Stuttering attitudes in Hong Kong and adjacent Mainland China

Public attitudes toward stuttering and cluttering in Chinese and Japanese speech-language pathology students

PURPOSE

This study utilized the Chinese and Japanese translations of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Cluttering (POSHA-Cl) to compare the differences in (a) attitudes towards stuttering versus cluttering in speech-language pathology (SLP) students in either China or Japan, (b) attitudes of SLP students in China versus Japan towards either stuttering or cluttering, and (c) attitudes of Chinese and Japanese students versus international databases for stuttering and cluttering.

METHOD

The POSHA-S and POSHA-Cl were both administered to 99 SLP students from six universities in China and 352 SLP students from two universities in Japan.

RESULTS

Attitudes toward stuttering were markedly different for Chinese versus Japanese students. Overall, stuttering attitudes were slightly more positive than cluttering attitudes in both countries; however, compared to China, Japanese SLP students attitudes toward stuttering and cluttering were more disimilar. In addition, compared with the international database, the attitudes of Chinese and Japanese SLP students toward self-reactions to both disorders were more positive.

CONCLUSION

Chinese and Japanese SLP students' attitudes toward both stuttering and cluttering are likely to be influenced by geography, culture, education, and the "halo effect." The attitudes of the SLP students in China and Japan are more negative than the attitudes as shown in the global data.

Attitudes toward stuttering of college students in the USA and China: A cross-cultural comparison using the POSHA-S

PURPOSE

This study compared the attitudes toward stuttering among college students in China and the USA using the POSHA-S survey, which assesses knowledge about stuttering and attitudes toward it. We investigated how cultural and social differences between the two groups influenced these attitudes.

METHODS

We collected 199 responses to the POSHA-S survey from various universities in China and the USA. We conducted a statistical analysis of 15 summary scores generated from the POSHA-S to determine if there were significant differences in attitudes toward stuttering between the two groups. Additionally, we retrieved percentile ranks relative to the global POSHA-S database to compare attitudes in both groups with global median scores.

RESULTS

The study revealed that Chinese college students hold more negative attitudes toward stuttering compared to their American counterparts and the global median scores. We discussed the social and cultural factors that may contribute to these attitudes. Furthermore, our findings emphasized the importance of addressing the lack of accurate information about stuttering in China, which could be a key factor driving these negative attitudes.

CONCLUSION

These results underscore the urgent need to raise awareness about stuttering and promote a shift in public attitudes, especially among college students in China, who play influential roles in society's future.

Predictors of public attitudes in Saudi Arabia toward people who stutter

PURPOSE

The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) was used to measure the attitudes of the general population in Saudi Arabia toward people who stutter (PWS) and to identify the predictors of the overall stuttering score (OSS).

METHOD

A total of 404 adults from Saudi Arabia (16.8% male and 83.2% female) completed an online POSHA-S questionnaire.

RESULTS

The attitudes of adults in Saudi Arabia were similar to those of other samples worldwide. Working status, income, and multilingualism were substantial predictors of the OSS.

CONCLUSION

Saudi adults have positive impressions, beliefs, and self-reactions to PWS. However, their knowledge of stuttering tends to be limited. Therefore, campaigns conducted to raise awareness of stuttering should adopt the most widely used sources of knowledge in the Saudi Arabian community (i.e., the Internet and social media). Sociodemographic variables predictive of positive versus negative OSS include working status and multilingualism. Unpredictive variables, that do not predict positive versus negative OSS, include age, gender, education, parental status, health, abilities, and income.

Stuttering experience of people in China: A cross-cultural perspective

PURPOSE

This study uses the Simplified Chinese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A-SC) to examine the stuttering experience of people in China and determine if there are differences between the data collected in China and other countries.

METHODS

A total of 139 responses to the OASES-A-SC were collected in an online self-help community of people in China who stutter. Descriptive analyses were conducted to obtain the understanding of how stuttering impacts the life experience of people in China who stutter. Comparisons were conducted regarding the groups of gender, highest education, and therapy history. Cross-cultural comparisons among the data collected from China, Australia, the Netherlands, Japan, Sweden, and the USA were also conducted.

RESULTS

The data for the OASES-A-SC showed a skewed distribution toward the severe end of the OASES-A impacting scale. About 93.5% participants rated the overall impact of stuttering on their life at and above the "Moderate" category. The mean scores of the General Information, Reaction to Stuttering, and Qualify of Life sections fell in the moderate-to-severe category. Compared with the data in other five countries, the Chinese data were significantly higher in the impact severity level.

CONCLUSION

The results showed that people in China who stutter have more adverse experiences related to stuttering compared with their counterparts in western or developed countries. Higher negative attitudes toward stuttering in China, social stigma against people with disabilities, and the fewer professional supports were discussed to be associated with this more adverse experience. Cultural differences such as a greater power distance and higher collectivism in Chinese culture were considered to be associated with the elevated level of adverse impact of stuttering in China.

Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K)

INTRODUCTION

Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter.

METHOD

The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment.

RESULTS

The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K.

CONCLUSION

The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.

Public attitudes toward stuttering in Malaysia

PURPOSE

This study aims to: (a) measure public attitudes toward stuttering in Malaysia using the Public Opinion Survey of Human Attitudes-Stuttering [POSHA-S], (b) determine how reported attitudes and knowledge related to stuttering compare to existing data, and (c) determine whether there are differences between groups for identified variables.

METHOD

A total of 250 adults (mean age = 29 years; range = 19-60 years) completed the POSHA-S in English. We compared this sample's attitudes toward stuttering to POSHA-S data from other global samples. General linear modeling examined differences in overall stuttering score, beliefs, and self reaction subscores for demographic variables such as age, gender, marital status, parenting, education, employment status, prior exposure to a person who stutters, multilingual, race, and religion.

RESULTS

The Malaysian participants' overall stuttering score and the beliefs and self reactions subscores were all considerably lower (i.e., less positive) than the other samples around the world from the POSHA-S database median values. Being male, receiving a higher education, and knowing someone who stutters were linked to having more positive self reactions, but none of those factors was linked to positive or negative beliefs. Those who had previously been exposed to stuttering scored significantly higher than those who had not.

CONCLUSION

Malaysians may have less positive attitudes toward stuttering than Westerners. More needs to be done to make society more accepting of people who stutter. Future research should aim to find ways to educate and to raise public awareness about stuttering.

Stuttering, family history and counselling: A contemporary database

BACKGROUND

Information about genetic influence is useful to when counselling parents or caregivers who have infants and children at risk for stuttering. Yet, the most comprehensive family aggregate database to inform that counselling is nearly four decades old (Andrews et al., 1983). Consequently, the present study was designed to provide a contemporary exploration of the relationship between stuttering and family history.

METHODS

Data were sourced from the Australian Stuttering Research Centre, comprising 739 participants who presented for assessment, treatment, or investigation of stuttering. Reported family history data were acquired from pedigrees collected during assessment. We sought to establish the relation of the following variables to family history of stuttering: incidence, proband sex, parent sex, stuttering severity, age, reported age of stuttering onset, and impact of stuttering. Data were analysed with chi-square tests for independence, logistic and linear regression models.

RESULTS

Results were broadly consistent with existing data, but the following findings were novel. Males and females who stutter have the same increased odds of having a father who stutters relative to a mother who stutters. Males had later stuttering onset than females, with genetic involvement in this effect. There was a greater impact of stuttering for females than males with a family history of stuttering.

CONCLUSION

These findings have clinical applications. Speech-language pathologists may have infant or child clients known to them who are at risk of beginning to stutter. Information from the present study can be applied to counselling parents or caregivers of such children about stuttering and family history.

Australian attitudes towards stuttering: A cross-sectional study

BACKGROUND

Negative reactions experienced by people who stutter often stem from unfounded attitudes and beliefs in the community.

PURPOSE

There is a need to better understand current public attitudes towards stuttering in Australia. The purpose of this study was to: (a) explore the attitudes and knowledge of a large sample of the Australian public using the Public Opinion Survey of Human Attitudes-Stuttering [POSHA-S], (b) identify how the reported attitudes towards, and knowledge of, stuttering compare to existing data, and (c) identify differences between groups for variables identified.

METHODS

A cross-sectional population study using the POSHA-S was conducted in Melbourne, Australia. Comparisons of the attitudes towards stuttering of this sample were made with data from other worldwide samples on the POSHA-S database. The influence on attitudes to stuttering of variables including age, gender, education level, country of birth, employment status and number of languages spoken was explored.

RESULTS

The Overall Stuttering Score (OSS) of the Australian sample was higher than the median score on the POSHA-S database. This suggests that the Australian public holds more positive attitudes than those other countries represented in the database. Being younger, more educated, employed, female, monolingual, born in Australia and not familiar with people who stutter were related to more positive attitudes for this sample. Some negative stereotypes towards stuttering were noted; people who stutter were identified as 'shy and fearful', and 'nervous and excitable'.

CONCLUSIONS

While the Australian public has generally positive attitudes towards stuttering, these attitudes still reflect some 'stuttering stereotypes'.

Sleep duration, insomnia, and stuttering: The relationship in adolescents and young adults

PURPOSE

Evidence of a linkage between neurodevelopmental stuttering and sleep difficulties has been suggested in studies involving children and adolescents. To further examine the relationship between stuttering and sleep, the current study explored both hours of sleep and insomnia in a longitudinal sample of adolescents and young adults living with stuttering.

