IN BRIEF: The following articles highlight the need for the use of differential diagnosis of associated psychosocial pathology (specifically Social Anxiety Disorder), so that stuttering may be more accurately researched and treated.  There are various self-report questionnaires available to help diagnose SAD. Two of the most popular are  the Liebowitz Social Anxiety Scale (LSAS-SR) and the Social Phobia Inventory (SPIN). It is suggested that the term Stuttered Speech Syndrome be used to classify those people who suffer the interwoven disabilities of stuttering and SAD.

• Terminology – How should stuttering be defined? And why?
• Awareness, Advocacy and Acceptance – Unifying Science with Experience (pdf)
• Recommended Reading
• Other Articles

Terminology – How should stuttering be defined? And why?

To be cited as: Irwin, M (2006). Terminology – How Should Stuttering be Defined? and Why? Published in J. Au-Yeung & M.M. Leahy (Eds.), Research, Treatment, and Self-Help in Fluency Disorders: New Horizons (pp. 41-45). Dublin: The International Fluency Association.

Abstract

The word stuttering is currently used to describe dysfluent speech, a speech syndrome and the symptoms of a speech disorder. This is confusing resulting in difficulties with public awareness and professional communication. Existing dictionary definitions are very limited in scope, do not mention covert behaviour, and do not always cross reference stuttering with stammering. Academic definitions where they are comprehensive are also cumbersome and there is confusion between the terms covert features, covert symptoms, covert stuttering and interiorized stuttering. A new definition, classification and diagnostic term (Stuttered Speech Syndrome) are proposed. The aim is to provide clarity and allow stuttering to be more easily and accurately discussed from both the listeners and the speakers perspective.

Read the full article here or download a copy in PDF format.

Recommended Reading

• Stuttering and Social Phobia (Social Anxiety Disorder): Background Information and Clinical Implications by Larry Molt, from Alabama, USA. International Stuttering Awareness Day Online Conference, 2003.
• American Speech-Language Hearing Association. (1998). Terminology Pertaining to Fluency and Fluency Disorders: Guidelines. ASHA Desk Reference Volume 3. 387-394.
• Kraaimaat, F.W., Vanryckeghem, M. & Van Dam-Baggen, R. (2002). Stuttering and social anxiety. Journal of Fluency Disorders, 27, 319-331.
• Stein, M.B., Baird, A., & Walker, J.R. (1996). Social Phobia in Adults With Stuttering. American Journal of Psychiatry, 153(2), 278-280.
• Moutier,C.Y.,& Stein,M.B. (1999). The History,Epidemiology, and Differential Diagnosis of Social Anxiety Disorder. J Clin Psychiatry, 60 (supp 9) 4-8.

Other Articles

(Better appreciated with an understanding of the advantage to research design in separating people who stutter with social phobia from those without it.)

