









































Communication, Society and Media 
ISSN 2576-5388 (Print) ISSN 2576-5396 (Online) 

Vol. 4, No. 2, 2021 
www.scholink.org/ojs/index.php/csm 

47 
 

Review Paper 

The Self-Reported Roles of Executive Functions, Behavior 

Experiences and Locus of Control in Adults Who Stutter 
Jane Roitsch1* 

1 Department of Communication Disorders & Special Education, Old Dominion University, Norfolk, 

Virginia, USA 
* Jane Roitsch, Department of Communication Disorders & Special Education, Old Dominion 

University, Norfolk, Virginia, USA 

 
Received: May 18, 2021         Accepted: May 25, 2021          Online Published: May 29, 2021 

doi:10.22158/csm.v4n2p47                       URL: http://dx.doi.org/10.22158/csm.v4n2p47 

 
Abstract 

Purpose: Myriad studies have endeavored to determine why people stutter. It has been suggested that 

prior experiences, self-perceptions, specific cognition abilities (i.e., executive functions), and/or 

whether a person perceives their stuttering to be controlled internally or externally can provide insight 

into stuttering behaviors. What is not known is whether a relationship exists between these variables 

has more influence on persons who stutter than another. This preliminary study used the Locus of 

Control of Behavior scale (LCB; Craig et al., 1984), Overall Assessment of the Speaker’s Experience of 

Stuttering; (OASES; Yaruss & Quesal, 2006, Yaruss & Quesal, 2008), and the Comprehensive 

Executive Function Inventory, (CEFI-A-SR; Naglieri & Goldstein, 2013) to better understand what 

relationships, if any, exist between locus of control of behavior, stuttering experiences, and executive 

functions in persons with fluency disorders. 

Method: A total of 116 adults who stutter completed online surveys which included demographic 

questions, the LCB, OASES, and CEFI-A-SR. 

Results: Self-monitoring was the lone executive function scale score demonstrating a relationship to 

LCB and OASES scores. 

Conclusions: An internal control of behavior and positive outlook on stuttering experiences as well as 

a sense of effective self-monitoring may be required for a person to manage stuttering behaviors 

effectively.  

Keywords 

executive functions, stuttering attitudes, stuttering behaviors, locus of control, stuttering experiences 

 



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The Relationship between Self-Reported Behavioral Control, Experiences, and Executive 

Functions in Persons Who Stutter 

1. Introduction 

Stuttering is a disorder of speech fluency that affects approximately 1% of adults (Craig et al., 2002). 

Although it can often be diagnosed early (i.e., around two years of age), stuttering may persist in as much 

as 20 percent of this population (Andrews et al., 1983; Bloodstein, 1995). For years, researchers have 

examined behaviors, perceptions, and cognitive functions of persons with fluency disorders. These 

investigations seek critical information, as adults who stutter report higher levels of stress, anxiety, 

depression, and social disorders than persons who do not stutter (Blood et al., 2001; Iverach et al., 2009; 

Tran et al., 2011). Persons who stutter also report feeling less control over life stressors than persons who 

do not stutter (Craig et al., 2009). 

Research has investigated several theories about why stuttering occurs. From a behavioral standpoint, it 

has been speculated that a relationship exists between Locus of Control of Behavior (LCB; Craig et al., 

1984) and long-term stuttering exists (DeNil & Kroll, 1995). Other research has endeavored to determine 

what impact stuttering experiences have on stuttering (OASES; Yaruss & Quesal, 2006, Yaruss & 

Quesal, 2008). Some researchers have reported functional brain differences may exist in persons who 

stutter compared to those who do not stutter (Gordon, 2002; Chang et al., 2009; Sowman et al., 2017). 

More specifically, abnormal attention and executive functioning network differences have been noted in 

children who stutter (Chang et al., 2017). These areas are discussed in depth in the following sections.  

1.1 Locus of Control of Behavior and Stuttering 

It has been suggested that the locus of control of behavior (i.e., whether persons feel their conditions arise 

due to internal vs. external factors) can impact long-term outcomes for individuals receiving behavioral 

therapy. In some studies, having an internal locus of control of behavior has been implicated in sustaining 

long-term outcomes in persons who stutter (Andres & Craig, 1988; De Nil & Kroll, 1995). In other works, 

locus of control has not been identified as a psychological predictor of stuttering (Ginsberg, 2010). Locus 

of control of behavior has also been shown to differ between persons who stutter and persons who do not 

stutter (Kumbhar & Gupta, 201). In a study aimed to determine the impact of self-reporting measures in 

persons who stutter, self-reporting of stuttering events were shown to be beneficial in the assessment and 

treatment of stuttering as they provided information about when a loss of control was perceived by the 

person who stutters. (Guntupalli, Kalinowski, & Saltklaroglu, 2010). Thus, there is the need to further 

examine the impact locus of control has on persons who stutter.  

