Acceptability of Racial Microaggressions From the Perspective of Speech-Language Pathology Students.

PURPOSE: Implicit racial and ethnic biases have been documented across a variety of allied health professions; however, minimal research on this topic has been conducted within the field of speech-language pathology. The purpose of this study was to understand implicit racial and ethnic bias in speech-language pathology students by examining their perceptions and attitudes about the acceptability of racial and ethnic microaggressions. We also examined whether the student ratings varied by their racial and ethnic identity (White vs. people of color [POC]). METHOD: Fifty-nine students (72% White, 28% POC) currently enrolled in a speech-language pathology program voluntarily completed the Acceptability of Racial Microaggressions Scale via an online Qualtrics survey. RESULTS: Although 70% of the student ratings classified the microaggressive statements as unacceptable, 30% of their ratings classified the statements as either (a) acceptable or (b) neither acceptable nor unacceptable. Although both groups of students rated the majority of statements as unacceptable, students who self-identified as White rated more statements as acceptable than students who self-identified as POC. CONCLUSIONS: Findings indicating relatively high rejection of microaggressive statements by speech-language pathology students are promising. However, responses were not uniform, and a nontrivial proportion of responses provided by speech-language pathology students reflected passivity toward or active endorsement of microaggressive statements.

Observer-rated outcomes of communication-centered treatment for adults who stutter: A social validation study.

Previous studies have reported that adults who stutter demonstrate significant gains in communication competence, per self-ratings and clinician-ratings, upon completion of a communication-centered treatment, or CCT. The purpose of this social validation study was to determine whether communication competence ratings reported by untrained observers are consistent with client and clinician judgments of communication competence gains following CCT. Eighty-one untrained observers completed an online survey that required each to view one of two videos depicting an adult who stutters during a mock interview recorded prior to CCT or after CCT. Observers were then asked to rate the communication competence of the interviewee on a 100-point visual analog scale and provide additional demographic information. Communication competence of the adult who stutters who had completed CCT was rated significantly higher in their post-treatment video. Upon controlling for two demographic factors found to be associated with observer ratings (years of education, years the observers had known an adult who stutters), significantly higher ratings of communication competence for the post-treatment video were maintained. These preliminary findings provide social validity for CCT by demonstrating that the gains in communication competence reported in previous studies through clinician and client observations are also reported by untrained observers who are not familiar with CCT.

Self-Perceived Communication Competence of Adults Who Stutter Following Communication-Centered Treatment.

PURPOSE: The purpose of this study was to assess self-perceived communication competence of adults who stutter following participation in a non-ableist treatment for which one of the core components focuses on communication - with no direct or indirect goals designed to reduce or modify stuttered speech. METHOD: Thirty-three adults who stutter completed the Self-Perceived Communication Competence scale (McCroskey & McCroskey, 1988) pre- and posttreatment. RESULTS: Findings indicate significant gains in self-perceived communication competence posttreatment. Pre- to posttreatment changes in stuttering did not predict posttreatment gains in self-perceived communication competence. CONCLUSION: The present study demonstrates that improvement in communication can be achieved independent of improvement in fluency, lending further support to the notion that stuttering and communication competence are distinct constructs.

Impact of self-disclosure and communication competence on perceived listener distraction.

PURPOSE: The purpose of this study was to investigate the distraction reported by unfamiliar adults when listening to a speaker who stutters, and whether listener distraction is influenced by two factors: self-disclosure and communication competence. METHOD: Two hundred seventy-five adults watched a video vignette and were asked to rate their level of distraction when observing an adult Latinx male producing stuttered speech. Each participant watched one of six randomized videos of the same speaker sharing the same content systematically manipulated by (a) presence or absence of 15% stuttering, (b) presence or absence of self-disclosure, and (c) high or low communication competence. RESULTS: Listener distraction was higher when rating speakers with low communication competence, regardless of whether stuttering or self-disclosure were heard. Videos wherein the speaker was fluent were rated as significantly less distracting, but only in the context of high communication competence. For videos wherein the speaker stuttered, listeners reported significantly less distraction when the speaker demonstrated high communication competence and self-disclosed. FINDINGS: These findings suggest that for persons who stutter, high communication competence and disclosing that they stutter will yield maximum reduction in listener distraction.

Listener perceptions of stuttering and stuttering modification techniques.

