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Purpose: Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. Method: One hundred one children and adolescents who stutter, aged 10–18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. Results: We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. Conclusions: Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. Supplemental Material: https://doi.org/10.23641/asha.26352556
Purpose: Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. Method: One hundred one children and adolescents who stutter, aged 10–18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. Results: We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. Conclusions: Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. Supplemental Material: https://doi.org/10.23641/asha.26352556
The purpose of this article is to present a theory of therapy for stuttering, its related assumptions, and findings from associated empirical studies. Specifically, we propose the Blank Center CARE™ Model of Treatment (CT) for stuttering, which differs from the current, widely employed fluency model of treatment (FT). The CT reflects the authors’ belief in the need to move away from fluency-focused or seemingly ableist treatments (i.e., any approach that attempts to correct, cure, or fix a disabling condition) for stuttering. The authors propose a shift toward a theory of treatment that addresses whole-person wellness and considers the treatment of stuttering from outside the framework of fluency shaping and stuttering modification. In support of such considerations, this article provides preliminary findings from both non-clinical and clinical studies of using the CT for children and adults. Although preliminary, these findings appear to lend empirical support to the authors’ belief that the treatment of stuttering needs to change. In essence, a change in the zeitgeist regarding the treatment of stuttering may contribute to an associated paradigm shift from FT to CT in the management of stuttering in children and adults.
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