Kenneth O. St. Louis

In intervention pre-test/post-test studies using educational, psychological, or related scales, when paired numerical or ordinal scores are not perfectly correlated, a statistical phenomenon known ...

Purpose: This study examined attitudes toward stuttering among graduate students enrolled in U.S. speech-language pathology programs and tested whether three educational experiences—fluency-related coursework, clinical experience (simulated-only vs. real/both), and extracurricular engagement—were associated with distinct components of attitudes. Method: A total of 145 speech-language pathology graduate students from 32 U.S. states completed the Public Opinion Survey of Human Attributes–Stuttering (POSHA-S) and a 12-item educational questionnaire. POSHA-S descriptive statistics were generated using the scoring workbook and referenced to the global POSHA-S database. Summary independent t tests compared current scores with the most recent U.S. speech-language pathology student benchmark. Two multiple linear regression models examined associations between educational experiences and POSHA-S subscores: Beliefs (cognitive) and Self-Reactions (affective–behavioral). Results: Participants demonstrated highly positive attitudes toward stuttering relative to global norms, with mean Overall Stuttering score (OSS), Beliefs score, and Self-Reactions score in the highest quartile (97th, 94th, and 97th percentiles, respectively). Compared with the 2014 sample, while no statistically significant differences were observed for OSS, Beliefs, or Self-Reactions, mean scores were numerically higher by approximately five to six units. In regression analyses, coursework completion significantly predicted higher Beliefs. The Self-Reactions model was significant; simulated-only clinical experience, real/both clinical experience, and extracurricular engagement were each associated with higher Self-Reactions. Conclusions: Speech-language pathology graduate students reported generally positive attitudes toward stuttering, with patterns suggesting that coursework relates most strongly to cognitive beliefs, whereas clinical (including simulated) and extracurricular experiences relate to affective–behavioral reactions. Findings support multimodal fluency education that integrates didactic instruction with opportunities for direct or simulated contact and community-based engagement.

This study investigates Australian primary school teachers' attitudes towards stuttering. While international research exists, there is limited data from this population in an Australian context. A total of 174 primary school teachers in Victoria, Australia, completed an online version of the Public Opinion Survey of Human Attitudes-Stuttering (POSHA-S). Responses were compared with international and Australian population data from the POSHA-S database. Australian teachers demonstrated significantly more favourable attitudes and greater self-awareness about stuttering than both the general Australian population and most international POSHA-S samples. Their mean Overall Stuttering Score was 37 (91^st percentile), significantly higher than the general population (p =.004) with a large effect size (d = 0.78). Compared to the Australian public, teachers reported greater comfort, reduced pity and fewer misconceptions, although knowledge gaps persisted. Informal sources of information about stuttering, such as the media and the internet, were commonly cited information channels. Teachers recognised the role of speech-language pathologists in supporting people who stutter. The findings highlight the need for targeted professional development for primary school teachers to align positive attitudes with evidence-based knowledge. This study also lays the groundwork for future qualitative research into how teachers support students who stutter.

Background: Negative public attitudes promote undesirable stereotypes and stigma in stutterers. Method: To mitigate negative attitudes, 403 respondents combined from 16 international samples filled out the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) before and after interventions to improve attitudes and were compared to 249 respondents from seven control groups. Investigators aimed (a) to replicate an extreme case of regression to the mean (i.e., “crossover” effect) reported earlier in larger combined samples in which respondents with high pre-scores ended with low post-scores, respondents with low pre-scores finished with high post-scores, and intermediate scorers were unchanged; and (b) to identify individual POSHA–S items related to overall attitude change and among the high and low scorers. Results: As in previous studies, stuttering attitudes improved in the intervention group but not in the control group. Intervention and control respondents demonstrated “crossover” but less than the earlier samples due to lower pre–post correlations. Item contributions to pre–post change and differences among the three change groups were inconsistent; however, high agreement items by respondents were less likely to vary than low agreement items. Conclusion: The “crossover” effect was replicated, and future research should explore its presence in other measures or conditions.

