In the United States, the Individuals with Disabilities Act (IDEA) requires that school-age children with disabilities receive individualized special education services to engage in free appropriate public education. Despite this mandate, there are inequities related to speech therapy services for children living in remote/rural areas due to a shortage of speech-language pathologists (SLPs) in all regions of the United States (ASHA, n.d.). In addition, for children who stutter , there are relatively few SLPs who report feeling comfortable evaluating and treating stuttering (e.g., Coalson et al., 2016; Crichton- Smith et al., 2003). Telepractice may be one solution for connecting children who stutter who live in rural areas with SLPs who specialize in stuttering in order to provide equitable and evidence-based evaluation and treatment services as outlined by the IDEA. 

Telepractice Group Therapy for Stuttering
Using the WHO-ICF framework, group therapy for school-age children who stutter provides a functional approach to targeting the activities and participation domains. Group treatment settings have been noted to provide clients who present with communication disorders an opportunity to express their feelings, attitudes, and emotions about their speech production in a socially relevant manner (e.g., Caughter & Dunsmuir, 2017). Group treatment may also provide the opportunity for clients who stutter to: increase their participation in group communication settings, increase their self-confidence as a communicator, become desensitized to stuttering, and practice generalization of learned therapeutic strategies (e.g., self-disclosure, voluntary stuttering, stuttering modification, and/or unapologetic, open stuttering). Shoster et al. (2011) reported that people who stutter who were enrolled in group therapy for stuttering demonstrated a reduction in speaking-related anxiety. Additionally, research about the effectiveness of stuttering support groups lends support to the notion that communication situations intentionally involving other people who stutter can be helpful in reducing internalized stigma and can lead to increased levels of psychological well-being (e.g., Boyle, 2013; Yaruss et al., 2002). Given that stuttering is a low-incidence population (approximately 1%), connecting clients via telepractice in group settings is one possible way to extend these benefits to individuals who may not live in the same geographic location. 

Purpose 
The purpose of this poster presentation is to describe a telepractice group therapy program for adolescents who stutter using a comprehensive stuttering treatment protocol which addresses all components of the WHO-ICF model and fulfills IDEA guidelines. 

Method

Participants
Participants were three female adolescents who stutter (ages 12-13), who were enrolled in group telepractice treatment for stuttering for one academic year. At the onset and conclusion of group telepractice therapy, participants were evaluated using the Stuttering Severity Instrument-Fourth Edition (SSI-4; Riley, 2009) to analyze their overt stuttering frequency, duration, and secondary behaviors/physical concomitants during a conversational sample and a reading sample. In addition to this static assessment of the participants’ overt speech production, their attitudes, perceptions, and experiences related to stuttering were evaluated using the Overall Assessment of the Speaker’s Experience of Stuttering- School-Age Version (OASES-S; Yaruss & Quesal, 2006). 

Procedures
Group telepractice sessions were conducted 1x per week for 50-minutes via Zoom. Treatment included individualized activities designed to partner with the participants to achieve their treatment plan goals. Some of the benefits of providing treatment for stuttering in a group environment for adolescents are the embedded nature of aspects of the WHO-ICF framework, including desensitization to stuttering through hearing and reacting to other participants’ stuttering, inherent socialization and participation with other children who stutter who are of a similar age/grade-level, exploration of attitudes, emotions, and feelings about stuttering in a supportive, understanding environment, and practice utilizing stuttering modification strategies in generalizable contexts which mirror classroom and group work settings. 

Results
When analyzed together, the participants demonstrated variability in overt stuttering frequency, duration, and associated physical concomitants throughout the group telepractice treatment; however, all three participants exhibited a reduction in their covert stuttering and reported a decreased impact of stuttering on their lives. This clinical evidence supports the idea that group telepractice stuttering therapy can have a positive impact on participants' lives even if their overt stuttering behaviors are not significantly reduced throughout treatment.
Participants were also asked to respond to the question: “What did you learn about yourself and your communication this year?” All participants responded to the question with descriptions of increased confidence and comfort with their stuttering. For example, Participant 1 reported: 
“I feel very comfortable in my stutter now. I'm happy I'm me and not somebody else…I mean a stutter just makes me unique and like different. Sometimes it does get in the way, but I know that I will overcome it someday, and like be able to like, not stop it completely, but like to like overcome the fear of like being embarrassed or something, and be able to like know that it'll all be okay and stuff.”
Taken together, the participants’ documented clinical progress towards their communication goals, their responses to the OASES-S, and their qualitative comments indicate that group therapy via telepractice with adolescents who stutter can successfully target all aspects of the WHO-ICF framework while also meeting the individual participants’ communication needs/goals. 

