Psychometric evaluation of the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering for adults (OASES-A-D)

The Association Between Stuttering Burden and Psychosocial Aspects of Life in Adults

PURPOSE

Stuttering is a speech condition that can have a major impact on a person's quality of life. This descriptive study aimed to identify subgroups of people who stutter (PWS) based on stuttering burden and to investigate differences between these subgroups on psychosocial aspects of life.

METHOD

The study included 618 adult participants who stutter. They completed a detailed survey examining stuttering symptomatology, impact of stuttering on anxiety, education and employment, experience of stuttering, and levels of depression, anxiety, and stress. A two-step cluster analytic procedure was performed to identify subgroups of PWS, based on self-report of stuttering frequency, severity, affect, and anxiety, four measures that together inform about stuttering burden.

RESULTS

We identified a high- (n = 230) and a low-burden subgroup (n = 372). The high-burden subgroup reported a significantly higher impact of stuttering on education and employment, and higher levels of general depression, anxiety, stress, and overall impact of stuttering. These participants also reported that they trialed more different stuttering therapies than those with lower burden.

CONCLUSIONS

Our results emphasize the need to be attentive to the diverse experiences and needs of PWS, rather than treating them as a homogeneous group. Our findings also stress the importance of personalized therapeutic strategies for individuals with stuttering, considering all aspects that could influence their stuttering burden. People with high-burden stuttering might, for example, have a higher need for psychological therapy to reduce stuttering-related anxiety. People with less emotional reactions but severe speech distortions may also have a moderate to high burden, but they may have a higher need for speech techniques to communicate with more ease. Future research should give more insights into the therapeutic needs of people highly burdened by their stuttering.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25582980.

FreDESS: a clinical tool for perceptual evaluation of stuttering

AIM

Stuttering is a communication disorder that involves both manifest speech disfluencies and associated symptoms. The purpose of the present study was to introduce an easily administered and ecologically valid assessment tool designed for perceptual evaluation of stuttered speech, FreDESS (frequency of stuttering events, duration of events, effort, secondary behaviours, and severity). More specifically, we wanted to study its reliability and validity.

METHOD

Video recordings of conversations with 38 people who stutter (PWS), 19 females and 19 males aged 13-25, were assessed by three speech language pathologists (SLP). Inter- and intrajudge reliability was estimated with intraclass correlation, standard error of measurement, and agreement between listeners. Internal consistency for the FreDESS parameters was estimated with Cronbach's alpha (α). To test the validity of FreDESS, the relationships between the average estimated parameters of frequency, duration, secondary behaviours, and severity of FreDESS and the Stuttering Severity Instrument (SSI-3), were analysed using intraclass correlation.

RESULTS

The interjudge reliability was good, especially for the frequency, duration, and severity parameters (90 per cent + agreement given 1 scale point difference). All parameters of the FreDESS had strong intrajudge reliability (ICC = 0.86-0.94) and the overall internal consistency was high (α = 0.98). The average ratings on the two assessment scales were in line with each other (r = 0.90-0.96), indicating high concurrent validity.

CONCLUSION

The FreDESS scale for the assessment of stuttered speech may be a valuable tool in clinical and research contexts. It is a valid and more time-efficient assessment instrument than the more commonly used SSI.

Self-Reported Stuttering Severity Is Accurate: Informing Methods for Large-Scale Data Collection in Stuttering

PURPOSE

To our knowledge, there are no data examining the agreement between self-reported and clinician-rated stuttering severity. In the era of big data, self-reported ratings have great potential utility for large-scale data collection, where cost and time preclude in-depth assessment by a clinician. Equally, there is increasing emphasis on the need to recognize an individual's experience of their own condition. Here, we examined the agreement between self-reported stuttering severity compared to clinician ratings during a speech assessment. As a secondary objective, we determined whether self-reported stuttering severity correlated with an individual's subjective impact of stuttering.

METHOD

Speech-language pathologists conducted face-to-face speech assessments with 195 participants (137 males) aged 5-84 years, recruited from a cohort of people with self-reported stuttering. Stuttering severity was rated on a 10-point scale by the participant and by two speech-language pathologists. Participants also completed the Overall Assessment of the Subjective Experience of Stuttering (OASES). Clinician and participant ratings were compared. The association between stuttering severity and the OASES scores was examined.

