Telepractice Treatment of Stuttering: A Systematic Review.

Purpose: The purpose of the current systematic review is to (1) guide and inform speech language pathologists involved in the treatment of persons who stutter in the development and implementation of live-stream, video telepractice services and (2) identify areas for future research related to telepractice and stuttering. Materials and Methods: Systematic searches of electronic databases, reference lists and journals identified seven studies that met predetermined inclusion criteria. These seven studies were analyzed and summarized in terms of the: (1) sample size, (2) characteristics of the participants, (3) technology and equipment utilized, (4) clinical setting, (5) treatment type, (6) research methodology, (7) results of the study, and (8) Oxford evidence-based practice levels. Results: Telepractice was used by university-based researchers and educators in the delivery of services to 80 participants who stutter. The services delivered included implementation of the Camperdown Program, the Lidcombe Program, and an integrated treatment approach. Conclusion: Live-stream, video telepractice appears to be a promising service- delivery method for treatment of stuttering using the Camperdown Program, Lidcombe Program, and integrated approaches. Further research is needed to determine if the initial evaluation and diagnosis of stuttering can be made using telepractice methodologies.

Prologue to the Forum: Speech and Language Tele-Intervention: The Future Is Now.

PURPOSE: This prologue introduces the LSHSS Forum: Speech and Language Tele-Intervention: The Future Is Now. The aims of the forum are (a) to report on the process of moving established in-person interventions to virtual delivery and (b) to provide speech-language pathologists (SLPs) with empirically based guidance on designing and implementing tele-interventions, in order to support academic success for school-age children with speech and language needs. The included articles explore the process, benefits, and challenges of providing intervention in speech, language, and literacy domains in a virtual environment with children. CONCLUSION: Although there are some logistical challenges, established treatments such as those targeting morphosyntax as well as communication partner training can be adapted for successful delivery online. In addition, the forum supports the delivery of an app-based articulation-focused intervention. SLPs report a number of challenges in relation to adapting and delivering interventions through telepractice, and parents express concerns in relation to SLPs' online evaluation of complex speech sound difficulties for children born with cleft lip and palate. Finally, using the principles of Minimal Intervention Needed for Change, a systematic approach to the adaptation of evidence-based interventions for online delivery, is outlined.

A Preliminary Comparison of In-Person and Telepractice Evaluations of Stuttering.

Purpose The purpose of this study was to compare in-person and telepractice evaluations of stuttering with adult participants. The research questions were as follows: Is an evaluation for stuttering via telepractice equivalent to an in-person evaluation in terms of (a) duration of individual evaluation tasks and overall length of the evaluation, (b) clinical outcomes across evaluating clinicians, and (c) participant experience? Method Participants were 14 adults who stutter (males = 11; age range: 20-68) who were simultaneously assessed via telepractice and in-person. Comprehensive evaluations included analysis of the speaker's stuttering, evaluation of the speaker's perceptions and attitudes about stuttering, and language testing. Evaluations were administered by either an in-person clinician or a telepractice clinician but were simultaneously scored by both clinicians. Participants were randomly assigned to the in-person-led assessment condition or the telepractice-led assessment condition. Results No statistically significant differences were found between the in-person and telepractice-led evaluations in terms of overall evaluation task duration, evaluation clinical outcomes, or participants' reported experiences. That is, telepractice evaluations for stuttering in adults may be an equivalent option to in-person evaluations. Conclusions Results of this preliminary study indicate that telepractice evaluations of stuttering may be comparable to in-person evaluations in terms of duration, clinical outcomes, and participant experiences. The current study supports the notion that telepractice evaluations may be a viable option for adult clients who stutter. Clinical considerations and future directions for research are discussed.

Self-report of self-disclosure statements for stuttering.

