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Lamoureux G, Finlay S, Moïse-Richard A, Ménard L, Verduyckt I. Mitigating stuttering self-stigma: How do we start and where do we go? Using a Participative Concept Mapping Approach to develop a local framework of principles. JOURNAL OF FLUENCY DISORDERS 2024; 81:106075. [PMID: 39067312 DOI: 10.1016/j.jfludis.2024.106075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE This study aims to create a stigma reduction framework for stuttering in the local context of Québec, Canada using the Participative Concept Mapping Approach (PCMA), focusing on both self and societal stigma. METHOD Employing a mixed-methods approach, this study engaged 17 experts-people who stutter, clinicians and health innovation specialists-in PCMA workshops. Via diverse steps, including generation, sorting and rating of ideas in response to the focus prompt, "To effectively address stuttering (self-)stigma, an intervention should…" these sessions led to a framework depicted in visual maps, then refined into actionable principles through qualitative analysis. Mixed-methods data analysis used the open-source R-CMap software to generate visual maps illustrating the relationships among ideas as well as importance and feasibility ratings. RESULTS The collaborative workshops identified 95 ideas in response to the focus prompt, reunited in 7 clusters, evolving into 16 principles to mitigate stuttering stigma and self-stigma. At the therapy level, these principles emphasize personalized therapy, thorough assessments, stigma-free therapeutic environment, empowerment, and the importance of group inclusivity and educating the relational circles. Societally, they advocate for initiatives such as improved educational outreach, empathy enhancement, and better representation. This dual approach targets individual experiences and societal views on stuttering, stressing the need for an all-encompassing intervention framework. CONCLUSION The findings demonstrate PCMA's usefulness in crafting local, culturally sensitive, tailored interventions for stigma reduction. The study emphasizes the necessity of holistic approaches that address individual experiences and societal perceptions, offering a model to conduct similar exercises in diverse local settings.
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Affiliation(s)
- Geneviève Lamoureux
- School of Speech-Language Therapy and Audiology, Université de Montréal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada.
| | - Sébastien Finlay
- School of Speech-Language Therapy and Audiology, Université de Montréal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Anne Moïse-Richard
- School of Speech-Language Therapy and Audiology, Université de Montréal, Montreal, Canada; Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada
| | - Lucie Ménard
- Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; Laboratoire de Phonétique, Université du Québec à Montréal, Canada
| | - Ingrid Verduyckt
- School of Speech-Language Therapy and Audiology, Université de Montréal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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Boyle MP, Cheyne MR. Major discrimination due to stuttering and its association with quality of life. JOURNAL OF FLUENCY DISORDERS 2024; 80:106051. [PMID: 38503059 DOI: 10.1016/j.jfludis.2024.106051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study aimed to identify what types of major discrimination have been experienced by adults who stutter throughout their lives, and investigate the association between the number of different types of major discrimination events experienced and quality of life. METHODS Measures of quality of life (Kemp Quality of Life Scale) and major discrimination (adapted Major Experiences of Discrimination Scale) were completed by 303 adults who stutter. Correlational and regression analyses were conducted with these variables. RESULTS A majority (56%) of the participants had experienced at least one episode of major discrimination due to stuttering during their lives. The major discrimination experiences most commonly reported included not being hired for a job and being discouraged by a teacher or advisor from pursuing certain careers or jobs because of stuttering. There was a significant negative relationship between quality of life and major discrimination. Increased major discrimination predicted lower quality of life even after taking into account demographic variables and severity of physical speech disruption. CONCLUSIONS The findings of a negative association between major discrimination and quality of life add support to the notion that reducing societal stigma related to stuttering should be a priority of the field. Discriminatory practices of listeners constitute a social-environmental barrier to communicative participation and quality of life in people who stutter and should be addressed by professionals in the field of speech-language pathology and other stakeholders.
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Affiliation(s)
- Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, United States.
| | - Madeline R Cheyne
- Department of Communication Sciences and Disorders, Montclair State University, United States
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Franken MC, Oonk LC, Bast BJEG, Bouwen J, De Nil L. Erasmus clinical model of the onset and development of stuttering 2.0. JOURNAL OF FLUENCY DISORDERS 2024; 80:106040. [PMID: 38493582 DOI: 10.1016/j.jfludis.2024.106040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/25/2023] [Accepted: 02/11/2024] [Indexed: 03/19/2024]
Abstract
A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker's experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus.
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Affiliation(s)
- Marie-Christine Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Leonoor C Oonk
- StotterFonds, Nijkerk, the Netherlands; University of Applied Sciences, Department of Speech-Language Therapy, Utrecht, the Netherlands
| | | | - Jan Bouwen
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Luc De Nil
- Department of Speech-Language Pathology, University of Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Canada.
