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Lasten kommunikointiasenteita arvioivan “Communication Attitude Test for Preschool and Kindergarten Children Who Stutter” (KiddyCAT) ja aikuisten kommunikointiasenteita arvioivan “Communication Attitude Test for Adults” (BigCAT) -testien kansainvälinen tutkimus on osoittanut, että änkyttävät lapset ja aikuiset suhtautuvat kielteisemmin puhumiseen kuin sujuvasti puhuvat verrokit. Tämän tutkimuksen tavoitteena oli arvioida KiddyCAT-Fin- ja BigCAT-Fin-testien suomennosten pätevyyttä (validiteettia) ja luotettavuutta (reliabiliteettia). Lisäksi tavoitteena oli määritellä kummallekin testille kliinisen käytön tueksi katkaisupistemäärä, jonka ylittävä pistemäärä ilmaisee keskimääräistä kielteisempää kommunikointiasennetta. Tutkimuksessa 86 alle kouluikäistä lasta (joista 41 änkyttävää) täytti KiddyCAT-Fin:n 12 kysymystä sisältävän itsearviointilomakkeen ja 109 aikuista (joista 29 änkyttävää) täytti BigCAT-Fin:n 34 kysymystä sisältävän itsearviointilomakkeen. Itsearviointien kokonaispistemäärien keskiarvot olivat lähellä alkuperäisten englanninkielisten versioiden arvoja. Lisäksi änkyttävien lasten ja aikuisten kommunikointiasenteet olivat merkitsevästi kielteisemmät kuin sujuvasti puhuvien. Kummankin testin sisäinen konsistenssi ja uudelleenmittausreliabiliteetti olivat korkeat. Suomennettujen KiddyCAT:n ja BigCAT:n voidaan todeta erottelevan änkyttävien ihmisten kommunikointiasenteet tehokkaasti sujuvasti puhuvien ihmisten asenteista, Research with the “Communication Attitude Test for Preschool and Kindergarten Children Who Stutter” (KiddyCAT) and “Communication Attitude Test for Adults” (BigCAT) in several countries have shown that children and adults who stutter have a significantly more negative attitude toward speech compared to their nonstuttering peers. The aim of the present study was to evaluate the validity and reliability of an authorized Finnish adaptation of the “Communication Attitude Test for preschool and kindergarten children who stutter” (KiddyCAT-Fin) and “Communication Attitude Test for Adults” (BigCAT-Fin). Moreover, the cut-off scores were defined for clinical use for both self-report tests. In this research, 86 preschool-aged children (41 of which stuttering) completed the KiddyCAT-Fin with 12 statements and 109 adults (29 of which stuttering) completed the BigCAT-Fin with 34 statements. The mean scores were descriptively close to those of the English version of both measures. Children and adults who stutter had a significantly more negative communication attitude than fluently speaking children and adults. Internal consistency and re-test reliabilities were high for both measures. To conclude, the Finnish versions of the KiddyCAT and BigCAT differentiate stuttering people efficiently from fluently speaking individuals based on their communication attitudes.

Purpose: Existing data stemming from investigations with the Speech Situation Checklist (SSC) have shown this standardised test to be a valid and reliable tool for assessing speech-related anxiety in children who stutter (CWS). The main purpose of this study was to compare Speech Situation Checklist-Emotional Reaction (SSC-ER) scores for Kannada-speaking children who do not stutter (CWNS) and CWS. In addition, the Speech Situation Checklist-Emotional Reaction in Kannada (SSC-ER-K) scores among different stuttering severity and age groups were compared in CWS.Method: The English version of the SSC-ER was forward-translated into Kannada and back-translated by the first author. SSC-ER-K was administered on 100 CWS and 275 CWNS aged between 7 and 14 years who were native speakers of the Kannada language. The severity of stuttering was estimated using the Stuttering Severity Instrument-fourth edition (SSI-4).Result: The results revealed that the SSC-ER-K scores of CWS were significantly higher in comparison with CWNS. CWS with moderate and severe degrees of stuttering had significantly higher scores when compared to those with a mild degree of stuttering. Furthermore, the older CWS (11-14 years) had significantly higher scores compared to the younger CWS (7-10 years). In addition, the SSC-ER-K appears to be a reliable self-report test. The above findings suggest the presence of significantly increased speech-related anxiety in CWS. Also, as age and severity of stuttering increased so did the level of their speech-related anxiety.Conclusion: The SSC-ER-K is a useful tool in the assessment of negative emotional reaction to specific speech situations in Kannada CWS and can assist speech-language pathologists in addressing speech-situation specific anxiety during treatment.