1.2 Experiences of Persons Who Stutter 

In addition to the LCB, experiences and reactions of persons who stutter have been identified as factors 

influencing not only stuttering treatment outcomes but also quality of life in persons who stutter 

(Klompas & Ross, 2004; Nang et al., 2018). Negatuive self-perceptions of stuttering have been 



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associated with stuttering impairments (Nang et al., 2018), and attitudes have been identified as 

influencing the social interactions of persons who stutter (Leith et al., 1993). Fortunately, understanding 

the environment, attitudes, and social experiences of persons who stutter has been shown to help shape 

self-perceptions and personal narratives, which can improve stuttering outcomes (O’Dwyer et al., 2018).  

1.3 Cognitive Skills and Stuttering: The Role of Executive Functions and Self-Reports 

Another area that has been explored in persons who stutter involves cognition. The act of stuttering has 

been suggested to involve certain cognitive breakdowns (Karniol, 1995). More specifically, persons who 

stutter have demonstrated deficits in attention (Heitmann et al., 2004; Ofoe et al., 2018; Singer, et al., 

2020), self-monitoring deficits (Goldiamond, 1965; James, 1981; Lickley et al., 2005; Vasic & Wijnen, 

2005), and inhibitory control (Eggers et al., 2013). These specific cognitive processes fall under the 

umbrella term of “executive functions”, or “EFs”.  

There are many definitions of EFs. EFs have been named as cognitive control activities that manage all 

other cognitive processes (Denckla & Reader, 1993). Baggetta and Alexander (2016) compared 

researcher definitions of EFs and found that most individuals identify EFs as a group of cognitive 

functions that provide guidance for learning and executing activities. 

Because EFs include several processes, (e.g., working memory, cognitive flexibility, inhibitory control) 

learning which process is involved and to what extent in which activity can be challenging. Tests of EFs 

exist to help parse out which EFs may be stronger or more involved in determining task outcomes. In 

persons who stutter, brain-based differences have been reported by researchers (Etchell & Sowman, 

2014). Additionally, attention to tasks that can impact comprehension have been shown to differ in 

persons who stutter compared to persons who do not stutter (Kamhi & McOsker, 1982).  

Self-reporting has been suggested as a tool that may provide insight in stuttering behaviors (Guntupalli, 

Kalinowski, & Saltuklaroglu, 2006; O’Brien, Packman, & Onslow, 2004).  

As the use of self-reporting has often been used by researchers and clinicians working with persons who 

stutter, this study investigated self-reported experiences, self-reported feelings of control, and 

self-reported EFs of persons who stutter. No research to date has directly examined these potential 

relationships. Therefore, gaining a better understanding about locus of control, life experiences and 

cognitive interactions of adults with persist stuttering can provide critical insights to drive support 

strategies and identify possible treatment options. 

For this study, an examination of EFs, self-perceptions and opinions of control were selected for 

investigation in persons who study as they reflect the outcomes of prior research. Although EFs may 

relate to factors impacting stuttering events in adults, no research to date has directly examined the 

potential relationship between EFs, self-perceptions and locus on control to determine the interactions 

between these variables in adults who stutter. 

 



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1.4 Purpose of the Study 

Few studies, if any, have investigated the relationships between the self-reported locus of behavior 

control, self-perceptions and cognitive functions (i.e., EFs) in adults who stutter. As locus of behavior 

control, experiences, and EFs have been suggested to influence stuttering behaviors and outcomes, the 

strength of each of these variables and the relationships between them in adults stutter can provide 

valuable insight into this population. For example, if strong relationships exist between certain variables, 

or if certain EFs are identified as strengths or weaknesses by persons who stutter, treatment could be 

designed accordingly. Therefore, in this study, the self-reports of behavioral control, self-perceptions and 

self-reported EFs in persons who stutter were collected and analyzed. It is hypothesized that EFs (e.g., 

attention, working memory, self-monitoring) may play a more significant role in the act of stuttering than 

previously determined. It is further hypothesized that, self-perceptions, locus of control, and EFs will 

demonstrate relationships with each other. Descriptive statistics, correlations and regressions will be 

used to analyze the results received. 

 

2. Method 

2.1 Participants 

This study investigated the self-reported EFs, behaviors and perceptions of persons who stutter who 

responded to an online invitation to participate. Upon receiving approval from the Institutional Review 

Board (IRB) at Old Dominion University, an announcement explaining the study purpose and invitation 

to participate was posted on the National Stuttering Association (NSA) website. Interested participants 

who met inclusion criteria (i.e., adults 18+ years of age who stutter) received further instructions were 

emailed links for completion.  

2.2 Procedure 

Data were collected anonymously, via online assessments. The invitation to participate in the 

assessments was posted for three months. Participants who volunteered for this study and met inclusion 

criteria received email access to the survey. The collection of information occurred online via 

self-reported responses to the materials listed below. 

2.3 Materials 

Following questions regarding demographic information and stuttering history, participants completed 

the Locus of Control of Behavior Survey (LCB; Craig et al., 1984), Overall Assessment of the Speaker’s 

Experience of Stuttering; (OASES; Yaruss & Quesal, 2006, Yaruss & Quesal, 2008), and the 

Comprehensive Executive Function Inventory, (CEFI-A-SR; Naglieri & Goldstein, 2013). 

2.4 Measures 

2.4.1 Demographic questions. Participants responded to an online fluency questionnaire section with 

nine demographic questions devised in Qualtrics (see Appendix A). 



