{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:16:25Z","timestamp":1790162185691,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examined the test\u2013retest and inter\u2010rater reliability of non\u2010clinician severity judgments using two brief rating tools\u2014the 11\u2010point Severity Scale (SEV) and the Visual Analog Scale (VAS)\u2014and evaluated their concurrent validity with clinician\u2010rated Stuttering Severity Instrument\u20104\u2010Turkish version (SSI\u20104\u2010TR) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This observational cross\u2010sectional study used speech samples from 15 adults who stutter as stimulus materials. Recordings were evaluated by two speech\u2010language therapists (SLTs) and two independent groups of non\u2010clinician raters (\n                      <jats:italic>n<\/jats:italic>\n                      = 26 per group). SLTs assessed stuttering severity using the SSI\u20104\u2010TR. One non\u2010clinician group rated severity using a VAS, whereas the other used SEV. All ratings were completed online across three sessions. To examine temporal stability, 30% of the samples were re\u2010rated after a one\u2010week interval.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both tools demonstrated excellent test\u2013retest reliability, with intraclass correlation coefficients of 0.997 for the VAS and 0.987 for the SEV. Inter\u2010rater reliability was moderate, with ICC values of 0.656 for the VAS and 0.573 for the SEV. Both scales showed strong positive correlations with SSI\u20104\u2010TR scores, with correlation coefficients of 0.835 for the VAS and\u00a0.814 for the SEV (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings indicate that the VAS and SEV demonstrated high test\u2013retest reliability and moderate inter\u2010rater reliability and showed strong associations with SSI\u20104\u2010TR scores, supporting the use of brief perceptual rating scales as practical screening instruments in large\u2010scale and time\u2010limited clinical and research settings where rapid and resource\u2010efficient assessment is required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known on this subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Perceptual severity ratings are widely used to estimate stuttering severity in both clinical and research contexts. Likert\u2010type scales have demonstrated acceptable reliability when applied by trained listeners, whereas the Visual Analog Scale (VAS) has shown strong psychometric performance in several perceptual domains such as voice and resonance assessment. However, empirical evidence regarding the reliability and validity of a single\u2010item VAS for evaluating stuttering severity remains limited. In addition, it is not yet clear whether trained non\u2010clinician raters can apply brief perceptual severity scales consistently, particularly when ratings are compared with standardized clinical measures such as the SSI\u20104.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What this study adds to the existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This study provides novel psychometric evidence comparing an 11\u2010point Likert\u2010type severity scale (SEV) and a Visual Analog Scale (VAS) for rating stuttering severity using trained non\u2010clinician raters. Both tools demonstrated excellent test\u2013retest reliability, moderate inter\u2010rater reliability, and strong concurrent validity with clinician\u2010rated SSI\u20104\u2010TR scores. The findings extend previous research by demonstrating that brief perceptual severity ratings can produce stable and clinically meaningful estimates when administered by trained but non\u2010expert listeners. The study also contributes to the literature by directly comparing continuous and categorical response formats within the same experimental framework.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What are the clinical implications of this study?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The findings suggest that brief perceptual severity scales such as VAS and SEV may serve as practical adjunct tools for screening, monitoring change, and large\u2010scale data collection in clinical and research settings where time and resources are limited. Trained non\u2010clinician raters may provide consistent evaluations under controlled conditions, supporting their potential role in structured assessment contexts. However, perceptual ratings should not replace comprehensive clinical evaluation and may be most informative when used alongside standardized measures such as the SSI\u20104 or frequency\u2010based indices to obtain a more complete representation of stuttering severity.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1460-6984.70325","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:49:31Z","timestamp":1788191371000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability and Concurrent Validity of the Likert\u2010Type Stuttering Severity Scale and the Visual Analog Scale in Turkish\u2010Speaking Adults Who Stutter"],"prefix":"10.1111","volume":"61","author":[{"given":"Ay\u015fe","family":"\u0130layda Mutlu","sequence":"first","affiliation":[{"name":"Speech and Language Therapy Department Faculty of Health Sciences Ba\u015fkent University  Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lkem","family":"U\u00e7al","sequence":"additional","affiliation":[{"name":"Speech and Language Therapy Department, Faculty of Health Sciences Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University  Ankara Turkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Uygulamal\u0131 \u00e7ok de\u011fi\u015fkenli Istatistiksel y\u00f6ntemler","author":"Alpar R.","year":"2011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JFLUDIS.2015.05.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010014\u20100176\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JCOMDIS.2018.07.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1063\u20104584(03)00082\u20107"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_AJSLP\u201021\u201000107"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1044\/2014_LSHSS\u201013\u20100067"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1597\/15\u2010164"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2023.101224"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/2050571X.2020.1730545"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1044\/2017_AJSLP\u201016\u20100079;REQUESTEDJOURNAL:JOURNAL:AJSLP;PAGEGROUP:STRING:PUBLICATION"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0133758"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","unstructured":"De Vet H. 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