This study aimed to compare the affective, behavioral, and cognitive reactions related to vocal function in people with Parkinson's disease (PWPD) and healthy controls using the Behavior Assessment Battery - Voice (BAB-Voice). The test's internal consistency was also described.31 PWPD and 19 healthy controls were recruited from September 2020 to March 2021. Participants completed four BAB-Voice subtests: Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD), Behavior Checklist (BCL), and Communication Attitude Test for Adults (BigCAT), describing the experienced negative emotional reaction, voice disruptions, coping behaviors, and negative attitude regarding communication respectively. Subtest scores were calculated and analyzed.The scores of the PWPD were significantly different from those of the controls (Pillai's Trace = 0.344,The BAB-Voice proved a tool with a good internal consistency that measured different psychosocial reactions in PWPD versus controls. PWPD exhibited significantly more negative emotions and voice problems in specific speech situations, more coping behaviors, and a more negative speech-related attitude. The specificity of information obtained from the BAB-Voice may aid in improving the treatment planning of voice disorders in PWPD.

Background: A large body of evidence suggests that the Communication Attitude Test (CAT) is a reliable and valid tool for assessing the speech-associated attitude of school-age children who stutter (CWS). Objective: The purpose of the present study was to adapt and validate the CAT for the Kannada-speaking school-age CWS. Methods: The original version of the CAT was forward- and back-translated by the first author. The Communication Attitude Test Kannada (CAT-K) was then administered to 293 children who do not stutter (CWNS) and 100 CWS. All children were native speakers of the Kannada language and were between the ages of 7 and 14 years. The Stuttering Severity Instrument-fourth edition (SSI-4) was used to estimate the severity of stuttering. Results: The data revealed that, in comparison to CWNS, the CWS’ mean CAT-K score was significantly higher, and a significant effect of stuttering severity and age on mean attitude scores was observed. In addition, results showed that the CAT-K is a reliable and valid test. Conclusion: The findings suggest the presence of a negative attitude in Kannada-speaking CWS and that the CAT-K is a useful tool in the assessment of Kannada school-age CWS. Given the need for speech-language pathologists to address a speech-associated negative attitude in CWS, incorporating the CAT-K as part of the diagnostic assessment of stuttering is valuable.

Objective: The purpose of this study was to obtain preliminary normative data for children who stutter (CWS) and children who do not stutter (CWNS) for the Turkish form of the KiddyCAT, and to determine whether differences in communication attitude exist among CWS and CWNS. Material and Methods: Following the translation process of the original English version into Turkish, the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT-TR) was administered to 53 Turkish preschool CWNS and 55 who stutter CWS. The KiddyCAT-TR scores were evaluated to determine whether the CWS differ by chronological age, younger age versus older age groups and gender. Results: The Cronbach’s alpha coefficient was obtained 0.72 for the CWS. The effect size found very high (d=1.14). The test-retest reliability coefficient was determined as 0.99. Group comparisons showed significantly higher mean scores for CWS compared to CWNS. Gender did not affect the test results. Conclusion: CWS develop a negative attitude towards their own communication from a very early age, which increases as they grow older. The results showed that the Turkish version of the KiddyCAT has high internal consistency and test-retest reliability and is a solid differential diagnostic tool to gauge the speech-related attitude among Turkishspeaking preschoolers., Amaç: Bu çalışmanın amacı, KiddyCAT'in Türkçe formu için kekeleyen ve kekelemeyen çocuklar için ön normatif veriler elde etmek ve kekeleyen ile kekelemeyen çocuklar arasında iletişim tutum farklılıkları olup olmadığını belirlemektir. Gereç ve Yöntemler: Orijinal İngilizce versiyonun Türkçeye çevrilmesi sürecini takiben, 53 kekelemeyen ve 55 kekeleyen Türk okul öncesi dönemdeki çocuğa KiddyCAT-TR uygulandı. Kekeleyen çocukların kekelemeyen çocuklara göre KiddyCAT-TR'den aldıkları puanları, kronolojik yaşa, daha küçük yaşa karşı büyük yaş gruplarına ve cinsiyete göre farklılık gösterip göstermediklerini belirlemek için değerlendirildi. Bulgular: Cronbach alfa katsayısı kekeleyen çocuklar için 0,72 elde edildi. Etki büyüklüğü çok yüksek bulundu (d=1,14). Test-tekrar test güvenirlik katsayısı 0,99 olarak belirlendi. Grup karşılaştırmaları, kekelemeyen çocuklara kıyasla kekeleyen çocuklar için önemli ölçüde daha yüksek ortalama puanlar gösterdi. Cinsiyet, test sonuçlarını etkilemedi. Sonuç: Okul öncesi dönemde kekeleyen çocuklar, çok erken yaşlardan itibaren kendi iletişimlerine karşı olumsuz bir tutum geliştirir ve bu durum yaşları ilerledikçe artar. Sonuçlar, KiddyCAT'in Türkçe versiyonunun yüksek iç tutarlılığa ve test-tekrar test güvenilirliğine sahip olduğunu ve Türkçe konuşan okul öncesi çocuklar arasında konuşma ile ilgili tutumu ölçmek için sağlam bir teşhis aracı olduğunu göstermektedir.