PURPOSE: The purpose of this study was to analyse naïve listener perceptions of speech containing unmodified stuttering, use of the pull-out technique, and use of preparatory-sets. METHOD: Participants (N = 62) were randomly assigned to listen to one audio sample (unmodified stuttered speech, speech with pull-outs, or speech with preparatory-sets) and completed a survey assessing perceptions of the speaker's speech and personality and the listener's comfort level and willingness to social interact with the speaker. RESULTS: Survey results revealed low perceptual ratings in all experimental conditions. Unmodified stuttered speech received significantly more positive ratings than the stuttering modification conditions in all measurements except for speech naturalness. Listeners reported being less willing to socially interact with those who use preparatory-sets than unmodified stuttered speech. CONCLUSION: The use of stuttering modification techniques did not improve listeners' perceptions or willingness to interact with persons who stutter. Clinicians and those who stutter should be aware that the use of speech techniques will not decrease negative social interactions or stereotypes.

Microaggression and the adult stuttering experience.

BACKGROUND: Microaggressions are subtle insults, invalidations, or slights that target people due to their association with a marginalized group. Microaggressive experiences have been shown to degrade quality of life and corroborate negative stereotypes towards persons with disabilities. To date, minimal research has been dedicated to exploring microaggressions within adults who stutter. METHODS: Seven adults who stutter participated in semi-structured focus group interviews similar to Keller and Galgay's (2010) qualitative investigation of microaggressions experienced by adults with a disability. Group interviews were transcribed and analyzed using QSR NVivo software to develop themes and subthemes. RESULTS: Eight major themes were identified within two supraordinate themes: Microaggressive Behavior (patronization, second-class status, perceived helplessness, workplace microaggression, clinical microaggression, denial of privacy) and Perception of Microaggressive Behavior (exoneration of listener, no or minimal microaggressive experience). Although patronization, second-class status, and helplessness were mentioned frequently by multiple participants, exoneration of the listener was the most frequently recurring theme. DISCUSSION: Based on these preliminary focus group interviews, stuttering-based microaggressions broadly resemble ableist microaggressions reported by Keller and Galgay (2010). Interviewees also expressed a reluctance to identify slights related to stuttering as microaggression and often characterized these incidents as unavoidable.

Verbal Response Inhibition in Adults Who Stutter.

Purpose Adults who stutter (AWS) often attempt, with varying degrees of success, to suppress their stuttered speech. The ability to effectively suppress motoric behavior after initiation relies on executive functions such as nonselective inhibition. Although previous studies found that AWS were slower to inhibit manual, button-press response than adults who do not stutter (AWNS), research has yet to confirm a consistent relationship between manual and verbal inhibition. No study has examined verbal inhibition ability in AWS. The purpose of this study, therefore, is to compare verbal response inhibition between AWS and AWNS, and compare verbal response inhibition to both the overt stuttering and the lived experience of stuttering. Method Thirty-four adults (17 AWNS, 17 AWS) completed one manual and three verbal stop-signal tasks. AWS were assessed for stuttering severity (Stuttering Severity Instrument-Fourth Edition: SSI-4) and experience with stuttering (Overall Assessment of the Speaker's Experience With Stuttering [OASES]). Results Results indicate no correlation between manual and verbal inhibition for either group. Generalized linear mixed-model analyses suggested no significant group differences in manual or verbal inhibition. Manual and verbal inhibition did not predict SSI-4 in AWS. However, verbal inhibition was uniquely associated with OASES scores. Conclusion Although underlying manual and verbal inhibition was comparable between AWS and AWNS, verbal inhibition may be linked to the adverse experience of stuttering rather than the overt symptoms of stuttering severity. Supplemental Material https://doi.org/10.23641/asha.15145185.

Manual response inhibition and quality of life in adults who stutter.

BACKGROUND: A considerable amount of research has identified inhibition differences, including slower inhibition of manual responses, in people who stutter. Recent investigations have failed to link slowed motor inhibition with overt stuttering severity. This study investigated the potential relationship between slowed manual response inhibition and the negative impact of stuttering upon individual lives of adults who stutter (AWS). METHODS: Thirty-four adults (AWS, n = 17; AWNS, n = 17) matched by nonverbal IQ completed a manual stop-signal task and provided a conversational speech sample. Motor inhibition latency for AWS and AWNS were compared. For AWS, motor inhibition latency was compared to the four subsections of the Overall Assessment of the Speaker's Experience with Stuttering (OASES; Yaruss & Quesal, 2006; General Information, Reactions to Stuttering, Communication in Daily Situations, Quality of Life). RESULTS: Similar to previous studies, AWS were significantly slower to inhibit inaccurate manual responses than AWNS. Quality of Life subtest of the OASES was found to significantly predict inhibition latency. CONCLUSION: These data replicate findings that indicate that AWS exhibit slower manual inhibition latency, and suggest that these inhibition differences may be associated with an individual's negative experience with stuttering rather than stuttering severity.

Segmental and metrical complexity during non-word repetition in adults who stutter.