Discussion and Conclusions
Telepractice offers clients who stutter the opportunity to connect with speech-language pathologists with specialty training and experience. Additionally, telepractice allows clients who stutter to connect with one another in group therapy sessions even if they are not located in the same geographic area. For example, a speech-language pathologist who splits their time between multiple school buildings may consider using telepractice as a means to connect clients who stutter and provide an opportunity for peer-to-peer connection which may not be possible with in-person treatment services. Treatment goals for adolescent children who stutter should be engaging, motivating, comprehensive in nature and focus on all components of the WHO-ICF framework. 

References:
American Speech-Language and Hearing Association (ASHA). Challenges to Successful Recruitment and Retention of School-Based SLPs. Accessed on May 17, 2021 from https://www.asha.org/careers/recruitment/schools/
Boyle, M. P. (2013). Psychological characteristics and perceptions of stuttering of adults who stutter with and without support group experience. Journal of Fluency Disorders, 38, 368–381.
Coalson, G., Byrd, C. & Rives, E. (2016). Academic, Clinical, and Educational Experiences of Self-Identified Fluency Specialists. Perspectives of the ASHA Special Interest Groups, 1, 16-43. 
Crichton-Smith, I., Wright, J., and Stackhouse, J. (2003). Attitudes of speech and language therapists towards stammering: 1985 to 2000. International Journal of Language and Communication Disorders, 38, 213–234.
Caughter, S. & Dunsmuir, S. (2017). An Exploration of the Mechanisms of Change Following an Integrated Group Intervention for Stuttering, as Perceived by School-Aged Children who Stutter. Journal of Fluency Disorders, 51, 8-23. 
Riley, G. D. (2009). Stuttering Severity Instrument–Fourth Edition (SSI-4) (3rd ed.). Austin, TX: Pro-Ed.
Shoster, D. & Davidovikj, N. & Filipova, S. & Lozanovska, B. (2011). The Importance of Group Therapy Used in the Treatment of Stuttering. Journal of Special Education and Rehabilitation, 12, 77-89. 
Yaruss, J. S., Quesal, R. W., Reeves, L., Molt, L. F., Kluetz, B., Caruso, A. J., . . . Lewis, F. (2002). Speech treatment and support group experiences of people who participate in the National Stuttering Association. Journal of Fluency Disorders, 27, 115–134.
Yaruss, J. S. & Quesal, R.W. (2006). Overall Assessment of the Speaker's Experience of Stuttering (OASES): Documenting multiple outcomes in stuttering treatment. Journal of Fluency Disorders, 31(2), 90–115.

Telepractice Group Therapy for Stuttering with Adolescents

Spatial reasoning is an inherent aspectof everyday life. For example, spatial reasoning supports young children playing with blocks, older children learning about positioning on a sports field,and adults navigatingwhere they need to go. Spatial reasoning is also a critical aspect of STEM (science, technology, engineering,mathematics,e.g., Wai, Lubinski, & Benbow, 2009). For example, chemists imagine molecules rotating to compare structure, and physicistsreason aboutthe influence of invisible forces on magnetic fields. As can be observed in the examples above, there are a wide range of spatial tasks. Spatial reasoning in real-world contexts can be complex and multifaceted(Atit et al., 2020). How individuals engage in spatial reasoning is highly context-specific, influenced by task demands, novelty of task, and prior knowledge (Uttal & Cohen, 2012). Unfortunately, most of what we know about spatial reasoning is driven by psychological research using psychometric tasks designed to isolate specific spatial skills,independent of context (for review see Atitet al.,2020). Without examining variability across contexts, models of spatial reasoning are incomplete and limited in scope (Resnick & Stieff, in press). In this symposium, we willexplore different contexts in which spatial reasoning is learned. In doing so, we will raise theoretical questions around universal aspects of spatial cognition as well as practical considerations, such as how and when spatial learning should be included in education. This work is important because spatial reasoning can be learned and improved (Uttal et al., 2013), and improvements in spatial reasoning causally support improvements in STEM (e.g., Hawes et al., 2022; Sorby, 2009).Although all four talks center on the role of context in spatial learning, the presenters are drawn from different disciplines, methodologies, and perspectives.Mary Hegartywillbegin by characterizingthe disconnect between psychological research in spatial reasoning and the spatial reasoning involved in complex STEM tasks. The next three talks unpack specific everyday STEM contexts where spatial reasoningis learned. Ilyse Resnick will present work in the learning sciences on shared book reading. David Uttal, a cognitive and developmental psychologist, will present on geographic information systems. Tom Lowrie, a mathematics education researcher, will present on the importance of embedded authentic tasks in spatial and STEM learning.