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2.4.2 Locus of Control of Behavior Scale (LCB). Participants also completed the LCB. The LCB is a 

17-question, 5-point Likert scale designed to measure how much control a person perceives they have 

over their own behavior(s) and distinguishes between two personalities; internal (i.e., persons who 

perceive outcomes as the result of their own behavior or control) and external (i.e., persons who feel that 

what happens to them is the result of external circumstances). Higher scores indicate more externality. In 

studies of persons who stutter and persons who do not stutter, significant differences were noted in the 

LCB scale scores of the two groups (Craig et al., 1984; Kumbhar & Gupta, 2016; Nil & Kroll, 1995), 

with persons who stutter demonstrating higher scores, thus greater externality. Kumbhar and Gupta 

(2016) suggest that the LCB scale may provide valuable insight to guide assessment and treatment of 

persons who stutter. 

2.4.3 OASES Self-Report. The next step included participants’ responses to the online OASES 

self-report. This protocol measures the impact of stuttering impact on the individual’s life and provides 

information via self-reporting which can be used in assessment and treatment. The OASES self-report 

includes the following sections: Overall Characteristics, General Information, Reactions to Stuttering 

Characteristics and Experiences, Communication in Daily Situations Characteristics and Experiences, 

and Quality of Life. Responses are grouped into five categories; mild (impact score of 1.00-1.49); 

mild-moderate (impact score of 1.50-2.24); moderate (impact score of 2.25-2.99); moderate-severe 

(impact score of 3.00-3.74); or severe (impact score of 3.75-5.00). Thus, the higher the impact score, the 

more severe the person who stutters feels their stuttering impacts each category. 

2.4.4 Comprehensive Executive Function Inventory-Adult -Self-Report (CEFI-A-SR). Participants also 

completed the Comprehensive Executive Function Inventory-Adult -Self-Report (CEFI-A-SR). This 

Likert-like scale has been clinically proven to provide insight into an individual’s assessment of the 

various components of their own EFs. This report assesses EF-related behaviors (e.g., inhibitory control, 

working memory), and identifies an individual’s EF strengths and weaknesses. Information captured by 

the CEFI-A-SR is useful to help identify a person’s specific EF skills based on the setting. The 

CEFI-A-SR provides a comprehensive look at overall EFs via standard scores and individualized subtest 

standard scores on 9 EF areas (i.e., attention, emotion regulation, flexibility, inhibitory control, initiation, 

organization, planning, self-monitoring, and working memory). The higher the scores, the stronger the 

individuals perceive their ability in that EF area. 

2.5 Data Analysis 

This study was a correlation and a stepwise regression research design and included an analysis of 

descriptive statistics involving several variables. Data were imported into SPSS Version 25 for data 

management and analysis. LCB, OASES, and CEFI-A-SR scale and subscale scores were calculated 

according to publication manual guidelines. Analysis began by obtaining study sample characteristics. 

Frequencies and percentages were reported for all variables. Independent samples t-tests and one-way 



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analysis of variance (ANOVA) were used to compare LCB, OASES, and CEFI-A-SR total score and 

subscale scores across demographic variables. Post hoc pairwise comparisons with Tukey’s correction 

for multiple comparisons was conducted for one-way ANOVA tests that yielded significant results. 

Pearson correlations were used to assess the correlation between LCB, OASES, and CEFI-A-SR total 

score and subscale scores. All assumptions for ANOVA and Pearson correlations were satisfied. A 

p-value < 0.05 was used to determine statistical significance. 

 

3. Results 

Initially, 171 individuals responded to the survey invitation. Among those individuals, 55 did not 

complete the survey in full and were excluded from the analytic sample. The final population consisted of 

116 individuals. Table 1 displays the sample characteristics obtained from the nine demographic 

questions in the survey (see Appendix A). 

 

Table 1. Sample Characteristics (N=116) 

Characteristic n % 

Region 

     Midwest 

     Northeast 

     Southeast 

     Southwest 

     West 

     Outside the US 

     Did not answer 

 

25 

24 

28 

12 

21 

5 

1 

 

21.6 

20.7 

24.1 

10.3 

18.1 

4.3 

0.9 

Race/ethnicity 

     African American 

     Asian 

     Hispanic 

     White 

     Mixed race 

     Prefer not to answer 

 

7 

6 

6 

89 

4 

2 

 

6.0 

5.2 

5.2 

76.7 

3.4 

1.7 

Age (in years) 

     18-24 

     25-34 

     35-44 

     45-54 

 

11 

33 

24 

21 

 

9.5 

28.4 

20.7 

18.1 



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     55-64 

     65+ 

     Did not answer 

12 

14 

1 

10.3 

12.1 

0.9 

Gender 

     Male 

     Female 

     Prefer not to answer 

 

74 

38 

4 

 

63.8 

32.8 

3.5 

Age determined to have a fluency disorder 

     Preschool age 

     School age 

     Adult 

     Following an injury as a child 

 

60 

51 

2 

2 

 

51.7 

44.0 

1.7 

1.7 

Seeking treatment 

     Yes 

     No 

 

13 

102 

 

11.2 

87.9 

Involved in a stuttering self-help group 

     Public 

     Private 

     No 

 

