Purpose: Previous studies of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S), using test and retest designs in modest-sized samples, have reported satisfactory test-retest reliability, i.e., correlations of about 0.80. Simultaneously, lower but moderate correlations between different first and second test respondents were observed and hypothesized to represent unspecified “societal” influences on stuttering attitudes. This study sought to clarify this and other potential relationships between first and second tests with the POSHA-S in a large, geographically and linguistically diverse sample.Methods: POSHA-S Overall Stuttering Scores (OSSs) of 345 respondents from 12 test-retest samples from four countries and languages, with no intervening interventions, were analyzed with correlations and by grouping respondents according to whose stuttering attitudes improved, remained the same, or worsened from test to retest.Results: Test and retest OSSs generally conformed to normal distributions and were not significantly different. Correlations between first versus second tests replicated earlier research. However, when the degree and direction of change from test to retest was considered, both in other correlations and in sorts of respondents, unexpected results emerged. Respondents with intermediate attitudes changed minimally, while those with most and least positive attitudes at the first test changed in opposite directions past the overall mean at second test.Conclusions: While demonstrating adequate test-retest reliability correlations on the POSHA-S, public attitudes were found to be less stable than previously assumed.

BACKGROUND Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries. AIMS The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents). METHODS & PROCEDURES Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes. OUTCOMES & RESULTS Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons. CONCLUSIONS & IMPLICATIONS The effect of geographic region and culture may predict sex-based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering. WHAT THIS PAPER ADDS What is already known on this subject The research clearly indicates that attitudes toward stuttering vary according to geographical region. Less clear is whether mothers and fathers from geographically diverse backgrounds hold different attitudes toward stuttering and the extent to which parental status (being a parent, parent of a child who stutters or nonparent) affects attitudes toward stuttering. What this study adds This study's findings confirm that geographical differences do influence attitudes toward stuttering. Male parents and nonparents tend to have equal or more positive attitudes toward stuttering in Middle Eastern samples, whereas non-Middle Eastern female parents and nonparents tend to show hold more positive attitudes. What are the clinical implications of this work? In addition to being culturally sensitive when working with parents of children who stutter, clinicians should also consider that mothers and fathers may have some differences in attitudes and behaviours toward their child's stuttering. These differences should be considered when designing treatment plans. It should also be noted that, despite statistical significance, the effect sizes in this study were low, suggesting that further research as well as close collaboration with parents of children who stutter is warranted.

ABSTRACT Primarily, this study explored attitudes toward stuttering of public school teachers in two countries, Bosnia & Herzegovina (B&H) (n = 125) and Egypt (n = 58), in order to identify differences in stuttering attitudes, that may exist between the two samples. Secondarily, it compared teacher attitudes from B&H and Egypt with stuttering attitudes of non-teacher samples from these two countries as well as from teacher and non-teacher samples from other European and Middle Eastern countries. All samples utilized the Public Opinion Survey of Human Attributes – Stuttering (POSHA – S). Comparing mean ratings, teachers from B&H held significantly more positive (accurate and sensitive) stuttering attitudes than Egyptian teachers on a majority of POSHA – S items and summary scores. Lack of knowledge and geo-cultural differences between B&H and Egypt are likely major factors in explaining the differences observed. Teachers’ attitudes were no more positive than the attitudes of the public or parents in either country. They also confirmed a pattern from previous research showing more positive attitudes in European samples than Middle Eastern samples. Educating teachers about stuttering will contribute to creating a more favorable school environment for children who stutter.

Background: Neurogenic stuttering is a subtype of acquired stuttering, and it is characterized by disfluencies associated with acquired brain damage. Objective: To provide an insight into pathophysiology, symptomatology, differential diagnosis, assessment, and treatment of neurogenic stuttering through a critical review of the literature. Methods: Studies published during the past and recent years were searched and analyzed on neurogenic stuttering. Results: Neurogenic stuttering is a complex disorder. The pathophysiological mechanism of neurogenic stuttering is not yet fully understood. It appears with several neurological diseases and conditions, and the use of some drugs. Differential diagnosis of neurogenic and psychogenic stuttering is a challenge for clinicians. Treatment usually requires a joint effort from speech therapists and doctors, most often neurologists Conclusion: Although research on neurogenic stuttering can be found in the literature, the complexity of this disorder still requires detailed monitoring and studying to provide the best treatment for patients.

Objective This study investigated acoustic and perceptual characteristics of the voice of patients with thyroid gland disorders such as hypothyroidism and hyperthyroidism immediately after the diagnosis was made and six months later, after using drug therapy. Materials and Methods The study includes 20 female outpatients with hypothyroidism and 27 female outpatients with hyperthyroidism. The criterion for the selection of the patients was a thyroid gland disorder medical diagnosis, no history of voice disorders and absence of other possible causes of voice changes. Acoustic, perceptual and aerodynamic parameters were assessed. Acoustic analysis was performed by specific software. Experienced speech and language pathologists made perceptual voice assessment by using grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Results Significant differences in patients with hypothyroidism were established on parameter amplitude perturbation, jitter and noise-to-harmonics ratio between pretreatment and posttreatment period, in which patients took drug therapy. In group of patients with hyperthyroidism significant difference was noted only on aerodynamic parameter maximum phonation time. There were a significant differences in all perceptual parameters in both groups of patients (p<0.05) in pre and posttreatment, except on grade and asthenia parameter in the group of patients with hypothyroidism and parameter grade was borderline insignificant in the group of patients with hyperthyroidism. Conclusion Voice quality is affected by thyroid disease. Thyroid gland disorders cause minor changes in acoustic voice parameters of patients with hypothyroidism and hyperthyroidism, but perceptual deviations in these patients are especially noticeable.

Received: 22 Jul. 2017 Accepted: 20 Oct. 2017