Journal of Fluency Disorders最新文献

{"title":"The effect of cognitive behavioral therapy-based practices on social anxiety and stuttering severity in children who stutter","authors":"Sabri Toğluk ,&nbsp;Yahya Aktu","doi":"10.1016/j.jfludis.2025.106192","DOIUrl":"10.1016/j.jfludis.2025.106192","url":null,"abstract":"<div><h3>Purpose</h3><div>Children who stutter (CWS) often face communication challenges in social settings, which may lead to increased social anxiety and exacerbate stuttering severity. This pilot study examines the effectiveness of cognitive behavioral therapy (CBT)-based interventions in reducing social anxiety and stuttering severity among CWS.</div></div><div><h3>Methods</h3><div>This pilot study employed a one-group pretest-posttest experimental design without a control group. Seventeen children aged 7–12 from a low socioeconomic area in Southeastern Türkiye participated in an eight-week CBT-based program that included cognitive restructuring, exposure tasks, and homework. Data were analyzed using Linear Mixed Effects Models (LMM), with CBT intervention defined as a fixed effect and individual variation as a random effect. Separate LMM analyses were conducted for social anxiety and stuttering severity.</div></div><div><h3>Results</h3><div>The LMM results revealed statistically significant reductions in both social anxiety and stuttering severity following the CBT-based intervention. Baseline levels of social anxiety and stuttering severity significantly predicted follow up outcomes, and the intervention led to meaningful decreases across both measures.</div></div><div><h3>Conclusion</h3><div>As a pilot study, these results highlight the potential of CBT-based interventions to reduce both social anxiety and stuttering severity in CWS. These results point to the potential utility of individualized early intervention strategies, including psychiatric nursing practices, within clinical and educational contexts to address the multifaceted nature of developmental stuttering.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106192"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content validity of AI-generated stuttering assessment and intervention programs based on expert review: A comparative analysis across age groups and language versions","authors":"Ayşe Nur Koçak ,&nbsp;Melis Buse Arslan","doi":"10.1016/j.jfludis.2025.106186","DOIUrl":"10.1016/j.jfludis.2025.106186","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the content validity and inter-rater reliability of stuttering assessment and intervention programs generated by artificial intelligence (GPT-4) in both Turkish and English for preschool, school-age, and adult populations. It also examined whether linguistic or cultural differences affected expert evaluations.</div></div><div><h3>Methods</h3><div>Twelve AI-generated programs (six in Turkish, six in English) were reviewed by twelve certified speech-language pathologists specializing in fluency disorders. Each item was rated using a 5-point Likert scale. Descriptive statistics, Cronbach’s Alpha, and Intraclass Correlation Coefficients (ICC) were calculated to assess consistency and reliability.</div></div><div><h3>Results</h3><div>The majority of items were rated as appropriate or highly appropriate (M = 4.6–4.9). The overall reliability among raters was poor (ICC = 0.45), while single-rater reliability was higher (ICC = 0.65). Only a small number of items were flagged for revision, typically involving emotional or contextual components. Experts noted that English versions tended to be more detailed and literature-consistent, whereas certain Turkish terms required clearer cultural adaptation.</div></div><div><h3>Conclusion</h3><div>GPT-4 can produce clinically relevant and linguistically accurate stuttering materials when paired with expert review. However, human validation remains essential to refine affective and culture-specific elements. These findings support the integration of AI-assisted tools in multilingual clinical content development.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106186"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in preschoolers who stutter and do not stutter: An exploratory study","authors":"Erika Queiroga Werkhaizer Soares ,&nbsp;Denise Brandão de Oliveira e Britto ,&nbsp;Stela Maris Aguiar Lemos","doi":"10.1016/j.jfludis.2025.106191","DOIUrl":"10.1016/j.jfludis.2025.106191","url":null,"abstract":"<div><div>This study aimed to assess the quality of life of children aged 2-who stutter and who do not stutter. We compared the quality-of-life scores between the two groups and analysed the relationship between their scores and sociodemographic data. We conducted a cross-sectional observational analytical study utilising a non-probabilistic convenience sample of 74 children in the specified age range. Data were collected using structured interviews (sample characterisation script), the Brazilian Economic Classification Criteria, and the Pediatric Questionnaire on Quality of Life (Generic Version 4.0). The Stuttering Severity Instrument (SSI-4) was used to classify the severity of stuttering. The collected data underwent descriptive, associative, and multivariate analyses. Association analyses were conducted between the dimensions of quality of life and total quality of life and the variables socioeconomic background, age, gender, family history of recovered and persistent stuttering, maternal education, and child education, as well as between stuttering severity and quality of life scores. No significant association was found between quality of life and stuttering as perceived by parents. Additionally, no association was observed between stuttering severity and quality of life in children with a confirmed diagnosis of stuttering. Therefore, the impact of stuttering on the quality of life appears to be unrelated to the onset of symptoms but, more likely, to negative communicative experiences during its development.