A country-wide probability sample of public attitudes toward stuttering in Portugal

BackgroundNegative public attitudes toward stuttering have been widely reported, although differences among countries and regions exist. Clear reasons for these differences remain obscure.PurposePublished research is unavailable on public attitudes toward stuttering in Portugal as well as a representative sample that explores stuttering attitudes in an entire country. This study sought to (a) determine the feasibility of a country-wide probability sampling scheme to measure public stuttering attitudes in Portugal using a standard instrument (the Public Opinion Survey of Human Attributes–Stuttering [POSHA–S]) and (b) identify demographic variables that predict Portuguese attitudes.MethodsThe POSHA–S was translated to European Portuguese through a five-step process. Thereafter, a local administrative office-based, three-stage, cluster, probability sampling scheme was carried out to obtain 311 adult respondents who filled out the questionnaire.ResultsThe Portuguese population held stuttering attitudes that were generally within the average range of those observed from numerous previous POSHA–S samples. Demographic variables that predicted more versus less positive stuttering attitudes were respondents’ age, region of the country, years of school completed, working situation, and number of languages spoken. Non-predicting variables were respondents’ sex, marital status, and parental status.ConclusionA local administrative office-based, probability sampling scheme generated a respondent profile similar to census data and indicated that Portuguese attitudes are generally typical.     

Public attitudes toward stuttering in Turkey: probability versus convenience sampling

Purpose: A Turkish translation of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) was used to compare probability versus convenience sampling to measure public attitudes toward stuttering. Method: A convenience sample of adults in Eski?ehir, Turkey was compared with two replicates of a school-based, probability cluster sampling scheme. Results: The two replicates of the probability sampling scheme yielded similar demographic samples, both of which were different from the convenience sample. Components of subscores on the POSHA-S were significantly different in more than half of the comparisons between convenience and probability samples, indicating important differences in public attitudes. Conclusions. If POSHA-S users intend to generalize to specific geographic areas, results of this study indicate that probability sampling is a better research strategy than convenience sampling.Educational objectives: The reader will be able to: (1) discuss the difference between convenience sampling and probability sampling; (2) describe a school-based probability sampling scheme; and (3) describe differences in POSHA-S results from convenience sampling versus probability sampling.     

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’.     

Comparing stuttering attitudes of preschool through 5th grade children and their parents in a predominately rural Appalachian sample

BackgroundTheories relating to young children’s social cognitive maturity and their prevailing social groups play important roles in the acquisition of attitudes. Previous research has shown that preschool and kindergarten children’s stuttering attitudes are characterized by stronger negative beliefs and self reactions than those of parents. By contrast, 12 year-old children’s stuttering attitudes have been shown to be similar to their parents’ attitudes. Other research indicates that parental stuttering attitudes are no different from attitudes of adults who are not parents.PurposeThe purpose of this study was to explore children’s stuttering attitudes of preschool through 5th grade children and to compare them to their parents’ attitudes.MethodChildren and parents from a rural Appalachian elementary school and child/parent pairs from other areas in the region responded to child and adult versions of the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S/Child and POSHA–S). Seven grade levels were included: preschool, kindergarten, 1^st grade, 2^nd grade, 3^rd grade, 4^th grade, and 5^th grade.ResultsConfirming earlier research, younger children’s attitudes toward stuttering were considerably less positive than those of their parents. As children matured up to the fifth grade, however, their stuttering attitudes progressively were more positive. Parents’ stuttering attitudes were quite consistent across all seven grade levels.ConclusionsConsistent with theories of attitudinal development, between the ages of 4 and 11 years, children’s measured attitudes toward stuttering improved and gradually approximated the attitudes of their parents and the general public.     

Origins of the stuttering stereotype: stereotype formation through anchoring-adjustment

The stereotype of people who stutter is predominantly negative, holding that stutterers are excessively nervous, anxious, and reserved. The anchoring–adjustment hypothesis suggests that the stereotype of stuttering arises from a process of first anchoring the stereotype in personal feelings during times of normal speech disfluency, and then adjusting based on a rapid heuristic judgment. The current research sought to test this hypothesis, elaborating on previous research by [White, P. A., & Collins, S. R. (1984). Stereotype formation by inference: A possible explanation for the “stutterer” stereotype. Journal of Speech and Hearing Research, 27, 567–570]. Participants provided ratings of a hypothetical typical person who stutters, a person suffering from normal speech disfluency and a typical male on a 25-item semantic differential scale. Results showed a stereotype of people who stutter similar to that found in previous research. The pattern of results is consistent with the anchoring–adjustment hypothesis. Ratings of a male stutterer are very similar to a male experiencing temporary disfluency, both of which differ from ratings of a typical male. As expected, ratings of a stutterer show a small but statistically significant adjustment on several traits that makes the stereotype of stutterers less negative and less emotionally extreme than the temporarily disfluent male. Based on the results of this research, it appears that stereotype formation is a result of generalization and adjustment from personal experience during normal speech disfluency.