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Dew CW, Gabel RM. How perceived communication skills needed for careers influences vocational stereotyping of people who stutter. JOURNAL OF FLUENCY DISORDERS 2024; 80:106039. [PMID: 38359501 DOI: 10.1016/j.jfludis.2024.106039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/15/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Prior research has revealed people who stutter experience role entrapment in which they are discouraged from pursuing certain careers over others. The Vocational Advice Scale (VAS; Gabel et al., 2004) is a reliable survey previously used to investigate this phenomenon. This study used the VAS to determine if communication skills required for careers influences reports of role entrapment. METHOD An online survey which included the VAS and perceptions of communication skills needed for each career listed on the VAS was distributed. Correlations between items on the two surveys were completed to investigate how communication skills influences the presence of role entrapment. In addition, a one-way analysis of variance was completed to explore differences between individuals who regularly provide career advice with those who do not. RESULTS Analysis found a significant correlation between perceived communication skills required for a career and the advice provided. As the perceived communication skills needed for a career increases, the likelihood of someone advising a person who stutters to pursue that career decreases. A one-way analysis of variance further revealed participants who regularly provide career advice did not differ from those participants who do not. CONCLUSION Perceived communication abilities needed for a career is a significant indicator of role entrapment towards people who stutter. Results agree with previous studies which found differences in advisability of certain careers over others for people who stutter, especially those which require communication within challenging situations (e.g., judge, attorney).
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Affiliation(s)
- Cody W Dew
- Binghamton University, Binghamton, NY, USA.
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Ameri M. From Classroom to Boardroom: Self-Advocacy and Navigating the Transition for Students with Disabilities. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:327-334. [PMID: 37955743 DOI: 10.1007/s10926-023-10144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE This article evaluates the effectiveness of Career Services in supporting college students with disabilities to self-advocate for their accommodation rights during the job search. METHOD A qualitative case study was conducted at one university to examine how their Career Services unit educates, trains, and supports students with disabilities in their professional development. Two rounds of interviews were conducted: one with university staff responsible for such services to assess policies and practices in providing support, and one with students and alumni with disabilities to gather feedback on their experiences with career planning and employment. RESULTS Three key themes emerged from the data: (1) Disability stigma negatively impacts a willingness to self-advocate among participants (this is especially true among those belonging to multiple marginalized groups); (2) the lack of transition support by the university further entrenches this stigma; and (3) participants report subsequent challenges in the crossover to employment. CONCLUSION These identified barriers discouraged participants from planning for and seeking workplace accommodations and highlighted the need for universities to provide more comprehensive support for their professional development.
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Teborg S, Hünefeld L, Gerdes TS. Exploring the working conditions of disabled employees: a scoping review. J Occup Med Toxicol 2024; 19:2. [PMID: 38291467 PMCID: PMC10826256 DOI: 10.1186/s12995-023-00397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/08/2023] [Indexed: 02/01/2024] Open
Abstract
PURPOSE Disabled people are often overlooked in considerations about work design, which contributes to their exclusion from the labor market. This issue also reflects within research, as the body of knowledge on the working conditions of disabled employees remains relatively limited. METHODS A scoping review was conducted to assess the research landscape concerning the working conditions of disabled employees. Five databases have been searched, focusing on relevant studies published between 2017 and 2022. RESULTS One hundred fourteen studies were included in the review. It was found that social aspects of work appeared within a substantial portion of the examined studies. Furthermore, it became evident that the interplay of accessibility and flexibility provides an important dynamic to make work design both inclusive and feasible. CONCLUSION The recurrent prominence of social aspects, accessibility, and flexibility across the studies shows common challenges and potentials within the work situation of disabled employees. This suggests avenues for future research and inclusive work design.
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Affiliation(s)
- Sophie Teborg
- Federal Institute for Occupational Safety and Health, Unit 1.2 Monitoring Working Conditions, Dortmund, Germany.
| | - Lena Hünefeld
- Federal Institute for Occupational Safety and Health, Unit 1.2 Monitoring Working Conditions, Dortmund, Germany
| | - Tomke S Gerdes
- Department of Rehabilitation Sciences, TU Dortmund University, Dortmund, Germany
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Croft RL, Byrd CT. Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4259-4279. [PMID: 37816227 PMCID: PMC10715847 DOI: 10.1044/2023_jslhr-23-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/30/2023] [Accepted: 08/02/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing. METHOD Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2. RESULTS Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior. CONCLUSION Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24223213.
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Affiliation(s)
- Robyn L. Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Courtney T. Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
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Norman A, Lowe R, Onslow M, O'Brian S, Packman A, Menzies R, Schroeder L. Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4414-4431. [PMID: 37751681 DOI: 10.1044/2023_jslhr-23-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
PURPOSE For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness. METHOD Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis. RESULTS Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall. CONCLUSIONS For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24168201.
