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.

Mothers' and fathers' attitudes toward stuttering in the Middle East compared to Europe and North America.

BACKGROUND: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries. AIMS: The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents). METHODS & PROCEDURES: Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes. OUTCOMES & RESULTS: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons. CONCLUSIONS & IMPLICATIONS: The effect of geographic region and culture may predict sex-based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering. WHAT THIS PAPER ADDS: What is already known on this subject The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds This study's findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non-Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work? In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child's stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted.

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.

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'.

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.

Changing Polish university students' attitudes toward cluttering.

PURPOSE: This quasi-experimental design study in Poland explored the extent to which attitudes toward cluttering of university students could be changed or improved after a series of activities dedicated to attaining deeper recognition of problems associated with fluency disorders. METHOD: University students were assigned to either an Experimental or a Control group, with 39 in each (total = 78). They all completed the Polish version of the Public Opinion Survey of Human Attributes-Cluttering (POSHA-Cl) on two occasions up to eight weeks apart. Participants in the Experimental group attended the following intervention activities: watching and discussing an educational video on cluttering, participating in a workshop on the nature of cluttering, and watching and discussing a documentary on the life experiences of people struggling with fluency disorders. The Experimental group also filled out an open-ended questionnaire at the end of the study. RESULTS: Pre-intervention comparisons indicated that participants assigned to either of the Experimental or Control groups differed significantly on 2 of the 15 summary ratings (13 %) of their pre-POSHA-Cl attitudes toward cluttering. For the Experimental group, the intervention resulted in significant positive changes in cluttering attitudes on 8 of the 15 summary ratings (53 %). In contrast, pre- and post- POSHA-Cl scores for the Control group were essentially unchanged (0 of 15 ratings). CONCLUSIONS: This quasi-experimental study demonstrated that it is possible to positively modify the cluttering attitudes of university students. This has implications for the length, content, and experiential components of interventions designed to improve public attitudes toward fluency disorders.

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.

Speech-Language Pathologists' Comfort Level With Use of Term "Stuttering" During Evaluations.

Purpose Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term "stuttering," might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of "stuttering" to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders. Method One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings. Results SLPs were significantly less likely to feel comfortable using the term "stuttering" compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences. Conclusions SLPs were significantly less comfortable relaying the diagnosis "stuttering" to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.

"Spontaneous" late recovery from stuttering: Dimensions of reported techniques and causal attributions.

PURPOSE: (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. METHODS: 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. RESULTS: A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). DISCUSSION: Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. CONCLUSION: The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies.

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.

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, 1st grade, 2nd grade, 3rd grade, 4th grade, and 5th 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.

Improving Polish Stuttering Attitudes: An Experimental Study of Teachers and University Students.

Purpose: This quasi-experimental design study in Poland evaluated the effects of a course on stuttering for university students and the effects of an educational workshop for public school teachers, both interventions designed to improve attitudes toward stuttering. Method: Participants (132 in-service teachers and 75 university students) completed the Polish version of the Public Opinion Survey of Human Attributes-Stuttering (St. Louis, 2011) twice, before and after 2 interventions for experimental groups and 3 months apart for control groups. Experimental teachers participated in a 2-hr workshop dedicated to stuttering. Experimental students enrolled in a 1-semester course wherein multiple activities (including the teacher workshop) were included to generate a comprehensive understanding of stuttering. None of the participants in either control group participated in the academic course for students or workshop for teachers. Results: Preintervention comparisons for teachers and for students confirmed that participants assigned to either experimental or control groups did not differ significantly on their attitudes toward stuttering. For both experimental teachers and students, the interventions resulted in significant positive changes in stuttering attitudes. Neither control group changed. Conclusions: This experimental study demonstrated that it is possible to positively modify stuttering attitudes of teachers as well as university students. It has implications for the length, content, and experiential components of interventions designed to improve public attitudes toward stuttering.

Changing Nonstuttering Preschool Children's Stuttering Attitudes.