RESULTS

There was a strong positive correlation between speech-language pathologist and participant-reported ratings of stuttering severity. Participant-reported stuttering severity correlated weakly with the four OASES domains and with the OASES overall impact score.

CONCLUSIONS

Participants were able to accurately rate their stuttering severity during a speech assessment using a simple one-item question. This finding indicates that self-report stuttering severity is a suitable method for large-scale data collection. Findings also support the collection of self-report subjective experience data using questionnaires, such as the OASES, which add vital information about the participants' experience of stuttering that is not captured by overt speech severity ratings alone.

Stuttering in individuals with Down syndrome: a systematic review of earlier research

The main objective of this systematic review was to synthesize the evidence on the occurrence and characteristics of stuttering in individuals with Down syndrome and thus contribute knowledge about stuttering in this population. Group studies reporting outcome measures of stuttering were included. Studies with participants who were preselected based on their fluency status were excluded. We searched the Eric, PsychInfo, Medline, Scopus, and Web of Science Core Collection databases on 3rd January 2022 and conducted supplementary searches of the reference lists of previous reviews and the studies included in the current review, as well as relevant speech and language journals. The included studies were coded in terms of information concerning sample characteristics, measurement approaches, and stuttering-related outcomes. The appraisal tool for cross-sectional studies (AXIS) was used to evaluate study quality. We identified 14 eligible studies, with a total of 1,833 participants (mean = 131.29, standard deviation = 227.85, median = 45.5) between 3 and 58 years of age. The estimated occurrence of stuttering ranged from 2.38 to 56%, which is substantially higher than the estimated prevalence (1%) of stuttering in the general population. The results also showed that stuttering severity most often was judged to be mild-to-moderate and that individuals with Down syndrome displayed secondary behaviors when these were measured. However, little attention has been paid to investigating the potential adverse effects of stuttering for individuals with Down syndrome. We judged the quality of the evidence to be moderate-to-low. The negative evaluation was mostly due to sampling limitations that decreased the representability and generalizability of the results. Based on the high occurrence of stuttering and the potential negative effects of this condition, individuals with Down syndrome who show signs of stuttering should be referred to a speech and language pathologist for an evaluation of their need for stuttering treatment.

The experience of Polish individuals who stutter based on the OASES outcomes

BACKGROUND

Prior research has shown that stuttering is a complex and individualized condition. The Overall Assessment of the Speaker's Experience of Stuttering (OASES; Yaruss & Quesal, 2016) is a well-researched tool that measures the impact of stuttering on an individual's life. This study has used the Polish version of the OASES to examine the experience of stuttering among Polish people who stutter.

METHOD

The original, English version of the OASES was translated into Polish. Reliability and validity for the Polish version were evaluated. Comparisons were made between samples from Poland and the United States for all of the sections and for the overall results of the OASES-S, OASES-T, and OASES-A. To explore the structure of the stuttering experience, a factor structure of the OASES was conducted.

RESULTS

Like other versions of the OASES, the OASES-Polish (OASES-PL) demonstrated good reliability and validity. Cross-cultural comparisons have shown that Polish school-age children had significantly lower knowledge and awareness of stuttering than children in the United States (USA). Factor analysis further revealed that the structure of the experience of stuttering is similar across all age groups, but the importance of the particular aspects of stuttering varies at different stages of life.

CONCLUSION

The OASES-PL is a reliable and valid instrument for measuring the impact of stuttering on Polish people who stutter and can therefore be used as a clinical tool. Polish results were relatively similar to those from the USA, though there were subtle cross-cultural differences that are worthy of further exploration.

EDUCATIONAL OBJECTIVES

After reading the article, the participant will be able: (1) to describe the diverse experiences of Polish people who stutter at different ages, (2) to explain the importance of quality of life analysis in diagnosis and speech therapy with people who stutter, and (3) to explain the breadth of the stuttering phenomenon among Polish individuals who stutter.

Stuttering experience of people in China: A cross-cultural perspective

PURPOSE

This study uses the Simplified Chinese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A-SC) to examine the stuttering experience of people in China and determine if there are differences between the data collected in China and other countries.

