Exploring Attitudes toward People Who Stutter

EXPLORING ATTITUDES TOWARD PEOPLE WHO STUTTER:

A MIXED MODEL APPROACH

Stephanie Hughes

A Dissertation

Submitted to the Graduate College of Bowling Green State University in partial fulfillment of

the requirements for the degree of

DOCTOR OF PHILOSOPHY

August 2008

Committee:

Rodney Gabel, Advisor

Jefferson E. Holcomb Graduate Faculty Representative

Roger Colcord

Larry Small

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ABSTRACT

Rodney Gabel, Advisor

The purpose of this study was to examine university students’ attitudes toward people

who stutter (PWS). A mixed model design explored the emotions, thoughts, and behaviors that

fluent speakers report when considering their interactions with PWS. 150 university students

responded to a 9-item, open-ended survey. Their responses were analyzed thematically to

explore participants’ perceptions regarding (a) descriptions of PWS and why these descriptions

are appropriate, (b) the causes of stuttering, (c) difficulties associated with being a person who

stutters, and (d) important considerations or facilitative techniques when interacting with PWS.

The themes derived from participants’ responses to the survey questions were also analyzed

quantitatively to examine group differences according to gender and level of familiarity with

PWS.

The results indicate that participants gave as many positive descriptions as negative

descriptions of PWS and were able to provide a rationale for their responses. The causes of

stuttering were generally considered to be neurophysiological, genetic, or psychological in

nature. Stuttering was perceived as having adverse social, academic, and vocational effects on

the lives of PWS. Participants also reported uncertainty about how to interact appropriately with

PWS. There were no significant differences for any of the survey questions on the basis of

participants’ gender or level of familiarity with PWS. The implications of these findings for fluent speakers,

PWS, and speech-language pathologists are discussed.

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For Marlowe, my constant companion for the past three years.

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ACKNOWLEDGMENTS

I would like to thank the members of my committee: my advisor, Rod Gabel, Roger

Colcord, Larry Small, and Jeff Holcomb. Rod, thank you for your unflagging support. I have

learned so much from you about how to be a good researcher, teacher, and clinician. I appreciate

all of the time and effort you invested in me as your student and look forward to our continued

collaboration. Roger, I have learned a great deal from you during our classes together. Thank

you for being so willing to share your knowledge of stuttering with me. Larry, your support over

the past four years has been one of the best parts of my program. Thank you for being such a

great chair. Jeff, thank you for so readily agreeing to be on my committee!

Dr. Mark Earley has given me an understanding of research design and statistics that I

never would have thought possible before beginning this journey. Your help with this study’s

design was invaluable. Thank you for being such an innovative instructor and a wonderful

person.

Farzan Irani and Adam Schlagheck deserve much credit for serving as peer reviewers.

Thank you both for the countless hours you spent coding data to ensure that this study was as

free from my biases as possible.

Thank you also to Derek Daniels and Biji Philip. Your support over the past four years

has been invaluable, and I will always treasure our friendship.

Finally, thank you to the Communication Disorders doctoral students at Bowling Green

State University: Charlie Hughes (welcome to the club, Bro!), Farzan Irani, Ramya Konnai,

Scott Palasik, Emily Rusnak, Eric Swartz, and Haidee Tan. I will never again hear the words

“tater tot,” “good, good,” or “Easy Onset” without thinking of you all. Thank you for livening

the place up.

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TABLE OF CONTENTS

Page

CHAPTER 1. INTRODUCTION ......................................................................................... 1

CHAPTER 2. LITERATURE REVIEW .............................................................................. 3

Attitude Theory.......................................................................................................... 3

Attitudes toward PWS as Reported in the Literature................................................. 7

Listeners’ Attitudes toward Stuttering ........................................................... 7

Variables that Influence Attitudes toward PWS ............................................ 26

Attempts to Ameliorate Negative Attitudes............................................................... 49

Need for the Present Study ........................................................................................ 50

Research Questions.................................................................................................... 54

CHAPTER 3. METHOD ...................................................................................................... 56

Design …………........................................................................................................ 56

Participants…............................................................................................................. 58

Instrumentation…………………………………………………………………… .. 64

Written Survey ............................................................................................... 64

Interviews....................................................................................................... 65

Procedures…….......................................................................................................... 66

Pilot Study...................................................................................................... 66

Data Collection .............................................................................................. 67

Data Analysis ................................................................................................. 68

Credibility ...................................................................................................... 70

Reliability....................................................................................................... 72

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CHAPTER 4. RESULTS...................................................................................................... 74

Survey Question 1: If you have had a conversation with someone who stutters,

what was it like? If you have not had a conversation with someone who

stutters, what do you think it would be like? ................................................. 75

Survey Question 2: How would you describe someone who stutters? Why did

you choose these words?................................................................................ 106

Survey Question 3: How do you think people who stutter are affected by their

stuttering? Please explain............................................................................... 141

Survey Question 4: If you were a person who stutters, how would your life be

different, and why? ........................................................................................ 156

Survey Question 5: What is a good way to act around someone who stutters?

Please explain................................................................................................. 174

Survey Question 6: What can people who stutter do to help their listeners?

Please explain................................................................................................. 186

Survey Question 7: What do you think causes stuttering? ........................................ 202

Survey Question 8: What kinds of experiences have you had with people who

stutter? Please explain.................................................................................... 215

Survey Question 9: Please share any comments you have about stuttering or your

reactions to these questions……………………………………………….... 237

Findings Related to the Research Questions……………………………………….. 248

CHAPTER 5. DISCUSSION................................................................................................ 257

Describing Fluent Speakers’ Experiences with PWS………………………………. 257

Benefits of this Study as Compared to the Existing Research………………………. 270

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New Directions in Attitude Research………………………………………………. 272

Implications………………………………………………………………………… 274

Limitations of the Study and Ideas for Future Research............................................ 280

Conclusions…............................................................................................................ 285

REFERENCES………… ...................................................................................................... 288

APPENDIX A. VISUAL REPRESENTATION OF THE DESIGN.................................... 304

APPENDIX B. WRITTEN SURVEY .................................................................................. 305

APPENDIX C. INFORMED CONSENT DOCUMENT - WRITTEN SURVEY............... 316

APPENDIX D. INFORMED CONSENT DOCUMENT - INTERVIEW ........................... 318

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LIST OF TABLES

Table Page

1 Sample vs. BGSU Demographics by Age, Academic Standing, and Ethnicity ........ 62

2 Frequency Counts and Percentages of Participants’ Familiarity with PWS.............. 63

3 Measures of Inter- and Intra-Rater Reliability........................................................... 73

4 Means and Standard Deviations for Effort Statements.............................................. 94

5 Means and Standard Deviations for Emotion Statements.......................................... 101

6 Participants’ Descriptions of PWS with Representative Statements ......................... 107

7 Participants’ Explanations for their Descriptions of PWS......................................... 108

8 Means and Standard Deviations for Descriptive and Explanatory Statements.......... 125

9 Correlations for Types of Descriptions and Types of Explanations .......................... 140

10 Means and Standard Deviations for Question 3 Themes........................................... 151


12 Comparison of Questions 3 and 4 with Means and Standard Deviations.................. 173




16 Means and Standard Deviations for Selected Question 8 Themes ............................ 228

17 Correlations for Types of Relationships with PWS and Descriptions of

Participants’ Interactions with PWS .......................................................................... 236


19 Components of Fluent Speakers’ Attitudes and their Implications for PWS…………. 267

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CHAPTER 1

Introduction

Stuttering is a communication disorder that disrupts the smooth, forward flow of speech

(Guitar, 2006). People who stutter (PWS) experience disruptions in their speech fluency as well

as adverse affective, cognitive, and behavioral reactions that stem from these disruptions

(Bennett, 2006). These reactions seem to occur, at least in part, from the anticipation of negative

reactions from listeners toward stuttering (Bloodstein, 1995; Sheehan, 1975; Van Riper, 1982).

Thus, “stuttering is apparently as much a disorder of communication as it is of speech; the

receiver [listener] is at least as important as the sender [person who stutters] in the interchange”

(Van Riper, 1982, p. 148).

Listener reactions to stuttering have been considered important for many decades.

Johnson (1934) surveyed PWS and found that stuttering in front of a close friend or family

member was perceived as less embarrassing than stuttering in front of strangers. Johnson

concluded that listener reactions influence PWS in a variety of ways, and that listeners should

make PWS feel as comfortable as possible by:

acting and speaking [so] that the stutterer will feel secure in one’s presence, will feel that

he is being accepted as an individual, and will feel that he has nothing to lose by

stuttering. Classroom teachers, speech clinicians, parents and society in general should

apply this knowledge at every opportunity. (44)

This statement suggests that there are appropriate and beneficial communication strategies that

listeners should employ in their interactions with PWS; however, few if any researchers have

provided specific details about these strategies or evidence for their effectiveness.

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It has become widely accepted that listener reactions to stuttering can inspire an

emotional reaction in PWS and can influence the severity of stuttering (Bloodstein, 1995). As

such, listener reactions to stuttering may affect PWS in a wide variety of contexts, including the

formation of intimate and social relationships (Boberg & Boberg, 1990; Linn & Caruso, 1998;

Shears & Jensema, 1969), educational experiences (Crowe & Walton, 1981; Dorsey & Guenther,

2000; Lass et al. 1992, 1994; Ruscello, Lass, Schmitt, & Pannbaker, 1994; Turnbaugh, Guitar, &

Hoffman, 1981), and interactions with speech-language pathologists (Lass et al. 1989; Ragsdale

& Ashby, 1982; Turnbaugh, Guitar & Hoffman 1979; Woods & Williams, 1971; Yairi &

Williams, 1970).

The purpose of this study is to conduct an in-depth investigation of fluent speakers’

attitudes toward stuttering and PWS. To accomplish this purpose, a mixed model research design

with an emphasis on qualitative methods was implemented to gain a more thorough

understanding of attitudes toward PWS and how these attitudes may affect interactions between

PWS and fluent speakers. The chapters are organized as follows: Chapter 2 provides a review of

attitude theory and examines the attitudes of fluent speakers toward PWS that have been reported

in the literature. A rationale for the present study and the guiding research questions are also

included in this chapter. Chapter 3 gives a detailed account of the study’s methods. Chapter 4

provides the qualitative and quantitative findings of the study. Chapter 5 discusses these findings

related to the research questions and provides implications for fluent speakers, PWS, speech-

language pathologists, and future research.

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CHAPTER 2

Literature Review

Attitude Theory

Many definitions for the term “attitude” have been proposed by various researchers, but

some commonalities among definitions exist. Attitudes are considered by most researchers to be

“overall evaluations of objects, which can be physical objects, people, policies, behaviors, etc.”

(Wegner & Carlston, 2005, p. 493). Attitudes are also considered to be dispositions to behave in

certain ways (Jaccard & Blanton, 2005). Furthermore, researchers generally agree that attitudes

consist of affective, behavioral, and cognitive components (Breckler, 1984; Triandis, 1971),

although the relative importance of and correlation between affect, behavior, and cognition in the

formation of attitudes has been debated (Eagly & Chaiken, 1993; Greenwald, 1989a; Zanna &

Rempel, 1988). Attitudes have tended to be viewed as stable constructs that remain unchanged

over time (Katz, 1960; Fishbein & Ajzen, 1975); however, more recent theories indicate that

attitudes are less stable than were previously thought (Kruglanski & Stroebe, 2005). Researchers

have found that attitudes can be contextually specific and may depend on the individual’s mood

and thoughts at the time he or she is asked attitudinally-related questions (Erber, Hodges, &

Wilson, 1995; Potter, 1998). Attitudes may even change as individuals are asked to provide a

rationale for their attitudes (Wilson, Kraft, & Dunn, 1989). Thus, the complex nature of attitudes

has resulted in several theories of attitude formation and attitude change.

Several theories have been proposed related to attitude formation and will be examined in

this review. Some theorists suggest that attitudes are learned and result from an individual’s

affective response to an environmental stimulus (e.g., Doob, 1947). Other theories suggest that a

person’s attitude and his or her behavior are related, so that measures of attitudes toward a given

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object can be used to predict a person’s behavior (Ajzen & Fishbein, 1977). In addition, Fishbein

and Ajzen (1975) provide a conceptual framework that relates beliefs, attitudes, intentions, and

behaviors toward an attitude object. For the purposes of this discussion, the attitude object may

be defined as a person who stutters. In this model, an individual holds beliefs about PWS. These

beliefs are linked to the individual’s intentions with respect to PWS. The individual’s behavior

toward PWS will then be influenced by his or her intentions. Behaviors and attitudes also interact

with beliefs, causing a feedback loop at various stages in the process. Additional research has

shown that attitudes will be especially correlated with behaviors if the person has had experience

with the attitude object or if his or her attitude is cognitively accessible (Fazio, 1990). Thus, the

behavior of an individual may be influenced by previous experiences or by any strongly-held

beliefs that predispose the individual to act a certain way toward an attitude object.

Some theorists have proposed that attitudes may be best understood in terms of the

functions that they serve for an individual (Rosenberg, 1956). Attitudes may serve multiple

functions for an individual, and these functions may vary depending on the situation (Snyder &

DeBono, 1989). For example, Katz (1960) proposed that some of these functions may include

maintaining the person’s self esteem and protecting the individual from unpleasantness (ego-

defensiveness function); helping the person to express values and beliefs (value-expressive

function); allowing the individual, based on learned experiences, to develop positive attitudes

toward things that are perceived as rewarding and negative attitudes toward things that may

result in negative consequences (adjustment or utilitarian function); and developing cognitive

schemas to organize knowledge (knowledge function). It is the cognitive functions of attitudes

that have been most thoroughly examined by researchers. Festinger (1957) suggested that

individuals seek out people and experiences that compliment their existing attitudes and avoid

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those people and experiences that are in conflict or disagree with their existing attitudes. If a

conflict does arise in which the individual is forced to reevaluate the appropriateness of his or her

attitude, cognitive dissonance can result. To relieve this cognitive dissonance and its associated

discomfort, the individual will come to change one or more of the affective, cognitive, or

behavioral components that comprise the attitude.

Attitudes also seem to provide a simplified cognitive guide for people as they encounter

an object, person, or event (Pratkanis, 1989). Individuals tend to rely on attitude heuristics to

provide a simple strategy for solving a problem. For example, one’s attitude toward physical

disability will influence one’s decision to either avoid or approach a person in a wheelchair. If

one holds a negative attitude toward disability, the attitude heuristic dictates that the person in

the wheelchair should be avoided. Conversely, if one has a positive attitude toward disability, the

attitude heuristic dictates that the person in the wheelchair can be approached (Pratkanis, 1989).

Thus, it appears that attitudes serve a variety of cognitive purposes that also influence behavior.

It seems reasonable to assume that fluent speakers will interact with PWS according to their

previous experiences with PWS and the attitudes that they hold regarding stuttering.

In addition to the cognitive functions mentioned above, a relatively new trend has been to

examine attitudes from the perspective of what motivates the individual who possesses the

attitude. Greenwald (1989b) suggests that “attitude toward the self (self-esteem) is a powerful

determinant of social behavior” (p. 438). According to this theory, people may seek out the

company of others with whom they feel most similar and reject the company of those with whom

they feel most dissimilar. Self-esteem may be a powerful motivator in which individuals try to

closely align themselves with ideal or desirable people, places, or objects, and reject those

people, places, or objects that seem to be repulsive or are not appealing socially. Individuals who

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hold favorable attitudes toward something or someone will react more positively to statements

that uphold this positive viewpoint. Similarly, individuals who hold negative attitudes toward an

attitude object will react most positively to statements and situations that uphold this negative

viewpoint. Such processes would appear to minimize cognitive dissonance whilst confirming and

strengthening the individual’s original attitude. Greenwald (1989b) also suggests that people who

have experience with a given attitude object will hold stronger attitudes that have a more

predictable effect on behavior; however, people are also very good at forming opinions rapidly in

response to a situation, object, or person that they have never before experienced. These theories

suggest that it may be useful to investigate the cognitive, motivational, ego-protective, and other

functions that have an impact on how PWS are perceived.