Background: Negative public attitudes promote undesirable stereotypes and stigma in stutterers. Method: To mitigate negative attitudes, 16 international samples of 403 total respondents took the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) before and after interventions and were compared to seven combined control groups with 249 respondents. Investigators sought (a) to replicate an extreme case of regression to the mean, the “crossover” effect reported earlier in larger combined samples where negative changers with high pre-scores ended with low post-scores and positive changers with low pre-scores finished with the high post-scores and (b) to identify POSHA–S items related to attitudes overall change and among negative, minimal, and positive changers. Results: As in previous studies, stuttering attitudes improved in the intervention group but not the control group. Intervention and control respondents demonstrated “crossover” but less than the earlier samples due to lower pre-post correlations. Item contributions to pre-post change and differences among the three changer groups were inconsistent; however, high agreement items by respondents were less likely to vary than items with less unanimous agreement. Conclusion: The “crossover” effect was replicated, and future research should explore its presence in other measures or conditions.

Previous studies show that interventions to improve attitudes toward stuttering yield inconsistent results on the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S). Comparisons of pre- and post-intervention samples indicate that success depends on the percentage of respondents who improved rather than the magnitude of change. A “crossover” effect emerged: respondents with the most positive pre-test attitudes showed lower post-test ratings, whereas those with the most negative pre-test attitudes showed the greatest improvement; respondents with intermediate attitudes showed little change. Similar patterns appeared in non-intervention samples, where one-third fell into positive, minimal, or negative change groups. The study analyzed 943 respondents from 29 intervention samples classified as unsuccessful (U), marginally successful (MS), successful (S), or very successful (VS), plus 345 respondents from 12 non-intervention samples. Using non-intervention data as a baseline, we calculated percentages shifting among the three change groups. In the VS category, interventions moved people from the negative and minimal change groups into the positive change group. In the S category, gains in the positive change group came from the negative change group. In the MS category, all intervention-related changes began in the negative change group, yielding modest growth in the positive and minimal change group. The U category showed shifts into both the positive and negative change group, mainly reducing the minimal change group. These findings suggest that interventions to improve attitudes toward stuttering should apply strategies tailored to individuals in positive, minimal, and negative change groups.

The Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) Database, intermittently updated, at the time of this report, contains 25,739 respondents from 45 countries with responses in 28 languages, representing 11 world regions. Among public and selected population samples, more than 600 self-identified stutterers are included. The Microsoft Excel database file features more than 150 columns of POSHA–S results. Some data, such as state/province and country of respondents, primary job or occupation, languages known, race, and religion, are included as text. Other demographic items and all attitude items are numerical data. The POSHA–S has check boxes or scales of 1–5 for other demographic variables and general ratings that compare stuttering to four other “anchor” attributes (intelligence, left-handedness, obesity, and mental illness). All subsequent stuttering attitude items are scored on a scale of 1–3, reflecting “no”, “not sure”, and “yes”, respectively. All scaled ratings are converted to a uniform −100 to +100 scale, with some item ratings inverted so that, uniformly, higher ratings reflect more positive attitudes and lower ratings reflect more negative attitudes. All respondents are classified according to population, a category within population, region or continent, country, language, and other distinctive features.

The Public Opinion Survey of Human Attributes–Stuttering (POSHA–S) Database, intermittently updated, currently contains 25,739 respondents from 46 countries with responses in 31 languages, representing 11 world regions. Among public and selected population samples, more than 600 self-identified stutterers are included. The Microsoft Excel database file features more than 150 columns of POSHA–S results. Some data, such as state/province and country of respondents’, primary job or occupation, languages known, race, and religion are included as text. Other demo-graphic and all attitude items are numeric data. The POSHA–S has check boxes or 1-5 scales for other demographic variables and general ratings that compare stuttering to four other attributes (intelligent, left handed, obese, and mentally ill). All subsequent stuttering attitude items are scored on a 1-3 scale reflecting “no,” “not sure,” and “yes.” All scaled ratings are converted to a uniform -100 to +100 scale, with some item ratings inverted so that, uniformly, higher ratings reflect more positive attitudes, and lower ratings reflect more negative attitudes. All respondents are classified according to population, category within population, region or continent, country, language, and other distinctive features.