Non-word repetition is weaker for adults who stutter (AWS) compared to adults who do not stutter (AWNS) as phonological demands increase. However, non-word stimuli used in previous studies varied by length, but did not vary with regard to segmental or metrical complexity. The purpose of the present study was to examine the unique influence of these two distinct types of complexity on non-word repetition in AWS and AWNS via administration of the Test of Phonological Structure (TOPhS). Twenty-four adults (12 AWNS, 12 AWS) repeated 96 non-words within a soundproof booth immediately after auditory presentation. All 96 non-word targets included on the TOPhS were one to four syllables in length and ranked based on segmental complexity (simple, moderate and complex) and metrical complexity (simple, moderate and complex). No main effect of metrical complexity was detected between groups, and no differences in accuracy were observed for non-words with simple or moderate segmental complexity. However, AWS were significantly more likely to produce a phonemic error when repeating words with complex segmental structure than AWNS, irrespective of metrical complexity. Segmental complexity may contribute to the differences in phonological working memory in AWS when controlling for metrical complexity and length.

Exploring the Effectiveness of an Intensive Treatment Program for School-Age Children Who Stutter, Camp Dream. Speak. Live.: A Follow-up Study.

The purpose of this follow-up study was to explore the effectiveness of an intensive treatment program-Camp Dream. Speak. Live.-within older, school-age children who stutter. Twenty-three school-age children who stutter (age range: 7-14 years) attended this week-long intensive therapy program for the first time. Outcome measures included Overall Assessment of the Speaker's Experience of Stuttering and the Patient Reported Outcomes Measurement Information System Pediatric Peer Relationships Form. Findings demonstrate significant improvements in quality of life and communication attitudes can be achieved in a short period of time when increasing fluency is not a target.

Nonword repetition in adults who stutter: The effects of stimuli stress and auditory-orthographic cues.

PURPOSE: Adults who stutter (AWS) are less accurate in their immediate repetition of novel phonological sequences compared to adults who do not stutter (AWNS). The present study examined whether manipulation of the following two aspects of traditional nonword repetition tasks unmask distinct weaknesses in phonological working memory in AWS: (1) presentation of stimuli with less-frequent stress patterns, and (2) removal of auditory-orthographic cues immediately prior to response. METHOD: Fifty-two participants (26 AWS, 26 AWNS) produced 12 bisyllabic nonwords in the presence of corresponding auditory-orthographic cues (i.e., immediate repetition task), and the absence of auditory-orthographic cues (i.e., short-term recall task). Half of each cohort (13 AWS, 13 AWNS) were exposed to the stimuli with high-frequency trochaic stress, and half (13 AWS, 13 AWNS) were exposed to identical stimuli with lower-frequency iambic stress. RESULTS: No differences in immediate repetition accuracy for trochaic or iambic nonwords were observed for either group. However, AWS were less accurate when recalling iambic nonwords than trochaic nonwords in the absence of auditory-orthographic cues. CONCLUSIONS: Manipulation of two factors which may minimize phonological demand during standard nonword repetition tasks increased the number of errors in AWS compared to AWNS. These findings suggest greater vulnerability in phonological working memory in AWS, even when producing nonwords as short as two syllables.

The effect of phonetic complexity on the speed of single-word productions in adults who do and do not stutter.

PURPOSE: The purpose of this study was to investigate the influence of phonetic complexity as measured by the Word Complexity Measure (WCM) on the speed of single-word production in adults who do (AWS, n=15) and do not stutter (AWNS, n=15). METHOD: Participants were required to name pictures of high versus low phonetic complexity and balanced for lexical properties. Speech reaction time was recorded from initial presentation of the picture to verbal response of participant for each word type. Accuracy and fluency were manually coded for each production. RESULTS: AWS named pictures significantly slower than AWNS, but there were no significant differences observed in response latency when producing word of high versus low phonetic complexity as measured by the WCM. CONCLUSION: Findings corroborate past research of overall slowed picture naming latencies in AWS, compared to AWNS. Findings conflict with data that suggest that the phonetic complexity of words uniquely compromises the speed of production in AWS. The potential interaction between lexical and phonetic factors on single-word production within each group are discussed.

Uniqueness Point Effects during Speech Planning in Adults Who Do and Do Not Stutter.

BACKGROUND/AIMS: Previous studies employing a variety of tasks have demonstrated that adults who stutter (AWS) pre-sent with phonological encoding differences compared to adults who do not stutter (AWNS). The present study examined whether atypical preverbal monitoring also influenced AWS performance during one such paradigm - the silent phoneme monitoring task. Specifically, we investigated whether monitoring latencies for AWS were accelerated after the word's uniqueness point - the phoneme that isolates the word from all lexical competitors - as observed for AWNS when monitoring internal and external speech. METHODS: Twenty adults (10 AWS, 10 AWNS) completed a silent phoneme monitoring task using stimuli which contained either (a) early uniqueness points (EUP), (b) late uniqueness points, or (c) no uniqueness point (NUP). Response latency when identifying word-final phonemes was measured. RESULTS: AWNS exhibited the expected uniqueness point effect when monitoring internal speech; word-final phonemes were accessed more rapidly for words with EUP than NUP. In contrast, AWS did not differ in the phoneme monitoring speed. That is, AWS did not exhibit the expected uniqueness point effects. CONCLUSION: Findings suggest that inefficient or atypical preverbal monitoring may be present in AWS and support theories that implicate the internal speech monitor as an area of deficit.