METHODS

A total of 139 responses to the OASES-A-SC were collected in an online self-help community of people in China who stutter. Descriptive analyses were conducted to obtain the understanding of how stuttering impacts the life experience of people in China who stutter. Comparisons were conducted regarding the groups of gender, highest education, and therapy history. Cross-cultural comparisons among the data collected from China, Australia, the Netherlands, Japan, Sweden, and the USA were also conducted.

RESULTS

The data for the OASES-A-SC showed a skewed distribution toward the severe end of the OASES-A impacting scale. About 93.5% participants rated the overall impact of stuttering on their life at and above the "Moderate" category. The mean scores of the General Information, Reaction to Stuttering, and Qualify of Life sections fell in the moderate-to-severe category. Compared with the data in other five countries, the Chinese data were significantly higher in the impact severity level.

CONCLUSION

The results showed that people in China who stutter have more adverse experiences related to stuttering compared with their counterparts in western or developed countries. Higher negative attitudes toward stuttering in China, social stigma against people with disabilities, and the fewer professional supports were discussed to be associated with this more adverse experience. Cultural differences such as a greater power distance and higher collectivism in Chinese culture were considered to be associated with the elevated level of adverse impact of stuttering in China.

Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K)

INTRODUCTION

Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter.

METHOD

The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment.

RESULTS

The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K.

CONCLUSION

The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.

Resilience in people who stutter: Association with covert and overt characteristics of stuttering

PURPOSE

Recent literature stresses the importance of resilience, as a trait, for successful coping with life's difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.

METHOD

Thirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker's Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.

RESULTS

A strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants' gender and age and their resilience levels (p > 0.05).

CONCLUSION

This study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.

Swedish outcomes of the Overall Assessment of the Speaker's Experience of Stuttering in an international perspective

Aim: The purpose of the present project was to translate the Overall Assessment of the Speaker's Experience of Stuttering (OASES) to Swedish, and to compare the results with available international data.Method: The Swedish versions of OASES-A, OASES-T and OASES-S were administered to 80 adults, 27 teenagers and 32 children who stutter, respectively. The overall impact scores and the impact scores for each of the four sections of the instrument were analyzed in relation to other studies involving the OASES.Results: The results revealed that all three Swedish versions of OASES had normally distributed outcomes and that they were reliable and valid. The overall impact scores for adults (2.33), teenagers (2.60) and children (2.28) all fell within Impact Rating Moderate. The mean overall impact score for OASES-A-S was significantly lower than corresponding data from USA, Australia and Japan (p < .01). There was no difference between Swedish and American teenagers, or between Swedish and American or Dutch schoolchildren.Conclusion: There seems to be cultural differences in the experience of negative consequences associated with stuttering. This suggests that cultural aspects should be carefully considered in assessment, treatment, and research involving individuals who stutter.

The relationship between the experience of stuttering and demographic characteristics of adults who stutter

PURPOSE

This study aims to examine the association between adults' experience of stuttering and their age, gender and marital status, as well as to evaluate the psychometric properties of the Hebrew version of the OASES-A.

METHODS

The Hebrew version of the OASES-A was administered to 91 adults-who-stutter. The validity of the translated version was evaluated using a subset of 43 participants, who also completed three additional instruments: (a) a Perceived Stuttering Severity (PSS) self-rating scale, (b) the Situation Avoidance Behavior Checklist (SABC), (c) the Students Life Satisfaction scale (SLSS). Finally, the correlations between the participants' OASES-A scores and their age, gender and marital status were calculated.

RESULTS

A negative correlation was found between the participants' OASES-A impact scores and their age (p<0.01). In addition, married participants exhibited lower OASES-A impact scores compared with unmarried participants (p<0.05). On the other hand, the speakers' gender was not associated with OASES-A impact scores.

RESULTS

revealed high internal consistency of the Hebrew OASES-A, and moderate to strong correlations with the additional examined instruments. Finally, results of the Hebrew version of the questionnaire were comparable with those obtained in other languages.

CONCLUSION

Our results indicated that, within our cohort, age and marital status are significantly associated with the personal experience of stuttering, whereas gender is not. In addition, the Hebrew version of the OASES-A is valid and comparable with equivalent versions in other languages. This facilitates the application of the OASES-A in future clinical and research settings.

