 years of therapy for stuttering were studied. The participants were asked to consider their experience with one or more speech-language pathologists with whom they had received fluency therapy and to describe the characteristics that made that individual effective or ineffective in promoting successful change in their ability to communicate. Analysis of these data resulted in 15 primary categories. Finally, the essential structure of an effective and ineffective therapeutic interaction was described. Results highlighted the importance for effective therapy of understanding the stuttering experience, forming a positive client-clinician, alliance, and being knowledgeable about stuttering and its treatment. Educational objectives: The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with an effective therapeutic interaction, (2) describe, from the perspective of a select group of adults who stutter, the themes associated with an ineffective therapeutic interaction, and (3) describe the ways in which an effective or ineffective therapeutic interaction could impact a person who stutters.     

Two paradoxes in stuttering treatment

The premise of this article is that effective communication should be a central, overarching goal in the treatment of stuttering. Not focusing on communication may have some unintended negative consequences on treatment. The negative consequences are the result of two paradoxes that confront clinicians and clients: the listener paradox and the communication paradox. The listener paradox concerns the different ways that typical listeners and clinicians respond to stuttering. The communication paradox concerns the use of treatment procedures that may have negative consequences on communication. Clinicians and clients need to evaluate treatment procedures in terms of the effect they may have on communication. Understanding these two paradoxes and making effective communication the focus of treatment may improve the long-term treatment outcomes of people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about (1) why effective communication should be the central goal in the treatment of stuttering; (2) how the listener and communication paradoxes may negatively impact on communication; and (3) how understanding these paradoxes may improve the long-term outcomes of people who stutter and also improve the comfort level clinicians have in treating individuals who stutter.     

Assistive/rehabilitation technology, disability, and service delivery models

The United Nation's Millennium Development Goals do not explicitly articulate a focus on disability; similar failures in the past resulted in research, policy, and practice that are not generalizable and did not meet the needs of persons with disabilities since they were developed for an "average" population. Academics and professionals in health and other disciplines should have a knowledge base in evidence-based practices that improve well-being and participation of people with disabilities through effective service delivery of assistive technology. Grounded by a theoretical framework that incorporates a multivariate perspective of disability that is acknowledged in the convention on the rights of persons with disabilities and the World Health Organization's International Classification of Functioning, Disability and Health, we present a review of models of assistive technology service delivery and call for future syntheses of the fragmented evidence base that would permit a comparative effectiveness approach to evaluation.     

Communication attitudes in children who stutter: A meta-analytic review

BackgroundThis article presents a meta-analytic review of differences in communication attitudes between children who stutter (CWS) and children who do not stutter (CWNS).MethodTo be included in this review, the studies had to include a group of CWS and CWNS between the ages of 3–18 years and a measurement of communication attitudes. The journal articles were identified by using the key words stutter*, speech disfluenc*, fluency disorder*, and stammer* cross-referenced to awareness*, reaction*, attitude*, KiddyCAT, CAT, A-19 Scale, PASS and OASES.ResultsA total of 18 studies met the inclusion criteria for this meta-analysis. The results showed that CWS exhibit more negative communication attitudes than CWNS from the preschool years. The differences between the groups increased with age, but were not influenced by gender.ConclusionThe results indicate that negative communication attitudes can be an effect of stuttering. Key issues requiring further investigation are whether communication attitudes differ as a function of age at stuttering onset and whether communication attitudes influence the development of stuttering.Educational Objectives: After reading this article, the reader will be able to: (a) summarise empirical findings with regard to the relationship between communication attitudes and childhood stuttering; (b) describe the different instruments used to measure communication attitudes; (c) discuss the relationship between communication attitudes, age and gender.     

Elevated attention deficit hyperactivity disorder symptoms in children who stutter

PurposeThis study described the proportion of children who stutter who exhibit Attention Deficit Hyperactivity Disorder (ADHD) symptoms, manifesting in inattentive and hyperactive/impulsive behaviours. Children who stutter with these challenging behaviours may not respond as quickly and successfully to stuttering treatment. A preliminary exploration of differences in treatment responsiveness for children with and without ADHD symptoms was undertaken.MethodParticipants were 185 preschool children who stutter who had completed stuttering therapy within 3 months prior to study commencement. Differences between groups of children who stutter with and without elevated ADHD symptoms were investigated, in terms of pre-treatment stuttering features (stuttering severity and typography), demographic variables (age at onset, time between onset and commencement of therapy, family history and sex) and treatment data (post-treatment stuttering severity and number of sessions to achieve discharge criteria).ResultsOne-half (50%) of participants exhibited elevated ADHD symptoms. These children required 25% more clinical intervention time to achieve successful fluency outcomes than children without elevated ADHD symptoms. Findings suggest that more ADHD symptoms, increased pre-treatment stuttering severity, and male sex were associated with poorer responsiveness to stuttering treatment.ConclusionThe large proportion of children exhibiting elevated ADHD symptoms, and the increase in clinical contact time required in this subgroup to achieve successful fluency outcomes, is suggestive of the need for clinicians to tailor stuttering intervention to address these concomitant behaviour challenges. Findings support the use of careful caseload management strategies to account for individual differences between children, and strengthen prognostic information available to parents and clinicians.     

National Stuttering Association members' opinions about stuttering treatment

As stuttering support groups, such as the National Stuttering Association (NSA), have gained prominence and visibility, it has become increasingly important for speech-language pathologists (SLPs) to learn about the people who participate in such groups. This article presents results of a brief survey completed by 200 members of the NSA to examine the opinions of support group members regarding the field of speech-language pathology and stuttering treatment options. Results indicate that NSA members hold a variety of opinions, both positive and negative, about the resources available to them. Findings highlight a number of ways in which SLPs can work with stuttering support groups, both to learn more about the needs of people who stutter and also to provide needed information about treatment options that are available for people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) the role of support groups in stuttering treatment; (2) the people who are members of the NSA; and (3) their opinions about various issues related to stuttering and its treatment.     

Validation of the Comprehensive ICF Core Set for rheumatoid arthritis: The perspective of psychologists

The ‘Comprehensive ICF Core Set for rheumatoid arthritis (RA)’ is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with RA. The objective of this study was to validate this ICF Core Set from the perspective of psychologists. Psychologists experienced in RA treatment were asked about the problems of RA patients, treated by psychologists, in a three-round survey using the Delphi technique. Responses were linked to the ICF. Twenty psychologists in five countries gave a total of 303 responses that were linked to 65 different ICF categories. Fifteen responses were linked to the not yet developed ICF component personal factors and nine were not covered by ICF. Overall, 66% of the ICF categories linked to the responses of the psychologists were represented by the Comprehensive ICF Core Set for RA. Several responses that were not covered need to be investigated further.