METHOD

The data for this study came from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative survey study following 13,564 US respondents over the course of 20 years. In each of the five survey waves, respondents noted their average hours of sleep. In addition, Wave IV, respondents indicated whether they suffered from insomnia (i.e., difficulty falling or staying asleep). Respondents who indicated stuttering at ages 18-26 (Wave III) and 24-32 (Wave IV) are considered as those with persistent stuttering-the focus of this analysis. Regression analysis assessed the association between stuttering, hours of sleep and insomnia controlling for sex, age, race, education and other demographic characteristics.

RESULTS

The sample included 261 participants (1.7% of total respondents) who identified themselves as people who stutter, comprised of 169 males and 92 females. Compared to their fluent counterparts, individuals who stutter reported to sleep, on average, 20 min less per night. Additionally, 15% of those who stutter reported difficulties falling or staying asleep almost every day or every day, which is twice as likely as controls. Results were robust to demographic characteristics and co-occurring conditions.

CONCLUSIONS

Speech-language pathologists should be aware of the association between stuttering and insomnia, as well as the lower average hours of sleep among adolescents and young adults who stutter. The possibility that lower sleep duration and insomnia may affect stuttering daily variability and impair improvement from stuttering are discussed.

Cultural difference in attitudes towards stuttering among British, Arab and Chinese students: Considering home and host cultures

BACKGROUND

Geographical and cultural differences have been shown to affect public attitudes towards stuttering. However, increasingly for many individuals in the world one's birthplace culture (or home culture) and culture in their local geographical environment (or host culture) are not the same.

AIMS

The effects of home culture and host culture in shaping the attitudes towards stuttering among students with British, Arab and Chinese home cultures attending one British university were explored. The effects of host culture were investigated by considering the time lived in the UK for Arab and Chinese students.

METHODS & PROCEDURES

The study used a descriptive survey design that included a standardized self-delivered questionnaire: the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S). Purposive sampling was carried out thorough volunteer mailing lists, student societies and personal contact. The final sample of 156 university students included 51 British, 52 Arab and 53 Chinese students.

OUTCOMES & RESULTS

Overall stuttering score (OSS), which is indicative of attitudes towards stuttering, was highest for British participants (mean = 30) and lowest for Chinese participants (mean = 13), with Arab participants falling in the middle (mean = 21). The differences in attitudes between the three groups were statistically significant, suggesting that home culture is a contributor to attitudes towards stuttering. A post-hoc item analysis of the POSHA-S revealed numerous specific differences in attitudes towards stuttering between the three groups, including differences in the attribution of the aetiology of stuttering, their role in helping people who stutter (PWS) and sympathy toward PWS. Time lived in the UK-a proxy measure for the role of host culture-did not significantly influence the attitudes of Arab and Chinese respondents.

CONCLUSIONS & IMPLICATIONS

To varying degrees, all three groups had evidence of stereotypical stuttering attitudes. Nevertheless, given similar ages and student status in the same university, observed respondent differences confirm previous research documenting geographical influences on stuttering attitudes in Western versus East Asian and Middle Eastern samples. The study also provides evidence that home culture was influential in shaping attitudes towards stuttering, but host culture was not a significant contributor. What this paper adds What is already known on the subject Public stereotypical beliefs towards stuttering are found across the world and hinder the quality of life among PWS. Different cultures have unique stereotypical beliefs towards PWS. What this study adds to existing knowledge To the best of our knowledge, no other study has investigated specifically if individuals who live in the same geographical location but have different home cultures, have similar or differing attitudes towards PWS. Results provide preliminary evidence that the home culture of an individual was influential in shaping attitudes towards PWS, but host culture, measured as the length of time living in the current geographical location, did not have a significant relationship with attitudes towards stuttering. What are the potential or actual clinical implications of this work This study highlights that culturally sensitive clinical practice should not be based on just the culture of the region but should take home culture into consideration as well, and clinicians should discuss cultural perceptions of stuttering with clients in clinical practice.

A Questionnaire Survey About Support Requests From School-Age Children and Adolescents Who Stutter

Purpose Children who stutter (CWS) face communication difficulties in school activities and at home. Although the importance of receiving support from their surroundings has been documented, few studies have investigated potential requests of CWS from their surroundings. This study aimed to elucidate such requests. Method A total of 43 school-age children and 25 adolescents who stutter completed a free-description questionnaire, including questions such as "what you want your classmates/your classroom teacher/your family to do about your stuttering?" Their descriptions were summarized and categorized based on similarity. Results The results indicate that 90.6% of the participants had more than one request for their classmates, classroom teacher, or family. A total of 197 items were extracted and categorized into seven themes. In particular, the responses included "listen attentively," "treat us naturally," and "make arrangements." While participants tended to hope for classmates or family to "listen attentively" and "treat us naturally," the request to "make arrangements" was higher for their teacher. Their potential requests varied by age: While school-age CWS wanted people around them to "listen carefully," the hope of adolescents who stutter was "treat us naturally." Conclusions The various potential requests of CWS were categorized, and the responses shed light on the importance of increasing knowledge of stuttering. The difference between the requests could reflect psychosocial differences between school-age children and adolescents who stutter. In addition, social interaction among peers is more developed in adolescents, and they could harbor fear of being excluded within their community.