Spatial Reasoning: The Role of Context in Learning

Rule Learning is Like Analogical Learning

During class, taking notes helps the encoding process, especially when students reformulate what is presented. After class, notes can be used for revision. Previous studies, mostly conducted in laboratory contexts, showed that note-taking on paper seems to be more efficient than on computer, probably because students are more likely to reformulate on paper. The originality of this study is to investigate students’ perceptions and strategies depending on their note-taking method during but also after class. Data of 108 students showed that students on paper (30%) declare making more reformulations and less multitasking that students on computer (70%). After class, review sheets are written for a large majority of the students on paper, whatever the method they used during class. These results suggest that even if computer is the most used method during class, paper is still used after class, and with paper are associated better strategies.

Note-taking during and after class: which strategies for which method?

Sampling assumptions --- the assumptions people make about how an example of a category or concept has been chosen --- help us learn from examples efficiently. One context where sampling assumptions are particularly important is in social contexts, where a learner needs to infer the knowledge and intentions of the information provider and vice-versa. The pedagogical sampling assumptions model describes a Bayesian account of how learners and providers should behave given different assumptions they have about the other (e.g., is the provider trying to deceive or help me? Does the learner trust me?). In this study, we tested how well this model could describe learning behaviour in the rectangle game, where a fictional information provider revealed clues about the structure of a rectangle that the learner (a participant) needed to guess. Participants received clues from either a helpful information provider, a provider who was randomly sampling clues, or one of two kinds of unhelpful providers (who could mislead but could not lie). We found that people learned efficiently and in line with model predictions when the provider was helpful and that this was the case even when no cover story was provided. However, although participants could identify that unhelpful providers were not being helpful, they struggled to learn the strategy those providers were using.


Inferring the truth from deception: What can people learn from helpful and unhelpful information providers?

Consensus-based social learning strategies often outcompete other strategies in evolutionary models. But while formal proofs suggest that consensus’ reliability is compromised when individual judgments are not independent, this makes for a notoriously implausible assumption in the biological world: the people we learn from are constantly learning from each other as well. How do we avoid being misled by consensus? We present two experiments and a computational model examining commonsense reasoning about how people’s public and private judgments are influenced by the consensus and social status of those around them. Results suggest that while people realize that these two factors can cause others’ public and private judgments to diverge, their own trust in public consensus depends on how accurately they believe it reflects their informants’ true beliefs.


Agenda setting and The Emperor’s New Clothes: people infer that letting powerful agents make their opinion known early can trigger information cascades and pluralistic ignorance

Intelligent tutoring systems (ITS) afford complex learning environments in which inductive reasoning is engaged, but where sparse log data complicates the classification of cognitive states. Using a simple rule learning task, we explore the feasibility of verbal think aloud protocols to contribute to machine learning algorithms designed to classify states of rule search, rule discovery, and rule following. Domain-general versus domain-specific contributions to classification are considered through the use of isomorphic rule learning tasks with numeric and spatial stimuli. We trained and tested models both within and across task domains. Models including verbal data outperform models based only on log data with particular improvement in classifying rule discovery. These results provide a foundation for real-time classification of cognitive states during ITS use.

Classification of Rule Learning Phases in Inductive Reasoning

Efforts to correct misconceptions have produces multiple types of complex interventions. However, past research has consistently shown that simple, factual statements may be equally effective in activating the incorrect information and prompting an integration of the correct concept. The current study tests the effectiveness of simple statements on 76 different misconceptions. Findings indicate that for the majority of misconceptions, simple statements are an effective intervention to reduce misconceptions. Limitations and future directions are discussed.


