Stuttering Treatment Priorities and Clinical Challenges Across the Lifespan in Iran: A Mixed-Methods Study of Speech-Language Pathologists

PURPOSE: This study provided an initial exploration of Iranian speech-language pathologists' (SLPs') treatment priorities, reported intervention approaches, and perceived clinical challenges for stuttering across the lifespan. METHOD: Seventy-four Iranian SLPs completed a Farsi online survey ranking three treatment aspects aligned with the World Health Organization's International Classification of Functioning, Disability and Health-overt stuttering behaviors, reactions to stuttering, and communication participation-across preschool, school-age/adolescent, and adult clients. They also rated intervention use frequency and described clinical challenges. Quantitative data were analyzed using nonparametric tests, qualitative responses were analyzed using reflexive thematic analysis, and exploratory mixed-methods integration linked clinician priority profiles to qualitative themes. RESULTS: Across all three age groups, clinicians ranked overt behaviors highest, reactions intermediate, and communication participation lowest. This hierarchy did not shift meaningfully across age groups and was not associated with education or clinical experience. Qualitative themes highlighted pressure for fluency, relapse, acceptance, generalization difficulties, emotional burden, and clinician uncertainty. Exploratory participant-level integration showed that clinicians with stronger fluency-anchored profiles appeared less likely to describe challenges related to relapse, generalization, and pressure for fluency. CONCLUSIONS: In this initial sample, clinicians' self-reported priorities remained strongly oriented toward overt speech behaviors despite contemporary multidimensional models of stuttering. Findings should be regarded as exploratory and as a basis for larger replication studies. Findings highlight the need for training and service models that more explicitly integrate participation, counseling-informed support, and stigma-responsive care across the lifespan.