Attitudes may also have important repercussions not only for the individuals who possess

them, but for others with whom these individuals interact. Because attitudes can predict

behavior, it is important to be able to measure the strength of one group’s attitudes toward

another group. Unfortunately, the relationship between attitudes and behavior is complex one.

Attitudes can be measured only inferentially in terms of observable cognitive, affective, and

behavioral responses to an attitude object, such as PWS (Eagly & Chaiken, 1993). Fishbein and

Ajzen (1975) reviewed 109 attitude-behavior relation studies and found that high correlations

were observed for attitudes and behaviors only when the measures of both attitudes and

behaviors were suitably specific. These findings indicate that it is very important to use research

methods that will provide a thorough understanding of the affective and cognitive responses that

may contribute to behaviors. It is necessary, therefore, to thoroughly explore the cognitive and

affective responses of fluent speakers toward stuttering in order to be able to better understand

their attitudes toward PWS.

7

Attitudes toward PWS as Reported in the Literature

A large body of literature has been generated about the characteristics of PWS and the

attitudes of listeners toward PWS. The concept of the “stuttering personality” was emphasized in

the early stuttering literature (Bender, 1939; Bryngelson, 1937; Green, 1936), with most

researchers of this period indicating that personality differences existed between PWS and fluent

speakers (Bryngelson, 1937; Johnson, 1932; Solomon, 1938). Thus, the measurement of

personality began to be emphasized as a clinical tool for speech clinicians who treated PWS

(Hawk, 1948), and a variety of personality tests such as the Rorschach test (Meltzer, 1944), the

California Test of Personality (Perkins, 1947), and projection tests (Wilson, 1951) were

administered to PWS. The results of these early research studies suggested that PWS possess

more unstable or neurotic personalities as compared to the general population. Subsequent

reviewers of this literature rejected the notion of the stuttering personality and indicated that

PWS are not psychologically different from people who do not stutter (Andrews et al., 1983;

Bloodstein, 1995; Prins, 1972; Sheehan, 1958; Van Riper, 1982). It seems that because most

researchers now agree that PWS do not possess significantly different personality traits as

compared to the general public, research efforts have shifted away from psychological tests of

personality and instead have focused on measuring listener perceptions of stuttering and PWS.

Listeners’ Attitudes toward Stuttering

Attitudes of speech clinicians. A series of seminal studies that explored speech clinicians’

attitudes toward PWS were conducted by Yairi and Williams (1970) and Woods and Williams

(1971). These studies have served as a foundation for most of the existing research on this topic.

Yairi and Williams (1970) asked school-based speech clinicians in the state of Iowa to complete

an open-ended questionnaire. In this questionnaire, the clinicians were asked to provide a written

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list of traits that could be used to describe elementary school-age boys who stutter. Participants

most frequently provided a total of 26 traits to describe boys who stutter. Seventeen of these

traits were judged by the researchers to be negative or undesirable, and only nine of the traits

were judged to be positive or desirable. Most of these characteristics were related to personality

traits rather than to physical or intelligence traits. The ten most cited traits, in order of the most

frequently occurring, were nervous, shy, withdrawn, tense, anxious, self-conscious, insecure,

sensitive, quiet, and intelligent. As the clinicians’ years of clinical experience increased, so too

did the median number of adjectives that they listed to describe boys who stutter. The provision

of more adjectives was viewed as being indicative of a stronger, more stereotypical belief system

about boys who stutter (Yairi & Williams, 1970). In a similar study, speech clinicians were asked

to write adjectives that described adult men who stutter (Woods & Williams, 1971). Once again,

the respondents provided mostly negative adjectives. The similarity of the adjectives used to

describe both men and boys who stutter indicated that clinicians may stereotype people who

stutter regardless of individual differences. Thus, there may be a trend among clinicians to

believe that “a stutterer is a stutterer is a stutterer” (Woods & Williams, 1971, p. 232).

The adjectives that the speech clinicians provided to describe boys and men who stutter

(Woods & Williams, 1971; Yairi & Williams, 1970) were arranged as semantic differential

scales by Woods and Williams (1976). The semantic differential method (Osgood, Suci, &

Tannenbaum, 1957) allows researchers to measure attitudes via a seven-point bipolar scale with

contrasting adjectives on either end of the scale. The Woods and Williams (1976) semantic

differential scales consisted of 25 paired items (e.g., open-guarded, friendly-unfriendly, fearful-

fearless, etc.). These scales were administered to seven groups of respondents, including speech

clinicians in public school settings. Participants used these scales to rate each of four

9

hypothetical people, including a typical eight-year-old male, a typical eight-year-old male who

stutters, a typical adult male, and a typical adult male who stutters. The results of this study

indicated that 95% of traits that were judged as negative were applied to males who stutter versus

typical males who did not stutter. Significant differences in ratings were not found for the age of

the hypothetical person who stutters (child versus adult) or for the participant group (e.g., speech

clinicians, students, teachers). These negative attitudes indicated the presence of a pervasive

negative stereotype towards PWS by most groups of listeners, including speech clinicians

(Woods & Williams, 1976).

In a similar study, Turnbaugh, Guitar, and Hoffman (1979) used semantic differential

scales (Woods & Williams, 1976) to measure the attitudes of speech language pathologists

(SLPs) toward PWS based upon stuttering severity. The 36 SLPs who served as participants

were asked to rate a hypothetical “typical individual” who was (a) normally fluent, (b) stuttered

mildly, (c) stuttered moderately, or (d) stuttered severely. The results of this study confirmed that

SLPs perceive PWS more negatively as compared to fluent speakers. There was an increase in

negative attitudes toward PWS when responses toward the mild stuttering and severe stuttering

conditions were compared. Only a weak negative correlation between SLPs’ years of experience

and their ratings of PWS was found, leading the authors to conclude that there was not a linear

relationship between SLPs’ experiences with PWS and their attitudes toward PWS.

Ragsdale and Ashby (1982) also surveyed SLPs using a semantic differential scale. In

this study, 206 SLPs were administered a newly-developed semantic differential scale that

assessed listeners’ attitudes on five dimensions, including evaluation (e.g., good-bad, successful-

unsuccessful), potency (e.g., strong-weak, hard-soft), activity (e.g., tense-relaxed, active-

passive), understandability (e.g., clear-confusing, usual-unusual), and anxiety (e.g., anxious-

10

calm, disturbed-undisturbed). Speech-language pathologists were found to hold mostly negative

views of PWS; however, SLPs who possessed the American Speech-Language-Hearing

Association’s Certificate of Clinical Competence showed more favorable responses to stuttered

speech samples. Perhaps most surprising was the finding that SLPs’ coursework or clinical

experiences with PWS did not result in significantly more favorable ratings of PWS. In addition,

the speech sample of a female who stuttered was rated more favorably on some dimensions than

a male who stuttered. The authors suggested that this finding may be related to the fact that more

males than females stutter, and that SLPs may have stronger preconceived notions or more actual

clinical experiences with males who stutter than females who stutter (Ragsdale & Ashby, 1982).

The attitudes of students in training to become SLPs and audiologists have also been

examined (St. Louis & Lass, 1981). In this study, 1,902 speech-language pathology and

audiology students from among 33 universities completed the Clinicians Attitude Toward

Stuttering (CATS) Inventory (Cooper, 1975). The CATS Inventory asks 50 attitudinal questions to

which respondents indicate the strength of their agreement on a five-point scale which ranges

from “strongly agree” to “strongly disagree.” As a group, the speech-language pathology and

audiology students appeared to believe that PWS have psychosocial problems and that

counseling PWS and their parents is an important component of stuttering therapy. Students who

had more clinical training also seemed to hold these views, a finding which the authors attributed

more to social acculturation in the United States than a by-product of clinician training.

Participants also seemed to feel that stuttering was one of the hardest disorders to treat and

indicated that most SLPs are neither competent nor comfortable when treating PWS. St. Louis

and Lass (1981) suggested that more research is needed to examine the effects of specific types

of training on student clinicians’ attitudes toward PWS.

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Silverman (1982) investigated the perceptions of 160 SLPs and 176 university students

regarding eight hypothetical individuals (“a girl,” “a girl who stutters,” “a boy,” “a boy who

stutters,” “a woman,” “a woman who stutters,” “a man,” and “a man who stutters”). The primary

purpose of this study was to determine if perceptions of girls and women who stutter are

different than the negative stereotype that has been reported for boys and men who stutter. A 47-

scale semantic differential questionnaire (Silverman & Zimmer, 1979) was administered to

participants, with each participant completing the scales for only one of the eight hypothetical

individuals. The results indicated that SLPs view females who stutter as being significantly

different on a variety of personality traits as compared to females in general and males who

stutter. The SLPs seemed to have a stronger negative stereotype for a female who stutters than

for a male who stutters, a finding that conflicts with that of Ragsdale and Ashby (1982). The

university students who participated in the study appeared to have a stronger stereotype for males

than for females who stutter, suggesting that different groups of people (e.g., professionals

versus laypersons) may hold different perceptions of PWS depending on the gender of the PWS

(Silverman, 1982).

Cooper and Cooper (1985) indicated that it is important to know what attitudes SLPs hold

about stuttering and PWS, as these attitudes will presumably influence therapeutic protocols and

treatment outcomes. They examined the attitudes of 674 SLPs toward stuttering, PWS, and

related issues by administering the CATS Inventory to SLPs who attended a workshop on

stuttering over a ten-year period. The authors found that over the ten-year time period there were

some changes in SLPs’ attitudes toward the personality of PWS. For example, as compared to

the sample gathered in 1973-1974, significantly fewer SLPs agreed in 1983 that PWS have

psychological problems and hold distorted perceptions of their own stuttering behavior and

12

social relationships. Other attitudes toward the personality of PWS did not show a significant

change over the course of the study. The majority of SLPs continued to believe that stuttering, as

compared to other speech disorders, is the most psychologically devastating. They also believed

that there are personality traits that are representative of PWS, and that PWS have feelings of

inferiority. Cooper and Cooper (1996) continued to administer the CATS Inventory to SLPs until

they had data that spanned two decades from 1983-1991. They found that attitudes among

clinicians had not changed significantly across the two decades in regard to the personality of

PWS.

Cooper and Rustin (1985) also utilized the CATS Inventory to assess cross-cultural

attitudes toward stuttering and PWS. They administered the CATS Inventory to 371 American

SLPs from six states and 331 SLPs from Great Britain. The results indicated that there were

significant differences between British and American clinicians in terms of appropriate treatment

strategies and perceptions of attitudes toward PWS. British clinicians were more likely to believe

that PWS have psychological problems, but American clinicians were more likely to believe that

clinicians should be more understanding of the feelings of their clients who stutter. American

clinicians were also more likely to believe that the general public has a more negative response

toward stuttering than do British clinicians. Cooper and Rustin (1985) indicated that the trend for

both American and British clinicians to attribute certain personality traits to PWS is troubling, as

there is little data to support these beliefs.

Horsley and FitzGibbon (1987) investigated the attitudes of speech clinicians and student

speech clinicians with various degrees of training toward children who stutter (CWS). For

comparison purposes, primary school student teachers and secondary school teachers also served

as participants. Participants completed semantic differential scales (Woods & Williams, 1976)

13

for eight hypothetical constructs that included stutterer/nonstutterer, pre-school/eight-year-old,

and boy/girl variables. Ratings of CWS were consistently negative, and for all but five traits a

statistically significant difference was found between ratings of CWS and children who do not

stutter. Some participants reported knowing PWS, however, this variable did not appear to

influence participants’ ratings of CWS. This finding may have important implications for

clinicians who treat PWS. The relationship between stereotypic beliefs and one’s actions is not

clear; however, stereotypes held by SLPs may have an effect on the therapeutic interaction

between clinicians and their clients who stutter, perhaps even to the extent that young CWS may

learn to fulfill the clinician’s negative expectations (Horsley & FitzGibon, 1987).

Unlike other researchers of the time, Lass et al. (1989) did not use semantic differential

scales or other quantitative methods to assess SLPs’ attitudes toward PWS. Instead, they asked

SLPs to write adjectives that described four hypothetical people who stutter, including a female

child, male child, female adult, and male adult. The inclusion of females (i.e., a female child and

female adult) was lacking in previous studies that had used this methodology (Woods &

Williams, 1970; Yairi & Williams, 1971). The SLPs provided a total of 529 adjectives to

describe the four types of hypothetical PWS, of which 69.9% were negative in nature, 24.2%

were positive, and 5.9% were neutral. Traits that describe personality were most often listed,

suggesting that many SLPs have negative stereotypes of PWS. Lass and colleagues (1989)

suggested that these negative stereotypes may be alleviated if SLPs can learn to separate the

person who stutters from his or her stuttering.

The self perceptions of SLPs their perceptions of PWS have been compared to determine

if differences exist between the perceptions of SLPs and members of the general public

(Kalinowski, Armson, Stuart, & Lerman, 1993). Semantic differential scales adapted from

14

Woods and Williams (1976) were administered to 58 SLPs and 138 members of the general

public. Participants were asked to complete the scales for themselves and for “a hypothetical

typical adult male stutterer.” The findings indicated that participants’ perceptions of PWS were

more negative than the self perceptions of SLPs and the general public. In addition, there were

only minimal differences in ratings reported for SLPs and the general public, suggesting that

both groups possess a strong negative stereotype of PWS.

The preceding studies indicate that speech clinicians consistently have held the same

negative attitudes toward PWS for over thirty years. It seems reasonable to assume that speech

clinicians who consider PWS to be psychologically different from typical speakers will interact

with their clients in a less than desirable manner, but how the attitudes of clinicians affect the

client-clinician relationship remains unclear at this time. It does appear, however, that SLPs

report stereotypical beliefs about PWS that are no different from those of people who have not

been trained to treat communication disorders.

Attitudes of educators. Like speech clinicians, the attitudes of educators toward stuttering

and PWS has been examined for many decades. As the following discussion will indicate,

educators generally report negative attitudes toward PWS. In one of the earliest studies of its

kind, Emerick (1960) explored the relationship between elementary school teachers’ ability to

count or tally instances of stuttering and their attitudes toward stuttering. The Iowa Scale of

Attitude Toward Stuttering was administered to 21 male and 127 female teachers. A speech

stimulus consisting of a 3.5 minute audiotaped recording of a male who stutters was made (the

types and amount of disfluencies were not disclosed by the author). Participants were instructed

to keep a count of the amount of stuttering they heard as the speech sample was played. The

order in which participants completed the attitude scale or heard the speech sample varied.

15

Statistical analysis of the data indicated a relationship between the amount of disfluencies noted

by participants and their attitudes toward PWS. Participants who had a more tolerant attitude

toward stuttering tended to observe more disfluencies. This trend applied most particularly to

those teachers who had taken at least one course in speech pathology as compared to teachers

with no formal training. Emerick (1960) suggested that training in speech pathology might result

in more tolerant attitudes toward stuttering while at the same time decreasing tolerance for

speech nonfluencies (e.g., typically occurring disfluencies that are not generally considered to be

core stuttering behaviors).

More recent research has also explored teachers’ attitudes toward stuttering. The attitudes

of 100 elementary school teachers toward stuttering were examined by Crowe and Walton

(1981). The teachers in this study completed the Teacher Attitudes Toward Stuttering (TATS)

Inventory which consisted of 36 attitude-based statements and nine general information

questions about stuttering. The TATS Inventory had not been validated at the time of the study.

