Changing adolescent attitudes toward stuttering

Purpose

Live oral or recorded video presentations on stuttering were delivered to high school students in order to determine the extent to which their attitudes toward stuttering could be improved.

Methods

A classroom teacher administered the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to two health classes before and after an oral live presentation by a person who stutters. She also gave the POSHA-S to two other similar classes before and after a True Life^®: I Stutter video presentation. The stuttering person in the oral condition was one of three people featured in the video. Also, following the video condition, students filled out the POSHA-S a third time after a short oral presentation by the same person who stutters.

Results

Measured attitudes improved overall on the POSHA-S and on selected items.

Conclusions

High school students hold similar attitudes toward stuttering and stutterers as adults, and these attitudes can be improved, at least temporarily, by a presentation on stuttering but more via a live presentation than a professionally prepared video.Educational objectives: (1) The reader will identify different ways to improve attitudes toward stuttering in high school students. (2) The reader will list advantages and disadvantages of live oral presentations and recorded video presentations as strategies to change attitudes toward stuttering. (3) The reader will identify characteristics of a speaker that can assist in attitude changes of high school students.     

Listener perceptions of stuttering and stuttering modification techniques

PurposeThe purpose of this study was to analyse naïve listener perceptions of speech containing unmodified stuttering, use of the pull-out technique, and use of preparatory-sets.MethodParticipants (N = 62) were randomly assigned to listen to one audio sample (unmodified stuttered speech, speech with pull-outs, or speech with preparatory-sets) and completed a survey assessing perceptions of the speaker’s speech and personality and the listener’s comfort level and willingness to social interact with the speaker.ResultsSurvey results revealed low perceptual ratings in all experimental conditions. Unmodified stuttered speech received significantly more positive ratings than the stuttering modification conditions in all measurements except for speech naturalness. Listeners reported being less willing to socially interact with those who use preparatory-sets than unmodified stuttered speech.ConclusionThe use of stuttering modification techniques did not improve listeners’ perceptions or willingness to interact with persons who stutter. Clinicians and those who stutter should be aware that the use of speech techniques will not decrease negative social interactions or stereotypes.     

Deflecting negative self-relevant stereotype activation: The effects of individuation

Under stereotype threat, when an individual risks confirming a negative self-relevant stereotype, activation of the stereotype can inhibit performance on a subsequent, related task. Although a significant amount of research has been devoted to examining the effects of stereotype activation on performance, relatively little is known about successful methods of intervention. Two experiments tested the hypothesis that individuation prior to performance would eliminate impairment due to stereotype activation. In both studies, Caucasian female participants in either a gender-prime or no-prime condition were administered a mathematics test. Gender primed, individuated participants outperformed gender primed, non-individuated participants and performed as well as unprimed, non-individuated (i.e., control) participants, supporting individuation as a protective measure against the detrimental effects of negative stereotype activation.     

Australian attitudes towards stuttering: A cross-sectional study

BackgroundNegative reactions experienced by people who stutter often stem from unfounded attitudes and beliefs in the community.PurposeThere is a need to better understand current public attitudes towards stuttering in Australia. The purpose of this study was to: (a) explore the attitudes and knowledge of a large sample of the Australian public using the Public Opinion Survey of Human Attitudes-Stuttering [POSHA-S], (b) identify how the reported attitudes towards, and knowledge of, stuttering compare to existing data, and (c) identify differences between groups for variables identified.MethodsA cross-sectional population study using the POSHA-S was conducted in Melbourne, Australia. Comparisons of the attitudes towards stuttering of this sample were made with data from other worldwide samples on the POSHA-S database. The influence on attitudes to stuttering of variables including age, gender, education level, country of birth, employment status and number of languages spoken was explored.ResultsThe Overall Stuttering Score (OSS) of the Australian sample was higher than the median score on the POSHA-S database. This suggests that the Australian public holds more positive attitudes than those other countries represented in the database. Being younger, more educated, employed, female, monolingual, born in Australia and not familiar with people who stutter were related to more positive attitudes for this sample. Some negative stereotypes towards stuttering were noted; people who stutter were identified as ‘shy and fearful’, and ‘nervous and excitable’.ConclusionsWhile the Australian public has generally positive attitudes towards stuttering, these attitudes still reflect some ‘stuttering stereotypes’.     