Louis K. Public attitudes towards people who stutter in South Egypt

Purpose

Stuttering is a multifactorial speech disorder with significant social and psychological consequences. There is a lack of knowledge about public attitudes towards people who stutter (PWS) and the factors that can determine such attitudes in underprivileged communities. This study aimed to assess the public attitudes in South Egypt towards PWS and compare our results with those stored in a reference database representing 180 different samples.

Methods

A multi-stage random sampling approach was used to recruit 650 people from Beni-Suef City in South Egypt. All participants were interviewed using the Arabic version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) after getting their informed consent. This instrument assesses people’s Beliefs and Self Reactions towards PWS in addition to their sociodemographic characteristics.

Results

The Beliefs and Self Reactions subscores in addition to the Overall Stuttering Score of the Egyptian sample were remarkably lower than the median values of the reference database (12 versus 34), (-4 versus 2), and (4 versus 18), respectively. TV, radio, and films were the main sources of knowledge about stuttering. Egyptian participants who reported average to high income were more likely to have a positive attitude (≥50% of Overall Stuttering Score) towards PWS than their counterparts with low income (Odds Ratio = 1.57, 95% Confidence Interval: 1.08–2.28).

Conclusion

People in South Egypt showed a less positive attitude towards PWS compared with other populations worldwide. Further studies should focus on changing the public attitudes towards PWS through awareness programs that consider the cultural perspectives of the society.

Public attitudes toward people who stutter in the workplace: A questionnaire survey of Japanese employees

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.

Comparing and Predicting Public Attitudes Toward Stuttering, Obesity, and Mental Illness

Purpose Extensive research on public attitudes has documented stigma toward stuttering, obesity, and mental illness; however, most studies have focused on only one of these conditions. This study sought to compare public attitudes toward stuttering, obesity, and mental illness as well as to identify the predictive potential of four ratings relating to these and other neutral or desirable conditions. Method Five hundred respondents who were selected from each of three international databases filled out the Public Opinion Survey of Human Attributes (POSHA) for stuttering, obesity, or mental illness. The POSHA surveys were as similar as possible, and all contained four general items asking respondents' "impression" of the attribute, extent to which he or she "wants to be/have" that attribute, "amount known" about the attribute, and "persons known" who manifest the attribute, for stuttering, obesity, and mental illness plus two others, namely, left-handedness and intelligence. The POSHA surveys also had the same summary scores, Beliefs, Self-Reactions, and an Overall Score. Results Summary scores for the three POSHA surveys in the 500-respondent samples revealed negative attitudes toward all three conditions, the most positive being toward obesity, followed by stuttering and then by mental illness. Stepwise regression analysis indicated that various general items had significant prediction potential not only of attitudes for the same condition but also of attitudes for other conditions. The greatest other condition predictions were between stuttering and mental illness. Conclusions Stuttering is regarded as less stigmatizing than mental illness but more stigmatizing than obesity. Additionally, positivity toward one condition results in limited positivity toward the others. Impressions and knowledge of-as well as experience with-stigmatized conditions can inform public awareness campaigns and individual clinical programs dealing with stigma. Supplemental Material https://doi.org/10.23641/asha.12860939.

Success in changing stuttering attitudes: A retrospective analysis of 29 intervention studies

BACKGROUND

Against the backdrop of hundreds of studies documenting negative stereotypes and stigma held by the public regarding people who stutter, a substantial number of investigations have attempted to improve public attitudes and measure their results with a standard instrument, the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S). Although the majority of interventions have been moderately to quite successful, a substantial minority have been unsuccessful.

PURPOSE

This study sought to determine what properties of interventions and demographic variables were predictive of least to most successful interventions. Preliminary to that, however, it required the division of samples into clearly differentiated categories of success.

METHOD

Twenty-nine different study samples containing 934 participants were categorized into four levels of success of interventions according to pre versus post POSHA-S summary mean ratings. Intervention properties and demographic characteristics and for each success category were analyzed for their predictive potential of successful attitude improvement.

RESULTS

Interventions characterized by high interest or involvement, meaningful material, and content that respondents found to be relevant, but not excessive, tended to be associated with more successful interventions. In contrast, demographic variables were weak predictors of intervention success.

CONCLUSION

The authors hypothesize that maximally effective interventions reflect optimal matches between participant characteristics and intervention features, although the critical variables in each are not yet apparent.

