TTM measures for adults who stutter (Rodgers et al., 2025)

Purpose: The purpose of this study was to validate three interdependent scales of readiness to change among adults who stutter. The scales are based on the transtheoretical model (TTM) that we previously developed through qualitative work with adults who stutter and stuttering specialists regarding the characteristics of making a positive change to how they live with stuttering.

Method: The anonymous, online survey was fully completed by 246 North American adults who stutter. The survey included three TTM scales (Stage of Change, Decisional Balance, and Situational Self-Efficacy) and the Quality of Life subscale of the Overall Assessment of the Speaker’s Experience of Stuttering (OASES-IV). Exploratory factor analyses were conducted to determine model fit and reduce the TTM scales to the most meaningful items. External validity was assessed by examining relationships between constructs.

Results: The five stages of change readily applied to adults’ readiness to make positive changes to how they live with stuttering. The Decisional Balance scale was reduced to 20 items subcategorized into three subscales (Interpersonal Pros, Internal Pros, and Cons), which all differed significantly across stages of change. The Situational Self-Efficacy scale was reduced to 17 items subcategorized into two subscales (Interpersonal Situations and Internal Situations), of which the former differed significantly across stages of change. The OASES-IV differed significantly across stages of change.

Conclusions: The findings suggest that, for adults, the behaviors subsumed in making positive changes to stuttering fit the TTM framework, including the stages of change and the cognitive predictors of readiness to change (decisional balance and situational self-efficacy). The relationship among our measures (except for the cons of change) mirrors how these measures behave in adolescents who stutter and other health populations, further corroborating the application of the TTM to the stuttering experience. Future research confirming the validity of these measures across stages of change is warranted, as well as how these measures can inform stage-matched interventions for people who stutter.

Supplemental Material S1. Stuttering verification screener.

Rodgers, N. H., Gerlach-Houck, H., Paiva, A., & Robbins, M. (2025). Measuring adults’ readiness to make a positive change to stuttering and the cognitive processes that predict it. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2025_JSLHR-24-00787