62 

23 

85 

 

53.4 

19.8 

26.7 

Other diagnoses 

     ADHD 

     ADHD and speech impairment 

     Language impairment 

     Speech impairment 

     Speech and language impairment 

     No 

 

19 

1 

1 

10 

1 

84 

 

16.4 

0.9 

0.9 

8.6 

0.9 

72.4 

Family history of a stuttering disorder 

     Yes 

     No 

 

46 

70 

 

39.7 

60.3 

 

3.1 Overall Demographics 

A quarter of the sample came from the Southeast, while approximately one fifth of participants came 

from the Midwest, Northeast, and Southwest respectively. The majority of study participants identified 

as white (76.7%). Almost 50% of participants were between the ages of 25 and 44, and the majority were 

male (63.8%). There were 51.7% of participants who reported they were preschool age when it was 



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determined that they had fluency disorder, while 44% participants reported to be school age. Almost 90% 

of participants reported they were not currently seeking treatment for their disorder; however, 73.3% 

were/are involved with a stuttering self-help group (53% public and 20% private). There were 40% of 

participants who reported they had a family history of stuttering. 

3.2 LCB, OASES, and CEFI-A-SR Scores by Region 

Table 2 reports the descriptive statistics (mean, standard deviation, minimum and maximum) for the 

LCB, OASES, and CEFI-A-SR scale scores. (It should be noted that higher scores on the LCB indicate 

greater externality, higher scores on the OASES indicate a greater negative impact of stuttering, and 

higher scores on the CEFI-A-SR, the stronger the individual perceives their ability in that EF area.) 

Independent samples t-tests and one-way ANOVAs showed that LCB, CEFI-A-SR Organization (OG), 

CEFI-A-SR Self-Monitoring (SM), and CEFI-A-SR total score differed by region (all p < 0.05). Post hoc 

tests showed the following results: Participants from the West had lower LCB scores than those outside 

the US (p = 0.01). Participants from the Southeast and West had significantly higher CEFI-A-SR 

Organization subscale scores than those outside the US (p = 0.049 and p = 0.02). Similarly, participants 

from the Midwest, Southeast, and West had significantly higher CEFI-A-SR Self-Monitoring subscale 

scores than those from outside the US (all p < 0.01). Lastly, participants from the Southeast and West had 

significantly higher CEFI-A-SR total scores than those from outside the US (p = 0.02 and p = 0.03). 

 

Table 2. Descriptive Statistics for LCB, OASES, and CEFI Scale and Subscale Scores 

 Minimum Maximum Mean Std. Deviation 

Locus of control 19.00 57.00 35.5826 7.99998 

OASES     

     General Information Raw Score 16.00 86.00 51.2174 12.94847 

     General Information Impact Score 1.20 4.30 2.6627 .67342 

     Reactions to Stuttering Raw Score 32.00 136.00 86.0614 24.07116 

     Reactions to Stuttering Impact Score 1.10 4.64 2.8904 .78596 

     Communication in Daily Situations Raw Score 2.00 103.00 58.2435 18.45554 

     Communication in Daily Situations Impact Score 1.00 4.65 2.4742 .73844 

     QOL Raw Score 19.00 109.00 54.2435 20.70579 

     QOL Impact Score 1.00 4.86 2.2362 .84263 

     Overall Raw Score 89.00 407.00 249.0174 69.60742 

     Overall Impact Score 1.12 4.57 2.5749 .69986 

CEFI     

     Attention 1.00 34.00 22.8319 6.02510 

     Emotional Regulation 7.00 36.00 24.3929 4.93992 



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     Flexibility 2.00 31.00 21.3274 4.71594 

     Inhibitory Control 2.00 33.00 23.6460 4.72629 

     Initiation 3.00 32.00 22.4690 4.73790 

     Organization 4.00 33.00 22.4690 5.17389 

     Planning 4.00 36.00 25.3186 5.80373 

     Self-Monitoring 3.00 27.00 20.0442 4.02978 

     Working Memory 4.00 35.00 22.3982 5.22450 

     Total 37.00 309.00 226.4071 42.76903 

 

3.3 LCB, OASES, and CEFI-A-SR Scores by Race 

The CEFI-A-SR scale and subscale scores were shown to differ by race. Post hoc tests showed the 

following: On the CEFI-A-SR Attention (AT) subscale, Asians scored lower than mixed race 

participants (p = 0.02). African Americans and Asians scored lower on the CEFI-A-SR Emotional 

Regulation (ER) subscale than mixed race on the CEFI-A-SR ER subscale (p = 0.01 and p = 0.001) while 

whites scored lower than Asians (p = 0.02). African Americans scored lower than all other race/ethnicity 

groups except Whites on the CEFI-A-SR Flexibility (FX) subscale (all p < 0.05). Asians scored less than 

mixed race participants on the CEFI-A-SR FX subscale (p =0.02). Asians scored lower on the 

CEFI-A-SR Initiation (IT) subscale than Hispanics (p =0.04). African Americans scored less than 

Hispanics, Whites, and mixed race on the CEFI-A-SR OG subscale (all p < 0.02). Asians scored less than 

mixed race participants on the CEFI-A-SR OG subscale (p = 0.02).  