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Affiliation(s)
- Alicia Norman
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Liz Schroeder
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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Boyle MP, Cheyne MR, Rosen AL. Self-Stigma of Stuttering: Implications for Communicative Participation and Mental Health. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3328-3345. [PMID: 37524109 DOI: 10.1044/2023_jslhr-23-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
PURPOSE The purpose of this study was to determine if self-stigma-related variables predicted communicative participation and mental health in adults who stutter. A progressive model of self-stigma was theorized and tested. METHOD Adults who stutter (N = 344) completed a survey that included measures of communicative participation, global mental health, and a variety of self-stigma-related variables including perceived enacted stigma, stigma awareness, anticipated stigma, felt stigma, stereotype agreement, and stigma application, in addition to demographic and speech-related variables. Hierarchical regression was performed to test whether self-stigma-related variables progressively explained significant variance in both communicative participation and global mental health.c Results: After controlling for demographic and speech-related variables, stigma-related variables were found to be significant predictors of both communicative participation and global mental health among adults who stutter. Most self-stigma-related variables entered later in the model predicted additional unique variance in the outcome variables than the self-stigma-related variables entered in previous steps, thus supporting the trickle-down and progressive nature of the self-stigma model theorized. CONCLUSIONS Accounting for self-stigma in the assessment and treatment of individuals who stutter may identify and ultimately reduce environmental and personal barriers to communicative functioning and well-being in people who stutter. The self-stigma terminology and model described in this study will help practitioners, researchers, and the public better understand the process of self-stigma and how it may be associated with adverse outcomes experienced by people who stutter.
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Affiliation(s)
- Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Madeline R Cheyne
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Amy L Rosen
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
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Lindsay S, Fuentes K, Tomas V, Hsu S. Ableism and Workplace Discrimination Among Youth and Young Adults with Disabilities: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:20-36. [PMID: 35976480 DOI: 10.1007/s10926-022-10049-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Young people with disabilities are persistently under-employed and experience concerning rates of discrimination and ableism in looking for work and within the workplace. Focusing on youth is salient because rates of ableism are often higher among younger ages compared to older. The objective of this systematic review was to explore the experiences and impact of workplace discrimination and ableism among youth and young adults with disabilities. METHODS Systematic searches of seven databases from 2000 to 2021 were conducted. Four reviewers independently applied the inclusion criteria, extracted the data and rated the study quality. RESULTS Of the 39 studies meeting our inclusion criteria, they represented 516,281 participants across eight countries over a 20-year period. The findings highlight the rates of workplace ableism, factors affecting workplace ableism (i.e., type of disability, gender, education level, lack of employers' knowledge about disability), ableism in job searching and anticipated ableism. The review also noted the impact of workplace ableism, which included pay discrimination, lack of job supports and social exclusion, job turnover and unemployment, and discrimination allegations and charges. CONCLUSIONS Our findings reveal the stark prevalence of workplace ableism among youth and young adults with disabilities. There is an urgent need for further in-depth research to understand youth's lived experiences of ableism and the development of solutions to address it so they can be included in a meaningful and respectful way in the workplace.
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Affiliation(s)
- Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.
| | - Kristina Fuentes
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Vanessa Tomas
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Shaelynn Hsu
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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Briley PM, Jacobs MM. Speech Therapy and Earnings: Economic Benefits for Individuals Who Stutter. Semin Speech Lang 2022; 43:233-243. [PMID: 35858608 DOI: 10.1055/s-0042-1748882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Stuttering is a complex communication disorder with effects that extend beyond difficulty with communication. Negative thoughts and feelings by the person who stutters (PWS), about the disorder or themselves, may potentially lead to detrimental avoidance behaviors which may ultimately alter life choices and participation in life events. One such area is the labor market. Studies have revealed an association between stuttering and reduced earnings. What is not understood is whether provision of speech therapy for PWS can help mitigate the negative labor market impacts of this condition. This article discusses the disorder of stuttering and how approach versus avoidance responses can contribute to wage differentials among PWS, while also providing evidence of such differences using a nationally representative dataset. Additionally, this article outlines the potential benefits received from speech-language pathology services which may correlate with improved labor market outcomes.
