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Purpose: The contextual variability of stuttering events makes it difficult to reliably elicit stuttered speech in laboratory settings. As a result, studies that compare stuttered versus fluent speech are difficult to conduct and, thus, are limited in the literature. The purpose of the current study is to describe a novel approach to elicit stuttering during laboratory testing. Method: A semistructured clinical interview leveraging the phenomenon of stuttering anticipation was administered to 22 adults who stutter (1st visit). The interview was used to generate participant-specific anticipated and unanticipated word lists, which were used as stimuli during a 2nd visit so that the validity of the method could be tested. Results: The method yielded a near-equal distribution of unambiguously stuttered and fluent utterances (43.6% and 43.5%, respectively). Moreover, 12.9% of the utterances were judged to be ambiguous, that is, not unambiguously stuttered or fluent. Conclusion: This approach outperformed previous attempts to elicit stuttering during laboratory testing. It could be implemented in future studies that compare neural, physiological, or behavioral correlates of fluent versus stuttered speech.

A student-friendly resource on stuttering and related fluency disorders by a who's who of global experts Stuttering and Related Disorders of Fluency, Fourth Edition honors the philosophy that discoveries of the past are the bedrock of the present and the inspiration for future explorations—in this context—the nature and treatment of stuttering. Initially developed over 30 years ago, the first two editions were edited by the late Richard F. Curlee and the third edition was co-edited by Richard F. Curlee and Edward G. Conture. The latest edition, co-edited by Patricia M. Zebrowski, Julie D. Anderson, and Edward G. Conture, brings together contemporary insights and a multinational perspective from 44 world-class academicians, clinicians, and researchers in the field of stuttering and related disorders. The book is organized into six sections and 17 chapters, with the first section describing basic facts and theories. The second section covers genetic, neural, linguistic, cognitive, and physiological factors. The third section features three dedicated chapters on the diagnosis of preschool-age children, school-age children, and adolescents and adults. The fourth section discusses treatment guidelines with three chapters organized by the same age demographics, while the fifth section covers language and phonological, bilingual and multicultural, and pharmacological considerations for treatment. The sixth, and last, section provides guidance on cluttering and acquired stuttering—from causes and symptoms to diagnosis and treatment. Key Highlights * Up-to-date, reader-friendly text is ideal for students with no or limited background or experience in the nature and treatment of stuttering and related fluency disorders * Comprehensive content covering all relevant aspects of stuttering in diverse populations across the lifespan, including etiology, development, diagnosis, and treatment * Contributions from a diverse group of top scholars and practitioners from the United States, Canada, Western Europe, and Australia This text is essential reading for upper-class undergraduates and early-stage graduate students in communication sciences and disorders. It also provides an invaluable classroom tool for instructors teaching basic courses on this subject and is a helpful sourcebook for researchers investigating stuttering and related fluency disorders.

Purpose: The purpose of this study was to examine group and individual differences in attentional bias toward and away from socially threatening facial stimuli among adolescents who stutter and age- and sex-matched typically fluent controls. Method: Participants included 86 adolescents (43 stuttering, 43 controls) ranging in age from 13 to 19 years. They completed a computerized dot-probe task, which was modified to allow for separate measurement of attentional engagement with and attentional disengagement from facial stimuli (angry, fearful, neutral expressions). Their response time on this task was the dependent variable. Participants also completed the Social Anxiety Scale for Adolescents (SAS-A) and provided a speech sample for analysis of stuttering-like behaviors. Results: The adolescents who stutter were more likely to engage quickly with threatening faces than to maintain attention on neutral faces, and they were also more likely to disengage quickly from threatening faces than to maintain attention on those faces. The typically fluent controls did not show any attentional preference for the threatening faces over the neutral faces in either the engagement or disengagement conditions. The two groups demonstrated equivalent levels of social anxiety that were both, on average, very close to the clinical cutoff score for high social anxiety, although degree of social anxiety did not influence performance in either condition. Stuttering severity did not influence performance among the adolescents who stutter. Conclusion: This study provides preliminary evidence for a vigilance-avoidance pattern of attentional allocation to threatening social stimuli among adolescents who stutter.