African Americans and Asians scored less than Hispanics, Whites, and mixed-race participants on the 

CEFI-A-SR Planning (PL) subscale (all p < 0.03). African Americans scored less than Hispanics, Whites 

and mixed-race participants on the CEFI-A-SR SM subscale (all p < 0.04). Asians scored less than 

Whites on the CEFI-A-SR subscale (p = 0.03). African Americans and Asians scored less than mixed 

race participants on the CEFI-A-SR Working Memory (WM) subscale (p = 0.02 and p = 0.02 

respectively). African Americans and Asians had lower CEFI-A-SR total scores than Hispanics, Whites, 

and mixed-race participants (all p < 0.05). Post hoc pairwise comparisons of CEFI-A-SR Inhibitory 

Control (IC) subscale scores between racial/ethnic categories that corrected for multiple comparisons did 

not yield statistically significant results, despite the statistically significant one-way omnibus ANOVA 

test.  

3.4 LCB, OASES, and CEFI-A-SR Scores by Age 

LCB, OASES general information impact score, OASES reactions to stuttering raw and impact score, 

OASES communication in daily situations raw and impact scores, OASES QOL raw and impact scores, 

OASES overall raw and impact score, CEFI-A-SR Emotional Regulation subscale, and CEFI-A-SR 

Planning subscale scores differed by age. Post hoc tests showed the following: Participants 18 to 24 years 



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of age scored higher than participants 45 to 54 years of age and people 65+ years of age (p = 0.001 and p 

= 0.03 respectively) on LCB. Participants 25 to 34 years of age and participants 35 to 44 years of age also 

scored higher than participants 45 to 54 years of age on LCB (p = 0.02 and p = 0.04). Participants 25 to 34 

years of age and 55 to 64 years of age had a lower OASES general information impact score than persons 

35 to 44 years of age (p = 0.03 and p = 0.01). OASES reactions to stuttering raw scores and impact scores 

were lower in participants 65+ years of age than those 35 to 44 years of age (p = 0.04). OASES 

communication in daily situations raw scores were lower among participants 65+ years of age than 

participants 25 to 34 years of age and 35 to 44 years of age (all p < 0.04). OASES communication impact 

scores were higher in participants 18 to 24 years of age than participants 55 to 64 years of age (p =0.04). 

OASES QOL impact scores were lower in participants 55 to 64 years of age than participants 18 to 24 

years of age and participants 35 to 44 years of age (p = 0.03). The OASES overall raw and impact score 

was less in participants 35 to 44 years of age than participants 55 to 64 years of age (p = 0.04). 

Participants 18 to 24 years of age scored lower than participants older than 45 years of age on the 

CEFI-A-SR Emotional Regulation subscale (p = 0.001, p = 0.02, and p = 0.03 respectively). CEFI-A-SR 

Planning subscale scores were higher among 45 to 54 years of age than participants 18 to 24 years of age 

(p = 0.03). 

3.5 OASES Scores  

3.5.1 OASES scores by gender. LCB, OASES, and CEFI-A-SR scale and subscale scores did not differ 

by gender or whether they were currently involved in a self-help stuttering group. 

3.5.2 OASES scores by age when fluency disorder was determined. OASES general information raw 

score, OASES reactions to stuttering raw and impact scores, OASES communication in daily situations 

impact score, and OASES overall impact score differed by what age it was determined a participant had 

a fluency disorder. Participants for whom it was determined that they have a fluency disorder at 

preschool age and school age had higher OASES general information raw scores than those for who it 

was determined that they have a fluency disorder as an adult (both p = 0.01). Post hoc pairwise 

comparisons of OASES reactions to stuttering raw and impact scores, OASES communication in daily 

situations impact score, and OASES overall impact score between age at diagnosis categories that 

corrected for multiple comparisons did not yield statistically significant results, despite the statistically 

significant one-way omnibus ANOVA test. 

3.5.3 OASES scores and present involvement in treatment for stuttering. OASES general information 

raw and impact score differed by whether they were currently seeking treatment for stuttering, with those 

not seeking treatment scoring higher on both subscales than those seeking treatment (both p < 0.02).  

3.6 LCB, OASES, and CEFI-A-SR Scores and Other Diagnosed Conditions 

Locus of control, OASES communication in daily situations impact score, OASES QOL impact score, 

OASES overall impact score, CEFI-A-SR Attention subscale score, CEFI-A-SR Inhibitory Control 



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subscale score, CEFI-A-SR Organization subscale score, and CEFI-A-SR Working Memory subscale 

score differed by other diagnoses (all p < 0.05). There are too few participants in some of the other 

diagnosis categories to conduct post hoc pairwise comparisons. 

3.6 LCB, OASES, and CEFI-A-SR Scores and Family Stuttering History 

OASES reactions to stuttering impact score, OASES QOL impact score, OASES overall and impact 

scores, and CEFI-A-SR Attention subscale scores differed by family history of stuttering (all p < 0.05). 

Specifically, those who had a family history of stuttering had lower OASES reactions to stuttering impact 

score, OASES QOL impact score, and OASES overall and impact scores and higher CEFI-A-SR 

Attention subscale scores than those without a family history of stuttering. 