Educational objectives: The reader will be able to: (1) explain how the negative stereotype of people who stutter arises; (2) discuss the negative implications of stereotypes in the lives of people who stutter; and (3) summarize why the stereotype of people who stutter is so consistent and resistant to change.     

Teacher attitudes toward stuttering

Attitudes of 100 elementary school teachers toward stuttering were studied using the Teacher Attitudes Toward Stuttering (TATS) Inventory. Teacher attitudes, as indicated by TATS Inventory scores, were compared with teacher knowledge of stuttering, age of teacher, number of years teaching experience, educational level, and whether the teacher had personal experience with a stutterer. Results indicated that significant positive correlations existed between teacher attitudes toward and knowledge of stuttering. Significant negative correlations were demonstrated between teacher attitudes/knowledge of stuttering and the presence of a stuttering child in the classroom. The applicability of the TATS Inventory as a clinical instrument in its current form and the research needed to enhance its flexibility are discussed.     

The social and communication impact of stuttering on adolescents and their families

Purpose

Stuttering can cause wide ranging psychosocial impact. This is particularly the case for adolescents who may face additional physical, emotional and personality changes as they become adults. This study reports the findings of an investigation into the social and communication impacts of stuttering on Australian adolescents seeking treatment for stuttering and their families.

Method

A cross-sectional design utilising questionnaires assessed the self-perceived communication competence and apprehension, stigma and disclosure, and experiences of teasing and bullying of 36 adolescents who stutter. Additionally, the impact of stuttering on the families of these adolescents was investigated.

Results

Adolescents who stutter have below average self-perceived communication competence, heightened communication apprehension, are teased and bullied more often than fluent peers, and they try to keep their stuttering secret. The families of the adolescents in the study reported high levels of emotional strain, family conflict and difficulty managing their child's frustrations.

Conclusion

The findings from this study emphasise the wide-ranging impact of stuttering beyond the surface level behaviours. Clinicians working with adolescents who stutter should take note of both the outcomes of this study and the suggestions for more effectively coping with the condition in this population.Educational objectives: The reader will be able to: (a) summarise findings with regards to the impact of stuttering on an adolescent's social and communication skills; (b) summarise areas of impact on the families of adolescents who stutter; (c) compare these findings with previous reported data for this population; (d) discuss the clinical implications of the results for working with adolescents who stutter and their families.     

The accuracy with which adults who do not stutter predict stuttering-related communication attitudes

The purpose of this study was to examine the extent to which adults who do not stutter can predict communication-related attitudes of adults who do stutter. 40 participants (mean age of 22.5 years) evaluated speech samples from an adult with mild stuttering and an adult with severe stuttering via audio-only (n = 20) or audio-visual (n = 20) modes to predict how the adults had responded on the S24 scale of communication attitudes. Participants correctly predicted which speaker had the more favorable S24 score, and the predicted scores were significantly different between the severity conditions. Across the four subgroups, predicted S24 scores differed from actual scores by 4–9 points. Predicted values were greater than the actual values for 3 of 4 subgroups, but still relatively positive in relation to the S24 norm sample. Stimulus presentation mode interacted with stuttering severity to affect prediction accuracy. The participants predicted the speakers’ negative self-attributions more accurately than their positive self-attributions. Findings suggest that adults who do not stutter estimate the communication-related attitudes of specific adults who stutter in a manner that is generally accurate, though, in some conditions, somewhat less favorable than the speaker's actual ratings. At a group level, adults who do not stutter demonstrate the ability to discern minimal versus average levels of attitudinal impact for speakers who stutter. The participants’ complex prediction patterns are discussed in relation to stereotype accuracy and classic views of negative stereotyping.Educational objectives: The reader will be able to (a) summarize main findings on research related to listeners’ attitudes toward people who stutter, (b) describe the extent to which people who do not stutter can predict the communication attitudes of people who do stutter; and (c) discuss how findings from the present study relate to previous findings on stereotypes about people who stutter.     

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.     

Speech pathology student clinician attitudes and beliefs towards people who stutter: A mixed-method pilot study

PurposeStuttering is a disorder of fluency that extends beyond its physical nature and has social, emotional and vocational impacts. Research shows that individuals often exhibit negative attitudes towards people who stutter; however, there is limited research on the attitudes and beliefs of speech pathology students towards people who stutter in Australia. Existing research is predominantly quantitative; whereas this mixed-method study placed an emphasis on the qualitative component. The purpose of this study was to explore the attitudes and beliefs of final year Australian speech pathology students towards people who stutter.MethodsThis mixed-method study applied the Public Opinion Survey of Human Attributes – Stuttering (POSHA-S) and semi-structured interviews to gather data from final year speech pathology students from a major university in Australia.Principal resultsThe overall qualitative findings identified that final year Australian speech pathology students exhibit positive attitudes towards people who stutter. The results also illustrated the role of education in influencing attitudes of students as well as increasing their confidence to work with people who stutter.Major conclusionThis research revealed that Australian final year speech pathology students exhibit positive attitudes towards people who stutter. They displayed an understanding that people who stutter may have acquired traits such as shyness as a response to their personal situation and environment, rather than those traits being endemic to them. Results also suggested that education can play a role in creating confident student clinicians in their transition to practice, and positively influence their attitudes and beliefs.     

Defining stuttering for research purposes

This is a response to a Letter to the Editor entitled “Stuttering prevalence, incidence and recovery rates depend on how we define it: Comment on Yairi & Ambrose’ article Epidemiology of Stuttering: 21st Century advances” by Paul Brocklehurst (2013). The criticism was directed specifically toward Yairi and Ambrose’ conclusions, based on review of recent studies, regarding the incidence and prevalence of stuttering. In this response, Brocklehurst's arguments and suggestions of criteria for incidence research are discussed and negated.     

The association of attitudes toward stuttering with selected variables

The Stuttering Inventory, designed to assess knowledge about and identify attitudes toward stuttering was completed by 203 subjects. The relative contributions of age, gender, years of education, knowledge about stuttering, number of people who stutter personally known, number of stuttering courses completed, and possession of the Certificate of Clinical Competence in speech-language pathology towards the prediction of attitudes toward people who stutter, their parents, and the efficacy of therapy were examined. Possessing the Certificate of Clinical Competence was the most reliable predictor of attitude scores. The limitations of this study and related research efforts using paper and pencil assessments of attitudes toward stuttering are discussed.     

“Math is Hard!” The effect of gender priming on women’s attitudes

In three studies, we examined the effect of a self-relevant category prime on women’s attitudes towards the gender-stereotyped domains of arts (positively stereotyped) and mathematics (negatively stereotyped). In Study 1, women who were subtly reminded of the category female (Study 1a) or their gender identity (Study 1b) expressed more stereotype consistent attitudes towards the academic domains of mathematics and the arts than participants in control conditions. In Study 2, women who were reminded of their female identity similarly demonstrated a stereotype-consistent shift in their implicit attitudes towards these domains relative to women in a control condition. The potential role of the working self-concept in mediating social category priming effects as well as the practical implications of these findings are discussed.     

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.     

College professors’ perceptions of students who stutter and the impact on comfort approaching professors

PurposePrevious literature has documented that college professors view hypothetical students who stutter more negatively than their fluent peers. The purpose of the present study was to investigate whether individuals who stutter report they experience more negative perceptions in the college classroom, and the impact of those perceptions on their comfort approaching professors.MethodsTwo hundred forty-six adults who do and do not stutter, matched for age, participated in this study. Participants were presented with 16 positive and negative personality traits and asked to rate how strongly they believed their professor viewed them along each trait. All participants were asked whether they felt comfortable approaching their professors to discuss their performance. Adults who stutter were asked additional questions to investigate their college experience more comprehensively.ResultsAdults who stutter reported they experienced significantly more negative perceptions from their professors than adults who do not stutter, and were significantly less likely to feel comfortable approaching their professors. These reported negative perceptions, specifically being perceived as less self-assured, predicted comfort approaching professors to receive performance feedback for adults who stutter. Finally, amongst adults who stutter, perception of how they were evaluated compared to their peers was significantly related to comfort approaching professors.ConclusionsResults support that the negative perceptions towards hypothetical students who stutter reported in previous literature are experienced by individuals who stutter, and that these perceptions drive comfort approaching professors for performative feedback. Results suggest professors may increase students’ comfort by clearly outlining equality in evaluation procedures.     

The Peer Attitudes Toward Children who Stutter scale: Reliability, known groups validity, and negativity of elementary school-age children's attitudes

Psychometric properties of the Peer Attitudes Toward Children who Stutter (PATCS) scale (Langevin, M., & Hagler, P. (2004). Development of a scale to measure peer attitudes toward children who stutter. In A.K. Bothe (Ed.), Evidence-based treatment of stuttering: empirical bases and clinical applications (pp. 139–171). Mahwah, NJ: Lawrence Erlbaum Associates.) and the extent to which peer attitudes are negative were re-examined. Results show that internal consistency was .97 and test–retest reliability was .85. In a known groups analysis participants who had contact with someone who stutters had statistically significant higher mean scores (more positive attitudes) than those who had not had contact. Nonsignificant findings for gender and grade call into question the usefulness of these variables as discriminators in future tests of known groups validity of peer attitudes toward children who stutter. Approximately one-fifth of participants had PATCS scores that were somewhat to very negative. These findings support calls for school-based education about stuttering.

Educational objectives

The reader will be able to: (1) summarize the social impacts of stuttering on school-age children who stutter, (2) describe the known groups method to test construct validity, (3) evaluate the psychometric properties of the Peer Attitudes Toward Children who Stutter scale, and (4) provide information about the proportion of students who appear to hold negative attitudes toward children who stutter.     

Political ideology predicts attitudes toward moral transgressors

We combine recent theoretical advances in the study of morality with a growing interest in the predictive power of political ideology to test new hypotheses concerning impression formation. In two experiments (total N = 3881), newly-formed attitudes depended upon United States citizens’ political ideology and the moral content of the attitude induction. Specifically, when forming impressions of a person violating moral foundations of Care/Fairness, political liberals disliked the person more than did conservatives. In contrast, when forming impressions of a person violating moral foundations of Loyalty/Authority/Purity, conservatives disliked the person more than did liberals. This work establishes that ideological differences are important not only for long-standing attitudes and judgments, but create attitudinal divides at the earliest stages of evaluation.     

Scale development to measure attitudes toward unauthorized migration into a foreign country

This study reports on the development and cross-national utility of a Likert type scale measuring attitudes toward unauthorized migration into a foreign country in two samples from "migrant-sending" nations. In the first phase a pool of 86 attitude statements were administered to a sample of 505 undergraduate students in Bulgaria (22.5% male; M age = 23, SD = 4.8). Exploratory factor analysis resulted in six factors, and a reduction to 34 items. The results yielded an overall alpha of (0.92) and alpha for subscales ranging from 0.70 to 0.89. In the second phase the 34-item scale was administered in a survey of 180 undergraduates from Sofia University in Bulgaria (16.7% male, M age = 23, SD = 4.8), plus 150 undergraduates from Hanoi State University in Vietnam (14.7% male, M age = 19, SD = 1.8). Results yielded a 19-item scale with no gender differences, and satisfactory alpha coefficients for a Vietnamese and Bulgarian sample of 0.87 and 0.89 respectively. This scale, equally applicable in both samples, includes items that reflect salient topics of concept of attitudes towards unauthorized migration. An exploratory principal component analysis of the Bulgarian and Vietnamese version of the 19-item scale yielded three factors accounting for 54% and 47% of the variance respectively. A procrustes analysis indicates high conceptual equivalence in the two samples for factor 1 and 2, and moderate for factor 3. This study lends support to the idea that despite different cultural meanings there is a common meaning space in culturally diverse societies.     

A survey of communicative disorders students' attitudes toward stuttering

Cooper's (1975) Clinician Attitudes Toward Stuttering (CATS) inventories were conpleted by 1,902 speech-language pathology and audiology students from 33 universities, each in a different state. The majority of respondents perceived stutterers as having psychosocial problems and believed that client and parental counseling were essential aspects of treatment. These views were relatively unaffected by student training and clinical exposure. In addition, most of the assumptions of Johnson's diagnosogenic theory of stuttering were held by the majority of the students surveyed. Most of the respondents believed that stuttering was difficult to modify and that speech clinicians were neither adept nor comfortable treating stutterers. These latter attitudes were significantly affected by training, i.e., the more advanced the students' training, the more pessimistic their views on clinician competence. Other professional attitudes and the effect of training on them are also discussed.     

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.