Purpose This project sought to develop consensus guidelines for clinically meaningful, comprehensive assessment procedures for people who stutter across the lifespan. Method Twelve expert clinicians and researchers who have written extensively about stuttering provided detailed descriptions of the type of data that they routinely collect during diagnostic evaluations of preschool children, school-age children, adolescents, and adults who stutter. Iterative content analysis, with repeated input from the respondents, was used to identify core areas that reflect common domains that these experts judge to be important for evaluating stuttering for varying age groups. Results Six core areas were identified as common components of a comprehensive evaluation of stuttering and people who stutter. These areas should be included to varying degrees depending upon the age and needs of the client or family. The core areas include the following: (a) stuttering-related background information; (b) speech, language, and temperament development (especially for younger clients); (c) speech fluency and stuttering behaviors; (d) reactions to stuttering by the speaker; (e) reactions to stuttering by people in the speaker's environment; and (f) adverse impact caused by stuttering. Discussion These consensus recommendations can help speech-language pathologists who are uncertain about appropriate stuttering assessment procedures to design and conduct more thorough evaluations, so that they will be better prepared to provide individualized and comprehensive treatment for people who stutter across the lifespan.

Background & objectives: Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design. Methods: Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points. Results: There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months. Conclusions: Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.

Purpose: During the 2019 Fourth Croatia Clinical Symposium, speech-language pathologists (SLPs), scholars, and researchers from 29 countries discussed speech-language pathology and psychological practices for the management of early and persistent stuttering. This paper documents what those at the Symposium considered to be the key contemporary clinical issues for early and persistent stuttering. Methods: The authors prepared a written record of the discussion of Symposium topics, taking care to ensure that the content of the Symposium was faithfully reproduced in written form. Results: Seven contemporary issues for our field emerged from the Symposium. Conclusion: Effective early intervention is fundamental to proper health care for the disorder. However, as yet, there is no consensus about the timing of early intervention and how it should be managed. Currently, clinical translation is a barrier to evidence-based practice with early stuttering, and proactive strategies were suggested for junior SLPs. Apprehension emerged among some discussants that treatment of early stuttering may cause anxiety. For persistent stuttering, assessment procedures were recommended, as were strategies for dealing with childhood bullying. There was agreement that SLPs are the ideal professionals to provide basic cognitive-behavior therapy for clients with persistent stuttering. Questions were raised about our discipline standards for basic professional preparation programs for stuttering management.

The purpose of this study was to establish normative and psychometric data for the Persian version of the Communication Attitude Test for Adults who Stutter (BigCAT) and to determine if there is a significant difference between the speech-associated attitude of Persian stuttering adults and their nonstuttering peers. The Persian BigCAT was administered to 90 people who stutter (PWS) and 90 people who do not stutter (PWNS). After the translation of the test and its equalization to Persian Language, content validity was determined by the opinions of experts. Then, the criterion validity with Erickson S24's test of communication attitude was determined in people who stutter. The reliability was examined using Kuder-Richardson coefficient and test-retest correlations. The results showed that the mean BigCAT score of PWS was significantly higher than that of PWNS (

The Communication Attitude Test for Adults who stutter (BigCAT) is an established measure of cognitive traits in adults who stutter (AWS). The primary purpose of the present study was to adapt and validate the BigCAT to the Kannada language. The secondary purpose was to compare AWS’ and adults who do not stutter (AWNS) BigCAT-K scores and compare AWS’ score in sub-populations in terms of severity and age. The study included a purposive sample of 100 AWS and 317 AWNS. There was high test-retest reliability and solid construct validity, as made evident by the results of the discriminant analysis and cross-validation. Further, as in other investigations with the BigCAT ( Vanryckeghem & Brutten, 2019 ), this self-report test revealed a statistically significant group mean difference between AWS and AWNS, suggesting the presence of a negative attitude towards communication in Kannada-speaking AWS. Further, individuals with severe stuttering had a significantly higher level of speech-associated negative attitude compared to those with mild stuttering. Age does not seem to influence the AWS’ speech-associated belief system. Both of these findings augment the existing scant literature on exploring the association between stuttering severity and age on the cognitive dimension of stuttering. The outcomes establish the BigCAT-K as an effective tool in the assessment and subsequent management of stuttering.

Objectives To investigate the self-perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status. Study Design Prospective cross-sectional investigation. Methods 148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB-Voice), a multidimensional assessment of self-perceived reactions to communication. The BAB-Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC-ER) and B) Speech Disruption (SSC-SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired). Results Descriptive comparison of the BAB-Voice in speakers with SD to previously published non-dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB-Voice subtest scores as a function of SD group status (working vs. retired). Conclusions BAB-Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB-Voice may inform the clinician of valid patient-centered treatment goals which target the impairment extended beyond the physiological dimension. Level of Evidence 2b.