Threatened to distraction: Mind-wandering as a consequence of stereotype threat

Two experiments tested the hypothesis that the threat of a negative stereotype increases the frequency of mind-wandering (i.e., task-unrelated thought), thereby leading to performance impairments. Study 1 demonstrated that participants anticipating a stereotype-laden test mind-wandered more during the Sustained Attention to Response Task. Study 2 assessed mind-wandering directly using thought sampling procedures during a demanding math test. Results revealed that individuals experiencing stereotype threat experienced more off-task thoughts, which accounted for their poorer test performance compared to a control condition. These studies highlight the important role that social forces can have on mind-wandering. More specifically, these results serve as evidence for task-unrelated thought as a novel mechanism for stereotype threat-induced performance impairments.     

Evidence that blatant versus subtle stereotype threat cues impact performance through dual processes

An experiment tested three competing hypotheses for how blatant and subtle stereotype threat cues influence the performance of female sports participants on a golf-putting task. A “predominant” model predicts that blatant threat cues have a more negative effect on performance than subtle threat cues, whereas an “additive” model predicts that both cues combine to have a greater negative effect than either threat cue alone. However, a “dual process” model predicts that each threat cue has an independent negative influence through separate mechanisms. To test these predictions, we varied the presence of blatant (e.g., the task frame) and subtle cues (e.g., the gender of the experimenter) for negative stereotypes about female athletes, and then measured both the number of strokes required to finish the course and accuracy on the last putt of each hole. The results supported the dual process model prediction: females required more strokes to finish the golf task when it was framed as measuring gender differences compared to racial differences in athletic ability, and females performed less accurately on the last putt of each hole in the presence of a male versus a female experimenter. The discussion focuses on how the presence of multiple stereotype threat cues can induce independent mechanisms that may have separate but simultaneously deleterious effects on performance.     

Resilience in people who stutter: Association with covert and overt characteristics of stuttering

PurposeRecent literature stresses the importance of resilience, as a trait, for successful coping with life’s difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.MethodThirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker’s Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.ResultsA strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants’ gender and age and their resilience levels (p > 0.05).ConclusionThis study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.     

Egalitarian goals trigger stereotype inhibition: A proactive form of stereotype control

Stereotype activation is often described as beyond control, unable to be prevented by willing it or engaging the self-regulatory system. Four experiments illustrate that this initial stage of the stereotyping process is controllable. Stereotypes are shown to be implicitly inhibited as part of a goal shielding process. In each experiment, egalitarian goals are triggered through a task in which participants contemplate a past failure at being egalitarian to African American men. This is followed in each experiment by a task that measures stereotype activation/inhibition using reaction times to words (either control words or stereotype-relevant words) that follow the presentation of either faces of Black or White men. The first two experiments examine participants with egalitarian goals versus those with a control goal, whereas the last two experiments examine people with egalitarian goals versus those whose egalitarian strivings have been satisfied (by contemplating success at being egalitarian). Only participants with egalitarian goals exhibit stereotype inhibition, and this occurs despite the fact that they lack awareness of the inhibition and lack the conscious intent to inhibit stereotypes at the time the response is made.     

Performance boosts in the classroom: Stereotype endorsement and prejudice moderate stereotype lift

The present study (N = 293) examined whether stereotype endorsement and prejudice moderate stereotype lift (i.e., a performance boost caused by the salience of a negative out-group stereotype in the testing situation). The stereotype in the focus of inquiry was the belief that immigrant students have lower intellectual ability than native students. French native high school students performed an intellectual test in a condition of low stereotype salience (the test was presented as assessing individual differences) or in a condition of high stereotype salience (the test was presented as assessing group differences between African immigrants and native students). As expected, results indicated that native students high in stereotype endorsement and those high in prejudice performed better in the high than in the low stereotype salience condition, whereas those low on these constructs did not. By identifying two moderators of stereotype lift, this study sheds new light on the achievement gap between immigrant and native students in educational institutions.     

