School-Age Differences in Reasonable Accommodations for Students Who Stutter: A Content Analysis of Medical Letters
Related Experiment Video
Updated: Oct 31, 2026
A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
Published on: February 21, 2011
Yoshikazu Kikuchi1,2, Yumi Yamaguchi1, Masamutsu Kenjo2
1Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Background:
Japanese schools must provide reasonable accommodations for students who stutter, but developmental variations in these needs are poorly understood. This study characterized accommodation requests in clinician-drafted medical letters to clarify these needs.
Methods:
Medical letters for 116 students who stutter (65 elementary, 51 secondary) were retrospectively analyzed. Accommodation content was classified using inductive content analysis. Group proportions were compared, and stuttering frequency (%SS) and social anxiety (LSAS-CA) were analyzed descriptively.
Results:
Five accommodation categories were identified. Elementary students significantly more frequently requested teacher-mediated protective support, such as reporting teasing and classroom stuttering explanations. Secondary students more frequently requested social functioning accommodations, including subject-teacher information sharing and entrance examination support. Presentation-related accommodations were highly prevalent across both groups (61.2% overall). Participants who completed the anxiety assessment exhibited elevated social anxiety (mean LSAS-CA: 42.1).
Conclusion:
Accommodation needs reflect structural school transitions, shifting from classroom protection under the elementary homeroom system to social participation support under the secondary subject-teacher system. Importantly, presentation-related needs represent a consistent concern, likely driven by subjective anxiety rather than objective stuttering severity. Medical letters may serve as valuable tools for initiating constructive clinician-family-school dialogue to facilitate tailored support.
