Narrative review of 5 VR-stuttering studies - VR matches live-audience conditions and repeated sessions reduce anxiety
How this was rated
Narrative or commentary paper; not primary experimental data.
Ratings use a simplified four-tier scheme (High, Moderate, Low, Very Low) informed by the GRADE working group. Learn more about how studies are rated.
The first VR-stuttering paper in Croatian academic literature. This narrative review synthesized five empirical studies examining VR with adults who stutter. Consistent evidence showed that VR environments produce communication experiences comparable to real-world settings and that repeated VR speaking sessions reduce anxiety. Authors are affiliated with DV Latica Zadar and the University of Zagreb Faculty of Education and Rehabilitation Sciences.
A commentary or narrative paper discussing VR and stuttering; not primary experimental evidence.
Key findings
- Stuttering frequency, communication apprehension, and confidence in VR correlate strongly with live-audience conditions
- Challenging virtual scenarios produce more stuttering than supportive ones
- Repeated VR sessions were associated with reduced anxiety and decreased physiological arousal
- VR occupies a practical middle ground between imagination-based and in-vivo exposure
Background
Virtual reality has been explored as a tool for supporting people who stutter for over a decade, but the evidence has remained scattered across individual studies. Marusic and Leko Krhen set out to bring these findings together in a narrative review, asking two questions: does VR produce communication experiences comparable to real life, and can repeated VR sessions lead to meaningful change?
What the researchers did
The authors identified and synthesized five empirical studies that used VR with adults who stutter. They examined the reported outcomes across three domains: ecological validity (does VR feel like real speaking?), behavioral response (does stuttering in VR match stuttering in real situations?), and change over time (do repeated sessions produce improvements?). The review also situated VR within the broader landscape of exposure-based approaches.
What they found
Across the reviewed studies, the evidence consistently showed that VR environments produce communication experiences closely resembling real-world conditions. Stuttering frequency, communication apprehension, and speaker confidence in VR all correlated strongly with live-audience measures. Importantly, VR scenarios could be manipulated to increase or decrease difficulty - challenging audiences produced more stuttering than supportive ones, mirroring what happens in everyday life. Studies that involved repeated VR sessions reported reductions in anxiety and physiological arousal over time. The authors positioned VR as occupying a useful middle ground between imagination-based approaches (which lack realism) and in-vivo exposure (which lacks control).
Why this matters
For clinicians considering VR, this review confirms that the technology produces genuine communicative responses rather than artificial ones. The ability to manipulate specific environmental variables - audience size, behavior, setting - means clinicians can construct individualized speaking hierarchies tailored to each person’s needs. This level of control is difficult to achieve with real-world practice alone.
Limitations
Only five studies were included, all involving adults. The review did not follow a systematic methodology, so relevant studies may have been missed. Most included studies used small samples and short-term designs, leaving questions about long-term outcomes unanswered.
Implications for practice
Clinicians can manipulate audience behavior, room size, and social pressure to build individualized hierarchies. VR should complement - not replace - direct clinician-led support.
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.
12 Speaking Environments
This review discussed VR's potential for stuttering support across everyday situations - Therapy withVR provides these environments ready to use, from cafes and classrooms to meeting rooms and auditoriums.
Real-Time Clinician Control
The clinician-controlled VR approach this review recommends is exactly how Therapy withVR works - professionals shape the virtual experience in real time from their laptop.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{marusic2022,
author = {Marusic, P. and Leko Krhen, A.},
title = {Virtual reality as a therapy for stuttering},
journal = {Hrvatska revija za rehabilitacijska istrazivanja},
year = {2022},
doi = {10.31299/hrri.58.1.6},
url = {https://withvr.app/evidence/studies/marusic-2022}
}TY - JOUR
AU - Marusic, P.
AU - Leko Krhen, A.
TI - Virtual reality as a therapy for stuttering
JO - Hrvatska revija za rehabilitacijska istrazivanja
PY - 2022
DO - 10.31299/hrri.58.1.6
UR - https://withvr.app/evidence/studies/marusic-2022
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.