Trait perspective-taking and need for cognition in the formation of stereotypes about people who stutter

People who stutter (PWS) suffer from stereotypes portraying them as timid and anxious, which may affect their relationships and careers. One of the mechanisms for this stereotyping is the anchoring and adjustment heuristic, whereby individuals make judgements about PWS by using previous experiences for the initial judgement and then adjust accordingly. In the current study (n = 309) we replicate previous findings that individuals stereotype PWS by anchoring to experiences with episodic stuttering and adjusting toward typical non-stuttering individuals, although insufficiently. We extend this finding by testing whether trait perspective-taking and need for cognition moderate this relationship. The results show that trait perspective-taking decreases stereotyping of non-PWS, while having no effect on PWS stereotyping. However, need for cognition exhibited no consistent moderating effect on stereotyping.     

Temperament and early stuttering intervention: Two perspectives

PurposeTo discuss clinical applications of research findings about temperament and early stuttering.MethodA “1000-bytes” format (Onslow & Millard, 2012) was used to provide readers with contemporaneous observation of a “conversation” between the authors. The conversation is proceeded by a prologue and followed by concluding statements from each author.ResultsOne author contended that comprehensive, multidimensional assessment of temperament domains is essential during clinical management of early stuttering, and the results of that assessment are best incorporated into a multifactorial treatment approach. The other author contested that view, arguing that such an approach is not empirically justifiable at present.ConclusionsThe authors agree about the salience of research on temperament and early stuttering but have different perspectives about the topic when applied to providing health care for early stuttering.     

An exploratory factor analysis of action responses to stuttering anticipation

PurposeWe previously introduced theStuttering Anticipation Scale (SAS; Jackson, E. S., Gerlach, H., Rodgers, N. H., & Zebrowski, P. M. (2018). My Client Knows That He’s About to Stutter: How Can We Address Stuttering Anticipation during Therapy with Young People Who Stutter? Seminars in Speech and Language, 39, 356–370) – a non-standardized self-report measure for children, teens, and adults who stutter (CWS, TWS, AWS) that quantifies how often they engage in 25 commonly reported action responses to anticipation. The purpose of this study was to leverage the SAS to explore the factor structure of action responses to stuttering anticipation.MethodsA total of 121 people who stutter completed the SAS online (27 CWS, 40 TWS, 54 AWS). We used exploratory factor analysis (EFA) to determine the underlying latent variables within the 25 SAS items that characterize how people who stutter respond to anticipation.ResultsA three-factor model was most appropriate for the data with regard to factor loadings and other model fit indices. The three factors were named: avoidance (17 items), physical change (4 items), and approach (4 items).ConclusionUnderstanding these three types of action responses to anticipation can help guide clinical decision-making by providing a novel framework for clinicians and their clients who stutter to discuss how the client tends to respond to anticipation, and explore ways to facilitate productive responses to anticipation.     

Reprint of: technology and the evolution of clinical methods for stuttering

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.Educational objectives: The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families.     