Purpose The aim of this study was to evaluate the usefulness of the Speech Situation Checklist for adults who stutter (SSC) in differentiating people who stutter (PWS) from speakers with no stutter based on self-reports of anxiety and speech disruption in communicative settings. The SSC's psychometric properties were examined, norms were established, and suggestions for treatment were formulated. Method The SSC was administered to 88 PWS seeking treatment and 209 speakers with no stutter between the ages of 18 and 62. The SSC consists of 2 sections investigating negative emotional reaction and speech disruption in 38 speech situations that are identical in both sections. Results The SSC–Emotional Reaction and SSC–Speech Disruption data show that these self-report tests differentiate PWS from speakers with no stutter to a statistically significant extent and have great discriminative value. The tests have good internal reliability, content, and construct validity. Age and gender do not affect the scores of the PWS. Conclusions The SSC–Emotional Reaction and SSC–Speech Disruption seem to be powerful measures to investigate negative emotion and speech breakdown in an array of speech situations. The item scores give direction to treatment by suggesting speech situations that need a clinician's attention in terms of generalization and carry-over of within-clinic therapeutic gains into in vivo settings.

Purpose The purpose of the current investigation was to explore the extent to which the life partners (LPs) of people who stutter (PWS) perceive their loved ones’ speech-situation specific emotional reaction, expectancy of speech disruption, and speech-related communication attitude. Methods Three subtests of the Behavior Assessment Battery (BAB): the Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD) and the Communication Attitude Test for Adults Who Stutter (BigCAT) were administered to 33 PWS and modified versions were administered to their LPs via Qualtrics Survey Software. Effect of relationship duration on subtest scores was considered. Perceived stuttering severity by the participant and their LP was also queried as part of a demographic questionnaire. Results PWS and their LPs rated BigCAT items in a similar way, while they rated certain SSC-ER and SSC-SD items differently. Importantly, between-group agreement was not affected by relationship duration. Among the PWS and LP, perceived stuttering severity influenced all BAB subtest scores. Conclusion LPs of PWS appear to be in tune with the cognitive aspects of their partner’s experience of stuttering. This has important clinical implications as it relates to active involvement of the family in speech intervention targeting fluency.

Summary Objective/Hypothesis This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Methods Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Results Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. Conclusions The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data.

Purpose The aim of this study was to establish normative data for Polish persons who stutter (PWS) and persons who do not stutter (PWNS) with the adapted version of the Behavior Assessment Battery (BAB; Vanryckeghem & Brutten, 2018) for adults and to investigate whether or not gender and age influenced the results. In addition, the BAB subtests' reliability and validity were examined. Method A Polish version of the BAB test procedures, including the Speech Situation Checklist–Emotional Reaction, Speech Situation Checklist–Speech Disruption, Behavior Checklist, and Communication Attitude Test for Adults Who Stutter (Vanryckeghem & Brutten, 2018), were individually administered to 123 adults who stutter and 151 adults who do not stutter between the ages of 17 and 70. Results PWS scored statistically significantly higher on all BAB subtests compared to PWNS. No significant between-groups gender or age difference was detected. The test data indicate high internal validity. The test items correlate well with the total score and significantly differentiate the two groups. The test battery validly differentiates PWS from PWNS with high accuracy. Conclusions The Polish version of the BAB for adults confirms data collected in previous cross-cultural investigations. The results once again differentiate PWS from PWNS in a powerful way. Compared to PWNS, PWS report significantly more anxiety and speech breakdown when speaking in particular speech situations. They also report their attitude toward speech to be significantly more negative compared to the typical speaker and indicate using a significant number of coping behaviors to avoid or escape difficult speaking conditions. The BAB test battery, in its totality, assists in multidimensional assessment, pre- and posttreatment comparison, and identification of treatment targets based on the answers of PWS to each test item.

Objective: The aim of this paper was to investigate the communication attitude of Slovenian preschool children who stutter by means of the Communication Attitude Test for Preschool and Kindergarten Children who Stutter (KiddyCAT), and to determine whether differences in communication attitude existed among preschool children who stutter, and their peers who are fluent speakers. In addition, the test’s discriminant value, its internal reliability and the factors underpinning the Slovenian version of the KiddyCAT were explored. Methods and Procedure: Data were gathered on a normative sample of 49 preschool children who stutter and 74 who do not stutter. The children were divided into two subgroups according to age: a ‘’younger’’ (3 to 4,4 years old) and ‘’older’’ (4,5 to 6 years old) group. Outcomes and Results: Results showed that preschool children who stutter scored statistically significantly higher on the KiddyCAT than preschool children who do not stutter. The effect size was large. A mean increase in scores among the preschool children who stutter was observed, but was not statistically significant. An opposite observation, again not significant, was made for preschool children who do not stutter. Also gender did not affect the test results. The test is internally reliable and has construct validity. Conclusion and Implications: The KiddyCAT is a useful tool for early detection of negative communication attitude of preschool children who stutter and helps in targeting cognitive-related stuttering intervention goals.

