Addressing Stuttering Variability in Assessment and Treatment: Perspectives of Speech-Language Pathologists

This study investigated how speech-language pathologists (SLPs) observe and address variability in stuttering assessment and treatment. Variability was examined in observable overt stuttering behaviors and beyond, encompassing the emotions, beliefs, and behaviors associated with stuttering, as well as speakers' ability to engage in daily activities and participate fully in their lives. The overarching goal of the study was to identify strategies for ensuring that variability is appropriately accounted for in clinical work related to stuttering.

The study employed a mixed-methods approach, combining quantitative and qualitative data collected through an online survey from 143 U.S.-based SLPs, including generalists (n = 116) and self-reported stuttering experts (n = 27). Quantitative data were analyzed using descriptive and inferential statistics to compare observations across aspects of stuttering, while qualitative data were analyzed using thematic analysis to identify patterns in clinical practices.

Both generalists and stuttering experts reported that they consistently observe variability across all aspects of stuttering. For overt behaviors, 100% of both groups noted variability. In reactions to stuttering, 96.3% of generalists and 100% of stuttering experts observed variability. Variability in daily participation was reported by 91.3% of generalists and 96% of stuttering experts. Thematic analysis revealed that stuttering variability is highly individualized, influencing overt behaviors, emotional responses, and daily participation, with SLPs emphasizing comprehensive assessments, tailored treatments, and education to address its challenges and opportunities. While both groups observed and addressed variability, generalists focused more on observable behaviors, whereas experts emphasized other aspects of the stuttering experience using a more holistic approach.

Effectively addressing the variability of stuttering requires comprehensive, context-sensitive strategies that address the broad experience of stuttering. By tailoring interventions to individual needs and fostering resilience related to variability, clinicians can improve outcomes for people who stutter.