Self-perception of stuttering: association with self-perception of hearing, fluency profile, and contextual aspects

Silva, Camila Eduarda Elias; Britto, Denise Brandão de Oliveira; Lemos, Stela Maris Aguiar

doi:10.1590/2317-1782/e20240103en

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Original Article • CoDAS 37 (1) • 2025 • https://doi.org/10.1590/2317-1782/e20240103en linkcopy

Self-perception of stuttering: association with self-perception of hearing, fluency profile, and contextual aspects

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose This study investigated the association between self-perception of stuttering and self-perception of hearing, speech fluency profile, and contextual aspects in Brazilian adults who stutter.

Methods Fifty-five adults who stutter (ages 18 to 58 years), speakers of Brazilian Portuguese speakers, participated in an observational study that included: (a) a clinical history survey to collect identification, sociodemographic, clinical, and assistance data; (b) the Brazil Economic Classification Criteria (CCEB); (c) a hearing self-perception questionnaire (Speech, Spatial and Qualities of Hearing Scale – SSQ, version 5.6); (d) self-perception of the impact of stuttering (Brazilian Portuguese version of the Overall Assessment of the Speaker's Experience of Stuttering – Adults – OASES-A); and (e) an assessment of speech fluency (Fluency Profile Assessment Protocol -- PAPF). Data analysis consisted of descriptive and bivariate analysis using Pearson’s chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient.

Results Most participants were classified as moderate to severe in the total classification of the impact of stuttering. There were moderate and weak negative correlations between the participants' self-perception of stuttering and self-perception of hearing.

Conclusion Self-perception of auditory abilities was greater to the extent that self-perception of the impacts of stuttering on quality of life was lower.

KEYWORDS:
Stuttering; Adult; Quality of Life; Fluency; Auditory Skills

Variables	N	Mean	SD	Median	Minimum	Q₁	Q₃	Maximum
Non-stuttered disfluencies	55	12.40	7.71	11.00	3.00	8.00	15.00	44.00
stuttering-like disfluencies	55	14.33	20.17	11.00	0.00	5.00	18.00	147.00
Words per minute	55	97.69	23.78	94.30	23.00	84.60	109.60	156.00
Syllables per minute	55	187.27	47.08	185.40	45.00	160.00	210.50	291.00
Speech disruption (%)	55	13.13	12.14	10.90	3.00	7.40	15.80	93.00
Stuttering-like disfluencies (%)	55	7.03	9.80	5.30	0.00	2.50	8.90	71.00
Impact score – Section 1	55	2.93	0.54	3.10	2.00	2.45	3.35	4.00
Impact score – Section 2	55	3.21	0.73	3.13	2.00	2.73	3.83	5.00
Impact score – Section 3	55	2.99	0.72	2.88	1.00	2.52	3.48	5.00
Impact score – Section 4	55	3.16	0.94	3.17	1.00	2.44	3.80	5.00
Impact score – Total	55	3.06	0.64	3.10	2.00	2.53	3.55	4.00