The BigCAT and the Erickson S-24, self-report measures of communication attitude, were administered in a randomly determined order to 72 adults who stuttered (PWS) and 72 who did not (PWNS). The two groups of participants differed from each other to a statistically significant extent on both of these measures of speech-associated attitude, regardless of gender. However, the BigCAT showed a larger between-group difference and a greater effect size than was made apparent by the S-24. These findings, and the presence of a significant group by test interaction, suggest that the BigCAT is the more powerful of these two test procedures for discriminating the speech-associated attitude of PWS from that of PWNS. It follows from this that the BigCAT is likely a more useful attitudinal measure than the S-24 with respect to clinical decision making that relates to differential diagnostic assessment and the management of stuttering. Learning outcomes: The reader will be (1) describe the BigCAT, a communication attitude test for adults who do and do not stutter, (2) discuss comparative data on the BigCAT and the Erickson S-24, based on information on the discriminative power of these measures of speech-associated attitude, (3) recognize that gender does not significantly effect the results of either the BigCAT or the Erickson S-24.

Background: Stuttering within a multi-dimensional framework revolves around the recognition that affective, behavioral and cognitive variables play a role in the nature and persistence of the disorder. Aside from clinical observations, the value of self-report standardized measures to explore the ‘below the surface’ structures that go along with stuttering has been acknowledged by many workers in the field of fluency disorders. As it relates to the investigation of the cognitive correlate of stuttering, self-report tests exploring speech-associated attitude have been established. The Communication Attitude Test for Adults who Stutter (BigCAT) is one of the more recently developed standardized assessment tools that serves this purpose. Aims: The aim of this investigation was to determine the BigCAT’s test-retest reliability. Methods and Procedure: The BigCAT was administered to a group of 33 adults who stutter and 50 adults who do not stutter. All participants were given the test twice between 5 and 7 days apart. Outcomes and Results: The test scores on the first and second administration of the BigCAT proved not to be statistically significantly different for both groups of participants. In addition, the correlations between the two BigCAT test scores were strong. As a side issue, it was observed that the scores of adults who do and do not stutter differed significantly on both occasions. Conclusion and Implications: In addition to previous data that have pointed to the BigCAT’s usefulness in discriminating individuals who stutter from those who do not based on their speech-associated belief system, and the test’s internal reliability, the present study indicates that the BigCAT has good test-retest reliability.

The Behavior Checklist, a self-report test procedure, was administered to 42 adults who stutter and 76 who do not in order to investigate the number, frequency of usage, type and nature of the responses that they reportedly employ to cope with the anticipation and/or presence of speech disruption. As a group, the participants who stutter reported a significantly greater number of speech-associated coping responses and a greater use of them than their nonstuttering peers did. Moreover, factor analysis made apparent fundamental between-group differences in the type and nature of certain forms of the coping responses reported by those who stutter and those who do not. This suggests that the quantitative and qualitative differences in the coping responses of those who do and do not stutter are potentially useful with respect to differential diagnostic and therapeutic decision making. Educational objectives: (1) The reader will be able to describe differences in the number, frequency and types of coping behaviors used by PWS and PWNS. (2) The reader will be able to list similarities and differences in the type and nature of coping behaviors used by PWS and PWNS. (3) The reader will be able to discuss the features and use of the Behavior Checklist, a self-report procedure for assessing the responses used by adults to cope with the anticipation and occurrence of speech disruption.

Background: Spasmodic dysphonia (SD) is often assessed and treated in a rather mono-dimensional way, despite knowledge of the impact of SD on a person’s quality of life. This study investigates how adults with SD think and feel about their speech, and cope with their voice problem. Methods: Adults with SD were asked to fill out the Behavior Assessment Battery’s (BAB-Voice) self-report tests. The Speech Situation Checklist-Emotional Reaction and Speech Disruption investigate negative emotional reaction and voice problems in particular speech situations. The Behavior Checklist provides an inventory of behaviours that might be used to avoid or escape voice problems. The Communication Attitude Test for Adults assesses speechassociated attitude. Results: Adults with SD had elevated scores on all BAB tests. Their results were comparable to BAB research with people who stutter. Conclusion: The data show the BAB’s potential to assist clinicians in diagnosis and in designing a tailored multidimensional treatment plan.

Mal-attitude and negative emotion specific to speech are known to correlate with severity among children who stutter. To determine if speech-associated mal-attitude and negative emotion also covary with each other, 143 grade-school children who stutter were administered Brutten's Communication Attitude Test (CAT). Then, independently, they also ranked their emotional reaction to those items of the CAT that had led them to report mal-attitude. The results revealed the existence of a statistically significant correlation of .89 between mal-attitude and negative emotion. Moreover, both speech-associated mal-attitude and negative emotion increased to a statistically significant extent with age and stuttering severity. These data highlight the importance of early detection and intervention as it relates to the cognitive and affective components of the stuttering syndrome. Educational Objectives: The reader will learn and be able to describe the relationship between school-age children's (1) stuttering and their mal-attitudes toward speech, (2) Their mal-attitudes and negative emotional reactions to speaking, and (3) the charges that occur in stuttering severity, mal-attitudes and negative emotional reactions between ages 7 and 13 years.

