Journal of Fluency Disorders 35 (2010) 159–160

Editorial

The association between quality of life and stuttering

It is with great satisfaction that I am able to introduce this special edition concerning the quality of life (QOL) ofpeople who stutter. In my opinion it is vital that researchers and clinicians working with Fluency Disorders begin tothink about how satisfied and content people who stutter are with their lives. It is known that disorders as varied aschronic pain, cancer, diabetes and traumatic spinal cord injury impose a very significant burden on QOL (Middleton,Tran & Craig, 2007). While few may question the burden imposed by cancer or traumatic spinal cord injury, surely it isimportant for successful long-term management issues that the QOL burden on people who stutter is better understoodand known.

Like many areas in health, there is no clear consensus over a working definition of quality of life (Cummins,2010). For instance, QOL should not be confused with measures such as “standard of living”, which is an assessmentbased largely on income. Early life quality work in health focused more on epidemiological factors such as morbidity,mortality and health services. However, contemporary methodologies have widened the QOL construct to include thestudy of the dynamics of the wellbeing of people and communities, including social, cultural, psychological and physicalaspects. Another recent development has been a shift to a person’s subjective opinions about and perceptions of theirown satisfaction with their health and life. QOL research, especially health related QOL, has become a construct thatattempts to assesses the wellbeing of a person from a multidimensional perspective, including physical, psychological,social, and vocational aspects.

Professor Cummins (2010) began his paper in this Special QOL Edition with the fundamental question: “Do peoplewith verbal fluency disorders experience lower life quality because of their condition? It would seem to an observerthat this must be so. The condition clearly creates difficulties in communication and therefore must be a burden.”Recent research findings suggest stuttering carries a significant burden. It is a chronic condition (Namasivayam &van Lieshout, 2008) that has been shown to have a substantial negative impact on quality of life (Craig, Blumgart,& Tran, 2009). People who stutter have increased risks of elevated fatigue, diminished social functioning, and morelabile emotional and mental health (Craig et al., 2009). Stuttering can also create unwanted barriers in the workplace(Klein & Hood, 2004), and research has now also confirmed that at very least sub-clinical levels of social anxiety areassociated with many adolescents and adults who stutter (Iverach, O’Brien, et al., 2009; Mulcahy, Hennessey, Beilby,& Byrnes, 2008). The risk of regression following successful treatment for stuttering is significantly increased forpeople who stutter who also have a psychological co-morbidity (Iverach, Jones, et al., 2009). Clearly, stuttering maybe more toxic than previously thought, and so it is important that studies are conducted that evaluate the impact it mayhave on life satisfaction.

This Journal of Fluency Disorders special edition presents an opportunity to introduce the QOL area to cliniciansand researchers in the field of fluency and communication disorders. It would have been desirable had the special editioninclude a larger range of papers than four. Perhaps this reflects the infancy of QOL research in the field of fluencydisorders. Nevertheless, the four papers in the Edition make a great contribution to the subject. The first paper waswritten by Dr Robert Cummins of the School of Psychology in Deakin University, Australia. Professor Cummins is aprominent international researcher in the area of life satisfaction and wellbeing research. He is also the Editor-in-Chiefof the Journal of Happiness. He presents an important introduction to the area of QOL, and he also raises methodologicalquestions that will challenge how QOL research is conducted within our field. He concludes by questioning an assumedlink between stuttering and lowered QOL when a subjective measure is used as an indicator variable. The second paper

0094-730X/$ – see front matter © 2010 Elsevier Inc. All rights reserved.doi:10.1016/j.jfludis.2010.08.002

160 Editorial / Journal of Fluency Disorders 35 (2010) 159–160

was written by researchers Dr Madeline Cruice (City University, London), and Drs Linda Worrall and Louise Hicksonfrom the School of Rehabilitation and Health Sciences (University of Queensland, Australia). These authors havestudied the negative impact associated with aphasia, and provide important insights into how to conduct QOL researchin the fluency area. This paper will prove to be highly useful for researchers intending to investigate QOL in peoplewho stutter.

The third paper was written by Dr Scott Yaruss (University of Pittsburgh, USA). His paper further explores theusefulness of sections of the OASES as a QOL measure. He concludes that people who stutter do report an adverseimpact on their quality of life as a result of stuttering and that QOL can be improved as a result of treatment forstuttering. The fourth study conducted by myself and colleagues, reports on the personal financial cost associatedwith stuttering and also reports factors that influence personal spending. Surprisingly, spending was not influenced bythe severity of the individual’s stuttering. I trust readers of the Journal of Fluency Disorders find these four papersinteresting, and I also hope that these papers encourage future QOL research in the fluency area.

References

Craig, A., Blumgart, E., & Tran, Y. (2009). The impact of stuttering on the quality of life in adult people who stutter. Journal of Fluency Disorders,34, 61–71.

Cummins, R. A. (2010). Fluency disorders and life quality: Subjective wellbeing vs. health related quality of life. Journal of Fluency Disorders, 34,161–172.

Iverach, L., Jones, M., O’Brien, S., Block, S., Lincoln, M., Harrison, E., et al. (2009). The relationship between mental health disorders and treatmentoutcomes among adults who stutter. Journal of Fluency Disorders, 34, 29–43.

Iverach, L., O’Brien, S., Jones, M., Block, S., Lincoln, M., Harrison, E., et al. (2009). Prevalence of anxiety disorders among adults seeking speechtherapy for stuttering. Journal of Anxiety Disorders, 23, 928–934.

Klein, J. F., & Hood, S. B. (2004). The impact of stuttering on employment opportunities and job performance. Journal of Fluency Disorders, 29,255–273.

Middleton, J., Tran, Y., & Craig, A. (2007). Relationship between quality of life and self-efficacy in persons with spinal cord injuries. ArchivesPhysical Medicine and Rehabilitation, 88, 1643–1648.

Mulcahy, K., Hennessey, N., Beilby, J., & Byrnes, M. (2008). Social anxiety and the severity and typography of stuttering in adolescents. Journalof Fluency Disorders, 33, 306–319.

Namasivayam, A. K., & van Lieshout, P. (2008). Investigating speech motor practice and learning in people who stutter. Journal of Fluency Disorders,33, 32–51.

Ashley Craig ∗Professor Rehabilitation Studies Unit, Northern Clinical School,

Sydney Medical School, The University of Sydney,PO Box 6, Ryde, NSW 1680, Australia

∗ Tel.: +61 2 9808 9236.E-mail address: a.craig@sydney.edu.au