Phonetic complexity of words immediately following utterance-initial productions in children who stutter.

PURPOSE: The purpose of the present study was to analyze phonetic complexity in the speech of children who stutter in a manner distinct from previous research with specific emphasis on three methodological considerations: (1) analysis of the word immediately following the initial word in the utterance; (2) accounting for other additional linguistic and lexical factors; and (3) discrimination of disfluency types produced. METHODS: Parent-child conversations were transcribed for 14 children who stutter (mean age=3 years, 7 months; SD=11.20 months) and coded for phonetic complexity using the Word Complexity Measure (WCM). Phonetic complexity of words immediately following the initial fluent or stuttered words of an utterance were included within binomial regression analyses, along with additional linguistic and lexical factors. RESULTS: Analyses indicate that the phonetic complexity of the second word of an utterance was not a significant contributor to the likelihood of whole- or part-word repetitions on the preceding initial word of the utterance. CONCLUSION: Findings support previous data that suggest the phonetic complexity of speech, at least as measured by the WCM, does not distinctly influence stuttered speech in preschool-age children.

Metrical Encoding in Adults Who Do and Do Not Stutter.

PURPOSE: The purpose of this study was to explore metrical aspects of phonological encoding (i.e., stress and syllable boundary assignment) in adults who do and do not stutter (AWS and AWNS, respectively). METHOD: Participants monitored nonwords for target sounds during silent phoneme monitoring tasks across two distinct experiments. For Experiment 1, the 22 participants (11 AWNS, 11 AWS) silently monitored target phonemes in nonwords with initial stress. For Experiment 2, an additional cohort of 22 participants (11 AWNS, 11 AWS) silently monitored phonemes in nonwords with noninitial stress. RESULTS: In Experiment 1, AWNS and AWS silently monitored target phonemes in initial stress stimuli with similar speed and accuracy. In Experiment 2, AWS demonstrated a within-group effect that was not present for AWNS. They required additional time when monitoring phonemes immediately following syllable boundary assignment in stimuli with noninitial stress. There was also a between-groups effect, with AWS exhibiting significantly greater errors identifying phonemes in nonwords with noninitial stress than AWNS. CONCLUSIONS: Findings suggest metrical properties may affect the time course of phonological encoding in AWS in a manner distinct from AWNS. Specifically, in the absence of initial stress, metrical encoding of the syllable boundary may delay speech planning in AWS and contribute to breakdowns in fluent speech production.

Description of multilingual participants who stutter.

PURPOSE: The purpose of this review was to examine the descriptions of multilingual participants provided in stuttering literature to determine how frequently and consistently relevant factors of language profile are reported. METHOD: We conducted a systematic search of published studies that included multilingual participants who stutter and reviewed the level of detail provided regarding language history, function, proficiency, stability, mode, accent, covert speech, and affective factors. RESULTS: Twenty-three studies qualified to be included in the systematic review, consisting of 342 different multilingual stuttering participants. Of these 23 studies, the most frequently reported information included language proficiency (70%), history (56%), and function (43%). The specificity of the information used to define these factors was inconsistent. Affect was mentioned in 22% of studies, and language stability, mode, and accent information was included in less than 10% of the studies. CONCLUSIONS: Results demonstrate that description of multilingual stuttering participants is inadequate and inconsistent. A recommended framework is provided for future studies to facilitate cross-study comparisons and enhance our ability to interpret the manifestation of stuttering in multilingual participants. EDUCATIONAL OBJECTIVES: The reader will be able to: (a) summarize the current validity of cross-study comparisons in available research of multilingual participants who stutter; (b) describe the range of language factors to be included when providing descriptions of multilingual participants who stutter; (c) discuss the importance of consistency when describing language profiles of multilingual research participants.

The influence of phonetic complexity on stuttered speech.

The primary purpose of this study was to re-examine the influence of phonetic complexity on stuttering in young children through the use of the Word Complexity Measure (WCM). Parent-child conversations were transcribed for 14 children who stutter (mean age = 3 years, 7 months; SD = 11.20 months). Lexical and linguistic factors were accounted for during the analysis. Results indicate that phonetic complexity, as measured by WCM, did not exhibit a significant influence on the likelihood of stuttering. Findings support previous data that suggest stuttering in preschool-age children does not appear significantly related to phonetic complexity of the production.