Swedish outcomes of the Overall Assessment of the Speaker's Experience of Stuttering in an international perspective

Aim: The purpose of the present project was to translate the Overall Assessment of the Speaker's Experience of Stuttering (OASES) to Swedish, and to compare the results with available international data.Method: The Swedish versions of OASES-A, OASES-T and OASES-S were administered to 80 adults, 27 teenagers and 32 children who stutter, respectively. The overall impact scores and the impact scores for each of the four sections of the instrument were analyzed in relation to other studies involving the OASES.Results: The results revealed that all three Swedish versions of OASES had normally distributed outcomes and that they were reliable and valid. The overall impact scores for adults (2.33), teenagers (2.60) and children (2.28) all fell within Impact Rating Moderate. The mean overall impact score for OASES-A-S was significantly lower than corresponding data from USA, Australia and Japan (p < .01). There was no difference between Swedish and American teenagers, or between Swedish and American or Dutch schoolchildren.Conclusion: There seems to be cultural differences in the experience of negative consequences associated with stuttering. This suggests that cultural aspects should be carefully considered in assessment, treatment, and research involving individuals who stutter.

Comparing stuttering attitudes of preschool through 5th grade children and their parents in a predominately rural Appalachian sample

BACKGROUND

Theories relating to young children's social cognitive maturity and their prevailing social groups play important roles in the acquisition of attitudes. Previous research has shown that preschool and kindergarten children's stuttering attitudes are characterized by stronger negative beliefs and self reactions than those of parents. By contrast, 12 year-old children's stuttering attitudes have been shown to be similar to their parents' attitudes. Other research indicates that parental stuttering attitudes are no different from attitudes of adults who are not parents.

PURPOSE

The purpose of this study was to explore children's stuttering attitudes of preschool through 5th grade children and to compare them to their parents' attitudes.

METHOD

Children and parents from a rural Appalachian elementary school and child/parent pairs from other areas in the region responded to child and adult versions of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S/Child and POSHA-S). Seven grade levels were included: preschool, kindergarten, 1^st grade, 2^nd grade, 3^rd grade, 4^th grade, and 5^th grade.

RESULTS

Confirming earlier research, younger children's attitudes toward stuttering were considerably less positive than those of their parents. As children matured up to the fifth grade, however, their stuttering attitudes progressively were more positive. Parents' stuttering attitudes were quite consistent across all seven grade levels.

CONCLUSIONS

Consistent with theories of attitudinal development, between the ages of 4 and 11 years, children's measured attitudes toward stuttering improved and gradually approximated the attitudes of their parents and the general public.

Children who stutter at 3 years of age: A community-based study

PURPOSE

Lack of social resources to support children who stutter may be due, in part, to the absence of epidemiological data regarding stuttering. This study investigated the proportion of three-year-old children who stutter in a city located in Hokkaido, a northern island of Japan.

METHODS

The speech of individual children was assessed as part of a routine, government-conducted health care examination for 3-year-old children. The number of children screened was 2274, or 94.4% of all children in the city. The first author participated in the health care examination, and followed up all of the children who were found to stutter.

RESULTS

At 3 years of age, 1.41% of the children exhibited stuttering; 82.8% of these children subsequently did not exhibit stuttering six months later. Boys were 1.57 times more likely to stutter than girls, but they had only 86% of the probability of reported or observed fluency seen in girls six months later. Significantly higher probability of later fluency was observed in children who exhibited normal, rather than delayed, language development at the 1.5-year health checkup preceding the 3-year health checkup.

CONCLUSION

The proportion of three-year-old children who stutter and fluency status 6 months later are reported for a large cohort of Japanese children in Hokkaido. Language skills at 1;6 year may potentially be a factor in natural recovery or persistence; because of limitations in our study design, this assumption requires additional study. This is the first preliminary study to determine the proportion of three-year-old children who stutter in a Japanese community.

Public awareness and knowledge of stuttering in Japan

PURPOSE

To determine laypeople's knowledge and awareness of stuttering in Japan.

METHODS

A total of 303 respondents, recruited by street sampling, completed a questionnaire assessing the prevalence, onset, gender distribution, occurrence in different races, cause, treatment, association with intelligence, and hereditariness of stuttering. The questionnaire used was a Japanese version of that devised by Van Borsel, Verniers, and Bouvry (1999) for use in Belgium.

RESULTS

Although around half of the respondents had heard or met a stutterer, they tended to misunderstand the stuttering; e.g., respondents estimated the prevalence of stuttering as high. Knowledge also differed according to age, gender, and education level. Specifically, older individuals, females, and individuals with higher levels of education tended to have greater knowledge of stuttering. In comparing the results of the present study with similar studies conducted in Belgium, China, and Brazil, we observed several similarities and differences.

