StutteringSpeaking Anxiety Not peer-reviewed

Eye-tracking VR helps people who stutter improve gaze during conversation

Walkom G · 2017 · MSc Thesis, Nottingham Trent University · Quasi-experimental · n = 12 · Adults who stutter and matched fluent controls
Evidence certainty: Very low certainty
How this was rated

Quasi-experimental study (n=12) without randomization. Early-stage evidence; needs replication in larger, controlled designs.

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.

This thesis integrated eye tracking into a VR exposure system to objectively measure gaze behaviors of people who stutter. Across three sessions, participants showed significant reductions in prolonged eye closures and a substantial increase in time spent looking at the avatar's face.

Clinical bottom line

A 12-participant quasi-experimental study suggesting that VR exposure produces measurable changes in adults who stutter; lack of randomization limits causal inference.

Key findings

  • Time spent looking at the avatar's head rose substantially (48% to 68%) across three sessions
  • Blink count decreased by 31% and blink duration by 41% from Session 1 to Session 3
  • Time fixating the back wall dropped significantly (17% to 5%), indicating reduced gaze avoidance
  • Self-reported distress decreased across all measurement points
  • Presenting participants with their own gaze data proved a feasible feedback mechanism

Background

Gaze avoidance - looking away from a listener’s face during moments of disfluency - is a common experience among people who stutter. It can affect how conversations feel for both speakers and listeners, and is often something people want to change. However, measuring gaze behavior has traditionally relied on external video analysis or subjective clinician ratings, both of which are time-consuming and imprecise. With eye-tracking sensors becoming available inside VR headsets, Walkom saw an opportunity to capture gaze data automatically and use it as a feedback tool.

What the researchers did

Twelve adults who stutter completed three VR sessions each lasting approximately six minutes, spaced across several weeks. A matched group of fluent speakers completed the same task as a baseline comparison. The VR system used a Fove 0 head-mounted display, one of the first consumer-grade HMDs with integrated eye-tracking capability. In each session, participants spoke to a virtual avatar in a one-to-one conversational scenario while the Fove 0’s eye tracker recorded fixation data in real time. After each session, participants were shown a visual summary of their own gaze patterns - where they had looked, for how long, and how their gaze shifted during the conversation. Self-reported distress was also measured at multiple points.

What they found

The gaze data revealed clear changes over the three sessions. People who stutter spent significantly more time looking at the avatar’s face by the final session, rising from 48% to 68% of total speaking time. Gaze avoidance, measured by time spent fixating the back wall, dropped markedly from 17% to just 5%. Blink frequency decreased by 31% and blink duration by 41%, suggesting a reduction in prolonged eye closures that often accompany moments of stuttering. Self-reported distress also decreased across sessions. Fluent speakers showed relatively stable gaze patterns across sessions; the divergence from the stuttering group’s trajectory over the three sessions is consistent with genuine behavioral change rather than pure familiarization, though the quasi-experimental design limits causal inference.

Why this matters

This research demonstrated that eye tracking embedded in VR headsets can replace subjective gaze observation with precise, quantifiable data. Perhaps more importantly, it showed that sharing this data with participants created a feedback loop - people could see their own avoidance patterns objectively and track their progress over time. This approach respects individual autonomy by giving people concrete information about their own behavior, empowering them to set and monitor their own goals.

Limitations

The sample size was modest at 12 participants per group, and the study ran for only three sessions, so it is unclear whether the gaze improvements would persist long term. The conversational scenario involved a single avatar, which may not capture the complexity of multi-person interactions. The study did not assess whether changes in gaze behavior carried over into real-world conversations outside the VR environment.

Implications for practice

Eye tracking within VR headsets can provide clinicians with objective, quantifiable gaze metrics - replacing subjective observation - and creating an effective feedback loop for supporting communication behavior change.

Editorial notes from withVR

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.

Eye Contact Toggle

This study explored eye tracking in VR for stuttering - Therapy withVR's eye contact toggle controls whether avatars follow the speaker's gaze, influencing the social dynamics this research investigated.

Real-Time Clinician Control

Observe and respond to the individual's experience in real time from the web app - the clinician-in-the-loop model this eye tracking research supports.

Cite this study

If you reference this study in your work, the canonical citation formats are:

APA 7th
Walkom, G. (2017). Eye Tracking in Virtual Reality: A New Objective Method of Exposure Therapy to Improve the Eye Gaze Behaviors of People Who Stutter. MSc Thesis, Nottingham Trent University.
AMA 11th
Walkom G. Eye Tracking in Virtual Reality: A New Objective Method of Exposure Therapy to Improve the Eye Gaze Behaviors of People Who Stutter. MSc Thesis, Nottingham Trent University. 2017.
BibTeX
@article{walkom2017,
  author = {Walkom, G.},
  title = {Eye Tracking in Virtual Reality: A New Objective Method of Exposure Therapy to Improve the Eye Gaze Behaviors of People Who Stutter},
  journal = {MSc Thesis, Nottingham Trent University},
  year = {2017},
  url = {https://withvr.app/evidence/studies/walkom-2017}
}
RIS
TY  - JOUR
AU  - Walkom, G.
TI  - Eye Tracking in Virtual Reality: A New Objective Method of Exposure Therapy to Improve the Eye Gaze Behaviors of People Who Stutter
JO  - MSc Thesis, Nottingham Trent University
PY  - 2017
UR  - https://withvr.app/evidence/studies/walkom-2017
ER  - 

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Funding & independence

withVR founder Gareth Walkom is the sole author of this MSc thesis, completed at the School of Architecture, Design and the Built Environment, Nottingham Trent University. Funding and ethics disclosures are stated in the thesis. Inclusion in this hub is editorially independent; withVR BV did not influence the summary or certainty rating.

Last reviewed: 2026-05-12 Next review due: 2027-05-12 Reviewed by: Gareth Walkom