Stuttering Therapy: The Relation between Changes in Symptom Level and Attitudes

TLDR

Measuring changes in communication attitudes has been a difficult and neglected aspect of stuttering treatment. The authors developed and refined a 24‑item Erickson scale, validated it with repeated measures in stutterers and nonstutterers, and compared attitude change rates to stuttering severity during therapy. The refined scale proved valid and reliable; it revealed that attitude normalization lags behind symptom remission, requiring supervised real‑world speaking to reach nonstutterer levels.

Abstract

The measurement of change in attitude has been a difficult and neglected aspect of treatment. Erickson constructed a scale to measure communication attitudes that distinguish stutterers from nonstutterers. The validity and reliability of the Erickson scale over repeated measures was assessed by administering it to a control group of 25 nonstutterers on two occasions and to a group of 25 stutterers on three occasions during a therapy program: before treatment, after the instatement of fluency, and after transfer to everyday conversation. An analysis of the items led to the deletion of those not suitable for repeated administration. The resultant 24-item scale was shown to be a more valid and reliable measure of change in the communication attitudes of stutterers. The rate of change was compared with the changes in the level of stuttering. After stuttering stopped, the stutterers' scores did not equal those of the nonstutterers until they experienced speaking outside therapy. A follow-up study confirmed these results. After the removal of symptoms by behavior therapy, attitude change was only partial, and it was not until the patients completed a program of supervised experience that their attitudes changed to normal.