Promoting Communication Well-Being with Stutter-Affirming Therapy: A Pilot Clinical Trial in the Schools

PROJECT SUMMARY/ABSTRACT CANDIDATE: Dr. Naomi Rodgers is an academic speech-language pathologist and Assistant Professor at the University of Iowa with expertise in scale development, qualitative methodologies, and experimental design in the study of the psychosocial aspects of stuttering. With this K23 mentored patient-oriented career development award, Dr. Rodgers will build on this foundation to develop new knowledge and skills needed to independently conduct clinical trials of multidimensional therapy for people who stutter, and to investigate factors related to intervention implementation. CAREER DEVELOPMENT PLAN: Dr. Rodgers will develop proficiency in (1) design and conduct of clinical trials of behavioral health interventions; (2) dissemination and implementation science; (3) team science and multi-site project management; and (4) school-based research. Developing these advanced skills will be critical to her success as an independent investigator who is committed to enhancing accessibility and implementability of effective stuttering therapy that improves psychological and communicative well-being for people who stutter across the lifespan in diverse clinical settings. ENVIRONMENT: Dr. Rodgers will train with a multidisciplinary team of extramurally funded mentors including: Dr. Elizabeth Walker (primary mentor), a leading applied researcher in the field of pediatric communication disorders; Dr. Geoffrey Curran (co- mentor), a leading implementation scientist; Dr. Gerta Bardhoshi (co-mentor), a leading school mental health researcher; and Dr. Anu Subramanian (co-mentor), a specialist in stuttering intervention and clinical education. RESEARCH: Although many school-based speech-language pathologists (SLPs) recognize that stuttering therapy should address cognitions and emotions alongside communication behaviors, status quo speech therapy often narrowly focuses on reducing stuttering frequency. There is a critical lack of high-level evidence for multidimensional approaches for school-age children who stutter (CWS), and it is unclear how to best support school SLPs in facilitating them. Avoidance Reduction Therapy for Stuttering (ARTS®) offers a theory-driven stutter-affirming approach to coaching CWS to reduce conditioned struggle behaviors in turn helping them develop comfortable, forward-moving communication. Aim 1 of this study involves partnering with topical experts and stakeholders to adapt ARTS® for school service delivery and develop a protocol to train school-based SLPs to implement ARTS® with school-aged CWS (aged 7-12 years). Aim 2 is to conduct a pilot randomized controlled trial with SLP-CWS dyads to evaluate preliminary effects of the ARTS® training and intervention on SLP and CWS outcomes, respectively. Aim 3 is to identify outcomes, barriers, and facilitators of implementing ARTS® in the schools, and to select and operationalize strategies to that we will evaluate in a subsequent fully powered hybrid effectiveness-implementation trial. The completion of these training and research aims are critical for Dr. Rodgers’ career development in creating, adapting, and evaluating evidence-based, implementable behavioral health interventions for people who stutter to enhance their quality of life and well-being.