Perfectionism and stuttering: Findings of an online survey

PurposeUsing a multi-dimensional measure of perfectionism: the Frost Multi-dimensional Perfectionism Scale (FMPS: Frost, Marten, Lahart, & Rosenblate, 1990), this study investigates: (a) whether adults who stutter (AWS) display more perfectionistic attitudes and beliefs than those who do not stutter, and (b) whether, in AWS, more perfectionistic attitudes and beliefs are associated with greater self-reported difficulty communicating verbally and speaking fluently.MethodIn the first analysis, FMPS responses from 81 AWS and 81 matched, normally-fluent controls were analyzed using logistic regression to investigate the relative contributions of four FMPS perfectionism-subscale self-ratings to the likelihood of being in the AWS group. In the subsequent analyses, data from the 81 AWS were analyzed using linear multiple regression to determine which FMPS subscale self-ratings best predicted their Communication-Difficulty and Fluency-Difficulty scores.ResultsBoth the likelihood of being a member of the AWS group, and also the magnitude of the AWS group's Communication-Difficulty and Fluency-Difficulty scores, were positively part-correlated to respondents’ Concern over Mistakes-Doubts about Actions (CMD) subscale self-ratings but negatively part-correlated to their Personal Standards (PS) subscale self-ratings.ConclusionsThe FMPS profiles of respondents who stutter suggest that, as a group, they are not abnormally perfectionistic overall, but may be (or perceive themselves to be) abnormally error-prone. Also, AWS who are more concerned about their errors and uncertain of their actions experience more difficulty communicating verbally and speaking fluently.Educational Objectives: After reading this article, participants will be able to: (a) describe the findings of previous research investigating the role of perfectionism in stuttering and psychopathologies; (b) discuss why a multidimensional assessment of perfectionism is important in relation to stuttering; (c) discuss ways in which data from perfectionism assessments can contribute to the planning of therapy for adults who stutter.     

Evaluating three stuttering assessments through network analysis,random forests and cluster analysis

PurposeIn stuttering, cognitive and behavioural variables interact in nonlinear fashion. These variables can be assessed by instruments which evaluate perceived impact of stuttering and stuttering severity. We applied three statistical methods in combination to the analysis of three assessment protocols to discover relationships within and between the tests to better understand variations in behavioural and social aspects of stuttering.MethodsScores from Stuttering Severity Index (SSI-IV), Overall Assessment of the Speaker’s Experience of Stuttering scale (OASES), and Unhelpful Thoughts and Beliefs About Stuttering scale (UTBAS), collected from 26 participants were compared using three statistical methods: network analysis, random forests, and cluster analysis.ResultsNetwork analysis demonstrated that SSI-IV only weakly interacts with a quality of life index (OASES) and a self-perception and belief systems index (UTBAS). Random forest analyses revealed the last two measures relate strongly to each other. The results from cluster analysis suggest a) a possible regrouping of OASES items and b) a possible use of one UTBAS scale instead of the three.ConclusionA combination of three statistical methods allowed us to evaluate the three assessments in more depth. The lack of interaction between the SSI-IV on the one hand, and OASES and UTBAS on the other, suggests that the network of the three commonly used stuttering assessments may be fractured in a non-productive way. A potential gap may exist for an assessment tool that would link behavioural and social aspects of stuttering.     

Stigma on my mind: Individual differences in the experience of stereotype threat

Stereotyped individuals vary in how chronically self-conscious they are of their stigmatized status, which Pinel (1999) has dubbed stigma consciousness. The current study investigated whether individual differences in stigma consciousness moderate the impact of gender stereotypes on the math performance of women. Results indicated that, under conditions designed to evoke stereotype threat (Steele, 1997), women high in stigma consciousness scored worse than women low in stigma consciousness on a math test. In the control (low threat) condition, stigma consciousness was unrelated to test performance. Possible mechanisms underlying this moderation are discussed.     

Birth weight and stuttering: Evidence from three birth cohorts

PurposePrevious studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples.MethodsLogistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500 g; normal range; high birth weight, ≥4000 g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent.ResultsNone of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6–3.6 times more likely than females to stutter.ConclusionOur results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering.     

Rising to the threat: Reducing stereotype threat by reframing the threat as a challenge

In two experiments, we found that the performance-inhibiting consequences of stereotype threat were eliminated when the threat was subtly reframed as a challenge. In Experiment 1, Black school children in North Carolina completed a 10-item mathematics test. Participants who reported their race before taking the test performed more poorly than participants who reported their race after completing the test, unless the test was framed as a challenge. Experiment 2 replicated this effect with undergraduates at a prestigious university. When reminded that they graduated from high schools that were poorly represented at the university, they performed more poorly than their peers on a math test. However, when the test was reframed as a challenge, this threat had no effect on their performance. These findings are discussed in terms of their theoretical and practical applications for both educational and athletic training.