Variables	N	Mean	SD	Median	Minimum	Q₁	Q₃	Maximum
SSQP1_Q1	55	7.84	2.49	8.00	0.00	6.00	10.00	10.00
SSQP1_Q2	55	9.71	0.71	10.00	6.00	10.00	10.00	10.00
SSQP1_Q3	55	8.15	2.21	9.00	3.00	7.00	10.00	10.00
SSQP1_Q4	55	6.80	2.59	7.00	1.00	5.00	9.00	10.00
SSQP1_Q5	55	8.29	1.73	9.00	3.00	7.00	10.00	10.00
SSQP1_Q6	55	5.87	2.88	7.00	0.00	4.00	8.00	10.00
SSQP1_Q7	53	7.38	2.10	8.00	2.00	6.00	9.00	10.00
SSQP1_Q8	52	6.83	2.53	7.00	1.00	5.00	9.00	10.00
SSQP1_Q9	55	7.13	2.58	8.00	0.00	5.00	9.00	10.00
SSQP1_Q10	55	4.64	2.95	5.00	0.00	3.00	7.00	10.00
SSQP1_Q11	55	6.58	2.37	7.00	1.00	4.00	8.00	10.00
SSQP1_Q12	55	7.60	1.99	8.00	3.00	6.00	10.00	10.00
SSQP1_Q13	55	7.04	3.02	7.00	0.00	5.00	10.00	10.00
SSQP1_Q14	55	4.64	3.00	5.00	0.00	2.00	7.00	10.00
SSQP2_Q1	54	7.00	2.84	8.00	0.00	5.00	9.25	10.00
SSQP2_Q2	55	7.53	2.67	8.00	0.00	6.00	10.00	10.00
SSQP2_Q3	55	9.13	1.55	10.00	3.00	9.00	10.00	10.00
SSQP2_Q4	55	8.09	2.34	9.00	0.00	7.00	10.00	10.00
SSQP2_Q5	53	6.89	2.52	7.00	0.00	5.50	9.00	10.00
SSQP2_Q6	55	7.85	2.40	9.00	0.00	7.00	10.00	10.00
SSQP2_Q7	55	7.55	2.38	8.00	0.00	6.00	10.00	10.00
SSQP2_Q8	54	7.48	1.94	8.00	1.00	7.00	9.00	10.00
SSQP2_Q9	55	7.60	2.29	8.00	0.00	7.00	9.00	10.00
SSQP2_Q10	52	6.65	2.94	8.00	0.00	5.00	9.00	10.00
SSQP2_Q11	53	6.79	2.74	7.00	0.00	5.00	9.00	10.00
SSQP2_Q12	55	7.67	2.37	8.00	0.00	7.00	10.00	10.00
SSQP2_Q13	55	7.93	2.19	8.00	0.00	7.00	10.00	10.00
SSQP2_Q14	53	8.09	3.07	10.00	0.00	6.50	10.00	10.00
SSQP2_Q15	51	6.94	2.87	7.00	0.00	5.00	10.00	10.00
SSQP2_Q16	51	7.39	2.65	8.00	0.00	5.00	10.00	10.00
SSQP2_Q17	54	7.81	2.27	8.00	0.00	6.00	10.00	10.00
SSQP3_Q1	55	8.44	2.56	10.00	0.00	8.00	10.00	10.00
SSQP3_Q2	55	7.55	3.32	9.00	0.00	5.00	10.00	10.00
SSQP3_Q3	55	8.67	2.29	10.00	0.00	8.00	10.00	10.00
SSQP3_Q4	55	9.02	1.97	10.00	1.00	9.00	10.00	10.00
SSQP3_Q5	55	9.15	1.45	10.00	4.00	9.00	10.00	10.00
SSQP3_Q6	55	9.36	1.79	10.00	0.00	10.00	10.00	10.00
SSQP3_Q7	55	6.93	3.07	8.00	0.00	5.00	10.00	10.00
SSQP3_Q8	55	9.27	1.27	10.00	5.00	9.00	10.00	10.00
SSQP3_Q9	54	9.11	1.71	10.00	3.00	9.00	10.00	10.00
SSQP3_Q10	55	9.04	1.60	10.00	3.00	8.00	10.00	10.00
SSQP3_Q11	55	9.05	2.04	10.00	0.00	9.00	10.00	10.00
SSQP3_Q12	55	8.04	2.63	10.00	0.00	7.00	10.00	10.00
SSQP3_Q13	55	8.00	2.43	9.00	0.00	7.00	10.00	10.00
SSQP3_Q14	55	6.47	3.20	7.00	0.00	4.00	10.00	10.00
SSQP3_Q15	55	7.27	2.93	8.00	0.00	5.00	10.00	10.00
SSQP3_Q16	43	7.84	2.91	9.00	0.00	6.00	10.00	10.00
SSQP3_Q17	55	9.20	1.65	10.00	0.00	9.00	10.00	10.00
SSQP3_Q18	55	5.78	3.13	6.00	0.00	4.00	8.00	10.00