Participants also completed the Alabama Stuttering Knowledge (ASK) Test, which consists of 26

true/false statements about stuttering. A total of 33 speech-language pathologists rank-ordered,

from zero to four, possible responses on the TATS Inventory, so that the most desirable teacher

responses were given a value of four and least desirable were given a value of zero. The results

indicated that teachers who had a greater knowledge of stuttering as measured on the ASK Test

had more desirable attitudes toward stuttering. Teachers who indicated that they currently had a

student who stuttered in their classroom had less desirable attitudes and scored lower on the ASK

Test than did teachers who did not have a student who stuttered. These findings would seem to

suggest that educators who teach students who stutter develop more negative attitudes toward

16

stuttering and PWS as compared to educators who have not had a student who stutters in the

classroom.

The research related to educators’ attitudes toward PWS has not been limited to only

elementary and secondary school teachers. Silverman (1990) examined whether 87 college

professors from three universities held negative attitudes towards a hypothetical student who

stutters. An 81-item semantic differential questionnaire (Silverman, 1985) was administered to

participants, but data for only two of these items, competent-incompetent and intelligent-

unintelligent, were reported. The results indicated that the vast majority of professors rated a

student who stutters as being at the center or towards the more positive end of the Likert scale for

these scale items. These results suggest that professors do not hold negative attitudes toward the

intelligence or competence of students who stutter; however, a control group (i.e., rate “a typical

student”) was not implemented in this study.

Dorsey and Guenther (2000), citing the lack of control group in the Silverman (1990)

study, conducted a survey in which 34 professors and 57 college students used a 7-point

semantic differential scale to rate either an average college student or a college student who

stutters on 20 personality traits. Four of the 20 traits (guarded, perfectionist, reserved, and

talkative) were judged to be neutral traits by a separate group of college students and professors,

and so participants’ responses on these traits were not analyzed. The remaining items consisted

of a number of positive traits (open, intelligent, bold, calm, self-assured, competent, and bright)

and negative traits (nervous, shy, self-conscious, passive, aggressive, dull, mediocre, reticent,

and incompetent). The results indicated that for all but one trait, aggressiveness, professors rated

the hypothetical college student who stutters as possessing more negative traits than the

hypothetical average college student. College students perceived the hypothetical college student

17

who stutters to hold more negative personality traits for 13 items as compared to the hypothetical

average college student. The college students felt that a student who stutters was more likely to

be less aggressive, less incompetent, and more intelligent as compared to the average college

student. Overall, the professors who participated in the study rated the college student who

stutters more negatively than did the college students, although these ratings varied on individual

items. Dorsey and Guenther (2000) suggested that although college students and professors may

be reluctant to engage in interactions with students who stutter, increased interaction

opportunities and educational programs about stuttering may help to change negative attitudes

toward PWS.

A series of studies by Lass, Ruscello, and colleagues (Lass et al. 1992, 1994; Ruscello,

Lass, Schmitt, & Pannbaker, 1994) asked elementary and secondary school teachers, school

administrators, and special education teachers to provide adjectives that describe four

hypothetical people who stutter, including a female child, male child, female adult, and male

adult. Similar results were found for all groups of respondents. Elementary and secondary school

teachers provided a total of 287 adjectives to describe PWS, of which 66.9% were negative in

nature, 20.2% were positive, and 12.9% were neutral (Lass et. al., 1992). A replication of this

study by Silverman and Marik (1993) found similar results. School administrators provided a

total of 197 adjectives to describe PWS of which 72.6% were negative in nature, 19.8% were

positive, and 7.6% were neutral (Lass et. al., 1994). Special educators provided a total of 241

adjectives to describe PWS of which 67.2% were negative in nature, 17.4% were positive, and

15.4% were neutral (Ruscello et. al., 1994). Thus, when asked to provide written descriptions of

PWS, professionals involved in education are likely to provide adjectives that are primarily

18

negative in tone, suggesting that educators, like SLPs, may be more tolerant of PWS if they

could separate stuttering from the person with the stuttering disorder (Lass et al., 1989).

Thus, with few exceptions (e.g., Silverman, 1990), it appears that educators and

administrators in school and university settings hold negative attitudes toward PWS. Even when

educators report knowing students who stutter (e.g., Crowe & Walton, 1981; Lass et al., 1992),

the negative stereotype of PWS persists. It is not well understood how teachers’ perceptions of

PWS influence their behavior toward students who stutter in the classroom. More research is

needed that provides a more in-depth exploration of teachers’ attitudes toward PWS and

correlates teachers’ attitudes with their behavior toward students who stutter in their classrooms.

Attitudes of medical professionals. Parents who are concerned about stuttering in their

child’s speech often turn to the child’s pediatrician for advice. Some physicians may take a “wait

and see” approach that does not relate to current best practices in early childhood stuttering

intervention (Yairi & Carrico, 1992). A comprehensive study was, therefore, conducted by Yairi

and Carrico in which 439 pediatricians responded to a questionnaire that asked about their

attitudes and practices toward young children who stutter. One item on the questionnaire asked

the pediatricians to state whether preschool children who stutter are above normal, below

normal, or are no different from normally-speaking children in terms of emotional stability,

intelligence, and maturity. Fifty-six percent of pediatricians thought that there was no difference

between preschoolers who stutter and those who do not in terms of emotional stability, but the

remaining 44% felt that preschool children who stutter are below normal for emotional stability.

Ten percent of pediatricians felt that preschoolers who stutter possess above normal intelligence,

1% below normal intelligence, and 56% of pediatricians felt that there was no difference in

intelligence between preschoolers who stutter and those who do not. Finally, for maturity, 2% of

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pediatricians thought that preschoolers who stutter have above normal maturity, 24% below

normal maturity, and 74% of pediatricians felt that there is no difference in maturity between

preschoolers who stutter and those who do not. These results appear to indicate that the majority

of physicians believe that there is no difference between preschoolers who stutter and those who

do not on the traits of emotional stability, intelligence, and maturity.

Attitudes of employers and employment Issues. Several researchers have examined

perceptions of employability for PWS. These studies have examined the perceptions of

rehabilitation counselors, employers, and students toward appropriate career choices for PWS.

Most studies have indicated that respondents feel that PWS are less employable than are

members of the general population and that PWS are better suited for some careers than others.

The review of the following studies indicates that PWS are at risk for occupational stereotyping.

Hurst and Cooper (1983a) developed the Alabama Rehabilitation Counselor’s Attitudes

Toward Stuttering (ARCATS) Inventory to assess vocational rehabilitation counselors’ attitudes

toward and knowledge of stuttering. The ARCATS Inventory consists of 25 true-false statements

that assess knowledge of stuttering and 15 statements that assess attitudes toward stuttering. One

hundred fifty-two vocational rehabilitation counselors in the state of Alabama completed the

ARCATS Inventory. Of these participants, 34.6% had never served PWS on a professional basis,

but 50.8% had served between one and four PWS. The results of the study suggested that the

participants believed that PWS have psychological problems and have certain identifiable

personality traits. On a positive note, the rehabilitation counselors’ responses suggested that

stuttering is perceived as being amenable to therapy and that PWS are good candidates for

vocational rehabilitation. Thus, vocational rehabilitation counselors may hold attitudes that are

conducive to the rehabilitation of PWS (Hurst & Cooper, 1983a).

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Hurst and Cooper (1983b) administered the Employer Attitudes Toward Stuttering

(EATS) Inventory to 644 employers. The EATS Inventory did not undergo validity or reliability

assessment prior to being used in the study. It consists of seven attitudinal statements about

stuttering to which respondents indicate their agreement on a five-point scale that range from

“strongly agree” to “strongly disagree.” The employers who participated in the study had a

variety of experience with interviewing and employing PWS. Thirty-six percent of employers

had interviewed between one and three PWS, and 40% reported employing between one and

three PWS. The results of the survey indicated that the majority of participants reported that

stuttering interferes with employability, but does not necessarily impact job performance. Three

out of five employers reported feeling uncomfortable when speaking with PWS, and the same

amount of employers rejected the idea of affirmative action programs for PWS. These findings

suggest that stuttering may handicap PWS for employability purposes.

Silverman and Paynter (1990) used an 81-item semantic differential questionnaire

(Silverman, 1985) to assess 48 college students’ perceptions of the occupational competency of

PWS as compared to fluent speakers in the same occupations. Four groups of 12 students rated

one of four hypothetical employees, including a factory worker, a factory worker who stutters, a

lawyer, and a lawyer who stutters. Ratings of the factory workers indicated differences between

the typical factory worker and factory worker who stutters on 16 items. Specifically, students

judged the factory worker who stutters to be more afraid, insecure, tense, cowardly, and weak

than the factory worker who does not stutter. In addition, the factory worker who stutters was

perceived as being less talkative, sociable, coordinated, dominant, affluent, aggressive, and

confident as compared to a typical factory worker. For the lawyer condition there were 34 items

in which students perceived a difference based on stuttering. As compared to a typical lawyer, a

21

lawyer who stutters was judged to be more afraid, confused, tense, discontented, frightened, lazy,

dependent, uncomfortable, naïve, and disorganized, as well as being less intelligent, employable,

competent, educated confident, talkative, mature, secure, natural, witty, stable, dominant, rich,

sane, alert, and aggressive. These findings suggest that PWS may be perceived more negatively

if they have careers in which communication is more highly valued.

In another study, Silverman and Bongey (1997) used a 20-item semantic differential

questionnaire to assess nurses’ attitudes toward physicians who stutter. Ten nurses received a

questionnaire that asked them to rate “a physician” and ten nurses received the same

questionnaire that asked them to rate “a physician who stutters.” The nurses in the study rated a

physician who stutters as being more afraid, tense, nervous, and aggravating in addition to being

less mature, intelligent, secure, competent, confident, educated, and reputable than a physician

who does not stutter. These results indicate that nurses, and perhaps others in the medical

profession, hold negative stereotypes of professionals who stutter.

Gabel, Blood, Tellis, and Althouse (2004) used the Vocational Advice Scale (VAS) to

investigate college students’ perceptions of appropriate career choices for PWS. The VAS is a

written questionnaire that asks respondents to indicate the degree (on a 5-point Likert-type scale)

to which they would advise someone to train for 43 jobs. The VAS was administered to 385

university students. One group of students was asked to provide career advice to an adult male

who stutters, and the other group of students was asked to give advice to an adult male who does

not stutter. Statistical analysis indicated that 20 of 43 careers were judged to be significantly less

advisable for an adult male who stutters than a typical adult male. Gabel et al. note that there

appear to be some similarities among the careers that were judged as being less acceptable for

PWS. Some careers (e.g., psychologist, physician, speech-language pathologist, etc.) may be

22

perceived as requiring high levels of communicative competence or the ability to help others by

speaking well. PWS may be limited in their career choices as a result of occupational

stereotyping by fluent speakers.

Thus, among many employers and laypersons, there is the perception that PWS are only

suited for certain jobs, particularly those that do not require a high degree of communicative

competence or verbal expression. Furthermore, it seems likely that jobs that do not require a high

level of communication will have less prestige than those that do not, and will pay less money.

More research is needed regarding (a) the rationale behind employers’ and laypersons’ attitudes

towards career suitability for PWS, (b) employers’ actual hiring practices related to PWS, and (c)

the effects of occupational stereotyping on quality of life issues for PWS.

Attitudes of laypersons. In addition to helping professionals and employers, some

researchers have examined laypersons’ attitudes toward PWS. College students and/or members

of the general public have often served as participants in these studies. For the most part,

researchers have tried to establish what laypersons know about stuttering and what they believe

about PWS. Semantic differential scales have been utilized most often to address these questions,

but other formats, such as interviews, have been used as well. The following studies are reviewed

to demonstrate that laypersons’ tend to have the same negative attitudes toward PWS as do other

professionals who may interact with PWS.

White and Collins (1984) used semantic differential scales (Woods & Williams, 1976) to

examine the origin of the stuttering personality stereotype. They hypothesized that student

ratings of “a typical adult male stutterer” versus “a normally fluent adult male speaker who

suddenly starts to stutter for a short period of time, after which he speaks fluently again” (p. 568)

would be similar. The semantic differential scales were administered to 80 undergraduate

23

students with 40 students in each condition. Student ratings of a typical adult male who stutters

were indeed similar to those of a normally fluent male who stutters only temporarily. White and

Collins proposed that listeners make inferences from their beliefs about the internal states of

fluent speakers who exhibit disfluencies (i.e., fluent speakers who exhibit disfluencies do so

because they are experiencing nervousness, shyness, etc.) and apply these inferences to PWS

(e.g., PWS do so because they are nervous, shy, etc.). Thus, stereotypically negative judgments

of PWS may be made out of uncertainty rather than derived from motivational factors (White &

Collins, 1984).

Ham (1990) asked 536 people from Tallahassee, Florida, to provide their perceptions of

people who stutter via semi-structured telephone interviews. These interviews were conducted by

a total of 59 graduate and undergraduate students who each called 10 people randomly in the

Tallahassee phone book. The age range of the participants varied from 11 to 85 years, and a wide

variety of occupations were represented. Methodologically, some concerns exist regarding this

study, particularly that the interviewers were described as “naïve” and did not seem to undergo

training before conducting the interviews, and that the researcher was unable to verify the

interviewees’ responses, presumably because the interviews were not audio-recorded.

Nevertheless, Ham found that participants’ provided a broad range of responses when asked to

define stuttering, state whether they have known a stutter or stuttered themselves, identify the

sort of person they thought would be most likely to develop stuttering, and provide advice to a

PWS to help their stuttering. The results of this study indicated that although many of the

participants knew someone who stutters, there was confusion regarding the definition of

stuttering. Forty percent of participants used circular reasoning to define stuttering (e.g.,

“Someone who stutters has a stutter in his speech”). Approximately 27% of respondents felt that

24

stuttering was best defined as repetitions, but the term “repetition” was not used consistently

among participants. Adding to this confusion over the definition of stuttering is that

approximately 21% of participants said that they had stuttered in their past, and 12% of

participants felt that they currently stuttered. This unusually high incidence of stuttering would

seem to suggest that laypersons consider stuttering to include disfluencies that are considered

typical by SLPs (e.g., revisions or repetitions of phrases), or that laypersons who infrequently use

part-word repetitions, for example, consider themselves to stutter on such occasions. More than

one-third of the participants indicated that they felt PWS are psychologically different from

fluent speakers, and described PWS as being shy, frustrated, and anxious. Finally, in regard to

the advice given to PWS, only 15% of the responses indicated that speech therapy might be

beneficial. These results suggest that stuttering is not well understood by the general public.

This lack of understanding and the complexity of attitudes toward stuttering was

acknowledged by Hulit and Wirtz (1994), who sought to determine how several variables impact

attitudes toward PWS by administering the Stuttering Inventory to 203 members of the general

public, students in speech-language pathology classes, and professional staff at a school district.

The Stuttering Inventory consists of 52 items that assess knowledge of and attitudes toward

stuttering, and was constructed from a variety of existing survey instruments, including the

Clinician Attitudes Toward Stuttering Inventory, the Parental Attitudes Toward Stuttering

Inventory, and the Alabama Stuttering Knowledge Test. Attitude items on the Stuttering

Inventory were represented by a Likert-type scale. The results indicated that gender, age, years

of education, personally knowing a PWS, knowledge of stuttering, completing a stuttering

course, and holding a certificate of clinical competence in speech-language pathology were not

good predictors of attitudes toward stuttering. Hulit and Wirtz (1994) indicated that there was a

25

narrow range in participants’ attitude scores and suggested that the variables under investigation

do not have an association with attitudes toward stuttering. Hulit and Wirtz further suggested that

we are at a crossroad in attitude measurement, and provided a list of the problems that are

inherent with survey research about stuttering. One of these problems is that there is not a

universally accepted definition of stuttering. Researchers have typically assumed that stuttering

has the same meaning for everyone when in fact it may not. Another issue is that the validity of

the inventories used to measure attitudes toward stuttering has never been demonstrated; and

indeed, it is very difficult to measure the validity of something as broad and inferential as an

attitude. Finally, regardless of their methods, researchers have asked respondents to make

judgments about people who stutter. The term stuttering may have negative implications, and

certainly provides a signal to the respondent that the person that they are judging has a

communication disorder. Hulit and Wirtz (1994, p. 258) suggest “that most people tend to react

uniformly to “different” and “disordered” no matter their level of knowledge or degree of

experience,” which may explain why speech-language pathologists consistently report similar

attitudes towards PWS as do the general public. Future research studies may investigate the

actions of others toward PWS rather than conducting paper and pencil inventories.

