Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results.

Delangle, Mathieu; Moïse-Richard, Anne; Leclercq, Anne-Lise; Labbé, David; Bouchard, Stéphane; Andrews, Sheldon; Ménard, Lucie

doi:10.1016/j.jfludis.2026.106194

Article (Scientific journals)

Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results.

Delangle, Mathieu; Moïse-Richard, Anne; Leclercq, Anne-Lise et al.

2026 • In Journal of Fluency Disorders, 87, p. 106194

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/342107

DOI
10.1016/j.jfludis.2026.106194

PubMed
41579638

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Keywords :

Anxiety; Exposure; Stuttering; Virtual reality; Child; Adolescent; Self Efficacy; Avatar

Abstract :

[en] [en] PURPOSE: Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. METHOD: Twelve students who stutter (aged 9-18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. RESULTS: The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. CONCLUSION: This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect.

Disciplines :

Speech and language therapy

Author, co-author :

Delangle, Mathieu; Marie Enfant Rehabilitation Centre, Sainte-Justine Hospital, Montreal, Canada, Laboratory of Phonetics, University of Quebec in Montreal, Canada. Electronic address: mathieu.delangle@grenoble-inp.fr

Moïse-Richard, Anne; Marie Enfant Rehabilitation Centre, Sainte-Justine Hospital, Montreal, Canada, University of Montreal, Canada

Leclercq, Anne-Lise ; Université de Liège - ULiège > Département de Logopédie

Labbé, David; École de Technologie Supérieure, Montréal, Canada

Bouchard, Stéphane; Université du Québec en Outaouais, Canada

Andrews, Sheldon; École de Technologie Supérieure, Montréal, Canada

Ménard, Lucie; Marie Enfant Rehabilitation Centre, Sainte-Justine Hospital, Montreal, Canada, Laboratory of Phonetics, University of Quebec in Montreal, Canada

Language :

English

Title :

Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results.

Alternative titles :

[fr] Parler face à face avec un avatar virtuel pour réduire l'anxiété chez les élèves qui bégaient : développement d'un outil et résultats d'une étude pilote

Publication date :

March 2026

Journal title :

Journal of Fluency Disorders

ISSN :

0094-730X

eISSN :

1873-801X

Publisher :

Elsevier Inc., United States

Volume :

Pages :

106194

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0094730X26000021?httpAccept=text/xml

Funders :

FRQS - Fonds de Recherche du Québec - Santé

Funding text :

We sincerely thank all the participants and their families who took part in this study. We are also grateful to the speech-language pathologists who contributed to the project, as well as to the teams from the Centre de r\u00E9adaptation Marie Enfant of the CHU Sainte-Justine and the Centre de r\u00E9adaptation en d\u00E9ficience physique Raymond-Dewar (IRD) for their collaboration. We would also like to thank Kevin Chenier for his initial contribution to the development of the tool. This work was supported by the Fonds de recherche du Qu\u00E9bec (FRQ) through the AUDACE program (grant number 2022-AUDC-300126).

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