School‐Age Differences in Reasonable Accommodations for Students Who Stutter: A Content Analysis of Medical Letters
Yoshikazu Kikuchi, Yumi Yamaguchi, Masamutsu Kenjo, Eriko Yoshida, Aoi Sato, Takashi NakagawaABSTRACT
Background
Japanese schools must provide reasonable accommodations for students who stutter, but developmental variations in these needs are poorly understood. This study characterized accommodation requests in clinician‐drafted medical letters to clarify these needs.
Methods
Medical letters for 116 students who stutter (65 elementary, 51 secondary) were retrospectively analyzed. Accommodation content was classified using inductive content analysis. Group proportions were compared, and stuttering frequency (%SS) and social anxiety (LSAS‐CA) were analyzed descriptively.
Results
Five accommodation categories were identified. Elementary students significantly more frequently requested teacher‐mediated protective support, such as reporting teasing and classroom stuttering explanations. Secondary students more frequently requested social functioning accommodations, including subject‐teacher information sharing and entrance examination support. Presentation‐related accommodations were highly prevalent across both groups (61.2% overall). Participants who completed the anxiety assessment exhibited elevated social anxiety (mean LSAS‐CA: 42.1).
Conclusion
Accommodation needs reflect structural school transitions, shifting from classroom protection under the elementary homeroom system to social participation support under the secondary subject‐teacher system. Importantly, presentation‐related needs represent a consistent concern, likely driven by subjective anxiety rather than objective stuttering severity. Medical letters may serve as valuable tools for initiating constructive clinician–family–school dialogue to facilitate tailored support.