One study that attempt to circumvent these issues was conducted by Guntupalli et al.

(2006). This study examined the psychophysiological responses of fluent speakers to PWS. The

fifteen fluent speakers, including university students and other laypersons, watched one-minute

video samples of PWS and fluent speakers. Data about participants’ emotional and physiological

reactions were gathered via measurements of heart rate and skin conductance. Participants

tended to have a slower heart rate when listening to PWS, indicating that listeners pay more

attention to the speech of PWS than that of fluent speakers. Increased skin conductance was also

26

noted as participants watched the videos of PWS, suggesting that listeners experience unpleasant

emotional arousal when listening to PWS. This study did not pair heart rate and skin conductance

measures with participants’ self-reports about their experiences while watching PWS speak.

Future research could combine psychophysiological and self-report data in order to provide a

more complete understanding of how the survey responses of fluent speakers correlate with more

direct measures of their reactions with PWS.

The preceding studies indicate that members of the general public are confused about

stuttering and hold negative attitudes toward PWS. It is unclear why such negative attitudes are

so widely held by laypersons, but confusion regarding the definition of stuttering and its causes

may help to contribute to the negative perceptions of PWS by this population.

Variables that Influence Attitudes toward PWS

In addition to examining the effects of group membership on perceptions of PWS,

researchers have explored the effects of certain variables on listener reactions to stuttering and

PWS. These studies have primarily relied upon laypersons as listeners. Some variables, such as

making eye contact and disclosing stuttering, are within the control of PWS and appear to

positively influence listener attitudes. Other variables, such as the listener’s culture, the gender of

the listener or the person who stutters, and the severity of the stuttering are largely beyond the

control of PWS and have been found to negatively impact listeners’ perceptions. Other variables

that have been explored are largely academic in nature, and relate to such things as the method of

stimulus presentation, use of person-first language, and other contextual variables.

Eye contact. One variable that is under the control of PWS is the amount of eye contact

they attempt to make with listeners. It is thought that appropriate eye contact is a part of effective

communication and may influence listener perceptions of the speaker (Kamhi, 2003). Tatchell,

27

van den Berg, and Lerman (1983) examined the effects of eye contact and fluency on listeners’

perceptions of PWS. A videotape was shown to 127 college students in which one of four

conditions was portrayed by an actor in conversation with another actor. These conditions were

normal eye contact and normal fluency, normal eye contact and disfluency, low eye contact and

normal fluency, and low eye contact and disfluency. Participants then completed semantic

differential scales related to such variables such as trustworthiness, competence, and dynamism.

The results indicated significant interaction effects for fluency and eye-contact. The authors

suggested that increased eye contact by PWS can lead to improved listener attitudes toward

PWS. A similar result was found by Atkins (1988) who used a 60-item semantic differential

questionnaire to survey 133 college students regarding the personality traits of people who have

good, minimal, and no eye contact. A hypothetical person who used minimal or no eye contact

was rated less favorably on 70% of the scale items, suggesting that PWS may be perceived

negatively if adequate eye contact is not maintained with listeners.

Disclosure/acknowledgement of stuttering. Disclosure of stuttering also seems to lead to

increased positive perceptions of people who stutter. Silverman (1988) asked 46 college students

who were enrolled in an introductory speech class to respond to an 81-item semantic differential

questionnaire in which they rated either “a stutterer” or “a stutterer wearing a shirt on which is

printed ‘I stutter. So what!’” The person who wears a T-shirt that acknowledges the stuttering

was rated more positively on 29 of the 81 traits; however, the trait “immature” was also

associated with the T-shirt. A systematic replication of the study was conducted (Silverman,

Gazzolo, & Peterson, 1990) in which 54 employees at a shopping mall were surveyed using the

same semantic differential scales. Similar results were found, suggesting that disclosure of

stuttering may be one situation in which negative stereotypes of PWS can be reduced.

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Collins and Blood (1990) examined the effects of stuttering severity and

acknowledgement of stuttering as factors that may influence listeners’ perceptions of PWS. The

authors hypothesized that people who do not stutter will prefer to interact with PWS who

acknowledge their stuttering, regardless of the stuttering severity, as compared to PWS who do

not acknowledge their stuttering. Furthermore, acknowledgement of stuttering was proposed to

alter listeners’ perceptions of the intelligence, personality, and appearance of PWS. To test these

hypotheses, 84 female college students who were not communication disorders majors served as

participants. Participants were given a cover story in which they were told that they were going

to work with one of two men who stutter for a class project about the effects of working with

PWS. The participants were told that, in an effort to save time, they were going to watch brief

interviews with the men who stuttered in order to determine with whom they would prefer to

work. Participants then watched one of four videotapes that consisted of two 2-4 minute

interviews with males who stuttered mildly or severely and who did or did not acknowledge their

stuttering. After watching each interview, participants completed a survey that consisted of a 14-

item semantic differential questionnaire (Burley & Rinaldi, 1986) and a written open-ended

survey that asked participants to explain how they felt the speaker would interact with strangers

and how he would act in a noisy environment. Participants were also asked to discuss how they

would act around the speaker. Finally, after having watched both interviews, participants were

asked to state which speaker they would prefer to work with and why. The results of the Collins

and Blood (1990) study indicated that PWS, particularly those who stutter severely, were rated

more favorably by participants when they acknowledged their stuttering. It is noteworthy that

participant ratings were more negative for people who stuttered severely, regardless of whether

or not they acknowledged their stuttering, as compared to those who stuttered mildly. This study

29

suggests that helping clients who stutter to acknowledge their stuttering may facilitate improved

interactions with others. Acknowledgement of stuttering by PWS may be a useful mechanism for

facilitating attitude change; however, Collins and Blood (1990) stated that a limitation of the

study is that mostly female participants rated male speakers. The findings may have been

different had an equal number of male and female participants rated both male and female

speakers who stutter.

A similar study (Healey, Gabel, Daniels, & Kawai, 2007) examined listeners’ perceptions

of videotaped samples of a male speaker who stuttered severely. Ninety laypersons were

randomly assigned to one of three groups for a total of 30 participants in each group. In each of

the three videos, the male speaker who stutters was asked the same question by the interviewer

(“Can you tell me about a job you have had?”). In one video, the male speaker who stuttered

disclosed that he stuttered at the beginning of his monologue. In another video, the disclosure

came at the end of the monologue. The third video consisted of the monologue only, and no

reference to the speaker’s stuttering was made. To assess participants’ reactions to each of these

conditions, a six-item Likert-scale questionnaire was administered. These items included the

following statements: (1) This person seems sincere. (2) This person is likeable. (3) This person

is trustworthy. (4) This person is friendly. (5) This person shows character. (6) This person is

emotionally well adjusted. After completing the Likert scale, all participants were asked open-

ended questions about their comfort level while listening to the speaker and whether disclosure

of stuttering impacted their perceptions of the speaker. The quantitative data was analyzed using

a multivariate analysis of variance, and the qualitative data was converted to percentages based

on positive, negative, or neutral comments about the speaker. The results based on Likert scale

data indicated that disclosing versus not disclosing stuttering did not result in an overall

30

difference in listeners’ ratings of the speaker. The time of disclosure was not significant on five

of the six Likert scales, although listeners perceived the speaker who disclosed his stuttering at

the end to be more friendly. The data from the open-ended questions indicated that the listeners

felt comfortable listening to the PWS whether or not he disclosed his stuttering. Some

participants who were in the disclosure groups seemed to perceive benefits to disclosing

stuttering, particularly at the beginning of a speech, but the majority of participants in the non-

disclosure group reported that disclosure of stuttering was not accompanied by any perceived

benefits. The authors indicated that listeners may be comfortable with stuttering, regardless of its

severity. More research is needed to determine whether society in general has become more

accepting of PWS and stuttering.

The aforementioned studies appear to indicate that acknowledging or disclosing one’s

stuttering will help to ease communicative interactions between PWS and their listeners. It is not

entirely clear as to why disclosure seems to have at least some positive affect on listeners’

perceptions of PWS. It seems likely that disclosure of stuttering, like making eye contact,

alleviates tension and confusion in the listener, but more research is needed that examines the

thoughts and emotions of listeners as they interact with PWS.

Therapy and therapeutic techniques. Another variable that is under the control of PWS is

whether to employ therapeutic techniques that may alleviate stuttering or help the person who

stutters to stutter more fluently and easily. Two independent investigations were conducted by

Manning, Burlison, and Thaxton (1999) to evaluate listener responses to stuttering modification

techniques. Participants in the first study consisted of 24 employees of a food processing plant.

They viewed two videotaped speech samples in counterbalanced order of a male speaker who

simulated stuttering. In one sample, (the stuttering only video) the speaker simulated fluency

31

breaks to a mild extent characterized by repetitions, sound prolongations, and blocks in which

there was no voicing or airflow. In the other sample, (the stuttering plus cancellation video) the

speaker repeated the content of the speech, but utilized cancellations after fluency breaks.

Participants in the second study consisted of 50 volunteer listeners who were employees of a

county school district. They also watched two videotaped speech samples of a man who

simulated stuttering. One of these videos was the stuttering only video from the first study. The

other video consisted of the same speaker applying pullouts (the stuttering plus pullout video).

After each video was presented, participants in both studies completed semantic differential

scales (Woods & Williams, 1976) and a 5-point handicap scale, in which listeners indicated how

much they felt the speaker was handicapped by his condition. Participants in both studies then

responded to open-ended questions that elicited their general reactions to the speaker, the degree

to which they would interact socially with the speaker, and what it would be like to work with

the speaker. The results of both studies indicated that participants felt that PWS who use pullouts

or cancellations are more handicapped than PWS who do employ these techniques. Participants

also responded less favorably to 42 of 50 semantic differential items when the speaker used

therapy techniques. Responses to the open-ended questions revealed that participants in both

studies provided the same types of generally negative reactions to the speaker who used therapy

techniques. The specific nature of the comments was not provided by the authors; instead only a

frequency count of positive and negative comments was documented. These results suggest that

listeners react more negatively to stuttering modification techniques than stuttering only;

however, the ability to generalize these results is limited because responses to only one speaker

were gathered.

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Gabel (2006) investigated university students’ attitudes toward PWS based on stuttering

severity and level of therapy involvement. Participants were given a 25-item semantic

differential questionnaire (Woods & Williams, 1976) and were asked to rate one of four

hypothetical conditions in which a man who stuttered severely or mildly chose or did not choose

to attend therapy to improve his stuttering. The results indicated that participants reported more

positive traits for the male who stutters mildly than the male who stutters severely. Attending

therapy was also perceived more positively than not attending therapy to improve stuttering.

There was no interaction between the stuttering and therapy variables, so that a person who

stutters severely was not regarded more positively for attending therapy than someone who

stutters mildly. Gabel (2006) suggested that most participants felt mildly positive or mildly

negative toward PWS based on their semantic differential scores. This finding may indicate that

participants feel mostly neutral or ambivalent toward PWS.

The Manning et al. (1999) and Gabel (2006) studies appear to indicate that although

participants may perceive attending stuttering therapy to be beneficial, PWS who actually

employ therapeutic techniques may be judged more negatively by their listeners. More

information is needed about laypersons’ perceptions of stuttering therapy and of therapeutic

techniques in order to gain a better understanding of listeners’ reactions to stuttering and how

these reactions may help guide the therapy process.

In addition to the three variables mentioned above, (eye contact, disclosure of stuttering,

and therapy involvement/use of therapeutic techniques), other variables that may affect listeners’

perceptions of PWS have been examined. These variables, such as stuttering severity, listeners’

cultural background and age, and the gender of PWS and their listeners are largely beyond the

control of the PWS.

33

Stuttering severity. The severity of stuttering has been examined by many researchers in

order to determine whether the level of severity influences listeners’ perceptions of PWS. For

example, Turnbaugh, Guitar, and Hoffman (1979) used semantic differential scales (Woods &

Williams, 1976) to measures SLPs’ attitudes toward PWS based upon stuttering severity. The 36

participants were asked to rate a hypothetical “typical individual” who was normally fluent,

stuttered mildly, stuttered moderately, or stuttered severely. The results of this study confirmed

that SLPs perceive PWS more negatively than fluent speakers. There was also an increase in

negative attitudes toward PWS when responses toward the mild stuttering and severe stuttering

conditions were compared.

Susca and Healey (2001) investigated listeners’ perceptions of simulated stuttering and

fluency. A total of 60 individuals comprised of university staff, undergraduate students, and

members of the general public served as participants. These participants did not have regular

contact with or knowledge of someone who stuttered. A speech sample (obtained while reading

the Rainbow Passage) from a 27-year old male who stutters was digitized and was used as

stimulus material. From this “core” sample containing 10% stuttered disfluencies, additional

stimuli containing 0%, 5%, and 15% stuttered disfluencies were created from a computer

program. An additional “treated” sample was developed, in which 0% disfluency was obtained

by reducing pauses, eliminating extra glottal pulses, and eliminating sudden onsets and offsets

from the core sample. A normal sample was developed that consisted of a 24-year-old male

reading the Rainbow Passage with a normal rate and manner. Each participant was randomly

assigned to one of the six conditions. After listening to the sample, participants were asked to

verbally describe the speaker’s speech. Participants then used a 7-point Likert scale that ranged

from “strongly disagree to “strongly agree” to rate the perceptual features associated with the

34

speaker. These scale items included: “This person is a competent speaker,” “This person is a

fluent speaker,” “This person read the story easily,” and “I felt comfortable listening to this

person” (p. 64). Finally, three more open-ended questions were asked that included “What

contributed to how comfortable you felt listening to this person?” “What were some of the

features of his speech that caught your attention?” and “How easy or difficult was it to

understand the story you just heard?” (p. 64). To interpret the data, the authors quantitized the

qualitative data, and counted the number of participants’ positive versus negative comments. The

results indicated that as the percentage of stuttered disfluencies increased, so too did the number

of negative comments provided by the respondents. The Likert data suggested that as the

speaker’s disfluencies increased, the participants’ comfort level decreased, and the speaker who

stuttered was perceived as having less speech competency and fluency than the typical speaker.

In addition to the results obtained above, Susca and Healey (2002) also performed a

phenomenological (qualitative) analysis of the 60 listeners’ comments toward the speech stimuli

based on different fluency levels. In phenomenological research, participants’ comments are

often grouped according to categories. Susca and Healey organized listener comments into three

categories which included comments about the speaker, comments about the listener, and

comments about the story (e.g., the Rainbow Passage). Speaker attributes included such theme

clusters as speech production (e.g., rate, voice characteristics, articulation, flow, effort,

naturalness); context (presentation style, context competence); and speaker identity (e.g., speaker

characteristics, ideational issues, language expression). Listener attributes were comprised of

those factors that influenced listener comfort, such as the effort required to listen to the speaker,

content familiarity, the amount of attention required, and the listening context. Finally, story

comprehension was influenced by the coherence, simplicity/complexity, and vocabulary of the

35

story. These results indicated that listeners tend to hold more negative attitudes toward a speaker

when increased stuttering is present in the speech sample; however, listeners also judge a

person’s speech on a variety of parameters other than stuttering. Furthermore, listener attributes

as well as speaker attributes appear to be influential in perceptions of PWS, suggesting that

therapeutic techniques should focus on helping clients who stutter be more effective

communicators in addition to reducing the frequency of stuttering (Susca & Healey, 2002).