DISCUSSION

Although most respondents were to some extent familiar with stuttering, their overall knowledge of the condition was limited. Certain factors could be involved in having knowledge of stuttering, such as one's life experience, cultural background, and social attitudes toward stuttering. The findings suggest the need for growing knowledge and awareness of stuttering.

Functional neural circuits that underlie developmental stuttering

The aim of this study was to identify differences in functional and effective brain connectivity between persons who stutter (PWS) and typically developing (TD) fluent speakers, and to assess whether those differences can serve as biomarkers to distinguish PWS from TD controls. We acquired resting-state functional magnetic resonance imaging data in 44 PWS and 50 TD controls. We then used Independent Component Analysis (ICA) together with Hierarchical Partner Matching (HPM) to identify networks of robust, functionally connected brain regions that were highly reproducible across participants, and we assessed whether connectivity differed significantly across diagnostic groups. We then used Granger Causality (GC) to study the causal interactions (effective connectivity) between the regions that ICA and HPM identified. Finally, we used a kernel support vector machine to assess how well these measures of functional connectivity and granger causality discriminate PWS from TD controls. Functional connectivity was stronger in PWS compared with TD controls in the supplementary motor area (SMA) and primary motor cortices, but weaker in inferior frontal cortex (IFG, Broca’s area), caudate, putamen, and thalamus. Additionally, causal influences were significantly weaker in PWS from the IFG to SMA, and from the basal ganglia to IFG through the thalamus, compared to TD controls. ICA and GC indices together yielded an accuracy of 92.7% in classifying PWS from TD controls. Our findings suggest the presence of dysfunctional circuits that support speech planning and timing cues for the initiation and execution of motor sequences in PWS. Our high accuracy of classification further suggests that these aberrant brain features may serve as robust biomarkers for PWS.

A country-wide probability sample of public attitudes toward stuttering in Portugal

BACKGROUND

Negative public attitudes toward stuttering have been widely reported, although differences among countries and regions exist. Clear reasons for these differences remain obscure.

PURPOSE

Published research is unavailable on public attitudes toward stuttering in Portugal as well as a representative sample that explores stuttering attitudes in an entire country. This study sought to (a) determine the feasibility of a country-wide probability sampling scheme to measure public stuttering attitudes in Portugal using a standard instrument (the Public Opinion Survey of Human Attributes-Stuttering [POSHA-S]) and (b) identify demographic variables that predict Portuguese attitudes.

METHODS

The POSHA-S was translated to European Portuguese through a five-step process. Thereafter, a local administrative office-based, three-stage, cluster, probability sampling scheme was carried out to obtain 311 adult respondents who filled out the questionnaire.

RESULTS

The Portuguese population held stuttering attitudes that were generally within the average range of those observed from numerous previous POSHA-S samples. Demographic variables that predicted more versus less positive stuttering attitudes were respondents' age, region of the country, years of school completed, working situation, and number of languages spoken. Non-predicting variables were respondents' sex, marital status, and parental status.

CONCLUSION

A local administrative office-based, probability sampling scheme generated a respondent profile similar to census data and indicated that Portuguese attitudes are generally typical.

A comparison of attitudes towards stuttering of non-stuttering preschoolers in the United States and Turkey

Background and objectives

Extensive research documents ubiquitous negative attitudes towards stuttering, but when and how they develop is unclear. This non-experimental, comparative study examined US and Turkish preschoolers to explore the origin of stuttering attitudes cross-culturally.

Method

The authors compared stuttering attitudes of 28 US and 31 Turkish non-stuttering preschoolers on English and Turkish versions of experimental prototypes of the newly developed Public Opinion Survey on Human Attributes–Stuttering/Child (POSHA–S/Child). Children first watched a short video of two stuttering avatar characters and then answered oral questions about stuttering. Parents completed a demographic questionnaire. Differences in the US and Turkish POSHA–S/Child means were calculated using the Mann–Whitney U test.

Results

Attitudes of the US and Turkish children were remarkably similar. Children rated most of the items negatively but also rated some items as neutral or positive. They held relatively more negative attitudes towards traits and personalities of children who stutter yet relatively more positive attitudes towards stuttering children’s potential.

Conclusion

Stuttering attitudes in children appear to be partly independent of culture.

Primary school teachers' opinions and attitudes towards stuttering in two South African urban education districts

BACKGROUND

As teachers form an important part of the intervention process with childrenwho stutter in primary school, the primary aim was to describe primary school teachers'attitudes in South Africa. The secondary aim was to compare teachers' attitudes towardsstuttering in South Africa with those from a pooled group of respondents in the Public OpinionSurvey of Human Attributes-Stuttering (POSHA-S) database from different countries collectedin 2009-2014.