Tourette syndrome, a condition first recognized in 1825, is characterized by the presence of multiple motor tics and one or more phonic tics. Individuals with Tourette syndrome may also demonstrate fluency failures in their speech. This study investigated the disfluencies and phonic tics in an 18-year-old affected male before and after a three week period of speech therapy. It was found that the speech pattern displayed by this subject did not completely conform to the classic pattern of stuttering but did bear more resemblance to cluttering. A limited number of therapy sessions resulted in a significant improvement of speech.

Twenty-four adults participated in a 2 (group) by 3 (rate) factorial study designed to determine the main and interactive effects of speech rate during reading on the frequency of stuttering. In this regard, the participants orally read three passages, one at their normal rate, one that was 30% faster than this rate, and one that was 30% slower. Rate was controlled by means of a computer software program, and passage order and reading rate were counter-balanced. The main effect of rate was significant. There was statistically more stuttering in the fast rate condition than in either the normal or slow rate condition. However, the frequency of stuttering in the normal and the slow rate conditions was not significantly different. Analysis of the experimental data of the eight participants who stuttered the most and the eight who stuttered the least, during base-rate oral readings, evidenced the presence of an interaction between group and rate. Those who stuttered the most showed a statistically significant increase in stuttering between the slow, normal, and fast rate conditions. In contrast, there was no significant difference in frequency between any of the three conditions for the group of eight participants who stuttered the least. These findings suggest that the extent to which rate affects fluency is a function of the degree to which stuttering is displayed. This possibility warrants consideration in relation to the use of rate management procedures.

Fifty-five Flemish children, ages 6 to 13, who stuttered and 55 who did not were the subjects of a two (group) by eight (age) factorial investigation of their response to a Dutch translation of the Communication Attitude Test (C.A.T.). The main effect results confirmed previous C.A.T. findings that, as early as age 6, children who stutter exhibit significantly more in the way of a negative speech-associated attitude than their peers do. In addition, the between-group difference in attitude diverged with age. The C.A.T. scores increased for those who stuttered and decreased for the normally fluent children. These data suggest that the attitude of the two groups of children was differentially affected by their speech-related experience history. It follows from this, and the other findings of the study, that the attitude toward speech of children who stutter warrants early clinical consideration and attention.

This investigation was designed to determine the relationship, if any, between the speech-associated beliefs and fluency failures of grade-school children who do and do not stutter. Toward this end, a Dutch version of the Communication Attitude Test (C.A.T.) was administered to 55 age-matched Belgian children representative of the two groups. Their C.A.T. scores and the degree to which they emitted fluency failures during oral reading and conversation were correlated. For the children in the experimental group, the C.A.T. scores covaried to a statistically significant extent with both the failures thought to characterize stuttering and those considered to be normal disfluencies. In contrast, the communication attitude scores of the nonstutterers did not correlate with the display of either of these classes of fluency failure. These findings would seem to indicate both that the difference between children who stutter and those who do not involves more than the degree to which their speech is disrupted and that determining the communication attitude of children whose fluency is problematic can serve as an aid in differential diagnostic assessment and therapeutic considerations.

Purpose To evaluate the effectiveness of behavioral interventions designed to treat stuttering in children. Method Studies were included for review if (a) the treatment was a behavioral intervention, (b) participants were between 2 and 18 years old, (c) the design was an experimental or quasi-experimental group design, and (d) the reported outcome measure assessed stuttering. An electronic search of 8 databases yielded a total of 9 studies, representing 327 treated participants across 7 different intervention types. Data were extracted for participant, treatment, and outcome characteristics as well as for methodological quality. Results An analysis of the treatment effects yielded significant positive effects approaching 1 SD when compared with a nontreatment control group. No significant differences emerged for studies comparing 2 different treatments. Conclusion Conclusions drawn from the extant research suggest that data to support the efficacy of behavioral intervention in children exists for a limited number of intervention strategies, based on a meager number of methodologically acceptable studies.

This study was designed to determine if the view of parents, as to their children's attitudes toward speech, was consistent with that of their offspring. Toward this end, a Dutch version of the Communicative Attitude Test (CAT-D) was administered to 55 Belgian grade school stutterers and nonstutterers and each of their parents. For both groups, the correlations between the children's CAT-D score and those of either their mother or their father was low, ranging from + .28 to + .34, though statistically significant. Statistical analysis also revealed that the parents of the children who stuttered viewed their offsprings' attitude toward speech as significantly more negative than their children did. The parents of the nonstutterers, on the other hand, felt that their child's speech-associated belief system was more positive than their children reported. Taken together, the data suggest that, with respect to the communication attitude of children as measured by the CAT-D, parents do not appear to be worthy surrogate informants. In this regard, there is reason to believe that the reports of parents cannot be used to adequately predict the speech-associated attitude of their children.