Purpose: Negative or uninformed stuttering attitudes proliferate among the general public, and bourgeoning research has shown that such attitudes might emerge as early as the preschool years. Much remains unknown about young children's stuttering attitudes, and conclusive recommendations to improve attitudes toward stuttering have yet to be advanced. This study sought to determine the effect of a new educational program on improving stuttering attitudes among preschool children using objective measures. Method: Thirty-seven preschool children learned about stuttering and sensitive peer interactions by participating in the newly developed Attitude Change and Tolerance program. The program teaches children about human differences with an emphasis on stuttering and how to interact with people who stutter. Children's stuttering attitudes were measured using the Public Opinion Survey of Human Attributes-Stuttering/Child (Weidner & St. Louis, 2014) before and after the program. Results: Pre-post comparisons showed statistically significant improvements in children's overall stuttering attitudes. In particular, children demonstrated gains relative to their perceptions of and reactions toward people who stutter. Conclusion: This study provides empirical evidence that young children's stuttering attitudes can be improved using the Attitude Change and Tolerance program. In addition, it supports previous research that negative stuttering attitudes emerge as early as preschool.

Maintenance of Improved Attitudes Toward Stuttering.

Purpose: This study sought to determine the extent to which experimentally induced positive attitudes in high school students in a previous investigation were maintained 7 years later. Method: Authors and assistants recruited 36 adults in their early 20s (Follow-up group) who, in high school, had witnessed either a live oral talk by a person who stutters or a professionally made video on stuttering designed for teens followed by a short talk by the same speaker. The Public Opinion Survey of Human Attributes-Stuttering was administered before and after the interventions in high school and 7 years later such that pre-post group comparisons were made. Previously, the Follow-up group had demonstrated highly positive changes in their attitudes after the interventions. In addition, a control group of 56 former high school students from the same state, who did not participate in the interventions, were recruited and compared to the Follow-up group. Results: The Follow-up group, which was found to be representative of the original high school cohort, held more positive Public Opinion Survey of Human Attributes-Stuttering mean ratings than the Control group, although somewhat less positive than their previous postintervention ratings. Conclusions: The Follow-up group maintained many of the positive changes in their beliefs and self reactions regarding stuttering that were induced 7 years earlier after witnessing personal stories and facts about stuttering.

Evidence-based guidelines for being supportive of people who stutter in North America.

PURPOSE: While many resources, particularly those available on the Internet, provide suggestions for fluent speakers as they interact with people who stutter (PWS), little evidence exists to support these suggestions. Thus, the purpose of this study was to document the supportiveness of common public reactions, behaviors, or interventions to stuttering by PWS.Methods 148 PWS completed the Personal Appraisal of Support for Stuttering-Adults. Additionally, a comparison of the opinions of adults who stutter based on gender and their involvement in self-help/support groups was undertaken. Results Many of the Internet-based suggestions for interacting with PWS are aligned with the opinions of the participants of this study. Significant differences were found amongst people who stutter on the basis of gender and involvement in self-help groups.Conclusions Lists of "DOs and DON'Ts" that are readily available on the Internet are largely supported by the data in this study; however, the findings highlight the need for changing the emphasis from strict rules for interacting with people who stutter to more flexible principles that keep the needs of individual PWS in mind.

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.

Speech pathology student clinician attitudes and beliefs towards people who stutter: A mixed-method pilot study.

PURPOSE: Stuttering is a disorder of fluency that extends beyond its physical nature and has social, emotional and vocational impacts. Research shows that individuals often exhibit negative attitudes towards people who stutter; however, there is limited research on the attitudes and beliefs of speech pathology students towards people who stutter in Australia. Existing research is predominantly quantitative; whereas this mixed-method study placed an emphasis on the qualitative component. The purpose of this study was to explore the attitudes and beliefs of final year Australian speech pathology students towards people who stutter. METHODS: This mixed-method study applied the Public Opinion Survey of Human Attributes - Stuttering (POSHA-S) and semi-structured interviews to gather data from final year speech pathology students from a major university in Australia. PRINCIPAL RESULTS: The overall qualitative findings identified that final year Australian speech pathology students exhibit positive attitudes towards people who stutter. The results also illustrated the role of education in influencing attitudes of students as well as increasing their confidence to work with people who stutter. MAJOR CONCLUSION: This research revealed that Australian final year speech pathology students exhibit positive attitudes towards people who stutter. They displayed an understanding that people who stutter may have acquired traits such as shyness as a response to their personal situation and environment, rather than those traits being endemic to them. Results also suggested that education can play a role in creating confident student clinicians in their transition to practice, and positively influence their attitudes and beliefs.