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106191"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of transcranial direct current stimulation on reading adaptation in adults who stutter","authors":"Narges Moein ,&nbsp;Cindy Nguyen ,&nbsp;Douglas Cheyne ,&nbsp;Luc De Nil","doi":"10.1016/j.jfludis.2026.106195","DOIUrl":"10.1016/j.jfludis.2026.106195","url":null,"abstract":"<div><h3>Background</h3><div>The reading adaptation effect in stuttering refers to decreased stuttering frequency during repeated readings. This study investigated whether anodal transcranial direct current stimulation (tDCS) over the left primary motor cortex (M1) enhances reading adaptation in adults who stutter.</div></div><div><h3>Methods</h3><div>Two consecutive studies were conducted. Study 1 was a randomized, double-blind, sham-controlled trial with twenty adults who stutter (14 males, 6 females) assigned to either an anodal tDCS (2 mA, 20 min) or a sham stimulation group. Participants read a passage five times during stimulation. Study 2 was an exploratory secondary single-case analysis of data from six participants (5 males, 1 female) who demonstrated measurable stuttering during reading (&gt;1 % syllables stuttered) in Study 1. Reading adaptation was quantified as percentage reduction in stuttering frequency from first to fifth reading trial.</div></div><div><h3>Results</h3><div>Study 1 showed no statistically significant difference in reading adaptation between anodal and sham groups (Mann-Whitney U = 30, p = 0.137), though a moderate effect size (r = 0.34) suggested a potentially meaningful difference. Study 2 revealed variable individual responses, with three participants showing greater reading adaptation under anodal stimulation and three showing greater adaptation under sham stimulation.</div></div><div><h3>Conclusions</h3><div>Anodal tDCS over the left M1 did not consistently enhance reading adaptation in adults who stutter, suggesting that the relationship between M1 excitability and reading adaptation is more complex than hypothesized. Future research should investigate alternative neural targets, stimulation parameters, and individual differences in stuttering severity to better understand the effects of neuromodulation on speech motor adaptation in speech disorders.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106195"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in stuttering research and discourse: A preface to the selected papers from the 2024 World Congress on Stuttering and Cluttering","authors":"Katie L. Winters,&nbsp;Dillon G. Pruett","doi":"10.1016/j.jfludis.2025.106190","DOIUrl":"10.1016/j.jfludis.2025.106190","url":null,"abstract":"","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106190"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amelioration of acquired stuttering following thalamic deep brain stimulation","authors":"Phoebe Matthews ,&nbsp;Intouch Sopchokchai ,&nbsp;Aisha Alkubaisi ,&nbsp;Benjamin Ho ,&nbsp;Stefan Lang ,&nbsp;Christopher R. Honey","doi":"10.1016/j.jfludis.2025.106174","DOIUrl":"10.1016/j.jfludis.2025.106174","url":null,"abstract":"<div><h3>Purpose</h3><div>Stuttering is a speech disorder that can have debilitating effects on quality of life. We present a case report of a patient with near complete resolution of acquired stuttering following thalamic deep brain stimulation (DBS) for essential tremor. A literature review of neuromodulation for both developmental and acquired stuttering is presented with proposed insights into the pathophysiology of acquired stuttering.</div></div><div><h3>Method</h3><div>A case report of a patient with acquired stuttering receiving thalamic DBS for essential tremor is presented. Clinical data on their stuttering severity and its impact on quality of life was prospectively collected before and six months after thalamic DBS for their essential tremor. Additional data on tremor severity, mood, cognition and overall quality of life are presented.</div></div><div><h3>Results</h3><div>At six months follow-up, there were significant improvements in the patient’s tremor and overall quality of life (as expected). There was also near complete resolution of their acquired stuttering and a resultant improvement in voice-related quality of life.</div></div><div><h3>Conclusion</h3><div>This case report details a patient with near complete resolution of acquired stuttering following thalamic deep brain stimulation for essential tremor. The Vim nucleus of the thalamus may play an important role in the pathophysiology of acquired stuttering. Additional studies will be needed to confirm the usefulness of thalamic DBS in acquired stuttering.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106174"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results","authors":"Mathieu Delangle ,&nbsp;Anne Moïse-Richard ,&nbsp;Anne-Lise Leclercq ,&nbsp;David Labbé ,&nbsp;Stéphane Bouchard ,&nbsp;Sheldon Andrews ,&nbsp;Lucie Ménard","doi":"10.1016/j.jfludis.2026.106194","DOIUrl":"10.1016/j.jfludis.2026.106194","url":null,"abstract":"<div><h3>Purpose</h3><div>Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter.</div></div><div><h3>Method</h3><div>Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy.</div></div><div><h3>Results</h3><div>The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation.</div></div><div><h3>Conclusion</h3><div>This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"87 ","pages":"Article 106194"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel use of choral speech significantly reduces stuttering in a simulated presentation setting: An exploratory study","authors":"Birtan Demirel","doi":"10.1016/j.jfludis.2025.106168","DOIUrl":"10.1016/j.jfludis.2025.106168","url":null,"abstract":"<div><div>Choral speech, defined as speaking in unison with another voice, has long been recognised for improving speech fluency while maintaining speech naturalness for people who stutter (PWS). However, its practical application has been limited by the need for a live second voice. This exploratory study investigated whether choral speech could be used in a simulated presentation setting with two alternative voice sources: participants’ own voice recording and computer-generated voice. The condition using participants’ own recording built on findings that many PWS experience increased fluency when speaking alone; participants therefore recorded their voice on their own, which was later played back through headphones during their presentation. In the computer-generated voice condition, participants synchronised their speech with a text-to-speech (TTS) decoder after uploading the presentation text. Two additional conditions were included for comparison: a baseline reading with no intervention, and a non-speech auditory feedback using white noise. Results showed a substantial decrease in disfluent syllables, with the mean percentage dropping from 10 % at baseline to below 3 % in both choral speech conditions. One participant reduced stuttering from 49 % to 2 %, and shortened reading duration from approximately 19 to 4 min with the TTS decoder, while improving perceived speech naturalness. To the author’s knowledge, these preliminary results are first to suggest that choral speech with a TTS decoder can significantly reduce stuttering in a simulated presentation setting. Further research should investigate its clinical potential to support real-life presentations and reduce public speaking avoidance.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"86 ","pages":"Article 106168"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential tolerance for the judgement of dysfluencies as stuttered speech in native and non-native speech-language pathologists","authors":"Audrey J. Dsouza,&nbsp;Santosh Maruthy","doi":"10.1016/j.jfludis.2025.106150","DOIUrl":"10.1016/j.jfludis.2025.106150","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate diagnosis of stuttering requires careful observation by trained professionals. Speech-language pathologists (SLPs) typically identify stuttering using a perceptual judgement. However, it is unclear if this perception is based on the amount or the type of dysfluencies. Hence, the study aimed to determine the frequency of syllable/part-word repetitions judged as stuttered and to determine if the listener's language influences their judgement of fluency.</div></div><div><h3>Method</h3><div>Narrative samples of a Kannada-speaking child who stutters containing 1 %, 3 %, 5 %, 10 %, and 15 % of syllable or part-word repetitions were judged by 27 Kannada and Malayalam-speaking SLPs each as fluent, disfluent, or stuttered. Further, an opinion about recommending the child for speech therapy was taken. The chi-square test and Fisher's exact test were performed to compare the difference between the two groups.</div></div><div><h3>Results</h3><div>Comparison between the five frequencies of dysfluencies and the judgement of speech revealed a significant difference for Kannada and Malayalam language groups. The non-native SLPs required more dysfluencies to judge speech as stuttered compared to the native SLPs. Both groups of SLPs recommended speech therapy for samples above 5 % dysfluencies.</div></div><div><h3>Conclusions</h3><div>Familiarity of Malayalam-speaking SLPs with the Kannada language and the experience of the participants in the assessment of stuttering could have influenced the differences obtained in this study. However, current results indicate a differential threshold for the perception of dysfluencies (syllable and part-word repetitions) and the influence of the listener's language familiarity. Hence, language familiarity may be a factor in the judgement of dysfluencies as fluent, disfluent, and stuttered speech.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"86 ","pages":"Article 106150"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the needs and preferences of Saudi Arabian adolescents who stutter","authors":"Einas Alharbi ,&nbsp;Sally Hewat ,&nbsp;Joanne Walters ,&nbsp;Rachael Unicomb","doi":"10.1016/j.jfludis.2025.106165","DOIUrl":"10.1016/j.jfludis.2025.106165","url":null,"abstract":"<div><h3>Purpose</h3><div>During adolescence, individuals experience rapid physical, cognitive, and psychosocial changes. This transition may raise additional challenges for an adolescent who stutters. Although previous research has examined the experiences of adolescents who stutter, their preferences remain unstudied, particularly in non-Western countries. This qualitative study explored how Saudi Arabian adolescents who stutter perceive their stuttering and its management, and their preferences for support.</div></div><div><h3>Method</h3><div>To gain preliminary insight into this unstudied area of research, eight participants, aged 13–17 years and 11 months, diagnosed with developmental stuttering by a qualified speech-language pathologist, and were Saudi Arabian citizens living in Saudi Arabia, were recruited through administrative staff at two clinics. Reflexive thematic analysis was used to identify themes and sub-themes.</div></div><div><h3>Results</h3><div>Data revealed four main themes: <em>Stuttering and my emotions; Stuttering and my environment; Therapy is a journey;</em> and <em>Listen to my voice.</em> Although some participants reported feeling positive about their stuttering, all participants had experienced negative emotions due to stuttering. Furthermore, others' awareness and reactions to stuttering played a significant role in shaping participants’ communication experiences. The results emphasised that stuttering therapy is a dynamic, individualized journey. Participants desired more than speech therapy; they also sought independence, privacy, and support from their social environment.</div></div><div><h3>Conclusion</h3><div>Results highlighted that Saudi Arabian adolescents who stutter want to be heard and supported by people in their environment. Key stakeholders, including speech-language pathologists, teachers, caregivers, adolescents, and professional bodies, could utilise this information to develop tailored evidence-based interventions and provide individualised support for adolescents who stutter.</div></div>","PeriodicalId":49166,"journal":{"name":"Journal of Fluency Disorders","volume":"86 ","pages":"Article 106165"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}