Variables	Impact of stuttering – Total			p-value
Variables	Mild/Moderate N (%)	Moderate/Severe N (%)	Severe N (%)	p-value
Sex
Females	4 (80.0)	25 (61.0)	5 (55.6)	0.650
Males	1 (20.00	16 (39.0)	4 (44.4)
Total	5 (100.0)	41 (100.0)	9 (100.0)
Educational attainment
High school graduate	1 (20.0)	25 (61.0)	5 (55.6)	0.332
Higher education incomplete	0 (0.0)	2 (4.9)	1 (11.1)
Bachelor’s degree	4 (80.0)	14 (34.1)	3 (33.3)
Total	5 (100.0)	41 (100.0)	9 (100.0)
Occupation
Student	0 (0.0)	18 (43.9)	3 (33.3)	0.030*
Employed	4 (80.0)	18 (43.9)	5 (55.6)
Domestic worker	0 (0.0)	1 (2.4)	0 (0.0)
Self-employed	0 (0.00	4 (9.8)	0 (0.0)
Unpaid worker	1 (20.0)	0 (0.0)	0 (0.0)
Unemployed	0 (0.0)	0 (0.0)	1 (11.1)
Total	5 (100.0)	41 (100.0)	9 (100.0)
Family history
No	2 (40.0)	10 (24.4)	3 (33.3)	0.688
Yes	3 (60.0)	31 (75.6)	6 (66.7)
Total	5 (100.0)	41 (100.0)	9 (100.0)
Time of onset
Childhood	5 (100.0)	34 (82.9)	5 (55.6)	0.105
Adolescence	0 (0.0)	6 (14.6)	2 (22.2)
Adulthood	0 (0.0)	1 (2.5)	2 (22.2)
Total	5 (100.0)	41 (100.0)	9 (100.0)
Previous SLH therapy
No	0 (0.0)	3 (7.3)	2 (22.2)	0.282
Yes	5 (100.0)	38 (92.7)	7 (77.8)
Total	5 (100.0)	41 (100.0)	9 (100.0)

Variables	OASES-A	p-value
Age	-0.082	0.552
CCEB score	-0.129	0.358
Normal disfluencies	-0.115	0.405
Stuttering-like disfluencies	0.052	0.707
Words per minute	-0.049	0.720
Syllables per minute	-0.007	0.959
Percentage of speech disruptions	0.009	0.948
Percentage of stuttering-like disfluencies	0.053	0.700