Past research with the Communication Attitude Test (CAT) has shown it to be a valid and reliable instrument for assessing speech-associated attitude of children who stutter (CWS). However, in Japan, the CAT has not been used extensively to examine the communication attitude of CWS. The purpose of this study was to determine if a Japanese version of the CAT could differentiate between the communication attitude of Japanese elementary school CWS and children who do not stutter (CWNS). A Japanese translation of the 1991 version of the Communication Attitude Test-Revised (CAT-R) was used in this study. Eighty Japanese CWS and 80 gender- and grade level-matched CWNS participated in the study. The results showed that CWS had a significantly more negative communication attitude than CWNS. Both CWS and CWNS in 1st grade showed significantly more positive communication attitudes than children in 2nd, 3rd, 4th, 5th, and 6th grades. Furthermore, a link between stuttering severity and CWS’ communication attitude was found. Additional research is needed to confirm the results of the current study, which indicate that the communication attitude of Japanese CWS becomes more negative as they get older. Learning outcomes : The reader will be able to: (1) Describe the process that was used to develop a Japanese version of the Communication Attitude Test (CAT-J). (2) Discuss attitude differences between Japanese children who stutter and those who do not and how grade level impacts a negative attitude toward communication. (3) Explain the link between stuttering severity and attitudes of Japanese children who stutter.

The purpose of this investigation was to provide normative and comparative data for the BigCAT, the adult form of the Communication Attitude Test, a sub-test of the Behavior Assessment Battery. The BigCAT, a 35-item self-report test of speech-associated attitude was administered to 96 adults who stutter (PWS) and 216 adults who do not (PWNS). The difference in the extent to which the two groups of participants reported a negative attitude toward their speech and speech ability, as measured by the BigCAT, was statistically significant. Moreover, the overlap in the scores of the PWS and PWNS was minimal, and the effect size attributable to group membership was very large. The BigCAT's high Cronbach Alpha coefficients, together with the fact that each of its items significantly differentiated PWS from PWNS, indicate that the BigCAT is an internally consistent measure of the attitude that they have about their speech. Gender did not have a significant influence on the attitude toward speech or speech ability of either the PWS or PWNS. Overall, the present data suggest that the BigCAT holds promise as an aid to clinical decision making that relates to the assessment and treatment of those who stutter. Learning outcomes: (1) The reader will learn about the BigCAT, a self-report measure of speech-associated attitude. (2) The reader will be given normative and comparative data that relate to the speech-associated attitude of PWS and PWNS as measured by the BigCAT. This will enable the clinician to use the BigCAT data as a useful source of information in clinical decision making that relates to assessment and treatment. (3) The reader will be informed about the internal reliability and content validity of the BigCAT, a gender-free measure of the speech-associated attitude of PWS and PWNS.

Research with the Communication Attitude Test and a Dutch translation (C.A.T.-D.) has shown that, from age 6 to 14, children who stutter show significantly more malattitudes toward speech than nonstutterers. Investigations also have shown that the test procedure has inter-item reliability and items that correlate significantly with the total score. Yet to be determined, however, is the C.A.T.'s test-retest reliability and its sensitivity to attitudinal change. To determine this, forty-four Dutch speaking Belgian grade-schoolers responded to the questionnaire's items on three separate occasions. The test was re-administered again 1 and 12 weeks later. The reliability coefficients for the subjects' test scores following a hiatus of 1, 11 and 12 weeks was +.83, +.81 and +.76, respectively. These statistically significant correlations show that the speech- associated attitudes of the stuttering children were positionally stable. Over a 1 week period their attitudes also evidenced absolute stability. However, with respect to the test's sensitivity, the significant absolute mean differences following an 11 and 12 week time period suggest that the test is capable of reflecting a change in speech-associated attitudes.

The purpose of this factorial study was to establish normative data for the Italian version of the Communication Attitude Test (CAT) in order to determine whether or not the speech-associated attitude reported by Italian children who stutter (CWS) differs significantly from that of their nonstuttering peers (CWNS). Toward this end, the Italian CAT was administered to 149 CWS and 148 CWNS between the ages of 6 and 14. The results showed that the mean CAT score of the CWS sampled is higher, to a statistically significant extent, than that of their nonstuttering peers. Moreover, age and gender did not differentially affect this result. Together, these findings and the large between-group effect size suggest that the CAT is a useful clinical aid in evaluating the attitude of Italian children whose fluency is problematic. It can serve well to determine if a child's speech-associated belief system needs to be addressed in therapy and, if so, whether or not the cognitive change tactics employed have been effective.