The Japanese version of the overall assessment of the speaker's experience of stuttering for adults (OASES-A-J): Translation and psychometric evaluation

PURPOSE

This study evaluates the psychometric performance of the Japanese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A), a comprehensive assessment tool of individuals who stutter.

METHODS

The OASES-A-J was administered to 200 adults who stutter in Japan. All respondents also evaluated their own speech (SA scale), satisfaction of their own speech (SS scale) and the Japanese translation version of the Modified Erickson Communication Attitude scale (S-24). The test-retest reliability and internal consistency of the OASES-A-J were assessed. To examine the concurrent validity of the questionnaire, Pearson correlation was conducted between the OASES-A-J Impact score and the S-24 scale, SA scale and SS scale. In addition, Pearson correlation among the impact scores of each section and total were calculated to examine the construct validity.

RESULTS

The OASES-A-J showed a good test-retest reliability (r=0.81-0.95) and high internal consistency (α>0.80). Concurrent validity was moderate to high (0.55-0.75). Construct validity was confirmed by the relation between internal consistency in each section and correlation among sections' impact scores. Japanese adults showed higher negative impact for 'General Information', 'Reactions to Stuttering' and 'Quality of Life' sections.

CONCLUSION

These results suggest that the OASES-A-J is a reliable and valid instrument to measure the impact of stuttering on Japanese adults who stutter. The OASES-A-J could be used as a clinical tool in Japanese stuttering field.

A preliminary investigation of daily variability of stuttering in adults

PURPOSE

Variability in frequency of stuttering has made the results of treatment outcome studies difficult to interpret. Many factors that affect variability have been investigated; yet the typical range of variability experienced by speakers remains unknown. This study examined the day-to-day variability in the percentage of syllables containing stuttered and nonstuttered disfluencies in the speech of six adult speakers in three spontaneous speaking situations and two reading tasks.

METHODS

The frequency of moments stuttering during the tasks were compared within and between speakers and days to document the degree of variability in stuttering frequency and explore whether there were any consistent patterns. The Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A) were also tested for day-to-day variability. Correlations between frequency, severity, and life impact were made.

RESULTS

The primary result of this study was the large range over which frequency of stuttering varied from day to day for the same individual. This variability did not correlate with any measures of stuttering severity but did correlate with life impact as measured by the OASES-A. No global pattern was detected in variability from day to day within or between participants. However, there were significantly more nonstuttered disfluencies present during the spontaneous speaking tasks than during the reading tasks. The day-to-day variability in the life impact of the disorder (OASES-A) was less than the day-to-day variability in observable stuttering behavior (percentage of syllables stuttered and SSI-4).

CONCLUSION

Frequency of stuttering varies significantly from situation to situation and day to day, with observed variability exceeding the degree of change often reported in treatment outcomes studies from before to after treatment. This variability must be accounted for in future clinical and scientific work.

Validation and evaluation of the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering for School-age children (OASES-S-D)

BACKGROUND

Stuttering can have a negative impact on many aspects of a speaker's life. Comprehensive assessment must therefore examine a range of experiences in order to reflect the overall impact of the disorder.

PURPOSE

This study evaluated the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering--School-age (OASES-S; Yaruss & Quesal, 2010), which examines the impact of stuttering on the lives of children ages 7-12.

METHOD

The OASES-S was translated to Dutch (OASES-S-D) using a forward/backward translation process. Participants were 101 Dutch-speaking children who stutter (ages 7-12) who were recruited by speech-language therapists throughout the Netherlands. All participants completed the OASES-S-D, the Children's Attitudes about Talking-Dutch, a self-assessment of severity, a clinical assessment of severity, and a speech satisfaction rating. A control group of 51 children who do not stutter also completed the OASES-S-D to determine whether the tool could differentiate between children who stutter and children who do not stutter.

RESULTS

All sections of the OASES-S-D except section I surpassed a Cronbach's alpha of 0.70, indicating good internal consistency and reliability. Comparisons between the OASES-S-D and other tools revealed moderate to high associations. The OASES-S-D was able to discriminate between children who stutter and children who do not stutter and between participants with different levels of stuttering severity.