Panico, Healey, Brouwer, and Susca (2005) used a short Likert scale and open-ended

questions to assess the degree to which stuttering severity influenced listeners’ perceptions of

PWS. The stimulus material was comprised of an adult male speaker who was videotaped while

reading a passage with various levels of fluency (e.g., 0%, 5%, 10%, and 15% stuttering

disfluency). An additional four audio samples were obtained from the videotapes. Sixty-four

undergraduate students and members of the general community who had little familiarity with

PWS were randomly assigned to one of the eight conditions. Participants then watched or

listened to the stimulus and completed a questionnaire in which a Likert scale was used to

indicate the degree to which participants agreed or disagreed with six statements that discussed

the competence of the speaker, the effects of stuttering on the listener, including such emotions

as curiosity, and impatience, as well as willingness to engage socially and professionally with the

speaker. After completing this questionnaire, participants were asked to verbally provide their

impressions of the speaker, to describe the speaker’s speech, and to note anything about the

speech that caught their attention. The results indicated that as the stuttering severity level

increased, so too did the listeners’ negative ratings and comments about the speech sample.

As previously discussed, Gabel (2006) investigated university students’ attitudes toward

PWS based on stuttering severity and level of therapy involvement. The results indicated that

36

participants perceived a male who stutters mildly more positively than a male who stutters

severely. Thus, it is apparent that those people who stutter severely are at a greater risk for being

perceived negatively by listeners. The aforementioned studies indicate that as stuttering severity

increases, so too does the amount of effort and concentration that the listener must spend while

conversing with the PWS. The listener’s comfort level also seems to decrease when more

stuttering is present. More research is needed to examine the perceptions of listeners as they

engage in communication interactions with PWS mildly, moderately, and severely.

Cultural differences. One variable that has been shown to influence listeners’ perceptions

of PWS is the culture background of the listener. Bebout and Arthur (1992) investigated cross-

cultural attitudes toward a variety of communication disorders, including stuttering. They

compared the attitudes of foreign-born students with native North-American students. The

participants’ countries of origin included the United States, Canada, Hong Kong, Singapore,

Malaysia, Taiwan, Southeast Asia, China, Japan, and Latin America. Participants responded to a

12-item questionnaire in which they were asked to provide their opinion to various statements on

a 4-point scale which ranged from “probably no,” “maybe no,” “maybe yes,” to “probably yes.”

The questionnaire items included statements that addressed the characteristics of PWS, such as

intelligence and emotional stability; whether PWS should seek professional help from doctors or

other helping professionals; effects of stuttering on the life of an individual who stutters,

including social relationships and employment opportunities; and how other people should act

toward PWS. Group comparisons indicated that non-native North Americans were more likely to

think that people with communication disorders are emotionally disturbed. Participants from

Asian countries, in particular, were also more likely to indicate that people with communication

disorders could speak better if they tried harder. Bebout and Arthur (1992) concluded that it is

37

important for speech-language pathologists to be aware of listeners’ culturally-influenced beliefs

and attitudes toward communication disorders in order to provide more effective treatment.

Listener age. Many researchers have conducted studies using college students or

members of the general public as participants, thus ensuring that data from participants with a

moderately large age range has been obtained. One study (McGee, Kalinowski, & Stuart, 1996)

explored high-school students’ perceptions of PWS and found that they reported similarly

negative reactions to PWS as did the general population. This research raises the question of at

what age negative attitudes toward PWS begin to develop.

Ezrati-Vinacour, Platzky, and Yairi (2001) examined children’s awareness of stuttering-

like disfluencies. The research objectives were to identify at which age fluent children begin to

recognize disfluencies, investigate whether specific types of disfluencies influence the age at

which children become aware of stuttering, and determine if there is a relationship between

children’s attitudes toward stuttering-like disfluencies and their level of awareness. Eighty

children ranging from ages three to seven years individually watched videotapes of two identical

seal puppets that were positioned side by side. One puppet would say a six-word sentence using

sound, syllable, and single-syllable-word repetitions for some of the sentences, and blocks and

prolongations for the others. The other puppet would say these same sentences fluently. The

order of fluent and nonfluent sentences was counterbalanced. After the child watched the puppets

say a pair of sentences, the experimenter paused the tape and asked the child if both puppets

talked in the same way. The child was also asked to point to the puppet on the screen that talked

like him or her. After all six pairs of sentences were viewed, the child was asked to label the

talking (e.g., “What do we call this kind of talking?”). The child was also asked if that kind of

talking was good or not good. The child then viewed another pair of fluent-disfluent utterances

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from the puppets and was asked which puppet s/he would like to play with and why. The results

indicated that some children as young as three-years can discriminate between fluent speech and

stuttering-like disfluencies, but that awareness of stuttering continues to rise as children reach

four and five years of age. The majority of five-year-olds can discriminate fluent from stuttered

speech. Children had a greater awareness of disfluencies that were characterized by repetitions

versus blocks or prolongations. The word “stuttering” was rarely used by children to label the

stuttering-like disfluencies, but as children became older they were able to provide descriptions

of stuttered speech. Children four-years and older almost unanimously agreed that the stuttered

speech was “not good” and that they would prefer to have a fluent speaker for a friend. These

findings suggest that the development of negative stereotypes may occur very early in a child’s

development, and that age-appropriate educational programs may be beneficial to prevent

negative attitudes toward PWS and others with disabilities (Ezrati-Vinacour et al., 2001). It is

still unclear as to why children perceive disfluent speech to be bad, and which variables

influence this perception. It does seem likely that the negative attitudes demonstrated by children

toward PWS are maintained throughout the life span and are hard to ameliorate.

Gender. Like cultural differences, gender differences may also account for some listener

perceptions. Burley and Rinaldi (1986) asked ten male and ten female naïve listeners who ranged

in age from 15-35 years to rate recorded speech samples of both male and female PWS on a

variety of traits using previously existing semantic differential scales. The authors found that

there were significant differences between the male and female listener ratings, with males

tending to rate the speech samples of PWS more negatively than the females. The sex of the

PWS did not have an effect on the ratings by the male or female listeners. Patterson and Pring

(1991) replicated this study but included a control group of fluent speech samples for the 20 male

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and 20 female naïve listeners. The results indicated that male and female listeners did not

provide significantly different ratings. In both the Burley and Rinaldi (1986) and the Patterson

and Pring (1991) studies, there was not a gender difference observed when respondents rated

both male and female stuttered speech samples. These findings suggest that the gender of PWS

and their fluent listeners may be irrelevant in the formation and maintenance of negative attitudes

toward PWS.

Social distance. Perhaps one of the only variables that is somewhat beyond the control of

PWS that has been found to positively influence attitudes toward PWS is the degree of social

distance between PWS and their listeners. It has been theorized (Allport, 1954) that under certain

circumstances, a reduction in prejudice (and negative stereotypes) can occur from increased

intergroup contact. This theory has been tested by a several researchers with mixed results.

Fowlie and Cooper (1978) administered semantic differential scales (Woods & Williams,

1976) to the mothers of 34 stuttering and 34 nonstuttering male children who were between the

ages of 6-11 years. The results indicated that mothers of children who stutter tended to describe

their child as being significantly more anxious, introverted, fearful, sensitive, withdrawn, and

insecure as compared to mothers who described their child who did not stutter. Fowlie and

Cooper’s research raises important questions about the temperament of children who stutter, but

raises the equally important question of whether individuals hold stereotypical beliefs about

stuttering that they apply to family members who stutter.

Doody, Kalinowski, Armson, and Stuart (1993) surveyed a total of 106 members of the

general public in three small, rural communities in Newfoundland, Canada. The authors asked

participants to complete a 25-item semantic differential questionnaire (Woods & Williams, 1976)

in order to investigate attitudes toward adult males who stutter as compared to adult males who

40

do not stutter. Eighty-five percent of the respondents knew at least one person who stutters and

39% reported a familial relationship with someone who stutters. Statistical analysis indicated that

there were not significant differences between members of the three rural communities or

between respondents with a family member who stutters versus those who did not have a family

member who stutters. People who stutter were perceived as being significantly different from

people who do not stutter on 20 of the 25 scale items and were perceived as being more guarded,

nervous, shy, self-conscious, tense, sensitive, anxious, withdrawn, quiet, avoiding, fearful,

passive, afraid, introverted, insecure, emotional, self-derogatory and inflexible. The five items

that were not significantly different included such traits as being friendly, cooperative, pleasant,

intelligent and perfectionistic. Thus, the rural communities under investigation had mostly

negative attitudes toward a hypothetical adult male who stutters as compared to a hypothetical

typical normal adult male speaker. These results are surprising because the majority of

respondents in the close-knit communities under investigation knew PWS or had a familial

relationship with someone who stutters. Doody et al. (1993) suggested that the negative

stereotype of PWS might persist under these conditions because the stuttering behavior (e.g.,

tension, struggle) is particularly salient, or because PWS may actually have significantly

different character traits as compared to fluent speakers. Doody et al. suggest that future research

“should examine the strength, genesis, and possible clinical implications of an existing and

pervasive negative stereotype” (p. 371) with an emphasis on examining ways in which the

negative stereotype can be changed.

Klassen (2001, 2002) conducted a series of studies to determine whether different groups

of people may interpret and understand stuttering differently. In the first study, (2001), 114

friends and colleagues of PWS were given a written questionnaire. The first part of the

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questionnaire assessed participants’ attitudes toward PWS in general and consisted of semantic

differential scales (Woods & Williams, 1976), portions of the CATS Inventory (Cooper 1975),

and the Parental Attitudes Toward Stuttering Inventory (Crowe & Cooper, 1977). The second

part of the questionnaire assessed participants’ attitudes toward one PWS in particular with

whom they were familiar. The participants in this study reported having less stereotypical beliefs

about PWS in general as compared to previously reported results (e.g., Hulit & Wirtz, 1994).

These results indicated that the increased social closeness of some people to PWS had a positive

effect on their attitudes toward PWS in general.

Using a similar methodology, Klassen (2002) identified six PWS and surveyed their close

acquaintances (including friends, family, teachers, fellow students, and colleagues) to see if these

significant others held the same negative stereotypes toward PWS that have been pervasive

throughout the stuttering literature. The six PWS were also surveyed for comparison purposes.

The 175 participants completed a two-part questionnaire. The first part asked participants to rate

PWS in general, and utilized six semantic differential items as taken from the Woods and

Williams (1976) scales. The second part asked participants to list the name of a PWS that they

knew personally (e.g., one of the six PWS with whom they were acquainted). The results

indicated that the people who were personally acquainted with at least one person who stutters

rated PWS more favorably on personality dimensions than has been reported for members of the

general public (Hulit & Wirtz, 1994). In addition, the people who stutter who also served as

participants in this study rated their speech as being more abnormal than did their acquaintances.

These findings suggest that different groups of people may hold different attitudes toward PWS

depending on their level of social distance. As a whole, the Klassen (2001, 2002) studies suggest

that ongoing contact with someone who stutters may lead to increased positive attitudes toward

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PWS; conversely, people who have little or no contact with someone who stutters may be more

likely to hold negative stereotypes about PWS.

Gabel, Tellis, and Althouse (2004) also investigated the effects of familiarity on

perceptions of PWS. College students who had varying degrees of familiarity with PWS

completed a 25-item semantic differential questionnaire (Woods & Williams, 1976). Unlike the

findings of Klassen (2001, 2002), no significant differences were found based on level of

familiarity with PWS. Gabel et al.(2004) suggested that future studies should investigate both the

quality and the quantity of relationships that participants have with individuals who stutter, as the

nature of the relationship and the number of PWS that one knows may influence one’s attitudes

toward PWS.

Thus, the majority of studies that have investigated the effects of social distance have

found that familiarity with stuttering and PWS does not necessarily correlate with positive

attitudes. More research is needed to determine how attitudes toward stuttering and toward PWS

in general are shaped by interacting socially with one or more PWS. In addition to social

distance, the review of the preceding studies indicates that stuttering severity and cultural

differences among listeners strongly affect perceptions of PWS. Listeners’ responses to stuttering

also tend to be consistently negative regardless of the age of the listeners or gender of the listener

or person who stutters.

Other studies as described below have examined variables that are somewhat more

academic in nature, such as whether the person who stutters is perceived more negatively in

speaking versus non-speaking situations, whether person-first labeling results in more positive

perceptions than disability-centered labels, whether researchers’ instructions to listeners impact

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their ratings of PWS, and whether the mode of stimulus presentation influences participants’

perceptions of PWS.

Speaking versus non-speaking situations. It is possible that PWS may be judged

negatively only when they are engaged in speaking tasks. Thus, Kalinowski, Stuart, and Armson

(1996) investigated whether the perceptions of PWS versus fluent speakers vary depending on

speaking and nonspeaking situations. One hundred eight members of the general public were

surveyed using semantic differential scales (Woods & Williams, 1976). Each participant

received two questionnaires. Some participants received questionnaires that asked them to rate

both “a typical normal adult male” and “a typical adult male stutterer when speaking in everyday

situations.” Other participants received questionnaires that asked them to rate both “a typical

normal adult male” and “a typical adult male stutterer in everyday life when not involved in

speaking situations.” Statistical analysis revealed that a hypothetical person who stutters was

perceived more negatively than the typical, normal adult male regardless of whether speaking

situations were involved or not. These results suggest that “the genesis of the stereotype stems

most likely from the stuttering behavior itself…the saliency and vividness of the behavior is so

powerful that character traits attributed to the stuttering moment transcend speaking situations”

(Kalinowski et al., 1996, p. 64). Thus, as Lass et al. (1989) have suggested, laypersons may not

be able to separate the speech of the person who stutters from the person himself.

Person-first labeling. Another variable that may impact listeners’ perceptions of PWS is

in regard to the label that is applied to the person who is doing the stuttering. St. Louis (1999)

conducted a preliminary investigation into the effects of using person-first labeling (i.e., “person

who stutters”) versus direct labels (i.e., “stutterer”). The survey respondents came from a wide

variety of ages and backgrounds and included the general public, SLPs, graduate SLP students,

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speech, language, or hearing impaired clients, and parents of these clients. Participants provided

responses to various questions about 12 types of disorders using Likert-type scales. Participants

did not respond significantly differently to the term “stutterer” versus “person who stutters.” St.

Louis concluded that person-first ratings do not lessen negative ratings related to stuttering and

PWS. A similar finding was obtained by Turnbaugh, Guitar, and Hoffman (1981) who

administered semantic differential scales (Woods & Williams, 1976) to college students and

found that the negative perceptions of PWS persisted even if the speaker was not described in

term of his stuttering (e.g., “stutterer” or “person who stutters.”)

Instructions to listeners. Bar (1969) investigated the role of listening instructions, the

severity of stuttering, and listeners’ experiences with stuttering on participants’ attitudes toward

PWS. Participants consisted of 89 speech therapists and 189 naïve listeners (college students)

who had never stuttered or communicated with someone who stuttered. All of these participants

listened to the same sample of a speaker who stutters, but the instructions that prefaced the

listening activity varied according to the group to which participants were assigned. These

groups consisted of the “content” group, in which participants were told only to focus on the

content of the speech; the “manner” group, in which participants were told to pay attention to the

way the speaker spoke; the “no instructions” group, in which participants received no specific

listening instructions; and the “biased” group, in which participants were told that the speaker

was a very severe stutterer and were to pay attention only to the content of the speech. After the

listening task, all participants completed a questionnaire which asked for an estimate of the

speaker’s stuttering and for the participant to recall factual information from the speech. The

results indicated that speech therapists paid more attention to the speech sample overall than did

the naïve listeners, and that the listening instructions did not significantly influence the speech

45

therapists’ perceptions of the speaker. In addition, both speech therapists and naïve listeners paid

significantly more attention to the manner of the speech (stuttering) than they did its content,

particularly when no listening instructions were given, although the speech therapists were able

to focus more on the content of the speech than the naïve listeners. The implications of this study

suggest that when stuttering is severe, listeners, including speech therapists, tend to be distracted

by the stuttering and do not pay as much attention to the content of the speech of PWS.