PURPOSE: To (1) analyze verbatim wording used by adults who stutter (AWS) to self-disclose stuttering, (2) determine contexts in which AWS may self-disclose, (3) examine the use of self-disclosure by AWS about other aspects of their identity, and (4) investigate the ways in which speech-language pathologists (SLPs) develop self-disclosure statements with AWS. METHOD: Web-based questionnaires were administered to AWS (N = 42) and SLPs (N = 33) who work with AWS. The AWS questionnaire asked about the verbatim wording of self-disclosure statements used by AWS and the contexts in which they utilize them. For SLPs, the questionnaire probed how and why they work with AWS to formulate self-disclosure statements. Responses were openly coded and then funneled into concepts for analysis. RESULTS: The majority of AWS provided verbatim self-disclosure statements which were educational in nature. However, when responding to fixed choices and when reporting on self-disclosing other aspects of their lives, the majority of participants selected a direct statement. The majority of AWS reported that they self-disclose when interviewing for a job. SLPs reportedly instruct their clients to use educational self-disclosure statements. SLPs also reported that they use an individualized approach to brainstorming self-disclosure statements. Finally, SLPs reported that they find self-disclosure beneficial because it facilitates self-empowerment for AWS. CONCLUSION: AWS may benefit from learning about the type of self-disclosure statements and the contexts in which other AWS chose to disclose. Additionally, SLPs who work with AWS may benefit from the reported procedures for and types of self-disclosure statements formulated by AWS.

The Effects of Self-Disclosure on Male and Female Perceptions of Individuals Who Stutter.

PURPOSE: The purpose of this study was to examine the influence of self-disclosure on observers' perceptions of persons who stutter. METHOD: Participants (N = 173) were randomly assigned to view 2 of 4 possible videos (i.e., male self-disclosure, male no self-disclosure, female self-disclosure, and female no self-disclosure). After viewing both videos, participants completed a survey assessing their perceptions of the speakers. RESULTS: Controlling for observer and speaker gender, listeners were more likely to select speakers who self-disclosed their stuttering as more friendly, outgoing, and confident compared with speakers who did not self-disclose. Observers were more likely to select speakers who did not self-disclose as unfriendly and shy compared with speakers who used a self-disclosure statement. Controlling for self-disclosure and observer gender, observers were less likely to choose the female speaker as friendlier, outgoing, and confident compared with the male speaker. Observers also were more likely to select the female speaker as unfriendly, shy, unintelligent, and insecure compared with the male speaker and were more likely to report that they were more distracted when viewing the videos. CONCLUSION: Results lend support to the effectiveness of self-disclosure as a technique that persons who stutter can use to positively influence the perceptions of listeners.

From Grapheme to Phonological Output: Performance of Adults Who Stutter on a Word Jumble Task.

PURPOSE: The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task. METHOD: Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT). RESULTS: Adults who stutter attempted to solve fewer word jumble stimuli than adults who do not stutter at the 4-letter, 5-letter, and 6-letter lengths. Additionally, adults who stutter were significantly less accurate solving word jumble tasks at the 4-letter, 5-letter, and 6-letter lengths compared to adults who do not stutter. At the longest word length (6-letter), SRT was significantly slower for the adults who stutter than the fluent controls. CONCLUSION: Results of the current study lend further support to the notion that differences in various aspects of phonological processing, including vision-to-sound conversions, sub-vocal stimulus manipulation, and/or lexical access are compromised in adults who stutter.

Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences.

PURPOSE: The purpose of the present study was to enhance our understanding of phonological working memory in adults who stutter through the comparison of nonvocal versus vocal nonword repetition and phoneme elision task performance differences. METHOD: For the vocal nonword repetition condition, participants repeated sets of 4- and 7-syllable nonwords (n=12 per set). For the nonvocal nonword repetition condition, participants silently identified each target nonword from a subsequent set of three nonwords. For the vocal phoneme elision condition, participants repeated nonwords with a target phoneme eliminated. For the nonvocal phoneme elision condition, participants silently identified the nonword with the designated target phoneme eliminated from a subsequent set of three nonwords. RESULTS: Adults who stutter produced significantly fewer accurate initial productions of 7-syllable nonwords compared to adults who do not stutter. There were no talker group differences for the silent identification of nonwords, but both talker groups required significantly more mean number of attempts to accurately silently identify 7-syllable as compared to 4-syllable nonwords. For the vocal phoneme elision condition, adults who stutter were significantly less accurate than adults who do not stutter in their initial production and required a significantly higher mean number of attempts to accurately produce 7-syllable nonwords with a phoneme eliminated. This talker group difference was also significant for the nonvocal phoneme elision condition for both 4- and 7-syllable nonwords. CONCLUSION: Present findings suggest phonological working memory may contribute to the difficulties persons who stutter have establishing and/or maintaining fluent speech. EDUCATIONAL OBJECTIVES: (a) Readers can describe the role of phonological working memory in planning for and execution of speech; (b) readers can describe two experimental tasks for exploring the phonological working memory: nonword repetition and phoneme elision; (c) readers can describe how the nonword repetition and phoneme elision skills of adults who stutter differ from their typically fluent peers.