3.7 Correlations 

Table 3 presents the Pearson correlations for the locus of control, OASES, and CEFI-A-SR scale and 

subscale scores. Locus of control is positively correlated with all OASES measures and negatively 

correlated with all CEFI-A-SR measures except the CEFI-A-SR Self-Monitoring subscale (all p < 0.01). 

The OASES overall and subscale scores are all highly positively correlated with each other (all p < 

0.01). Similarly, the CEFI-A-SR total and subscale scores are all highly positively correlated with each 

other (all p < 0.01). 

OASES general information raw score is negatively correlated with CEFI-A-SR Attention (p < 0.05), 

Flexibility (p < 0.01), Planning (p < 0.05), and Total Scores (p < 0.05). OASES general information 

impact score is negatively correlated with all CEFI-A-SR scores except the CEFI-A-SR 

Self-Monitoring subscale score (all p < 0.01). The OASES reaction to stuttering raw score is negatively 

correlated to the CEFI-A-SR Emotional Regulation and Flexibility subscale scores (p < 0.01 and p < 

0.05 respectively) but none of the other CEFI-A-SR scores. The OASES reaction to stuttering impact 

score is negatively correlated to the CEFI-A-SR Emotional Regulation, Flexibility, Inhibitory Control, 

Initiation, and Planning scores (all p < 0.05). The OASES communication in daily situations raw and 

impact scores is not correlated with the CEFI-A-SR measures. The OASES QOL raw score is 

negatively correlated with the CEFI-A-SR Emotional Regulation, Initiation and total scores (all p < 

0.05). The OASES QOL impact score is negatively correlated with the CEFI-A-SR Emotional 

Regulation, Flexibility, Initiation, and total scores (all p < 0.05). The OASES overall raw score is 

negatively correlated with the CEFI-A-SR Emotional Regulation, Flexibility, and Initiation scores (all p 

< 0.05). The OASES overall impact score is negatively correlated with the CEFI-A-SR Attention, 

Emotional Regulation, Flexibility, Inhibitory Control, Initiation, Planning, and total score (all p < 0.05). 

 

 

 

 



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Table 3. Pearson Correlations for the Locus of Control, OASES, and CEFI Scale and Subscale 

Scores 

 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 

1. Locus 1                     

OASES                      

2. General 

Information 

Raw Score 

0.3

8** 

1                    

3. Gen Info 

Impact Score 

0.4

4** 

0.9

2** 

1                   

4. Reactions 

Raw Score 

0.5

1** 

0.7

6** 

0.7

3** 

1                  

5. Reactions 

Impact Score 

0.5

3** 

0.7

4** 

0.7

7** 

0.9

9** 

1                 

6. Comm raw 

Score 

0.5

3** 

0.6

3** 

0.5

8** 

0.7

3** 

0.7

1** 

1                

7. Comm Impact 

Score 

0.3

7** 

0.6

6** 

0.6

5** 

0.7

4** 

0.7

4** 

0.9

3** 

1               

8. QOL Raw 

Score 

0.4

7** 

0.6

5** 

0.6

4** 

0.8

5** 

0.8

4** 

0.7

5** 

0.7

9** 

1              

9. QOL Impact 

Score 

0.4

9** 

0.6

6** 

0.6

8** 

0.8

3** 

0.8

4** 

0.7

2** 

0.8

0** 

0.9

8** 

1             

10. Overall Raw 

Score 

0.4

6** 

0.8

2** 

0.7

8** 

0.9

5** 

0.9

3** 

0.8

7** 

0.8

8** 

0.9

2** 

0.9

1** 

1            

11. Overall 

Impact Score 

0.5

1** 

0.8

1** 

0.8

3** 

0.9

3** 

0.9

4** 

0.8

2** 

0.8

9** 

0.9

2** 

0.9

3** 

0.9

8** 

1           

CEFI                      

12. Attention -0.2

8** 

-0.2

0* 

-0.2

9** 

-0.0

9 

-0.1

4 

-0.0

3 

-0.1

7 

-0.1

1 

-0.1

6 

-0.1

2 

-0.2

0* 

1          

13. Emotional 

Regulation 

-0.5

2** 

-0.1

6 

-0.2

9** 

-0.3

0** 

-0.3

7** 

-0.1

3 

-0.2

3 

-0.2

6** 

-0.2

8** 

-0.2

2* 

-0.3

1** 

0.5

9** 

1         

14. Flexibility -0.3

4** 

-0.2

9** 

-0.3

7** 

-0.2

3* 

-0.2

9** 

-0.0

7 

-0.1

7 

-0.2

1* 

-0.2

5** 

-0.2

3* 

-0.2

9** 

0.6

4** 

0.5

6** 

1        

15. Inhibitory 

Control 

-0.4

0** 

-0.1

6 

-0.2

7** 

-0.1

4 

-0.2

2* 

-0.0

5 

-0.1

8 

-0.1

5 

-0.1

8 

-0.1

5 

-0.2

3* 

0.5

6** 

0.6

5** 

0.6

1** 

1       



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16. Initiation -0.3

3** 

-0.2

0 

-0.3

1** 

-0.1

8 

-0.2

3* 

-0.0

3 

-0.1

6 

-0.2

5** 

-0.2

9** 

-0.1

9* 

-0.2

7** 

0.6

8** 

0.5

6** 

0.6

7** 

0.5

4** 

1      

17. Organization -0.2

9** 

-0.1

3 

-0.2

6** 

-0.0

9 

-0.1

5 

0.0

5 

-0.0

9 

-0.1

2 

-0.1

7 

-0.1

0 

-0.1

8 

0.7

2** 

0.6

4** 

0.6

8** 

0.6

4** 

0.7

7** 

1     

18. Planning -0.3

6** 

-0.1

9* 

-0.3

0** 

-0.1

9 

-0.2

5* 

-0.0

6 

-0.1

4 

-0.1

5 

-0.1

8 

-01.