METHOD

A quantitative, cross-sectional survey research design was used. Primary schools intwo education districts in Western Cape, South Africa, were sampled. The POSHA-S, a selfadministeredquestionnaire, was completed by a cluster sample of 469 participants.

RESULTS

Overall positive attitudes towards stuttering were found, specifically related to thepotential of people who stutter, although the result should be interpreted with caution as thesample was not homogenously positive. Teachers still had misconceptions about personalitystereotypes and the cause of stuttering. The attitudes of the South African sample were slightlymore positive compared with the samples in the current POSHA-S database.

CONCLUSION

When developing stuttering intervention strategies, there are a number of keyconsiderations to take into account. The study provides a basis for speech-language therapiststo think about intervention with teachers and which areas of stuttering to consider.

Public attitudes toward stuttering in Europe: Within-country and between-country comparisons

INTRODUCTION

Epidemiological research methods have been shown to be useful in determining factors that might predict commonly reported negative public attitudes toward stuttering. Previous research has suggested that stuttering attitudes of respondents from North America and Europe (i.e., "The West"), though characterized by stereotypes and potential stigma, are more positive than those from several other regions of the world. This inference assumes that public attitudes within various regions characterized by "The West" are similar.

PURPOSE

This study aimed to determine the extent to which public stuttering attitudes are similar or different both within regions of three different European countries and between or among five different European countries or similar geographic areas. It also aimed to compare these European attitudes to attitudes from 135 samples around the world using a standard measure.

MATERIAL AND METHODS

Using convenience sampling, 1111 adult respondents from eight different investigations completed the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in the dominant language of each country or area. In Study I, the authors compared attitudes within three different regions of Bosnia & Herzegovina, Italy, and Norway. In Study II, the authors compared attitudes between combined samples from Bosnia & Herzegovina, Italy, and Norway (with additional respondents from Sweden), and two other samples, one from Germany and the other from Ireland and England.

RESULTS

Attitudes of adults from the three samples within Bosnia & Herzegovina, Italy, and Norway were remarkably similar. By contrast, attitudes between the five different countries or area were quite dramatically different. Demographic variables on the POSHA-S did not predict the rank order of these between-country/area differences. Compared to the POSHA-S worldwide database, European attitudes ranged from less positive than average (i.e., Italians) to more positive than average (i.e., Norwegians and Swedes).

CONCLUSION

Factors related to national identity appear to play a significant role in differences in public attitudes in Europe and should be explored in future research.

Public attitudes toward-and identification of-cluttering and stuttering in Norway and Puerto Rico

PURPOSE

The study sought to compare public attitudes toward cluttering versus stuttering in Norway and Puerto Rico and to compare respondents' identification of persons known with these fluency disorders.

METHOD

After reading lay definitions of cluttering and stuttering, three samples of adults from Norway and three from Puerto Rico rated their attitudes toward cluttering and/or stuttering on modified versions of the POSHA-Cl (for cluttering) and POSHA-S (for stuttering). They also identified children and adults whom they knew who either or both manifested cluttering or stuttering.

RESULTS

Attitudes toward cluttering were essentially unaffected by rating either cluttering only or combined cluttering and stuttering on the same questionnaire in both countries. The same was also true of stuttering. Attitudes were very similar toward both disorders although slightly less positive for cluttering. Norwegian attitudes toward both disorders were generally more positive than Puerto Rican attitudes. The average respondent identified slightly more than one fluency disorder, a higher percentage for stuttering than cluttering and higher for adults than children. Cluttering-stuttering was rarely identified.

CONCLUSION

Given a lay definition, this study confirmed that adults from diverse cultures hold attitudes toward cluttering that are similar to-but somewhat less positive than-their attitudes toward stuttering. It also confirmed that adults can identify cluttering among people they know, although less commonly than stuttering. Design controls in this study assured that consideration of stuttering did not affect either the attitudes or identification results for cluttering.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) describe the effects-or lack thereof-of considerations of stuttering on attitudes toward cluttering; (b) describe differences in public identification of children and adults who either clutter or stutter; (c) describe differences between attitudes toward cluttering and stuttering in Norway and Puerto Rico.

The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Bipolar Adjective Scale (BAS): aspects of validity

PURPOSE

In order to estimate instrument validity, attitudes toward stuttering measured by the newly developed Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and the Woods and Williams (1976) semantic differential scale (referred to herein as the Bipolar Adjective Scale [BAS]) are compared in college students on one occasion as well as before and after coursework on fluency disorders.

METHOD

Undergraduate and graduate students (n=321) from four universities filled out online versions of the POSHA-S and BAS. Two-thirds were speech-language pathology (SLP) majors; one-third were students in other majors. A subset of the SLP students (n=35) filled out the two instruments again after 8-13 weeks of coursework on fluency disorders.

