Stuttering Auditory Feedback Assessment Form
Please complete this assessment to help us understand your experience with auditory feedback and stuttering. All responses are confidential and no sensitive personal information is collected.
Age Group
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55+
Prefer not to say
How often do you notice changes in your speech fluency when using auditory feedback devices?
*
1
2
3
4
5
Which type of auditory feedback have you used?
*
Delayed Auditory Feedback (DAF)
Frequency-Altered Feedback (FAF)
Masked Auditory Feedback (MAF)
Other
Rate your overall comfort using auditory feedback during speech.
*
1
2
3
4
5
Which best describes your experience with auditory feedback?
*
Very helpful
Somewhat helpful
Neutral
Somewhat unhelpful
Not helpful at all
Please indicate the degree to which you agree with the following statements about auditory feedback and your speech.
*
Rows
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Auditory feedback improves my speech fluency.
1
2
3
4
5
Auditory feedback increases my confidence during speaking.
6
7
8
9
10
I find auditory feedback distracting.
11
12
13
14
15
I would recommend auditory feedback devices to others who stutter.
16
17
18
19
20
How likely are you to continue using auditory feedback tools in the future?
*
1
2
3
4
5
Have you experienced any side effects or challenges while using auditory feedback?
*
Yes
No
If yes, please describe any side effects or challenges (optional).
Additional comments or suggestions (optional)
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