7 

-0.2

4* 

0.7

1** 

0.6

7** 

0.7

1** 

0.6

3** 

0.7

7** 

0.7

9** 

1    

19. 

Self-Monitoring 

-0.1

1 

-0.0

2 

-0.1

0 

0.0

0 

-0.0

5 

0.1

3 

0.0

8 

-0.0

3 

-0.0

3 

0.0

1 

-0.0

3 

0.4

7** 

0.4

1** 

0.6

5** 

0.4

8** 

0.6

5** 

0.6

5** 

0.7

2** 

1   

20. Working 

Memory 

-0.2

6** 

-0.1

4 

-0.2

5** 

-0.0

6 

-0.1

3 

0.0

1 

-0.1

1 

-0.1

0 

-0.1

5 

-0.1

0 

-0.1

8 

0.7

7** 

0.5

6** 

0.7

1** 

0.6

0** 

0.7

0** 

0.8

1** 

0.7

2** 

0.5

6** 

1  

21. Total -0.3

9** 

-0.2

0* 

-0.3

2** 

-0.1

7 

-0.2

4 

-0.0

2 

-0.1

6 

-0.1

9* 

-0.2

3* 

-0.1

7 

-0.2

6** 

0.8

3** 

0.7

7** 

0.8

4** 

0.7

7** 

0.8

5** 

0.9

0** 

0.9

0** 

0.7

5** 

0.8

7** 

1 

** p < 0.01; * p < 0.05 

 

4. Discussion 

As the need for additional research and avenues into other potential means of managing fluency 

disorders in adults is warranted, this research was designed to help persons who stutter, as well as 

clinicians and therapists working with persons who stutter. The demographic questions, LCB, OASES, 

CEFI-A-SR self-report in this survey provide insights into the background, experiences, and 

perceptions of adults who stutter. 

4.1 Demographic Differences 

Differences in scores were reported occurred based on region. Persons who stutter from the 

Southeastern and Western parts of the United States felt more organized, reported greater 

self-monitoring, and overall scored higher on their self-assessment of executive function via the 

CEFI-A-SR than others throughout the country and those who live outside United States. This may 

suggest the need for increased supports for individuals who stutter based on where they live, how much 

interaction they have with others, and regional and demographic parameters.  

CEFI-A-SR scores overall differed significantly by race, with Asians and African American participants 

reporting lower levels than Whites on several subscales (e.g., Flexibility, Organization). These results 

reflect the work of others who caution generalizing information about persons who stutter to other 

cultures (Shames, 1989) and encourage further research into stuttering treatment that considers 

multicultural identification (Finn & Cordes, 1997).  

Age was a significant factor in the reported scores of all scales. Overall, the younger the person who 

participated in our survey was, the less they felt that they had control over their stuttering behaviors, 

and the less emotional control and planning they felt they had. Younger participants also felt that 



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stuttering had a greater overall impact on their lives. Interestingly, studies of children who stutter have 

often reported little to no significant difference in the stuttering events of African American children 

and White children (Olsen et al. (1999). Similarly, when queried about their own confidence and social 

acceptance, young children who stutter reported no difference when compared to children who did not 

stutter (Hertsberg & Zebrowksi, 2016). Likewise, there were no significant difference in the classroom 

interactions of students who stutter and students who do not stutter (Adriaensens et al., 2017). All 

studies, including the present investigation, underline the importance of understanding the individual 

and unique nature of stuttering.  

4.2 Perceptions of Stuttering 

The present study supports the work of other investigations that report fluency disorders and/or the 

perception of fluency change over time for the person who stutters. Researchers have found that 

changes occur for individuals who stutter throughout the life span (Peters & Starkweather, 1989). In the 

present study, self-consciousness related to stuttering becomes more apparent with age. 

Self-consciousness also increased the longer a person had been identified or self-identified as a person 

who stutters. Specifically, participants in this study who stuttered as preschool and school age had 

higher OASES general information raw scores than those for whom it was determined had a fluency 

disorder as an adult. For persons working with individuals who stutter, the importance of knowing how 

long that person had been dealing with stuttering is important to consider, as time since onset or 

diagnosis may impact perceptions and outcomes in therapy.  

Participants who were seeking treatment had lower OASES general information raw and impact scores 

than those not seeking treatment. These findings support the work of other researchers who have 

identified the importance of support groups for persons who stutter (Bradberry, 1997; Krall, 2001; 

Ramig, 1993; Yaruss et al., 2002). The current study suggests support groups may help persons better 

internalize control over their stuttering and reduce the overall impact of stuttering in their lives. These 

results suggest participation in support groups should be encouraged for persons who stutter. 