Mode of stimulus presentation. Several researchers have addressed whether the method of

stimulus presentation (e.g., audio versus audiovisual samples of PWS) affects participants’

perceptions of PWS. The effect of mode of stimulus presentation has been examined in

conjunction with other measures that include frequency and severity ratings of stuttered speech,

speech naturalness ratings, and primary versus secondary stuttering behaviors. Some of the

research in this area is examined below to suggest that perceptions of PWS are similar regardless

of whether participants listen to an audiotape of someone who stutters, watch a videotape of

someone who stutters, or rate a hypothetical person who stutters.

Researchers have investigated the effects of audio- versus videotaped samples of PWS on

perceptions of stuttering severity and speech naturalness. Williams, Wark, and Minifie (1963)

examined raters’ perceptions of frequency and severity of stuttered speech based upon audio,

visual, and audiovisual stimuli. The researchers found that listeners perceived the severity of

stuttering similarly, regardless of whether the stimuli were presented in the audio or the

audiovisual mode. In addition, measures of stuttering severity obtained from rating scales were

not influenced by the mode of presentation. Williams et al. (1963) suggest “that the use of audio

cues alone is sufficient for obtaining useful and reliable measures of frequency stuttering and

severity of stuttering” (p. 99). Similarly, Martin and Haroldson (1992) attempted to determine

46

whether audio or audiovisual presentation mode influenced raters’ perceptions of the speech

naturalness of PWS. There was not a significant difference in ratings of stuttering severity based

upon mode of presentation, although audiovisual speech naturalness ratings were significantly

lower than audio-only speech naturalness ratings. These results indicate that laypersons perceive

few differences between audio- and videotaped samples of PWS.

Turnbaugh, Guitar, and Hoffman (1981) conducted a study in which they examined the

extent to which raters assign personality traits on the basis of audio versus audiovisual

recordings, primary, secondary, or no stuttering behaviors, and stutterer label versus no label.

Three videotapes were made in which a male simulated stuttering with various degrees of

severity and primary versus secondary stuttering behaviors. One videotape consisted of fluent

speech, another had a moderate amount of primary stuttering behaviors, and the third videotape

consisted of a moderate amount of syllables stuttered in which secondary behaviors were present.

Audiotapes were then made from each of the three videotapes, creating a total of six conditions.

Participants were assigned to one condition and were told that they were listening to and/or

watching an interview with a male who stutters. This procedure was then repeated with another

group of additional participants who were told only that the tapes were of an interview with a

male, thus allowing the researchers to identify differences in rater perceptions based on the label

of stuttering. Participants’ responses to a modified version of the Woods and Williams (1976)

semantic differential scales revealed that the participants assigned similar personality traits to the

speaker regardless of the presentation mode, presence or absence of primary, secondary, or no

stuttering behaviors, or the presence or absence of a stutterer label. A second part to the

Turnbaugh et al. (1981) study consisted of participants rating either a “hypothetical normal

speaker” or a “hypothetical stutterer.” The participants rated the hypothetical stutterer more

47

negatively on several semantic differential items as compared to the hypothetical normal

speaker. The ratings for the hypothetical stutterer were also similar to those provided by

participants in the first part of the study, in which participants provided negative responses to

PWS in a variety of contexts (e.g., audio versus audiovisual recordings, primary, secondary, or

no stuttering behaviors.)

Other researchers have also found that the mode of stimulus presentation does not

significantly impact raters’ perceptions of PWS. Panico et al. (2005) used a mixed methods

approach to examine the impact of presentation mode (audio versus audiovisual) and stuttering

severity (0, 5, 10, or 15% disfluent) on raters’ attitudes toward PWS. Raters watched or listened

to one of the samples and then completed a Likert-type scale and four open-ended questions.

Data analysis involved frequency counts of positive versus negative statements as made by the

raters and the development of theme clusters. The authors concluded that there were not

significant differences between audio and audiovisual stuttered speech samples. In addition, as

the level of stuttering severity increased, so did the raters’ negative comments. This finding is

consistent with a similar study by Susca and Healey (2001) in which Likert scale data and

written comments suggested that negative ratings and comments about PWS increased as the

level of stuttering severity increased.

The results of these studies indicate that attitudes toward PWS are not significantly

different based on whether respondents react to hypothetical PWS or an audio or audiovisual

sample when measured by Likert scales, semantic differential scales, and open-ended questions.

Indeed, the review of the research would appear to indicate that researchers who decide to

provide respondents with an audio or audiovisual demonstration of stuttered speech instead of

using hypothetical descriptions of PWS may face several challenges. First, qualitative

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researchers will most likely wish to explore the individual perceptions of each participant.

Providing an example of stuttered speech may alter participants’ mental representations of

stuttering and thus, cause them to reevaluate their attitudes toward PWS before completing the

questionnaire or interview. Some participants may never have had the opportunity to speak

individually with someone who stutters, and may not have seen or heard stuttering demonstrated

in the media. Such participants may still have an idea about what stuttering is and how they feel

about people who stutter. In a situation that is perhaps rarer, a participant might not know

anything about stuttering and have no opinions about PWS. This information is still vitally

important, but cannot be accurately obtained if a speech sample is provided. Second, if a sample

of stuttered speech is provided, what variables should be included? Should the speaker be a child

or adult? Male or female? Have mild, moderate, or severe stuttering? This last variable is of

particular concern, as researchers have concluded that more severe stuttering leads to more

negative ratings of PWS (e.g., Turnbaugh et al., 1981; Susca & Healey, 2001; Panico et al.,

2005). In any case, even if a typical or average example of a PWS could be accurately

represented, it might not match participants’ mental representations of stuttering. Third,

regardless of whether speech is stuttered or not, the acoustic signal contained in the speech

samples provides cues to listeners. According to Kent and Read (2002, p. 238), “An individual’s

personality or emotional state can be determined from patterns of speech.” Thus, in our everyday

lives we are constantly judging all of the speakers we come into contact with on such traits as

nervousness, masculinity/femininity, and even intelligence. It would be very difficult for

researchers to differentiate between the impact of stuttering on listeners’ perceptions versus the

impact of other acoustic cues contained in the speech signal. Finally, providing an example of

stuttered speech might encourage participants to make judgments about a single individual who

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is unfamiliar to them rather than an individual who is familiar to the participant or PWS in

general.

In summary, there is little evidence to suggest that the perceptions of participants in

research studies are influenced by the terms that are used to label PWS, researchers’ instructions

to participants, or by the mode of stimulus presentation. When people who stutter are described

in hypothetical contexts, participants’ ratings also do not appear to vary. Thus, attitudes toward

PWS seem to differ vary little from study to study, regardless of the variables that are

manipulated.

Attempts to Ameliorate Negative Attitudes

A small number of researchers have examined factors which might change listeners’

attitudes toward PWS. For example, McGee, Kalinowski, and Stuart (1996) examined whether

watching a videotape about stuttering would change the negative perceptions of high school

students toward a hypothetical high school male who stutters. Thirty-six high school students

completed semantic differential scales (Woods & Williams, 1976) for either a hypothetical

“normal high school male” or a “high school male who stutters.” Analysis of these data indicated

that the high school students held strong negative stereotypes of a high school male who stutters.

These stereotypes remained unchanged after participants watched the video “Voices to

Remember” in which stuttering by adults was depicted by an 11-year-old female narrator. The

results of this study suggest that watching the video “Voices to Remember” in and of itself was

not enough to change viewers’ attitudes about PWS. It may also be that the video simply

enhanced the negative stereotypes that the participants already possessed.

Snyder (2001) investigated how attitudes toward PWS may be changed as a result of

learning about stuttering via videotapes. Twenty-one graduate students in a speech-language

50

pathology program were administered the CATS Inventory prior to and after watching an

emotionally-charged video that documented the life of a young girl who stutters. Another group

of thirty-four graduate SLP students completed the CATS Inventory prior to and after watching a

videotape that demonstrated immediate amelioration of stuttering via therapeutic techniques. A

comparison of the two conditions indicated that few, if any changes, in participants’ attitudes

toward stuttering and PWS resulted from viewing the videotapes. Snyder indicated that it may be

more beneficial to measure listeners’ psychophysiological responses to stuttering rather than to

continue to administer paper and pencil questionnaires to measure attitudes towards PWS.

The work of McGee et al. (1996) and Snyder (2001) emphasizes the difficulty of

improving attitudes toward PWS. It is clear that researchers do not know enough about variables

that may contribute to the negative attitudes of PWS, and thus, they are unable to manipulate

these variables in order to promote more positive attitudes toward PWS.

Need for the Present Study

A significant amount of research has indicated that most groups of people hold negative

attitudes toward people who stutter. These groups have included a variety of professionals such

as speech-language pathologists (Lass et al. 1989; Turnbaugh et al., 1979; Ragsdale and Ashby,

1982; Woods & Williams, 1971; Yairi & Williams, 1970), educators (Crowe & Walton, 1981;

Dorsey & Guenther, 2000; Lass et al. 1992, 1994; Ruscello, Lass, Schmitt, & Pannbaker, 1994;

Silverman & Marik, 1993), and medical professionals (Silverman & Bongey, 1997; Yairi &

Carrico, 1992) in addition to members of the general public (Doody et al., 1993; Ham, 1990;

Hulit & Wirtz, 1994). These negative attitudes have proven resistant to change (McGee et al.,

1996; Snyder, 2001) and do not appear to vary according to such variables as the age of the PWS

(Lass et al. 1992, 1994; Woods & Williams, 1971), the use of therapeutic techniques (Manning

51

et al., 1999), or whether respondents rated a hypothetical PWS, an audiotaped stuttered speech

sample, or a videotaped stuttered speech sample (Panico et al., 2005; Turnbaugh et al., 1981).

Attitudes toward PWS have been measured using a limited number of research

methodologies. The most common method of attitude assessment has been semantic differential

scales such as those developed by Woods and Williams (1976). Other researchers have

developed their own semantic differential scales and a supporting rationale for their use (e.g.,

Burley & Rinaldi, 1986; Ragsdale & Ashby, 1982; Silverman, 1985). Semantic differential

scales are practical because they can be administered relatively quickly and inexpensively to

large numbers of participants (Schneider, 2005); however, there are several limitations to this

method of attitude assessment. One limitation is that the scales tend to assume that the bipolar

adjectives hold the same meaning for all respondents (Schneider, 2005). If the adjectives have

different connotations and implications for each respondent, it may be difficult for researchers to

accurately interpret the results. Participants also tend to give socially desirable or moderate

responses to scale items (Baron, 1996). In addition, there are some indications that societal

attitudes toward PWS may be improving (Gabel, 2006; Healey et al., 2007); however, it is

difficult to assess the degree of attitude improvement when the semantic differrential scales that

are currently in use are 20-30 years old. Updated and more varied methodologies are necessary

to gain a better understanding of attitudes toward PWS.

For many years research participants have indicated via semantic differential scales that

they perceive PWS to be more shy, anxious, and withdrawn than fluent speakers. Researchers

have reported these findings as being indicative of a negative stereotype of PWS, but it is not

known why participants hold these beliefs and what effects these stereotypes might have on

interactions between fluent speakers and PWS. It is also unclear if stuttering truly causes

52

communication breakdowns or other adverse consequences. Most studies have not provided

opportunities for participants to elaborate on their answers to questionnaires, resulting in a very

limited understanding of the meaning of participants’ responses. Thus, it is proposed that

qualitaitve methods are needed to provide new insights into the attitudes of listeners toward

PWS. Qualitaitve research designs allow researchers to ask questions that assess the deeper

meaning of the phenomenon under investigation (Creswell, 1998). Qualitative research methods

are necessary because little is known about how reactions to stuttering and PWS have developed,

why they persist, and the implications of these attitudes for interactions between PWS and the

fluent speakers with whom they interact.

Few studies have conducted such in-depth qualitative investigations into attitudes toward

PWS. Many studies have used a superficially qualitative design in which participants are asked

to list adjectives that describe PWS (Lass et al., 1989; 1992, 1994; Ruscello et al., 1994; Woods

& Williams 1971; Yairi & Williams, 1970). The adjectives that participants provided in these

studies were analyzed for frequency counts but little else, minimizing the explanatory power that

these studies could have had if the researchers had asked participants to provide a rationale for

their responses. Some researchers have utilized a mixed-methods approach and have asked

participants to provide open-ended statements along with quantitatively-driven responses (e.g.,

Healey et al., 2007; Manning et al., 1999; Panico et al., 2005); however, most of these articles

have tended to quantitize the qualitative data. Thus, participants’ open-ended responses have

often been categorized as positive or negative statements and reported as percentage data rather

than analyzed for their deeper meanings. To date, purely qualitative research methods have been

used in only one study (Susca & Healey, 2002). This study asked participants to respond to five

questions about a recorded sample of stuttered speech. Susca and Healey’s results indicated that

53

the frequency of stuttering influences listeners’ perceptions of PWS; however, it remains unclear

as to why a consistently negative stereotype of PWS has been reported in the literature and the

consequences of such negative stereotypes.

The literature related to attitudes toward other types of communication disorders seems

equally inadequate to address the larger issues related to this topic. Studies have investigated

listeners’ attitudes toward people with articulation disorders, (Crowe Hall, 1991; Mowrer, Wahl,

& Doolan, 1978; Silverman & Paulus, 1989; Ruscello, Stutler, & Toth, 1983), hearing disorders,

(Blood, Blood, & Danhauer, 1978; Danhauer, Blood, Blood, & Gomez, 1980; DeCaro,

Dowlaiby, & Maruggi, 1983; Dengerink & Porter, 1984; Lass et al., 1986; Brown Zahn & Kelly,

1995), voice disorders (Blood, Mahan, & Melvin, 1979; Lallh & Rochet, 2000; Lass, Ruscello,

Stout, & Hoffmann, 1991), and disorders requiring the use of augmentative and alternative

communication (see McCarthy and Light, 2005, for a comprehensive review). None of these

studies have employed methods other than semantic differential and Likert-type scales. Indeed,

only a few studies of this sort have implemented mixed methods or qualitative research

approaches (Berkay, Gardner & Smith, 1995; Cooper, Rose, & Mason, 2004; Fisher & Brooks,

1981; Parasnis, DeCaro, & Raman, 1996). These studies have all investigated listeners’ attitudes

toward deaf and hearing impaired populations; however, Kiger (1997) has suggested that

attitudes toward deaf people are structurally different from attitudes toward people with other

types of disabilities. Thus, it appears necessary to conduct comprehensive studies of attitudes

toward individuals with specific types of communication disorders rather than assuming that

there is a common basis for people’s attitudes toward communication disorders in general. The

concept of a hierarchy of disability, in which some disabilities are perceived more negatively

54

than others (Deal, 2003; Smart, 2001) may also prevent researchers from making generalizations

about people’s attitudes toward all types of communication disorders.

In summary, although there is ample evidence to suggest that a person with a

communication disorder of any type is likely to be perceived more negatively than a person

without a communication disorder, the current literature cannot provide a comprehensive

explanation for why these negative attitudes exist and persist. This statement is especially true of

the stuttering research, because despite the widely reported negative attitudes toward PWS that

have been documented within the stuttering literature, there have been few studies that have

attempted to understand the emotions and cognitive processes from which many people’s

attitudes toward PWS are formed. At this time we have an incomplete understanding of these

attitudes and the conceivable effects they may have on interactions between people who stutter

and fluent speakers. Thus, the purpose of this study is to explore attitudes toward PWS from both

a deeper and broader perspective than has been reported previously in the literature. It is hoped

that this study will provide a more comprehensive and useful understanding of the attitudes of

fluent speakers toward people who stutter.