In recent years, the importance of a multimodal approach to the assessment of the person who stutters (PWS) has become increasingly recognized. The Behavior Assessment Battery (BAB), which is a normed test procedure developed by G. Brutten, makes it possible to assess the multidimensional facets of this disorder. The emotional and speech-disruptive components that differentiate one who stutters from one who does not (PWNS) are evaluated by means of the Speech Situation Checklist (SSC), their use of behaviours secondary to stuttering are assessed through the Behavior Checklist (BCL) and the person's speech-related attitude is determined via the Communication Attitude Test (CAT). Each of these BAB tests has been shown to be a reliable and valid measure whose obtained normative data are essentially equivalent in Western countries.Because of the lack of normative data on children from non-Western cultures, the present preliminary study was aimed to investigate if the affective, behavioural and cognitive reports of non-stuttering Pakistani children on the BAB measures are like those of their Western peers.Forty-five non-stuttering Pakistani children between the ages of 8 and 11 were administered the SSC, BCL and CAT.As in previous studies, the mean score of the normally fluent children on each of the BAB tests fell into the lower end of the possible distribution of scores. Intercorrelations between the different tests were statistically significant.Although the BCL and CAT results were similar to those found in Western-based investigations, the emotional reaction and speech disruption scores on the SSC reported by Pakistani children sampled were numerically higher to an extent that is noteworthy. The latter finding suggests that this particular BAB measure might be affected by cultural differences. It points to the possibility that the norms of test procedures, such as the BAB, might not be fully appropriate for use in other than Western cultures.

The data of recent research studies have shown that by 3 years of age children show an awareness of dysfluency and that by at least the age of six, youngsters who stutter have a speech-associated attitude that is more negative than that of their peers. These findings led to the present study in which the KiddyCAT, a self-report measure, was used to compare the attitude toward speech of 45 children, between the age of three and six, who stuttered with that of 63 who did not. The data of this investigation showed that, as a group, the preschool and kindergarten children who stuttered had significantly more in the way of a negative attitude toward their speech than was found among their non-stuttering peers of the same age and gender. This finding is not consistent with the classically held position that the reactive aspects of stuttering do not generally develop until well after its onset. It suggests the need to measure, by standardized means, the speech-associated attitude of incipient stutterers and, when appropriate, to make the assessment and treatment of negative attitude toward speech a meaningful aspect of therapy.The reader will be able to: (1) describe the difference in the speech-associated attitude of preschoolers and kindergartners who do and do not stutter; (2) summarize what we currently know about self-report tests used to assess speech-related attitude among children as young as 3; and (3) evaluate the usefulness of assessing the belief system of children whose fluency is considered problematic.

It is often stated that stuttering is a common speech disorder in individuals with Tourette syndrome (TS). It has also been suggested, however, that the fluency failures observed in people with TS do not completely conform to the classic pattern of stuttering. The present paper describes the results of an analysis of the speech patterns of three individuals with TS. A picture emerged that bears some resemblance to stuttering, cluttering, and palilalia but that is also different from each of these disfluency types.

The aim of the present study was to investigate the presence of social anxiety in adults who stutter. This was done by administering the Inventory of Interpersonal Situations (IIS) ( Van Dam-Baggen & Kraaimaat, 1999 ), a social anxiety inventory, to a group of 89 people who stuttered and 131 people who did not stutter. Two components of social anxiety were measured by the ISS, the extent to which emotional tension or discomfort is perceived in social situations and the frequency with which social responses are executed. The people who stuttered displayed significantly higher levels of emotional tension or discomfort in social situations. They also reported a significantly lower frequency of social responses compared to their nonstuttering peers. In addition, about 50% of the scores of the people who stuttered fell within the range of a group of highly socially anxious psychiatric patients. The results of the study suggest that the measurement of social anxiety is an important element in the assessment of adults who stutter. Educational objectives: The reader will learn about and be able to describe (1) the IIS as an assessment procedure for evaluating social anxiety, (2) the level of discomfort expressed by adult stutterers in social situations, and (3) the effect of social anxiety on stutterers’ responsiveness in social situations.

Background Laryngeal dysfunction can be a salient feature in the clinical symptomatology of speakers diagnosed with Amyotrophic Lateral Sclerosis (ALS). In addition to dysphonia, swallowing function is also disrupted. This paper reviews what is known about laryngeal dysfunction resulting from ALS. Results Presented is a case report of a female, diagnosed with ALS, whose initial symptoms were caused by laryngeal bulbar involvement that was characterized by dysphonia and dysphagia. Conclusions In bulbar forms of ALS, voice and/or swallowing difficulties are often the initial signs of disease. Careful examination of the muscles innervated by bulbar nerves, and tracking the rate of progressive deficit in the affected muscles, will help to solidify an accurate diagnosis. With therapy, the ability to swallow safely may still be maintained even when voice and articulation abilities are such that oral communication is inefficient.

Research has shown that even relatively young children can be aware of disfluencies in their speech and can manifest a negative speech-related attitude. This paper presents outcomes of a study aimed at comparing communication attitudes among stuttering and nonstuttering Polish-speaking preschoolers using the Polish version of the KiddyCAT . The findings are consistent with those reported in prior internationally-based studies. Outcomes of the present investigation indicate the existence of a statistically significant difference between the attitudes towards communication of stuttering and non-stuttering preschool-age children.