4.3 Self-Monitoring 

The CEFI-A-SR Self-Monitoring subscale was the lone variable that demonstrated a positive 

correlation between LCB scores and the OASES general information impact score. As previously noted, 

the CEFI-A-SR Self-Monitoring subscale is defined as the ability to evaluate behaviors internally and 

make changes as needed to fix or amend mistakes. This suggests that participants in this study feel that 

when their self-monitoring is not effective, their feelings of internal control diminish, and their 

experiences about stuttering are also negatively affected. Introspection or self-monitoring has long been 

examined to support long-term therapeutic changes in persons who stutter (Goldiamond, 1965; James, 

1981; Lickley et al., 2005; Martin & Haroldson, 1982; Vasic & Wijnen, 2005). 

 



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The concept of self-monitoring is straightforward, with the impetus of the control following on the 

person who stutters. But therein may lay the challenge. If a person who stutters feels that their ability to 

self-monitor is determined by their ability to manage their fluency, anything other than a stutter-free 

event may create a negative feeling about their internal control abilities and that entire experience. This 

may be what occurred for the persons in this study. It could be that persons who usually feel they 

possess control of their situations internally and overall have a positive life experiences related to 

stuttering feel when a stutter event happens, their ineffective or poorer self-monitoring is to blame. 

Both traditional means of stuttering management (i.e., fluency-shaping and stuttering management 

techniques) incorporate the use of self-monitoring. Therapists and clinicians should understand the 

importance of self-monitoring and how it influences perceptions of t abilities and even reality for 

persons who stutter. For example, the work of Lickley et al. (2005) reported that persons who stutter 

are often hypervigilant about their speech and may even assume or identify dysfluencies even when 

they do not occur. If self-monitoring of speech in all persons is likely rooted in a person’s inner speech 

as suggested by Levelt (1983), persons who stutter may be underestimating their self-monitoring 

abilities their own internal control of fluency events that negatively impacts their stuttering experience.  

4.4 Conclusion 

Findings in this study provide insight into the behaviors, perceptions and cognitive functions of persons 

who stutter. Clinicians and therapists must be knowledgeable of effective ways to provide guidance and 

therapy to persons who stutter. The results strongly suggest there is the potential need for increased 

studies involving the influence and perceptions of self-monitoring in persons who stutter. As many 

individuals in this study have suggested, internal control of behavior and perceptions of their 

experiences with stuttering is not enough to override feelings of limited or ineffective self-monitoring 

in persons who stutter.  

4.5 Limitations 

Since the design of this research involved online data collection, it is possible that internal validity was 

influenced by instrumentation, selecting and administration. Posting the invitation to participate solely 

on the National Stuttering Association webpage limits the randomness of this sample. Instrumentation 

limits internal validity in that the survey was designed and validated by the researchers of this study via 

a pilot sampling of 10 individuals. Although all instructions were provided in a written format, the 

influence of a prior question response on a subsequent answer, especially if survey fatigue set in cannot 

be ruled out.  

As the survey was administered online, the potential for someone other than the NSA member to 

complete it was a present, albeit small danger. External validity threats are few as it can be presumed 

the persons who responded to the invitation to participate were a representative sample of the 

population of persons with fluency disorders. Thus, the findings of this research may be widely applied 



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to assist persons who stutter.  

The possibility that participating individuals were either highly motivated for or against the topic being 

questioned cannot be overlooked in this online format. Accordingly, the motivation for responding and 

participating may have some inherent outcome bias. The persons who stutter and chose to participate in 

this survey may not represent the feelings or comfort level of all persons who stutter.  

4.6 Future Directions 

To strengthen the validity of this study’s findings, future studies should include direct assessments (i.e., 

not self-reports) to determine whether self-monitoring skills is an EF difficulty consistently present in 

persons who stutter. Additionally, these direct assessments can help identify other EF challenges that 

persons who stutter may encounter and thus guide treatment, management, and behavior modification. 

These studies could then be compared to the self-reported EF results to determine whether persons who 

stutter accurately portray their actual EF abilities. As many studies focus on children who stutter, an 

increased focus on adults who stutter and persons who have are known to be lifelong stutters would 

provide insight into the changes in the perceptions, behaviors, abilities, and needs of persons who 

stutter. This data would also provide valuable insight into the needs of persons who stutter over time. 

 

Funding 

This research did not receive any specific grant from funding agencies in the public, commercial, or 

not-for-profit sectors. 

 

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Appendix 

Appendix A. Demographic Questions 

1) Which region of the world do you live in? 

2) What is your ethnicity? 

3) What is your age? 

4) What is your gender? 

5) At what age was it determined you had a fluency disorder (stutter?) 

6) Are you currently seeking treatment for your stuttering? 

7) Are you currently involved with a stuttering self-help group? 

8) Other than stuttering, were you ever diagnosed with any of the following: 

attention deficit hyperactivity disorder 

speech impairment 

language impairment 

9) Does anyone in your family have a stuttering disorder? 