Just Tell the Truth: Correcting Misconceptions with Simple, Factual Statements

Psycholinguistic analyses provide a means of evaluating large language model (LLM) output and making systematic comparisons to human-generated text. These methods can be used to characterize the psycholinguistic properties of LLM output and illustrate areas where LLMs fall short in comparison to human-generated text. In this work, we apply psycholinguistic methods to evaluate the psycholinguistic properties within sentences from student-generated long-form analogies about biochemical concepts. We compare analogies generated by human subjects enrolled in introductory biochemistry courses to analogies generated by chatGPT. We use 78 features extracted from Coh-metrix that analyze text cohesion, language, and readability (Graesser, McNamara, Louwerse, & Cai, 2004). We perform an unsupervised cluster analysis. Results illustrate a high level of performance for clustering student-generated and chatGPT-generated analogies. To evaluate which features contribute most to model performance, we use a hierarchical cluster analysis. Results from the hierarchical cluster analysis illustrate several linguistic differences between the two groups.


Long-form analogies generated by chatGPT lack human-like psycholinguistic properties

Previous work has demonstrated that relational preference in the Relational Match-to-Sample task can be improved compared to baseline by providing people with the opportunity to consider the target item in isolation prior to receiving the full triad. However, it remains unclear whether the benefits of these supports persist in their absence, or can be observed when a prior strategy has already been established to complete the task. To this end, we conducted two experiments using 2 (presentation-type) by 2 (order) mixed designs to examine the efficacy of two previously established task supports: isolated-focus and description. The aims of this work were to gain further insight into the utility of these supports as a means of promoting relational preference both when the supports are present and when they are absent. We discuss the implications for pedagogical practices and extensions of this work to other materials and tasks.


Sustaining Relational Preference in a Repeated Relational Match-to-Sample Task in the Absence of Task Support

Infants are born into rich social networks and are faced with the challenge of learning about them. Previous research shows that infants learn about the individuals in observed social interactions, but it is not clear whether they infer their individual dispositions or their relationships to one another. The current studies address this question in 12-month-old infants and 16- to 18-month-old toddlers who observe social interactions involving imitation. In Studies 1 and 3, infants and toddlers expected that imitators, compared to non-imitators, would respond to their social partners’ distress. Likewise, they expected the targets of imitation, compared to non-targets, to respond to their partner’s distress. In Study 2, these expectations did not generalize to interactions with a new partner, providing evidence for learning about the original individuals’ relationship. In Study 3, infants’ expectations did not generalize to responses to laughter, suggesting a focus on established social relationships. Together, these results provide evidence that infants and toddlers learn about the social relationships of unknown individuals by observing interactions involving imitation.


Infants Infer Social Relationships between Individuals who Engage in Imitative Social Interactions

Commutativity–the fact that changing the order of operands in an operation does not change the results–is a fundamental principle of mathematics. How does its understanding develop in children? While this question has mostly been addressed for addition, here we focus on multiplication. We ask whether children’s formal learning of multiplication commutativity relies on pre-existing non-symbolic intuitions, or whether it is first learnt symbolically and only later elaborated as a general principle that extends to concrete situations. 2nd and 3rd graders received an intervention on commutative multiplication, before and after which they played a number comparison game testing their understanding of commutativity in symbolic and non-symbolic contexts. Our results suggest that the commutative principle of multiplication may not be available to intuition before formal teaching: perceiving that 2 groups of 3 dots and 3 groups of 2 dots contain the same number of dots requires mastering commutativity symbolically first.

Underline digital video library

Telepractice Group Therapy for Stuttering with Adolescents

Spatial Reasoning: The Role of Context in Learning

Rule Learning is Like Analogical Learning

Note-taking during and after class: which strategies for which method?

Inferring the truth from deception: What can people learn from helpful and unhelpful information providers?

Agenda setting and The Emperor’s New Clothes: people infer that letting powerful agents make their opinion known early can trigger information cascades and pluralistic ignorance

Classification of Rule Learning Phases in Inductive Reasoning

Just Tell the Truth: Correcting Misconceptions with Simple, Factual Statements

Long-form analogies generated by chatGPT lack human-like psycholinguistic properties

Sustaining Relational Preference in a Repeated Relational Match-to-Sample Task in the Absence of Task Support

Infants Infer Social Relationships between Individuals who Engage in Imitative Social Interactions

Do school-age children learn that 2 x 3 = 3 x 2 relying on previous intuitions?

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