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Affiliation(s)
- Patrick M Briley
- Department of Communication Sciences and Disorders, College of Allied Health Sciences, East Carolina University, Greenville, North Carolina
| | - Molly M Jacobs
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
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Connery A, Yaruss JS, Lomheim H, Loucks TM, Galvin R, McCurtin A. Obtaining consensus on core components of stuttering intervention for adults: An e-Delphi Survey with key stakeholders. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:112-127. [PMID: 34818457 DOI: 10.1111/1460-6984.12680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence-based practice involves the synthesis of multiple forms of evidence to inform clinical decision-making and treatment evaluation. Practice- and patient-based evidence are two forms of evidence that are under-represented in the stuttering literature. The collection of such knowledge is essential to support the design and delivery of effective stuttering interventions for adults. AIMS To build stakeholder consensus on the core components of intervention for adults who stutter, and to establish a guiding framework for the design and development of evidence-based interventions for adults who stutter. METHODS & PROCEDURES Adults who stutter and speech and language therapists (SLTs) with experience in providing stuttering intervention participated in the three-round e-Delphi Survey focused on: (1) identifying key stuttering intervention components, including principles, practices, and structural and contextual elements; and (2) obtaining group consensus on stuttering intervention components. Statements were categorized using the International Classification of Functioning, Disability and Health (ICF) model adapted to the study of stuttering. OUTCOMES & RESULTS A total of 48 individuals agreed to participate: 48/48 (100%) completed the Round 1 questionnaire, 40/48 (83%) responded to Round 2 and 36/40 (90%) participated in Round 3. Following content analysis of Round 1, 101 statements were developed, and consensus was achieved on 89 statements perceived as representing the core components of stuttering intervention for adults. Categorization of these statements reflected the key stuttering intervention components relating to personal reactions to stuttering, limitations in life participation and environmental factors. CONCLUSIONS & IMPLICATIONS Consensus on the core components of stuttering intervention was reached through engagement with key stakeholders. The evidence-based framework presented highlights the range of key intervention components a clinician should consider when designing interventions for adults who stutter. WHAT THIS PAPER ADDS What is already known on the subject Evidence-based practice endorses the synthesis of multiple knowledge forms including research, practice and patient evidence to support clinical decision-making and treatment evaluation. The stuttering literature is characterized by an over-representation of efficacy evidence, with significantly less practice and patient evidence to guide clinical practice. What this paper adds to existing knowledge This study adds valuable practice- and patient-based evidence for effective stuttering intervention components for adults who stutter. These relate to personal reactions to stuttering, limitations in life participation and environmental factors. What are the potential or actual clinical implications of this work? This research presents a stakeholder-informed framework for stuttering intervention to guide SLTs working with adults who stutter in designing evidence-based interventions. The framework supports the adoption of a person-centred approach to intervention to ensure each client's unique needs, preferences, values and desired outcomes are explored and integrated into therapy.
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Affiliation(s)
- Amy Connery
- School of Allied Health, University of Limerick, Limerick, Ireland
- HSE Dublin South West, Tallaght, Dublin, Ireland
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - Holly Lomheim
- ISTAR-Institute for Stuttering Treatment and Research, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Torrey M Loucks
- ISTAR-Institute for Stuttering Treatment and Research, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Arlene McCurtin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
- Health Implementation in Science & Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland
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Seitz SR, Choo AL. Stuttering: Stigma and perspectives of (dis)ability in organizational communication. HUMAN RESOURCE MANAGEMENT REVIEW 2021. [DOI: 10.1016/j.hrmr.2021.100875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Iimura D, Miyamoto S. Public attitudes toward people who stutter in the workplace: A questionnaire survey of Japanese employees. JOURNAL OF COMMUNICATION DISORDERS 2021; 89:106072. [PMID: 33388698 DOI: 10.1016/j.jcomdis.2020.106072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/29/2020] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE Negative attitudes toward stuttering by people in their work roles have been previously reported. These attitudes could differ depending on whether or not someone knows a person or has been in contact with a person who stutters. This study aimed to elucidate public attitudes toward people who stutter at work. METHODS A web-based questionnaire survey of 730 adults drawn from the general public throughout Japan was conducted. It gathered information on respondents' demographics, contact experience with people who stutter, knowledge of stuttering, and attitudes and experiences toward stuttering at work, using a Likert-type scale. To investigate the factors associated with their attitudes and experiences toward stuttering at work, respondents' demographic information and contact experience were entered into a multivariable model using ordinal logistic regression analysis. RESULTS We analyzed the data of 671 respondents, of whom 77.2 % were company employees; 41.3 % knew a person who stutters at their workplace, among their friends, and/or in their family, and 34.7 % had been in the position of hiring any individual. Respondents perceived the employment of people who stutter to be somewhat positive overall. Regression analysis revealed that only the factor of workplace contact experience to be significantly positively associated with the respondents' attitudes toward stuttering. That is, knowing a person who stutters in one's workplace was significantly associated with more positive attitudes. CONCLUSION Previous studies have reported widespread negative public attitudes toward stuttering. Our results can supplement this literature, especially regarding attitudes in the workplace. Our findings suggest that the main factor that is associated with people's positive attitudes is their contact experience with people who stutter in their workplace.
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Affiliation(s)
- Daichi Iimura
- Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki-shi, Okayama, 701-0193, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, 305-8577, Japan.
| | - Shoko Miyamoto
- Faculty of Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, 305-8577, Japan
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