At-home VR speaking practice reduces stuttering and anxiety
How this was rated
Small pilot (n = 5), no comparison condition, no long-term follow-up. Design cannot rule out practice effects, regression to the mean, or expectation. Useful as evidence of feasibility and as a template for larger controlled trials.
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Five adolescents and young adults who stutter used commercial VR headsets at home for one week, completing progressively challenging speaking scenarios. Stuttering frequency dropped nearly in half and heart rate decreased significantly.
This small pilot suggests that a brief, graded at-home VR program is feasible for adolescents and young adults who stutter, with self-reported and physiological signals moving in a favorable direction over one week. Larger controlled studies are needed before treating this as evidence of effect.
Key findings
- Stuttering frequency decreased from 18.67% to 9.71% syllables stuttered (p < .001)
- Heart rate dropped from 101.47 to 94.07 bpm (p = .004)
- Daily surveys showed progressive improvements in self-reported anxiety
- At-home delivery using commercially available headsets proved feasible
Background
Most VR research with people who stutter has taken place in clinical or university settings with specialized equipment. This limits the practical reach of VR-based support. Kumar, Cecil, and Tetnowski explored whether commercially available VR headsets could be used at home to provide meaningful speaking practice, using a “digital twin” concept where virtual environments mirror real-world communication situations.
What the researchers did
Kumar, Cecil, and Tetnowski at Oklahoma State University (IRB-approved) provided five adolescents and young adults who stutter (4 males, 1 female, ages 12-30) with commercial VR headsets - Meta Quest 2 and Meta Quest 3 - to use at home. The VR applications were built in Unity 3D (engine 2022.3.15f1) with C# programming. Three progressively challenging simulations were developed and named: Rocket Assembly (Easy), Bob’s Burger Palace (Medium), and Industrial Factory (Hard). Participants completed five 15-20 minute sessions per week. Heart rate was recorded via an Empatica E4 wristband, and GoPro cameras provided environmental context recording. Participants completed daily self-report surveys about their anxiety levels.
What they found
Stuttering frequency dropped substantially, from an average of 18.67% syllables stuttered at baseline to 9.71% by the end of the week - a statistically significant reduction. Heart rate also decreased significantly, from 101.47 bpm to 94.07 bpm, suggesting reduced physiological arousal during speaking. Daily survey responses showed a steady trend of decreasing self-reported anxiety across the week. All participants were able to set up and use the equipment independently at home without technical difficulties.
Why this matters
This study offers early evidence that VR-based speaking practice does not need to be confined to clinical environments or require expensive specialized hardware. The at-home, self-directed model could significantly expand access, particularly for people who stutter in areas with limited specialist services. The progressive difficulty structure aligns with well-established principles of graded exposure, and the combination of objective measures (stuttering frequency, heart rate) with subjective reports strengthens the findings.
Limitations
The sample of five participants is very small, and the study lasted only one week with no long-term follow-up. There was no control group, so improvements could reflect practice effects, familiarity, or natural variability rather than the VR intervention specifically. The generalizability to different age groups and stuttering severities remains uncertain.
Implications for practice
Commercially available VR headsets may support at-home stuttering practice through graded speaking scenarios. The progressive difficulty model offers a practical template for hierarchical exposure.
Implications for research
A randomized design with a comparison condition would help separate practice effects from the VR-specific contribution. Longer-term follow-up, diverse samples, and standardized protocols for the graded scenarios would all strengthen the evidence base.
Where this connects to Therapy withVR
The study above is independent research and does not endorse any product. The notes below are commentary from withVR on how the themes in this research relate to features of Therapy withVR. The research findings are not claims about Therapy withVR.
Customizable Avatars
This study envisioned personalized virtual representations - Therapy withVR's avatar system with cultural customization and multiple placement options moves toward the individualized practice this research proposes.
AI Features
AI-generated conversation, emotional speech, and real-time translation align with this study's vision of intelligent, responsive virtual interaction partners.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{kumar2024,
author = {Kumar, T. S. and Cecil, J. and Tetnowski, J. A.},
title = {The Potential of virtual reality Digital Twins to serve as therapy approaches for stuttering},
journal = {IEEE 12th International Conference on Serious Games and Applications for Health (SeGAH)},
year = {2024},
doi = {10.1109/SeGAH61285.2024.10639574},
url = {https://withvr.app/evidence/studies/kumar-2024}
}TY - JOUR
AU - Kumar, T. S.
AU - Cecil, J.
AU - Tetnowski, J. A.
TI - The Potential of virtual reality Digital Twins to serve as therapy approaches for stuttering
JO - IEEE 12th International Conference on Serious Games and Applications for Health (SeGAH)
PY - 2024
DO - 10.1109/SeGAH61285.2024.10639574
UR - https://withvr.app/evidence/studies/kumar-2024
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published paper.