More than meets the eye: Self-rated covert stuttering is linked to reduced psychosocial and communicative outcomes

Purpose: The purpose of this study was to investigate whether self-rated covert stuttering (i.e., the extent of being able to keep stuttering hidden from others) was associated with anxiety, quality of life, social role satisfaction, speech usage, and salience of stuttering among adults who stutter. Methods: A sample of 316 adults who stutter was asked about the extent to which they believed they were successful in concealing their stuttering so that others did not know that they stuttered. The sample was divided into two groups, one comprised of people who believed they were more often than not overtly stuttering, and those who believed they were more covert. Groups were compared on variables of anxiety, quality of life, social role satisfaction, speech usage, and salience of stuttering, taking into account demographic and speech-related variables. Results: There were significant correlations between level of self-rated covertness and all dependent variables. The group that reported being more covert reported significantly higher levels of stuttering salience, and significantly lower levels of quality of life, social role satisfaction, and speech usage compared to the less covert group, after taking into account demographic variables. Conclusion: Focusing on stuttering visibility in therapy or research, without taking covert stuttering into account, may not optimize outcomes important psychosocial and communicative factors important to people who stutter. Taking into account the extent to which a person who stutters tries to hide their stuttering in assessment and treatment may help improve psychosocial and communicative outcomes, regardless of their physical speech disruption severity.