Oficinas terapêuticas em grupo: intervenção fonoaudiológica em adultos que gaguejam

Abstract

Stuttering is recognized as a fluency disorder primarily characterized by involuntary speech disruptions, such as repetitions of sounds, syllables, words and/or parts of words, sound prolongations, and blocks that interrupt the normal flow of verbal communication. These episodes occur involuntarily and can significantly affect an individual's ability to communicate in various social and professional contexts. The etiology of stuttering is considered multifactorial, involving a combination of genetic, neurological, emotional, and environmental factors. There is a known genetic predisposition associated with the disorder, as evidenced by recurring family history in many cases. Additionally, neurological factors, such as atypical functioning of brain regions responsible for speech and language, are also cited as possible contributors. Environmental and emotional aspects, especially those stemming from how parents, interlocutors, and society respond to stuttering episodes in childhood, may influence the persistence or worsening of the condition. Given the complexity of stuttering, various therapeutic approaches have been developed and refined over time. The most effective intervention programs tend to integrate techniques aimed at modifying stuttering and shaping fluency, along with coping strategies such as boosting selfesteem and self-confidence, and promoting desensitization. These interventions have shown promising results not only in improving fluency but also in enhancing the quality of life of individuals who stutter, encouraging greater acceptance and social inclusion. The main objective of this study was to analyze data obtained from assessment protocols applied to adults who stutter before and after participating in a therapeutic workshop conducted in an online group format. Specific objectives included: Analyzing the association between aspects of the subjective experience of stuttering and the severity of the disorder, investigating family history, objective fluency parameters, and self-reported participant feelings, Comparing stuttering severity and fluency parameters pre- and post-online therapeutic workshop, Comparing self-perception of stuttering, communication, and quality of life before and after group speech-language therapy interventions. Methods: Data collection was carried out via online forms (Google Forms) and meetings hosted on the Zoom platform, allowing access to a broad and geographically diverse sample. Participants were self-declared adults who stutter, recruited through outreach in support groups, social networks, and other digital platforms. Collected data included sociodemographic information (such as age, gender, and marital status), family history of stuttering, and speech samples for detailed fluency profile assessment. Validated instruments were used, including the Speech Fluency Profile Assessment Protocol (PAPF), the Stuttering Severity Instrument – Fourth Edition (SSI-4), and the Overall Assessment of the Speaker’s Experience of Stuttering – Adult Version (OASES-A). These tools enabled both objective and subjective evaluations of the stuttering experience. Data were analyzed using descriptive and inferential statistical methods, with specialized software ensuring rigor in result interpretation. Three scientific manuscripts emerged from the study, each addressing distinct aspects of stuttering and therapeutic intervention outcomes. Results: The first manuscript included 49 participants and examined associations between the subjective experience of stuttering and variables such as stuttering severity, family history, objective fluency parameters, and self-reported feelings. Statistically significant associations were found between the impact of stuttering on individuals' lives and their self-perception as communicators. Specifically, greater perceived impact correlated with feelings of inferiority as a speaker, insecurity in speaking situations, a high number of common disfluencies, and lower fluency measured in words per minute. These results underscore the importance of emotional aspects in therapeutic approaches. The second manuscript, involving 52 participants, focused on comparing stuttering severity and fluency parameters before and after an online group therapeutic workshop, along with activity descriptions. Assessment involved SSI-4 and additional fluency parameters such as number of blocks, repetitions, prolongations, and speech naturalness. Although no statistically significant change was found in the overall classification of stuttering severity post-workshop, improvements were noted in specific fluency aspects—namely a reduction in blocks and increased naturalness of speech. This suggests that while overall severity may not shift dramatically in a short timeframe, such workshops can effectively foster measurable gains in fluency. The third manuscript, with 35 participants, aimed to compare self-perception of stuttering, communication, and quality of life before and after group speech-language therapy interventions. Data showed a significant reduction in the perceived impact of stuttering and a substantial improvement in quality of life. A particularly noteworthy finding was that most participants initially classified their condition as having a moderate to severe impact, but post-intervention, they were reclassified as experiencing mild to moderate impact. Conclusion: The findings from these three manuscripts contribute to a deeper understanding of the challenges faced by adults who stutter. The data highlight the importance of therapeutic approaches that extend beyond fluency improvement, encompassing emotional, social, and subjective dimensions of the stuttering experience. The speaker’s own experience must occupy a central role in clinical analyses and decisions, as it provides critical insight into how stuttering affects everyday functionality, emotional well-being, and social participation. The study emphasizes the relevance of incorporating the perspective of people who stutter not only in clinical speech-language practices but also in future research. This fosters the development of more effective, individually responsive, and personalized interventions, respecting the diversity of speaker experiences. Group interventions conducted online, as described in this study, are especially promising, as they create welcoming environments, encourage sharing, and reduce isolation. In summary, this study reinforces the essential role of speech-language pathology in promoting fluency and—most importantly—in improving the quality of life for individuals who stutter. Therapeutic efforts should prioritize strategies that foster social inclusion, strengthen speaker identity, and embrace stuttering as part of the spectrum of human communicative diversity. These actions are fundamental for enabling speakers to express themselves with greater freedom, confidence, and authenticity across all areas of life.