RESULTS

Correlations between all ratings of the POSHA-S and BAS were run for the 321 students. Only 26% of the correlations were statistically significant (R ≥ ± 0.129), and the large majority of these reflected small relationships. POSHA-S ratings were correlated with up to 77% of the items of the BAS while BAS items were correlated with up to 45% of the POSHA-S ratings. After coursework on stuttering, students' attitudes improved on both instruments, but more on the POSHA-S than the BAS.

CONCLUSIONS

Greater evidence of discriminant validity than convergent validity characterized the POSHA-S and BAS. Both measures showed improved attitudes after fluency disorders coursework, but more so for the POSHA-S, confirming previous reports of construct validity. The POSHA-S taps relevant constructs not included in the BAS, which provide advantages for intracultural, international, and other comparisons of public attitudes toward stuttering.

LEARNING OUTCOMES

The reader will be able to: (1) describe differentiating characteristics of the POSHA-S and BAS as measures of public attitudes toward stuttering, (2) describe the overlap and lack of overlap in the constructs measured by POSHA-S and BAS, (3) describe discriminant versus convergent validity and (4) describe advantages of the POSHA-S and BAS in various types of comparative studies of stuttering attitudes.

Stuttering attitudes of students: Professional, intracultural, and international comparisons

PURPOSE

The study sought to identify major-specific, training, and cultural factors affecting attitudes toward stuttering of speech-language pathology (SLP) students.

METHOD

Eight convenience samples of 50 students each from universities in the USA and Poland filled out the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in English or Polish, respectively. USA samples included undergraduate and graduate students in SLP majors or non-SLP majors as well as a sample of non-SLP students who were Native Americans. Polish samples included SLP (logopedics), psychology, and mixed majors.

RESULTS

SLP students held more positive attitudes than non-SLP students in both countries. Graduate students held more positive attitudes than undergraduate students in the USA, and this effect was stronger for SLP than for non-SLP students. Native American students' stuttering attitudes were similar to other American non-SLP students' attitudes. Polish student attitudes were less positive overall than those of their American student counterparts.

CONCLUSION

SLP students' attitudes toward stuttering are affected by a "halo effect" of being in that major, by specific training in fluency disorders, and by various cultural factors, yet to be clearly understood.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) describe major factors affecting SLP students' attitudes toward stuttering; (b) describe similarities and differences in attitudes toward stuttering of students from the USA and Poland; (c) describe similarities and differences in attitudes toward stuttering of Native American students from the USA and non-Native American students.

Louis KO. Modifying Attitudes of Arab School Teachers Toward Stuttering

Purpose

The authors of this quasi-experimental design study explored the effect of an educational documentary video that presented factual and emotional aspects of stuttering on changing attitudes toward stuttering of preservice trainees and in-service public school teachers in Kuwait.

Method

Participants were 99 preservice trainees (48 control, 51 experimental) and 103 in-service teachers (49 control, 54 experimental). All participants completed 22 items from the Public Opinion Survey of Human Attributes—Stuttering (POSHA–S; St. Louis, 2005; translated into Arabic) and 17 additional items pre and post treatment. Participants in the experimental group viewed the awareness video.

Results

Pretreatment comparisons confirmed that the control and experimental groups did not differ on their attitudes toward stuttering. As predicted, the posttreatment ratings for the control group were not different from the pretreatment ratings. A significant shift in attitudes (mostly in a positive direction) from pre to post treatment was observed for the experimental group of preservice trainees but not for the experimental group of in-service teachers. Interpretation of the difference in outcomes for the experimental preservice group as compared to the experimental in-service group is confounded by gender differences across groups.

Conclusion

The authors of this study demonstrated that it is possible to positively modify preservice trainees' attitudes of people who stutter by using an educational documentary video.

Public attitudes toward stuttering in Poland

BACKGROUND

People who stutter often experience negative judgments and reactions to their stuttering from the nonstuttering majority. Many are stigmatized because of their stuttering and threatened with social exclusion, placing them at risk for compromised quality of life.

AIMS

The purpose of this investigation was to measure public attitudes toward stuttering in Poland.

METHODS & PROCEDURES

A sample of 268 respondents (mean age = 29 years; range = 15-60 years) from numerous different geographic and urban-rural settings in Poland filled out a Polish translation of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S).

OUTCOMES & RESULTS

Polish respondents displayed attitudes toward stuttering and people who stutter that were generally similar or "average" in comparison with other samples around the world from the POSHA-S database.

CONCLUSIONS & IMPLICATIONS

Although generally typical of other Western societies studied, attitudes of adolescents and adults from Poland were notably different in some ways, such as in the beliefs that emotional trauma or viruses and disease can cause stuttering as well as in the self reaction that they would feel uncomfortable speaking with a stuttering person. Overall, social exclusion and stigma are as likely among Poles who stutter as among most other populations studied.