DISCUSSION

The OASES-S-D appears to be a reliable and valid measure that can be used to assess the impact of stuttering on 7- to 12-year old Dutch-speaking children who stutter.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) describe the purpose of the OASES-S-D measurement tool; (b) summarize the translation process used in creating the OASES-S-D; (c) summarize the aspects of stuttering measured in the different sections of the OASES-S-D; (d) describe with what measurement tools the validity of the OASES-S-D was investigated; and (e) describe the differences between the American-English version and Dutch translation of the OASES-S.

Acceptance and Commitment Therapy for adults who stutter: psychosocial adjustment and speech fluency

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N=20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.

The Impact of a Stuttering Disorder on Western Australian Children and Adolescents

In this study, we examined the impact of a stuttering disorder on children (n=50) and adolescents (n=45) living in Western Australia. We compared the reactions and experiences of children and adolescents who stutter to children and adolescents who do not stutter. We compared the participants who stuttered and the fluent participants using adapted versions of the Overall Assessment of the Speaker’s Experience of Stuttering (OASES). We also examined the relationship between biopsychosocial impact and stuttered speech frequency. We saw higher levels of adverse impact in young people who stuttered compared to their fluent peers. In addition, we found moderate correlations between OASES scores and stuttered speech frequency in children. These findings provided a baseline for establishing the degree of negative impact that a stuttering disorder may bring about in children and adolescents. The experiences of young people who stuttered were significantly different from the experiences of young people who were typically fluent. These findings reinforce the notion that stuttering is a disorder that can lead to negative impact for young people.

Stuttering in School-Age Children: A Comprehensive Approach to Treatment

Purpose

This letter, prepared through a close collaboration between the authors and more than 100 colleagues, responds to a paper by the editor of Language, Speech, and Hearing Services in Schools that highlighted the need for research on treatment for stuttering in school-age children.

Method

Our response addresses 3 themes: First, we offer agreement with the editor’s call for research because more evidence about treatment for children who stutter is certainly needed. Second, we provide an overview of recent literature, demonstrating that the majority of current treatments include strategies for helping children improve speech fluency in addition to helping them increase acceptance of their stuttering and diminish the negative consequences of the disorder. Third, we present several strategies designed to help clinicians respond to the individual needs of children who stutter in a data-based, comprehensive manner that focuses on minimizing the adverse impact of stuttering on children’s educational endeavors, and on their lives as a whole.

Conclusion

Much has been learned about the factors that contribute to the successful treatment of stuttering in school-age children, and evidence will continue to accumulate. Meanwhile, speech-language pathologists can help children increase their fluency while simultaneously minimizing the adverse impact of their speaking difficulties and helping them improve their overall communication.

Australian normative data for the Overall Assessment of the Speaker's Experience of Stuttering

People who stutter often report negative impacts on their wellbeing as a result of their chronic fluency disorder. The need for a comprehensive assessment of the wellbeing and experience of stuttering should be a prime consideration when measuring treatment outcomes. One such measure designed to evaluate wellbeing and aspects of the individual's experience of his or her stuttering is the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Normative data for the OASES Adult version (OASES-A; and hereafter referred to simply as the OASES) has begun to be collected over the past 10 years, though none are available for an Australian population. This paper presents Australian normative data for the OASES for 200 adult males and females who stutter, aged between 18 and 85 years. Additionally, the influence of age, sex, and frequency of stuttering on the Australian OASES scores are also presented. No significant relationships between OASES scores were found for sex and age, which is in keeping with the USA original dataset. However, those participants who had more severe stuttering were more likely to have higher negative impacts for 'General Information', Communication in Daily Situations,' and for the overall OASES score. Implications for further research are discussed.

EDUCATIONAL OBJECTIVES

The reader will be able to: (i) describe the purpose of the Overall Experience of the Speaker's Experience of Stuttering for Adults (OASES), (ii) evaluate the relevance of the OASES to treatment planning and the evaluation of stuttering treatment outcomes in the adult population, and (iii) compare Australian normative dataset with the USA and Dutch normative datasets for the OASES.

Quality of life in adults who stutter

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual's speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual's coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants.