Emotional and Social Aspects of Stuttering in Women Kathleen Scaler - - PowerPoint PPT Presentation

Emotional and Social Aspects of Stuttering in Women

Kathleen Scaler Scott, Ph.D., CCC-SLP, BRS/M-FD Assistant Professor Dinamichele Boyer Graduate Student Misericordia University

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Introduction

• The experiences and perspectives of persons who stutter has

added to the literature and informed clinical practice. Qualitative research has helped us to gain an in depth knowledge (Tetnowski & Damico, 2001) of the experiences of persons who stutter regarding treatment (Cream, Packman, & Llewellyn, 2004; Irani, Gabel, Daniels, & Hughes, 2012), life experiences (Daniels, Gabel, & Hughes, 2012; Daniels, Hagstrom, & Gabel, 2006; Klompas & Ross, 2004), recovery (Finn & Felsenfeld, 2004), management (Plexico, Manning, & DiLollo, 2005; Plexico, Manning, & Levitt, 2009 a, b) and therapeutic relationships (Plexico, Manning, DiLollo, 2010).

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• Gender differences in attitudes and

experiences of adults who stutter have been studied to a small degree. Silverman & Zimmer (1979) found quantitative differences in self-esteem in women who stutter as compared to men, as well as gender differences in stuttering symptomatology and treatment experiences (1982).

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Attitudes of others toward people who stutter by age and gender

• Silverman (1982) found that clinicians

considered stuttering to have a stronger negative impact upon females and children, whereas university students considered stuttering to have a stronger negative impact upon males, regardless of age.

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• Qualitative analyses of adults who stutter

have included women as part of their sample. Whether the perspectives of women who stutter differ from men who stutter has not been explored via formal qualitative analysis. The experience of women who stutter at different points in their lifetime has not yet been explored via formal qualitative analysis.

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• This study was designed as a preliminary look

at the experiences of women who stutter in late adolescence, twenties, and forties. It was designed as a first step in using qualitative methodology to compare the experiences of people who stutter across ages and gender.

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Participants

Participant Age Occupation OASES Total Impact Score A 17 Student Moderate B 23 Elementary School Teacher Mild/Moderate C 46 Grant Program Developer/ Manager Moderate

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Methods

• Data was collected via ethnographic interviews with

two adults and one teen with a confirmed diagnosis

• f stuttering
• Analysis of the interviews followed the

recommendations of Smith and Osborn (2003) for Interpretive Phenomenological Analysis (IPA). Procedures included orthographic transcription of all interviews, reading of transcriptions by multiple coders, culling interviews for relevant themes, identifying and clustering emerging themes, triangulation among coders, and member checking.

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Selected Finding One

• Private attitudes toward public reactions and responsibility

in educating others about stuttering shifts with age: Adolescence

• A: I feel like kids at my age now kind of are more judgmental

in a way so I feel like it is harder around peers

• A: Teachers have definitely been very understanding and

they don’t pressure me to do anything or they don’t ask me a billion questions about it to the point where it’s it’s kind of like as if they don’t get it all. They just kind of seemed to accept it and just let me be in class like.

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Selected Finding One

• Private attitudes toward public reactions and responsibility

in educating others about stuttering shifts with age: 20s

• B: …stuttering is like a jerk detector.
• B: …sometimes my first impressions are wrong and they just

might be nervous about something else so sometimes it’s like tricky.

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Selected Finding One

• Private attitudes toward public reactions and responsibility

in educating others about stuttering shifts with age: 40s

• C: So I kind of see it as, for something like this, the more

people I tell I think the better… The more people… Now they know someone who stutters were maybe they didn’t know anyone.

• C: Well, I kind of did this a little bit when I started disclosing

at work to try and help them because people want to know how they should react, right? The same way with if you’re in a wheelchair, do you want me to open the door for you, or is that patronizing? So, people generally want to know what’s the appropriate thing to do.

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Selected Finding Two

• Regret of avoidance can move in a positive or negative

direction: Adolescent

• A: Sometimes I have felt like I couldn’t do things. For example,

a big thing has been participating in classes and doing a big group presentation. In eighth grade every eighth grader has to have a speech and have to say it in front of the whole middle school and I didn’t do it and I think that it has definitely held me back from doing some things.

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Selected Finding Two

• Regret of avoidance can move in a positive or negative direction: 20s
• B: It was basically the same “did you forget your name?” thing. In that

moment I was so tired, I was there to get my nails done I was not there to have to educate someone about stuttering. Sometimes you’re tired, and you don’t feel like giving a whole rigmarole. So she just said that, and I was just like “no” and I’m just like well, I guess I’m not coming here again. I didn’t feel like getting into it.

• B: The thing I was really proud of myself for in this moment is I think a lot
• f times it’s really easy to shrug these things off and just be like, ha ha,

because it’s hard to react in the moment, but that time I said no actually I stutter, I was stuttering. And he immediately was like, oh. And then immediately the volunteer sitting next to him after a past in my ballot was like oh he didn’t mean anything by it. But I was like well, it’s still hurtful so you should be more careful.

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Selected Finding Two

• Regret of avoidance can move in a positive or negative direction: 40s
• C: Maybe it’s like when I didn’t have to give my presentation in college and

there is a certain amount of relief. But I didn’t feel good about that decision.

• C:As I got older, I would have the little challenges for myself. I would say if I

didn’t stutter, would I do this? If the answer was yes, I would do it. A lot of times I would be like, oh I can’t do that because I stutter. I said, no, no. If I didn’t stutter, would I still do this? Yes. So, then I would do it. It was just a little personal victory for me.

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Selected Finding Three

• Turning points involve several components

– Talking/ discussing feelings/ attitudes toward stuttering – Participation in a support group – Presence of successful role models – Support of teachers

Adolescent:

A: I guess when I switched from public school to private and I’m met my new friends, I told them that I went to therapy for that and they seemed to accept it so I guess that was positive. I: You said earlier that like now you’ve kind of learned to not make stuttering a big deal and to not worry about it so much. What things do you think made your view about that change over time? A: Probably all the support I had at school.

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Selected Finding Three

• Turning points involve several components

– Talking/ discussing feelings/ attitudes toward stuttering – Participation in a support group – Presence of successful role models – Support of teachers

20s:

B: I think what’s nice about being in the NSA is it gives you a way to talk about it [stuttering]. B: …my mom has come to the NSA conferences with me since like this is going to be our eighth or 10th conference and she is with me every year so right now she really gets it so it’s like I can talk about it with her in a way that I couldn’t before she started coming to the conferences. B: One thing also, for me, and my first conference I met this girl named Kerry who was a teacher. I forget would grade she taught in elementary school and she

• stuttered. I guess this was a turning point actually. Basically, meeting her and

talking to her made me realize that I could be a teacher and stutter.

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Selected Finding Three

• Turning points involve several components that vary with

age

– Talking/ discussing feelings/ attitudes toward stuttering – Participation in a support group – Presence of successful role models – Support of teachers

40s:

C: I joined the NSA covert stuttering list. And I started working on that. That’s been good. C: Going to my first full NSA conference, it struck me that when you’re around stuttering all the time, that’s the normal. That was normal to me. And everyone had their own style and their own personality through their stutter and it really became like a style. No two styles were the same. I remember so clearly being at the airport, waiting to go home, ordering some food, everyone talking fluently, and being like, wow, there’s nothing. It’s just so boring. No pizzazz. Nothing.

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Selected Finding Four

• Positive shift came about when individuals were ready to talk about stuttering

AND someone who knew them as a person (who stutters) was available to talk with them.

• A: Sometimes, my advisor presents me to them first and then I just kind of talk

with them and let them know about how it’s been a bit difficult to participate in classes and to just let them know that I will participate but it just takes a little bit

• f time for me to kind of ease into it.

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Selected Finding Four

• Positive shift came about when individuals were ready to talk about stuttering

AND someone who knew them as a person (who stutters) was available to talk with them.

• B: But then one of my teachers when I was in seventh grade noticed and said

something to my mom about it so I started seeing a speech therapist here and she was like so wonderful I saw her for probably four years at least from seventh grade to almost the end of high school and so with her it really got me into really thinking about stuttering and really being okay with it and accept it. That’s the first, like, I guess I didn’t realize that it wasn’t okay with it, but it wasn’t something that I never really talked about with my friends or anybody, really. So through her I started to realize, really realize, that it was okay to talk about it with others that I know.

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Selected Finding Four

• Positive shift came about when individuals were ready to talk about stuttering

AND someone who knew them as a person (who stutters) was available to talk with them.

• C:When I met my husband I didn’t tell him I stuttered. We dated long distance for

five years, over the phone, talking every night. Almost every night. I did not tell them I stuttered until we moved in together. The only reason I told him was because I was having trouble at work. My stuttering was getting worse and I couldn’t hide it anymore.

• C:Someone at the NSA conference once, the first year I went to my first full NSA

conference, she said, “you think stuttering is ugly don’t you?” I said yes I do. For

• me. Not for anybody else just when I do it, I feel [ugly]. I felt like it may mean less

than; like I had to compromise more than I needed to because when I stuttered, I’m not entitled to the full range of… I always felt like my stuttering had to be put up with.

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Comparison of findings to existing literature

• Variations in impact upon self-esteem (Blood, Blood,

Tellis, & Gabel, 2003; Silverman & Zimmer, 1979) and concept of “suffering” (Corcoran and Stewart, 1998)

• Positive role of support (Yaruss, Quesal, & Murphy,

2002)

• Little discussion of stuttering among teens (Blood,

Blood, Tellis, & Gabel, 2003)

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Implications

Private attitudes toward public reactions and responsibility in educating others about stuttering shifts with age – Should our educational material to the public vary with age of the person who stutters?

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Implications

• Regret of avoidance can move in a positive or negative

direction

– How can we use regret to help individuals reframe their future responses? (DiLollo, Neimeyer, & Manning, 2002)

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Implications

• Positive shift came about when individuals were ready to

talk about stuttering AND someone who knew them as a person (who stutters) was available to talk with them.

– Always be ready to offer, but realize they may not be ready to hear it

• Age factors: “Let me be,” “Actions speak louder”

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Future areas of research

• Do similar themes emerge in larger samples of

women?

• How do the perspectives of boys and men

who stutter compare to those of girls and women who stutter?

• How do we help persons who stutter persist in

educating those who most need it?

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References

• Blood, G.W., Blood, I.M., Tellis, G.M., & Gabel, R.M. (2003). A preliminary study of self-

esteem, stigma, and self-disclosure in adolescents who stutter. Journal of Fluency Disorders, 28, 143-159.

• Corcoran, J. A., & Stewart, M. (1998). Stories of stuttering: A qualitative analysis of interview
• narratives. Journal of Fluency Disorders, 23, 247–264.
• Cream, A., Packman, A., & Llewellyn, G. (2004). The playground rocker: A metaphor for

communication after treatment for adults who stutter. Advances in Speech-Language Pathology, 6(3), 182-187.

• Daniels, D.E., Gabel, R.M., & Hughes, S. (2012). Recounting the K-12 school experiences of

adults who stutter: A qualitative analysis. Journal of Fluency Disorders, 37, 71-82.

• Daniels, D.E., Hagstrom, F., & Gabel, R.M.(2006). A qualitative study of how African American

men who stutter attribute meaning to identity and life choices. Journal of Fluency Disorders, 31, 200-215.

• DiLollo, A., Neimeyer, R.A., & Manning, W.H.(2002). A personal construct psychology view of

relapse: indications for a narrative therapy component to stuttering treatment. Journal of Fluency Disorders, 27, 19-42.

• Finn, P. & Felsenfeld, S. (2004). Recovery from stuttering: The contributions of the qualitative

research approach. Advances in Speech-Language Pathology, 6(3), 159-166.

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References

• Irani, F., Gabel, R., Daniels, D., & Hughes, S. (2012). The long-term effectiveness of intensive

stuttering therapy: A mixed methods study. Journal of Fluency Disorders, 37, 164-178.

• Klompas, M., & Ross, E. (2004). Life experiences of people who stutter, and the perceived

imapct of stuttering on quality of life: Personal accounts of South African individuals. Journal

• f Fluency Disorders, 29, 275-305.
• Plexico, L,, Manning, W. H., & DiLollo, A. (2005). A phenomenological understanding of

successful stuttering management. Journal of Fluency Disorders, 30, 1–22.

• Plexico, L,, Manning, W. H., & DiLollo, A. (2010). Client perceptions of effective and ineffective

therapeutic alliances during treatment for stuttering. Journal of Fluency Disorders, 35, 333- 354.

• Plexico, L,, Manning, W. H., & Levitt, H. (2009 a). Coping responses by adults who stutter: Part
• I. Protecting the self and others. Journal of Fluency Disorders, 34, 87-107.
• Plexico, L,, Manning, W. H., & Levitt, H. (2009 b). Coping responses by adults who stutter: Part
• II. Approaching the problem and achieving agency. Journal of Fluency Disorders, 34, 108-126.
• Silverman, E-M. & Van Opens, K.(1980). An investigation of se- bias in classroom teachers’

speech and language referrals. Language, Speech, and Hearing Services in Schools, XI, 169- 174.

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References

• Silverman, E-M. & Zimmer, C. H. (1979). Women who stutter: Personality and speech
• characteristics. Journal of Speech and Hearing Research, 22, 553-564.
• Silverman, E-M. & Zimmer, C. H. (1982). Demographic characteristics and treatment

experiences of women and men who stutter. Journal of Fluency Disorders, 7, 273-285.

• Smith, J. A. & Osborn, M. (2003). Interpretive phenomenological analysis. In J. A. Smith (Ed.),

Qualitative Psychology (pp. 51-79). Thousand Oaks, CA: Sage Publications.

• Tetnowski, J.A., & Damico, J.S. (2001). A demonstration of the advantages of qualitative

methodologies in stuttering research. Journal of Fluency Disorders, 26, 17-42.

• Yaruss , J. S., Quesal, R. W., & Murphy, B. (2002). National stuttering association members’
• pinions about stuttering treatment. Journal of Fluency Disorders, 27 227–242.

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