Purpose: This article is the first in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. In this article, we describe the process of developing measures to assess stage of change (SOC) by defining behaviors of stuttering management, as well as the two primary cognitive constructs that underlie one's readiness to make behavioral change: decisional balance (DB) and situational self-efficacy (SSE). This work hinges on the ability to develop an operational definition of what it means to successfully manage or do something positive about one's stuttering. Method: We used an iterative process to develop the three scales. Through qualitative analysis of key informant interview and focus group transcripts with 24 adolescents who stutter and 26 clinicians specializing in stuttering, we developed stuttering-specific SOC, DB, and SSE scales. The drafted scales were cognitively tested with nine adolescents who stutter. Results: Thematic analysis yielded a three-part definition of successful stuttering management that formed the basis for the SOC scale: (a) learning and using strategies to modify speech or stuttering, (b) changing negative thoughts and attitudes regarding stuttering, and (c) talking without avoiding sounds, words, or situations. Results from this analysis support a broader view of successful stuttering management; that is, it is likely that doing so requires more than just behavior change, which has long been considered the main objective of stuttering treatment. Additional analyses yielded pros and cons of managing stuttering (62 items for the DB scale) and situations in which it is difficult to manage stuttering (39 items for the SSE scale). Conclusions: Qualitative analyses provided a three-part definition of \"stuttering management\" and a comprehensive pool of items that would allow measurement of DB and SSE that underlie readiness to manage stuttering among adolescents. In the companion article in this two-part series, we describe the next step in scale development: exploratory scale validation of the drafted SOC, DB, and SSE scales.

Purpose: This article is the second in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. The purpose of this article was to apply and explore the validity of newly developed Transtheoretical measures for adolescents who stutter. Method: The online survey was completed by a national sample of 173 adolescents who stutter between the ages of 13 and 21 years. The multipart survey included a Stage of Change scale, Decisional Balance scale, and Situational Self-Efficacy scale. Participants also completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), either the teenage or adult version depending on the participant's age, so preliminary construct validity of the new scales could be examined. Exploratory factor analyses were conducted to determine model fit and reduce the scales to the most meaningful items. External validity of the threepart survey was examined by comparing OASES scores across stage of change as well as evaluating the functional relations between the three scales. Results: Adolescents' readiness to manage stuttering could be clearly described with five discrete stages, although most of the respondents reported being in the Maintenance stage. The pros of managing stuttering reliably predicted stage placement. Internal consistency of the scales ranged from good to excellent. OASES scores differed across stages of readiness in complex but predictable ways. Conclusions: These findings suggest that the Transtheoretical Model fits the target behaviors involved stuttering management among adolescents. Further examination of the application of the model to validate a stage-based framework for change among individuals who stutter is warranted.

Pediatricians often are the first health care professional parents turn to when they are concerned their child may be stuttering. At this point, the pediatrician can direct parents to a number of available resources for more information and also can provide referral to a speech-language pathologist who has undergone graduate training and received certification in speech-language pathology.

[...]the top insurance providers in the U.S., including Medicare and Medicaid, cover physical therapy, occupational therapy and mental health therapy for medical necessity or developmental disorders-but speech therapy is covered only if it is deemed \"medically necessary\" (meaning that the disorder is secondary to injury, illness or disease). Along with increased therapy rates in general and the elimination of training waivers, even for our own university students (because doing so is noncompliant with Medicare and Medicaid rules), we have seen a reduction in our caseload of people who stutter, even though the number of people seeking help has not decreased and even though we offer a generous sliding fee scale and flexible treatment options.

Adverse events during hospitalization are a major cause of patient harm, as documented in the 1991 Harvard Medical Practice Study. Patient safety has changed substantially in the decades since that study was conducted, and a more current assessment of harm during hospitalization is warranted. We conducted a retrospective cohort study to assess the frequency, preventability, and severity of patient harm in a random sample of admissions from 11 Massachusetts hospitals during the 2018 calendar year. The occurrence of adverse events was assessed with the use of a trigger method (identification of information in a medical record that was previously shown to be associated with adverse events) and from review of medical records. Trained nurses reviewed records and identified admissions with possible adverse events that were then adjudicated by physicians, who confirmed the presence and characteristics of the adverse events. In a random sample of 2809 admissions, we identified at least one adverse event in 23.6%. Among 978 adverse events, 222 (22.7%) were judged to be preventable and 316 (32.3%) had a severity level of serious (i.e., caused harm that resulted in substantial intervention or prolonged recovery) or higher. A preventable adverse event occurred in 191 (6.8%) of all admissions, and a preventable adverse event with a severity level of serious or higher occurred in 29 (1.0%). There were seven deaths, one of which was deemed to be preventable. Adverse drug events were the most common adverse events (accounting for 39.0% of all events), followed by surgical or other procedural events (30.4%), patient-care events (which were defined as events associated with nursing care, including falls and pressure ulcers) (15.0%), and health care-associated infections (11.9%). Adverse events were identified in nearly one in four admissions, and approximately one fourth of the events were preventable. These findings underscore the importance of patient safety and the need for continuing improvement. (Funded by the Controlled Risk Insurance Company and the Risk Management Foundation of the Harvard Medical Institutions.).