SSQ - Part 1 (Speech Hearing)	OASES-A		p-value
SSQP1_Q1 – You are talking with one other person and there is a TV on in the same room. Without turning the TV down, can you follow what the person you’re talking to says?	-0.123		0.370
SSQP1_Q2 – You are talking with one other person in a quiet, carpeted lounge-room. Can you follow what the other person says?	-0.136		0.321
SSQP1_Q3 – You are in a group of about five people, sitting round a table. It is an otherwise quiet place. You can see everyone else in the group. Can you follow the conversation?	-0.274*		≤0.001*
SSQP1_Q4 - You are in a group of about five people in a busy restaurant. You can see everyone else in the group. Can you follow the conversation?	-0.269*		0.047*
SSQP1_Q5 – You are talking with one other person. There is continuous background noise, such as a fan or running water. Can you follow what the person says?	-0.086		0.535
SSQP1_Q6 – You are in a group of about five people in a busy restaurant. You CANNOT see everyone else in the group. Can you follow the conversation?	0.019		0.892
SSQP1_Q7 - You are talking to someone in a place where there are a lot of echoes, such as a church or railway terminus building. Can you follow what the other person says?	-0.137		0.329
SSQP1_Q8 - Can you have a conversation with someone when another person is speaking whose voice is the same pitch as the person you’re talking to?	-0.524*		≤0.001*
SSQP1_Q9 - Can you have a conversation with someone when another person is speaking whose voice is different in pitch from the person you’re talking to?	-0.513*		≤0.001*
SSQP1_Q10 – You are listening to someone talking to you, while at the same time trying to follow the news on TV. Can you follow what both people are saying?	-0.315*		0.019*
SSQP1_Q11 – You are in conversation with one person in a room where there are many other people talking. Can you follow what the person you are talking to is saying?	-0.424*		0.001*
SSQP1_Q12 - You are with a group and the conversation switches from one person to another. Can you easily follow the conversation without missing the start of what each new speaker is saying?	-0.366*		0.006*
SSQP1_Q13 – Can you easily have a conversation on the telephone?	-0.243		0.074
SSQP1_Q14 – You are listening to someone on the telephone and someone next to you starts talking. Can you follow what’s being said by both speakers?	-0.447*		0.010*
SSQ – Part 2 (Spatial Hearing)	OASES-A		p-value
SSQP2_Q1 – You are outdoors in an unfamiliar place. You hear someone using a lawnmower. You can’t see where they are. Can you tell right away where the sound is coming from?	0.091		0.513
SSQP2_Q2 – You are sitting around a table or at a meeting with several people. You can’t see everyone. Can you tell where any person is as soon as they start speaking?	-0.117		0.396
SSQP2_Q3 – You are sitting in between two people. One of them starts to speak. Can you tell right away whether it is the person on your left or your right, without having to look?	-0.092		0.502
SSQP2_Q4 - You are in an unfamiliar house. It is quiet. You hear a door slam. Can you tell right away where that sound came from?	-0.166		0.226
SSQP2_Q5 – You are in the stairwell of a building with floors above and below you. You can hear sounds from another floor. Can you readily tell where the sound is coming from?	-0.092		0.510
SSQP2_Q6 - You are outside. A dog barks loudly. Can you tell immediately where it is, without having to look?	-0.084		0.540
SSQP2_Q7 - You are standing on the footpath of a busy street. Can you hear right away which direction a bus or truck is coming from before you see it?	-0.044		0.752
SSQP2_Q8 – In the street, can you tell how far away someone is, from the sound of their voice or footsteps?	-0.045		0.748
SSQP2_Q9 - Can you tell how far away a bus or a truck is, from the sound?	-0.054		0.698
SSQP2_Q10 - Can you tell from the sound which direction a bus or truck is moving, for example, from your left to your right or right to left?	0.098		0.491
SSQP2_Q11 - Can you tell from the sound of their voice or footsteps which direction a person is moving, for example, from your left to your right or right to left?	0.054		0.701
SSQP2_Q12 - Can you tell from their voice or footsteps whether the person is coming towards you or going away?	0.188		0.188
SSQP2_Q13 - Can you tell from the sound whether a bus or truck is coming towards you or going away?	0.140		0.140
SSQP2_Q14 – Do the sounds of things you are able to hear seem to be inside your head rather than out there in the world?	-0.065		0.643
SSQP2_Q15 – Do the sounds of people or things you hear, but cannot see at first, turn out to be closer than expected when you do see them?	0.249		0.088
SSQP2_Q16 - Do the sounds of people or things you hear, but cannot see at first, turn out to be further away than expected when you do see them?	-0.024		0.870
SSQP2_Q17 - Do you have the impression of sounds being exactly where you would expect them to be?	0.148		0.286
SSQ – Part 3 (Qualities of Hearing )		OASES-A	p-value
SSQP3_Q1 – Think of when you hear two things at once, for example, water running into a basin and, at the same time, a radio playing. Do you have the impression of these as sounding separate from each other?		0.052	0.708
SSQP3_Q2 – When you hear more than one sound at a time, do you have the impression that it seems like a single jumbled sound?		-0.014	0.922
SSQP3_Q3 – You are in a room and there is music on the radio. Someone else in the room is talking. Can you hear the voice as something separate from the music?		-0.210	0.123
SSQP3_Q4 – Do you find it easy to recognise different people you know by the sound of each one’s voice?		-0.045	0.745
SSQP3_Q5 – Do you find it easy to distinguish different pieces of music that you are familiar with?		-0.105	0.447
SSQP3_Q6 – Can you tell the difference between different sounds, for example, a car versus a bus; water boiling in a pot versus food cooking in a frypan?		-0.090	0.513
SSQP3_Q7 – When you listen to music, can you make out which instruments are playing?		-0.058	0.672
SSQP3_Q8 – When you listen to music, does it sound clear and natural?		-0.099	0.472
SSQP3_Q9 – Do everyday sounds that you can hear easily seem clear to you (not blurred)?		-0.204	0.139
SSQP3_Q10 – Do other people’s voices sound clear and natural?		-0.125	0.362
SSQP3_Q11 – Do everyday sounds that you hear seem to have an artificial or unnatural quality?		-0.089	0.516
SSQP3_Q12 – Does your own voice sound natural to you?		-0.062	0.655
SSQP3_Q13 – Can you easily judge another person’s mood from the sound of their voice?		-0.040	0.773
SSQP3_Q14 – Do you have to concentrate very much when listening to someone or something?		-0.104	0.411
SSQP3_Q15 – Do you have to put in a lot of effort to hear what is being said in conversation with others?		-0.233	0.087
SSQP3_Q16 – When you are the driver in a car can you easily hear what someone is saying who is sitting alongside you?		-0.380*	0.012*
SSQP3_Q17 – When you are a passenger can you easily hear what the driver is saying sitting alongside you?		0.057	0.678
SSQP3_Q18 – Can you easily ignore other sounds when trying to listen to something?		-0.100	0.466

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[1] Caption: N = number of individuals; SD = standard deviation; Q = quartile; % = percentage