• Alm, P.A. (2004). Stuttering, emotions and heart rate during anticipatory anxiety: a critical review. Journal of Fluency Disorders, 29, 123-133.
• Alm, P.A., & Risberg, J. (2007). Stuttering in adults: The acoustic startle response, temperamental traits, and biological factors. Journal of Communication Disorders, 40, 1-41.
• Attanasio, J.S. (1991). Research Design Issues in Relationships Between Anxiety and Stuttering: Comments on Craig. Journal of Speech and Hearing Research, 34, 1079-1080.
• Blood, G.W., Blood, I.M., Maloney, K., Meyer, C., & Qualls, D.C. (2007). Anxiety levels in adolescents who stutter. Journal of Communication Disorders, 40, 452-469.
• Caruso, A.J., Chodsko-Zajko, W.J., Bidinger, D.A., & Sommers, R.K. (1994). Adults who stutter: Responses to cognitive stress. Journal of Speech and Hearing Research, 37, 746-754.
• Connor, K.M., Davidson, J.R.T., Churchill, L.E., Sherwood, A., & Weisler, R.H. (2000). Psychometric properties of the Social Phobia Inventory (SPIN). The British Journal of Psychiatry, 176, 379-386.
• Cooper, E.B. (1993). Chronic Perseverative Stuttering Syndrome: A Harmful or Helpful Construct? American Journal of Speech-Language Pathology, FIND REST, 11-15.
• Craig, A. (1990). An investigation into the relationships between anxiety and stuttering. Journal of Speech and Hearing Disorders, 55, 290-294.
• Dietrich, S., & Roaman, M.H. (2001). Physiological arousal and predictions of anxiety by people who stutter. Journal of Fluency Disorders, 26, 207-225.
• DiLollo, A., Manning, W.H., & Neimeyer, R.A. (2003). Cognitive anxiety as a function of speaker role for fluent speakers and persons who stutter. Journal of Fluency Disorders, 28, 167-186.
• DiLollo, A., Neimeyer, R.A., & Manning, W.H. (2002). A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment. Journal of Fluency Disorders, 27, 19-42.
• Ezrati-Vinacour, R., & Levin, I. (2004). The relationship between anxiety and stuttering: a multidimensional approach. Journal of Fluency Disorders, 29, 135-148.
• Gabel, R.M., Colcord, R.D., & Petrosino, L. (2002). Self-Reported Anxiety of Adults who Stutter. Perceptual and Motor Skills, 94, 775-784.
• George, M.S., & Lydiard, R.B. (1994). Social Phobia Secondary to Psychical Ability: A Review of Benign Essential Tremor (BET) and Stuttering. Psychosomatics, 35(6), 520-523.
• Gray, B.B., & Karmen, J.L. (1967). The Relationship Between Nonverbal Anxiety and Stuttering Adaptation. Journal of Communication Disorders, 1, 141-151.
• Heimberg, R.G., Mueller, G.P., Holt, C.S., Hope, D.A., & Liebowitz, M.R. (1992). Assessment of Anxiety in Social Interaction and Being Observed by Others: The Social Interaction Anxiety Scale and the Social Phobia Scale. Behavior Therapy, 23, 53-73.
• Ingham, R.J. (1990). Commentary on Perkins (1990) and Moore and Perkins (1990): On the Valid Role of Reliability in Identifying “What is Stuttering?”. Journal of Speech and Hearing Disorders, 55, 394-397.
• Ingham, R.J., & Andrews, G. (1971). The Relation Between Anxiety Reduction and Treatment. Journal of Communication Disorders, 4, 289-301.
• Kent, R.D. (2006). Evidence-Based Practice in Communication Disorders: Progress not Perfection. Language, Speech and Hearing Services in Schools, 37, 268-270.
• Kessler, R.C., Stein, M.B., & Berglund, P. (1998). Social Phobia Subtypes in the National Comorbidity Survey. American Journal of Psychiatry, 155(5), 613-619.
• Kraaimaat, F., Janssen, P. & Brutten, G.J. (1988). The Relationship Between Stutterers’ Congnitive and Autonomic Anxiety and Therapy Outcome. Journal of Fluency Disorders, 13, 107-113.
• Mahr, G.C., & Torosian, T. (1999). Anxiety and Social Phobia in Stuttering. Journal of Fluency Disorders, 24, 119-126.
• Martin, R.R., & Haroldson, S.K. (1981). Stuttering Identification: Standard Definition and Moment of Stuttering. Journal of Speech and Hearing Research, 46, 59-63.
• Martin, R.R., & Haroldson, S.K. (1981). Looking for What to Know: A Reply to Wingate. Journal of Speech and Hearing Research, 24, 623-624.
• Meline, T., & Schmitt, J.F. (1997). Case Studies for Evaluating Statistical Significance in Group Designs. American Journal of Speech-Language Pathology, 6(1), 33-41.
• Menzies, R.G., Onslow, M., & Packman, A. (1999). Anxiety and Stuttering: Exploring a Complex Relationship. American Journal of Speech-Language Pathology, 8, 3-10.
• Messenger, M., Onslow, M., Packman, A., & Menzies, R. (2004). Social anxiety in stuttering: measuring negative social expectancies. Journal of Fluency Disorders, 29, 201-212.
• Perkins, W.H. (1984). Stuttering as a Categorical Event: Barking Up the Wrong Tree – Reply to Wingate. Journal of Speech and Hearing Disorders, 49, 429-441.
• Perkins, W.H. (1990). Gratitude, Good Intentions, and Red Herrings: A Response to Commentaries. Journal of Speech and Hearing Disorders, 55, 402-404.
• Perkins, W.H. (1990). What is Stuttering? Journal of Speech and Hearing Disorders, 55, 370-382.
• Ratner, N.B. (2005). Evidence-based practice in stuttering: Some questions to consider. Journal of Fluency Disorders, 30, 163-188.
• Ratner, N.B. (2006). Evidence-Based Practice: An Examination of Its Ramifications for the Practice of Speech-Language Pathology. Language, Speech and Hearing Services in Schools, 37, 257-267.
• Smith, A. (1990). Toward a Comprehensive Theory of Stuttering: A Commentary. Journal of Speech and Hearing Disorders, 55, 398-401.
• Stewart, T., & Birdsall, M. (2001). A Review of the Contribution of Personal Construct Psychology to Stammering Therapy. Journal of Constructivist Psychology, 14, 215-226.
• Wakaba, Y.Y. (1983). Group Play Therapy for Japanese Children Who Stutter. Journal of Fluency Disorders, 8, 93-118.
• Wingate, M.E. (1981). Knowing What to Look for: Comments on Stuttering Identification – Standard Definition and Moment of Stuttering. Journal of Speech and Hearing Research, 24, 622-623.
• Yaruss, J.S. et al. (2002). Speech treatment and support group experiences of people who participate in the National Stuttering Association. Journal of Fluency Disorders, 27, 115-134.
• Young, M.A. (1975). Observer Agreement for Marking Moments of Stuttering. Journal of Speech and Hearing Research, 18, 530-540.