Impact of virtual reality on stuttering and heart rate in virtual and real-life settings: A mixed methods study

Virtual reality (VR) is a promising adjunct to traditional therapies for people who stutter (Al Nafjin, 2021; Brock, 2023; Brundage, 2008; Cecil et al., 2024; Tentu et al., 2024). In spite of these results, we are uncertain of the impact of using VR to promote carryover of therapeutic gains into real world settings. Three research questions were explored for the purpose of this study. They are 1) Is there a statistically significant difference in the percentage of stuttered syllables between pre-test measures within a Virtual Reality simulation, post-test measures following take-home therapy within the Virtual Reality simulation, and the real-life parallel post-intervention? 2) Is there a statistically significant difference in anxiety, as measured by heart rate, between pre-test measures within a Virtual Reality simulation, post-test measures following take-home therapy within the Virtual Reality simulation, and the real-life parallel post-intervention? 3) What are participants’ feelings and experiences of stuttering in the Virtual Reality simulations and their real-life parallels? Percentage of stuttering decreased from pre-test measures in VR to post-test in VR and from pre-test in VR to real life settings, The percentage of stuttering decreased from pre-test to post-test measures in VR and from pre-test in VR to the real-life parallels. However, there was an increase in stuttering frequency between post-VR and real-life parallels. These differences did not reach statistical significance, but there was a statistically significant difference for heart rate between pre-test and real-life measures. Also, heart rate increased from pre-test to real-life. A qualitative thematic analysis was conducted on semi-structured interviews regarding the participants experience regarding VR, which were completed after the real-life parallel post-intervention, resulting in four major themes and ten sub-themes. Clinical and research implications show promising trends for VR as an adjunct to traditional stuttering therapy.