Research Questions

This study is intended to be exploratory in nature and will provide qualitative data that

may be useful in the development of future research studies on this topic. The large amount of

participant data also makes it possible to develop quantitative research questions and methods, so

that broader inferences regarding the nature of college students’ attitudes toward PWS and

stuttering may be made. Thus, there are two sets of research questions, qualitative and

quantitative, that will be addressed in this study.

55

Qualitative Research Questions

Qualitative research questions are generally broad and require participants to freely

express their opinions on a given topic. The data gathered from this study were considered from

within the framework of four qualitative research questions:

1) What descriptions do participants provide when asked to describe a person who

stutters, and what rationale do they provide for these descriptions?

2) What do participants know about stuttering in terms of its cause?

3) What difficulties do participants associate with being a person who stutters?

4) What do participants report as being important considerations or facilitative

techniques when interacting with PWS?

Quantitative Research Questions

In addition to the four qualitative research questions, analysis of the data collected in this

study were guided by two quantitative research questions:

1) To what extent do participants hold similar or different attitudes toward stuttering

and PWS based on frequency counts and percentages of (a) statements related to

specific themes for each survey question? and (b) positive, neutral, and negative

statements?

2) To what extent do participants vary in terms of demographic characteristics such as

gender and level of familiarity with PWS?

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CHAPTER 3

Method

Design

This study utilized a multistrand conversion mixed model design (Tashakkori & Teddlie,

2003) with an emphasis on qualitative methods. Appendix A provides a visual representation of

this research design. Although it is perhaps more commonplace to hear the term mixed method

versus mixed model, according to Tashakkori and Teddlie (2003), mixed model designs are

different from mixed method designs. Mixed method designs tend to integrate qualitative and

quantitative approaches only in the methods stage of a study, whereas mixed model designs

integrate both approaches throughout many stages of a study (e.g., the research

purpose/questions, methods section, inferences that the researcher draws from the data, etc.). The

mixed model design of this study was necessary in order to more clearly examine and understand

the attitudes of large numbers of college students toward stuttering and PWS.

The following description of the methods used in this study is based on the guidelines for

qualitative versus quantitative research paradigms, as it is important to adhere to the assumptions

of the major method when conducting mixed model research (Morse, 2003). Where appropriate,

a description of the study’s quantitative aspects has been provided; however, it is important to

clearly identify the components of qualitative research that make it the primary focus of the

study.

Qualitative methodologies are becoming increasingly common in stuttering research in

terms of understanding the experiences of PWS (Corcoran & Stewart, 1998; Petrunik &

Shearing, 1983; Whaley & Parker, 2000) and analyzing recovery from stuttering (Finn &

57

Felsenfeld, 2004; Huber et al., 2004; Plexico, Manning, & DiLollo, 2005). A standard definition

of qualitative research has been provided by Creswell (1998, p. 15):

Qualitative research is an inquiry process of understanding based on distinct

methodological traditions of inquiry that explore a social or human problem. The

researcher builds a complex, holistic picture, analyzes words, reports detailed views of

informants, and conducts the study in a natural setting.

The concept of qualitative research is founded on a constructivist paradigm. In this mode of

thought, qualitative research is thought to be useful in interpreting “a world in which reality is

socially constructed, complex, and ever changing” (Glesne, 1999, p. 5). Thus, qualitative

researchers wish to explore, in detail, how participants in a study perceive or experience a

particular phenomenon, such as stuttering and PWS. The researcher also plays an important role

in qualitative designs and is expected to be personally involved with participants and to

demonstrate an empathetic understanding of the phenomenon (Glesne, 1999). To gain a deeper

understanding of the research topic, qualitative researchers ask questions that begin with how or

what to assess the deeper meaning of the phenomenon under investigation (Creswell, 1998).

Qualitative research methods are necessary for the current study in order to conduct an in-depth

exploration of listeners’ attitudes toward PWS.

In addition to qualitative methods, the use of quantitative methods in this study was

essential. Thus, the type of research design is mixed in nature. Tashakkori and Teddlie (2003)

have provided three reasons why mixed designs are useful. First, these types of designs can

answer research questions that a pure qualitative or quantitative approach cannot. Second,

stronger and better inferences can be made when methodologies are combined. Finally, mixed

designs can allow researchers to obtain and make sense of participants’ views, which may be

58

quite diverse. Mixed designs have been defined as “the incorporation of various qualitative or

quantitative strategies within a single project that may have either a qualitative or quantitative

theoretical drive” (Morse, 2003). In this study, the theoretical drive is qualitative in nature;

however, the large number of participants who provided data made it possible to incorporate

quantitative research questions, data analysis, and inferences into the research process. For

example, it is appropriate to ask questions about and to analyze the participants’ demographic

information, such as their gender and the number of people they know who stutter. Additional

information about the percentage of positive, neutral, and negative participant comments and the

frequency with which themes were observed can contribute to a greater understanding of

attitudes toward PWS.

Participants

University students served as research participants in the present study for several

reasons. College students are a convenient population from which to gather data, and they have

often been included in studies that have examined attitudes toward PWS (Bebout & Arthur,

1992; Collins & Blood, 1990; Dorsey & Guenther, 2000; Gabel et al., 2004; Panico et al., 2005;

Tatchell et al., 1983 Silverman, E., 1982; Silverman, F.H., 1988; Silverman & Paynter, 1990;

Susca & Healey, 2001, 2002; White & Collins, 1984). Only a few of these studies have given

participants the opportunity to justify their responses (e.g., Collins & Blood, 1990; Panico et al.,

2005; Susca & Healey, 2001, 2002), and so the use of college student participants was deemed

appropriate in order to gain information that could help to develop an understanding of why

students in previous studies have reported generally negative attitudes toward PWS in

quantitatively-driven studies. Furthermore, of those studies that have used multiple groups of

participants, such as SLPs, teachers, college students, and members of the general public, (e.g.,

59

Dorsey & Guenther, 2000; Horsley & FitzGibbon, 1987; Kalinowski et al., 1993; Panico et al.,

2005; Susca & Healey, 2001, 2002), only a few of these studies have reported minor differences

among groups of participants (e.g., Dorsey & Guenther, 2000). Thus, the attitudes reported in the

literature appear to be consistent among most groups of participants, indicating that attitudes

toward PWS tend to be universal rather than a byproduct of one’s profession or group

membership. It was presumed that the responses of college students to the written survey and

interview questions would be similar enough to those of SLPs, teachers, and members of the

general public that surveying college students would be sufficient to answer the research

questions.

The number of participants in qualitative research studies can vary. As many as ten

participants have been suggested as an ideal number of participants for interviews in qualitative

research studies (Creswell, 1998); however, there is no pre-determined number of interviewees

that is needed. The only other qualitative study that has examined listener attitudes toward

stuttering (Susca & Healey, 2002) involved 60 interviewees who were asked simple questions

about a stuttered speech sample that required only a brief response. Glesne (1999) suggests that a

breadth of understanding on a given topic can be achieved by involving a greater number of

research participants in a qualitative study. Thus, a relatively large sample of 150 university

students participated in the present study in order to gain a breadth of understanding regarding

students’ attitudes toward stuttering and PWS.

In order to participate in the present study, participants were required to be at least 18

years of age, have no history of stuttering, not be a communication disorders major, and be

enrolled as a student at Bowling Green State University (BGSU). Of the 580 surveys distributed

to students, 207 were returned for a response rate of 35.8%. Six participants (1%) reported that

60

they currently or previously identified as a person who stutters and were excluded from the data

set. Despite attempts to recruit from equal numbers of men and women, there were fewer male

than female respondents. Of the 201 students who returned a survey and met the criteria to

participate in the study, 153 (76.1%) were women and 48 (23.9%) were men. The disparity

between men and women respondents was lessened somewhat by excluding from the data set 51

surveys from women received during the later stages of data collection. Thus, for data analysis

purposes, the final sample size was 150 participants consisting of 102 women (68%) and 48 men

(32%). These gender differences may be accounted for in part by the lower ratio of males

(44.3%) to females (55.7%) at BGSU as noted in the 2007 census information published online

by Bowling Green State University’s Institutional Research Office. In addition, more women

than men volunteered to take the survey (58.6% versus 41.4%), and women were more likely to

return the completed survey than men (45% response rate versus 20%). Two men and 16 women

also completed an oral interview. Women who returned the written survey were also more likely

than men to volunteer to be interviewed (67% versus 55%). Finally, Dillman (2007) suggests that

women are simply more likely to complete survey studies.

The average age of the participants was 22.5 years (SD = 6.18) with an age range of 18-

58 years. Reports of academic standing indicated that 42% of participants were freshmen or

sophomores, 34% were juniors or seniors, 22.7% were graduate students, and 1.3% were

nontraditional students. Information about the ethnicities of participants was also obtained. The

majority of participants were white/Caucasian (82%), but other ethnicities included

black/African-American (10%), Hispanic (3.3%) and Asian/Pacific-Islander (3.3%). A small

number of participants (1.3%) declined to give their ethnicity. With the exception of Native

American/American Indian students, no ethnic group was underrepresented in the data set as

61

compared to the larger University population. Table 1 provides a comparison of participants’

ages, academic standing, and ethnicities with that of BGSU based on a 2007 census report

(BGSU Institutional Research Office). It should be noted that, in general, the purpose of

qualitative research is not to obtain a target sample that is representative of the larger population.

Comparison data is therefore provided for informational purposes only.

Participants reported a variety of academic majors from among BGSU’s Colleges. The

majority of participants (54%, n = 81) were in the College of Education and Human

Development which includes such diverse majors as rehabilitation counseling, interior design,

tourism, and human movement/leisure studies in addition to education. Other participants were

from the College of Arts and Sciences (22%, n = 33), the College of Business Administration

(10%, n = 15), the College of Health and Human Services (7%, n = 11), and the College of

Technology (5%, n = 7). Three participants (2%) reported that they were undecided as to their

major.

Participants varied in terms of their familiarity with PWS and ranged from knowing no

one who stutters to knowing nine PWS (M = 1.42, SD = 1.51). One participant reported knowing

a total of 36 PWS and was removed as an outlier from subsequent statistical analyses related to

familiarity with PWS. Thirty-seven participants (24.7%) reported not knowing anyone who

stutters. The remaining 112 participants reported knowing a combined total of 265 PWS. Table 2

provides frequency counts and percentage data of participants’ familiarity with PWS.

Participants’ specific experiences with PWS are examined in greater detail in the results section.

In addition to familiarity with PWS, 34 participants (22.3%) reported taking some type of class

that discussed communication disorders.

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Table 1 Sample vs. BGSU Demographics by Age, Academic Standing, and Ethnicity

Sample

BGSU

% Difference

(Sample – BGSU)

Age Range

18-19 35.3% 37.8% -2.5%

20-21 30.7% 37.6% -6.9%

22-29 23.4% 19.9% +3.5%

30+ 28.7% 2.7% +26%

Academic Standing

Freshman/Sophomore 42% 43.8% -1.8%

Junior/Senior 34% 38.4% -4.4%

Graduate Student 22.7% 14.7% +8%

Nontraditional Student 1.3% 3.1% -1.8%

Ethnicity

White/Caucasian 82% 79.8% +2.2%

Black/African-American 10% 8.9% +1.1%

Hispanic 3.3% 3.3% 0%

Asian/Pacific Islander 3.3% .8% +2.5%

Native American 0% .6% -.6%

Declined to Answer 1.3% 6.5% -5.2%

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Table 2

Frequency Counts and Percentages of Participants’ Familiarity with PWS

Familiarity Level Number PWS Known

N Percentage of Participants

None 0 37 24.7%

Not very well known 0 91 61.1%

1 38 25.5%

2 7 4.7%

3 8 5.4%

4-7 5 3.3%

Well known 0 99 66.4%

1 38 25.5%

2 8 5.4%

3 3 2.0%

4-7 1 .7%

Very well known 0 114 76.5%

1 26 17.5%

2 9 6.0%

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Instrumentation

Stimulus

Written survey. A written survey was developed for use in this study (see Appendix B).

This survey consisted of two parts. The first part of the survey was a demographic questionnaire

(adapted from Gabel et al., 2004), which asked participants to provide such information as their

age, gender, ethnicity, and academic major. Participants were also asked to indicate whether they

consider themselves to be a person who stutters (either currently or in the past), and if they ever

had a class that discussed communication problems. In addition, participants were asked if they

know someone who stutters, and if so, how well they know that person. The second part of the

survey consisted of nine questions that relate to stuttering and PWS. All of the items on the

questionnaire were developed based on the review of the stuttering literature. In some cases,

questions were included because they address important concepts that have never been asked of

participants in previous studies. Other questions were modified so that more detailed information

from participants could be obtained. For example, Question 2 asked participants to describe PWS

and to provide a rationale for this description. This question is appropriate because of the many

studies that have asked participants to describe PWS, (Lass et al., 1989, 1992, 1994; Ruscello et

al., 1994; Yairi & Williams, 1970; Woods & Williams, 1971), none have asked participants to

tell why this description was provided. Question 8 asked participants to describe experiences they

have had with PWS in order to gain a more in-depth understanding of participants’ backgrounds

related to stuttering and PWS. Question 1 (“What would it be like/what is it like to have a one-

on-one conversation with someone who stutters?”), Question 5 (“What is a good way to act

around someone who stutters?”), and Question 6 (“What can people who stutter do to help their

listeners?”) were designed to assess perceived sources of communication breakdowns and

65

barriers to effective communication between fluent speakers and PWS. Question 3 (“If you were

a person who stutters, how would your life be different?”) and Question 4 (“How do you think

people who stutter are affected by their stuttering?”) were asked to gather information related to

the perceived effects of stuttering and limitations that stuttering imposes on the lives of PWS.

Question 7 asked participants to report their perceptions about what causes stuttering. This

question was included because it was conceivable that some participants believe that stuttering is

caused by some defect in personality, such as a lazy or anxious temperament. The ninth and final

question asked participants to share any comments about stuttering or their reactions to the

survey.

Interviews. Participants who completed the written survey were given the opportunity to

indicate whether they would be willing to participate in an oral interview with the researcher. If

they were willing to be interviewed, participants provided their name and e-mail address on the

written survey. Participants were contacted via e-mail to set up an interview time if the

participant’s written responses were ambiguous or required more clarification, or if the responses

seemed particularly insightful or useful when interpreting the data. Follow-up interviews with

these participants served the purpose of obtaining additional information that helped to

illuminate themes or clarify general trends among participants’ responses.

Interview questions in general were participant-specific, e.g., “I noticed that you said that

‘special precautions’ should be taken when interacting with people who stutter. Could you

elaborate on some of these precautions?” Other questions were participant-specific but also

asked for elaboration on trends among participants’ responses in general, e.g., “You, like many

other participants, wrote that one should ‘act normally’ around people who stutter. Can you give

66

me some examples of how to respond normally?” Open-ended questions and probes were used to

obtain information from participants.

The written survey data and the interviews were conducted concurrently. As soon as a

survey was received the researcher read it to determine if that participant’s responses warranted

an interview based on the criteria as previously described. If so, attempts to schedule an

interview with the participant were made. Interviews were scheduled for 30 minutes but most

required 20 minutes or less to complete. The interviews took place in a quiet therapy room in the

Health Center Building of BGSU. Each interview was audio-recorded and transcribed verbatim.

Information from the interviews were used to make inferences when analyzing the qualitative

data. There was not a specific number of interviews that were required, as the number of

interviews depended upon participants’ written survey responses and the availability of

participants to complete the interview. Instead, interviews were conducted until data saturation

was obtained, which occurred after the 18th interview, or 12% of the total sample.

Procedures

Pilot Study

A short pilot study was completed to examine the effectiveness of the survey questions.

The questionnaire was administered to 28 students in an introductory communication disorders

course. The students were offered a small amount of extra credit to complete the questionnaire

and provide a critique of its format, grammar, and overall ease of use. A review of these data

suggested that most students provided thoughtful answers and did not feel that the questionnaire

needed to be changed from its original format. While reading students’ responses to the

questions it became apparent that, on occasion, some students provided answers that were vague

or confusing, while other students provided responses that seemed particularly well articulated

67

and insightful. As a result of this finding, conducting interviews with participants was considered

appropriate to gain a more thorough understanding of the thought processes of students as they

contemplate stuttering and PWS.

Data Collection

The researcher visited a total of 38 classrooms on the campus of BGSU to recruit

participants. The purpose of the study and participants’ responsibilities for both the written

survey and interview were explained using a standard script. The exclusionary criteria were also

discussed at this time. It was emphasized that even students who did not know someone who

stutters could participate in the study, as the inclusion of participants with different levels of

familiarity with stuttering was necessary to provide a broader perspective from which to analyze

and interpret the data both qualitatively and quantitatively. Students who volunteered to

participate received a written survey and consent form (Appendix C) in a return envelope. As an

incentive to participate, a form to enter into a drawing to win an iPod Shuffle was also included

with the survey. Students who took a survey were asked to place their name and e-mail address

on a sign-up sheet so that response rate data could be obtained and friendly reminders to

complete the survey could be sent via e-mail at weekly intervals. Also included on the survey

was a separate page that asked if participants would be interested in participating in a follow-up

interview about stuttering and PWS. As the written surveys were received, the researcher read

them to determine which participants should be contacted to complete a face-to-face interview.

The consent form for interview participants is included in Appendix D. The purpose of these

interviews was to clarify written survey responses, so only a small subset (n = 18) of the

participants was interviewed. The interviews occurred concurrently with analysis of the written

data.

68

Instructor permission to visit each classroom was obtained via e-mail prior to recruiting

participants. Identifying these instructors was largely a matter of convenience, e.g., the

researcher’s personal or professional acquaintance with the instructors; however, to achieve the

target sample of 150 students of various ages and majors, instructors unknown to the researcher

were also contacted. An attempt was made to recruit students of various ages and majors. Thus

recruiting took place in several sections of an introductory public speaking course that was

required for all majors. These classes were attended mostly by freshmen and sophomores, but

also some juniors and seniors. Other participants were recruited from 300-400 level courses

attended primarily by juniors and sophomores of a particular major (e.g., biology, sociology,

English), and from graduate level courses. In some cases, disproportionate numbers of men or

women attended courses for upper-level undergraduate and graduate courses. For example, in

education classes women far outnumbered men, but in technology classes there were more men

than women. Every attempt was made to recruit equal numbers of men and women by visiting

similar numbers of classrooms that were heavily skewed in terms of gender.

Data Analysis

Participants’ written responses to the survey questions were typed into a word document

and interview responses were transcribed verbatim during ongoing data collection. The general

format for analysis of qualitative research as proposed by Maxwell (2005) was used to analyze

all data. In the first step in the analysis process, the researcher read over the data as it became

available and took notes regarding initial impressions. Preliminary ideas about the nature of

participants’ attitudes and how participants’ responses could be categorized and organized were

developed. This process, called coding, was used to develop relationships among participants’

statements that allowed for comparisons of the data. After these general codes were established,

69

two peer reviewers coded a subset of the data to make sure that the researcher’s interpretation of

the data was not biased (see the discussion on credibility, below). Once the codes were

established the data were arranged into themes, which allowed the researcher to present the

broader issues that were representative of participant’s individual responses (Maxwell, 2005).

Quantitative data analysis was conducted after the qualitative analysis was completed.

The quantitative analysis was descriptive in nature and served to provide the reader with

additional information about participants and their attitudes toward stuttering and PWS. The

demographic information, including participants’ age, academic major, academic status (e.g.,

undergraduate, graduate student), and number of acquaintances who stutter was entered into

SPSS and analyzed to obtain frequency counts, percentages, and other types of descriptive data

for each of these variables. Once themes were established via qualitative analysis, participants’

statements were analyzed for frequency counts and percentage data as a means of helping to

make broader inferences about college students’ attitudes toward stuttering and PWS.

Multivariance Analysis of Variance (MANOVAs) for gender, level of familiarity with PWS, and

interactions between gender and familiarity were conducted to determine whether group

differences on survey responses existed for men versus women or for participants who were

more familiar versus less familiar with PWS. When appropriate, Pearson Product Moment

Correlations were also used to identify associations between themes on survey responses.

A similar procedure was used with some questions to code participants’ responses as

positive, neutral, or negative, as has been done by other researchers (Healey et al., 2007; Lass et

al. 1989, 1992, 1994; Manning et al., 1999; Ruscello et al., 1994). More specifically, the criteria

to make judgments about the tone of each statement were as follows: If a participant’s response

to a given survey question seemed supportive of PWS, provided a sense of hope or optimism for

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those who stutter, expressed normalcy while interacting with PWS, or suggested that the

participant experienced good or normal reactions to PWS, the statement was coded as positive.

Negative statements were typically blunt in nature, offered little or no rationale for the

participant’s seemingly negative statements, expressed the hopelessness or awfulness associated

with stuttering or interacting with someone who stutters, or suggested that the participant would

experience bad or unpleasant reactions while interacting with PWS. Neutral statements did not fit

clearly into either the positive or negative category, or were ambiguous in general. Positive,

negative and neutral ratings were subjected to the same types of reliability analysis as were the

other themes.

Credibility

As this study was primarily qualitative in nature, the assumptions for credible qualitative

research were met. Qualitative researchers do not employ control groups, randomized sampling

of participants, or other methods that are designed to account for extraneous variables or other

threats to validity (Maxwell, 2005). Thus, there is a need to establish that the qualitative methods

and the conclusions drawn by qualitative researchers are credible and do not stem from the

researcher’s own biases. In qualitative research, the term validity is used to refer to the

“correctness or credibility of a description, conclusion, explanation, interpretation, or other sort

of account” (Maxwell, 2005, p. 106). The validity of the research process and the conclusions

drawn from the data in this study were addressed in a variety of ways. A methodological journal

was kept as a log of how the study progressed and the rationale that was used to help make

certain decisions and interpret the data. The journal was reviewed by others who were not

directly involved in the study to verify that there was a lack of researcher bias throughout the

study. Another way that researcher bias was minimized was through the use of bracketing.

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Bracketing occurs when the researcher is interviewed about the topic under investigation so that

his or her opinions and potential biases can be acknowledged before the researcher interacts with

participants and analyzes the data. The primary researcher therefore completed the written

survey and was interviewed about stuttering and PWS by a peer who had knowledge of stuttering

and PWS, but who was not affiliated with the study itself.

In addition to bracketing and journaling, a number of other validation procedures to

ensure that the data and the researcher’s conclusions are credible have been described by

Creswell (1998). The types of validation procedures that were used in this study included

triangulation, providing detailed descriptions of the research process and the participants, and

peer review. Triangulation involves the “use of multiple and different sources, methods,

investigators, and theories to…shed light on a theme or perspective” (Creswell, 1998, p. 202).

Obtaining data from a variety of sources, including the written surveys and oral interviews

served as the basis for triangulation in the present study. The use of quantitative as well as

qualitative research questions, data analysis procedures, and inferences was also a form of

triangulation. Providing detailed descriptions of the participants and the research process allows

readers of the study to make inferences regarding how well the outcomes of the study would

transfer to similar participants and settings (Creswell, 1998). This study incorporated these

procedures to ensure that the themes and conclusions that were derived from the data were

trustworthy and were as free from the researcher’s personal bias as possible. Peer reviews

provided constructive criticism from people who were not directly involved in the research

process and had no stake in the study’s outcome. Two graduate students who did not have a

history of stuttering served as peer reviewers. These individuals had both completed graduate-

level coursework in stuttering and had experience with mixed methods research.

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Reliability

The two peer reviewers as described above also helped to provide measures of inter-rater

reliability. A subset of the larger data set was randomly selected for analysis (approximately 25%

of the responses on each survey question, or 38 participant responses for each of the nine

questions). A training session with the reviewers was conducted prior to reliability analysis,

during which time the reviewers received the data for each question and were given instructions

on how to code qualitative data. The reviewers were asked to examine two questions per week

on their own time and to provide a written summary of their impressions to the primary

researcher. The primary researcher completed the same procedure and weekly meetings were

held to compare impressions of the data. Once the codes for each question were agreed upon, the

subset of 38 participants’ responses were coded by each of the reviewers and the researcher to

determine whether each of the three reviewers perceived individual participant’s statements as

belonging to the same theme. Measures of intra-rater reliability were obtained when the primary

researcher re-coded the data subset approximately two weeks after the group coding session.

Percent agreement and Cohen’s Kappa were used to establish inter- and intra-rater

reliability. These measures were obtained via the use of the Program for Reliability Assessment

with Multiple Coders (PRAM Version 4.5), available online through Skymeg Software. Percent

agreement ranged from 91% - 97% for inter-rater measures and 95% - 100% for intra-rater

measures. Cohen’s Kappa was also determined, as it is a more robust measure than percent

agreement because it accounts for agreements that may occur by chance (Sim & Wright, 2005).

Cohen’s Kappa coefficients ranged from .88 - .96 for inter-rater measures and .93 - 1.00 for

intra-rater measures. According to Landis and Koch (1977), Cohen’s Kappa coefficients that fall

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between .81-1.00 indicate almost perfect agreement. Measures of inter- and intra-rater reliability

for each survey question are provided in Table 3.

Table 3

Measures of Inter- and Intra-Rater Reliability

Inter-rater Measures Intra-rater Measures

Question Number

Number of Statements

Percent Agreement

Cohen’s Kappa

Percent Agreement

Cohen’s Kappa

1 160 93.3 .925 100 1.00

2 130 94.1 .931 96.9 .964

3 140 94.5 .920 100 1.00

4 129 96.9 .959 99.2 .990

5 95 91.2 .884 97.9 .97

6 92 92 .893 94.6 .930

7 60 92.8 .890 100 1.00

8 97 93.8 .929 99 .988

9 48 92.4 .902 100 1.00

* Cohen’s Kappa coefficients of .81-1.00 indicate almost perfect agreement (Landis & Koch, 1977)

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CHAPTER 4

Results

The responses of participants to each of the survey questions are presented in this chapter

as categorical themes, or simply “themes,” that are representative of the codes which were

established to organize participants’ responses. (Summative themes representative of

participants’ responses to all of the survey questions are presented in Chapter 5.) Each of the

nine survey questions is discussed separately, with the survey question placed as a centered,

italicized heading to identify the question under discussion. A number of subheadings provide

more details about the findings for each of the questions. The “Descriptive Findings –

Qualitative and Quantitative” section identifies the themes that were extrapolated from

participants’ responses and the percentage of responses associated with each theme. The

“Qualitative Results” section elaborates on these themes and gives examples of statements from

individual participants. Whenever possible, percentage data is included in this section to avoid

vague terms such as “Some participants believed…” or “Many participants wrote…” The

“Quantitative Results – Comparisons” section examines the non-descriptive statistics for each

question and often includes Multiple Analyses of Variance (MANOVAs), t tests, and/or Pearson

Product Moment correlations. The “Summary of Qualitative and Quantitative Results” section

provides a general discussion of participants’ responses to the individual survey questions. This

information is provided so that the reader may understand the results and implications of

individual survey questions. Participants’ responses are related to the six research questions and

the implications of these responses are considered at the end of this chapter. In this section, the

broader implications of participants’ responses to the research questions are discussed. As a final

note, the tables associated with many of the statistical analyses were quite long and often

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disrupted ease of readability when placed within the text. Thus, in most cases, the tables

associated with individual survey questions have been placed directly after the summary section

for each question.

Survey Question 1: If you have had a conversation with someone who stutters, what was

it like? If you have not had a conversation with someone who stutters, what do you think it would

be like?

The first survey question asked participants to describe their conversations with someone

who stutters. The question was worded in such a way that even participants who had never

spoken with someone who stutters could respond by imagining what it would be like to converse

with someone who stutters. This question was designed to elicit participants’ general reactions

while speaking (or thinking about speaking) with someone who stutters. In this way, data may be

gathered about the emotions, thoughts, and behaviors of fluent speakers as they interact with

PWS.

Descriptive Findings - Qualitative and Quantitative

Qualitative. Three themes emerged from these responses and included statements that

discussed (1) whether or not the participant had ever conversed with PWS, (2) perceptions of

effort for PWS or their listeners during conversations, and (3) emotions or thoughts of the

participants, PWS, or both parties while conversing. Statements that referred to emotions or

thoughts were also judged on the basis of whether they seemed to be positive, neutral, or

negative in nature.

Quantitative. A total of 666 statements were provided by the 149 participants who

answered the question (M = 4.47, SD = 2.25). Approximately 16% of the statements (n = 109)

included participants’ reports of whether they had ever spoken to someone who stutters. Most of

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these statements (n = 77, 70.6%) indicated that the participant had conversed with at least one

PWS, whereas 32 statements (29.7%) referred to participants who had never spoken with a PWS.

These statements appear to roughly correspond with the numbers of participants who knew PWS

(75.3%) versus those who did not (24.7%) as reported on the demographic portion of the written

survey.

Participants made 277 statements (41.60% of the total responses) related to the perceived

effort involved when speaking to someone who stutters. On average, participants reported 1.86

statements about effort (SD = 1.54). Twenty-three of these statements indicated that participants

felt that PWS have to expend effort while communicating, often in the form of general difficulty

while speaking, having to take more time when conversing, and struggling to get words out. The

majority of statements (n = 254) referred to the participants’ own perceived efforts while

speaking with PWS. These statements included such remarks as needing to concentrate harder

when listening to PWS or difficulty understanding stuttered speech (n = 81, 31.9%, coded as

“Concentration/Intelligibility”), spending extra time when engaging in conversation with PWS (n

= 51, 20.1%, coded as “Time”), offering help or advice to PWS or refraining from offering such

help (n = 47, 18.5% coded as “Help”), having extra patience with PWS or their stuttering (n =

47, 18.5%, coded as “Patience”), and trying to figure out how to act around PWS or how to avoid

offending them (n = 30, 11.8%, coded as “How to act”).

The number of comments made by participants regarding effort ranged from one to eight.

Because some participants made more comments than others regarding aspects of effort, the ratio

of each type of effort statement to the total number of statements about effort were calculated.

“Concentration/Intelligibility” statements had a total ratio of 41.38 (M = .14, SD = .39). “Time”

statements had a total ratio of 26.79 (M = .18; SD = .31). “Help” statements had a total ratio of

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21.14 (M = .32, SD = .57). “Patience” statements had a total ratio of 21.01 (M = .14, SD = .27,

and “How to act” statements had a total ratio of 13.59 (M = .09; SD = .23).

Statements related to emotions or thoughts accounted for 282 (42.34%) of the total

number of statements. The majority of responses (n = 226) were reports of participants’ own

emotions and thoughts about talking with PWS. Many participants indicated that they had or

thought they would have positive emotions or thoughts when conversing with someone who

stutters (n = 102, 45.1%). Slightly more statements (n = 109, 48.2%) indicated that participants

had experienced or anticipated negative emotions or thoughts. Fifteen statements (6.6%) were

judged to be neutral. The average ratio of positive statements and negative statements to the total

number of statements about participants’ thoughts and emotions were calculated to account for

variations in the numbers of statements provided by individual participants, which ranged from

one to 10 statements. The total ratio for positive statements was 57.57 (M = .39, SD = .43). The

total ratio for negative statements was 57.99 (M = .39, SD = .45), and 7.41 for neutral statements

(M = .50, SD = .18).

In addition to reporting their own thoughts and emotions, some participants also reported

their perceptions of the emotions or thoughts of PWS or both PWS and listeners during the

conversation. Of these 56 statements, three were neutral and 53 (94.64%) indicated that the

participants perceived PWS as experiencing negative thoughts and emotions during

conversations with fluent speakers. These findings may suggest that PWS are perceived as

feeling more negatively about their stuttering than are fluent speakers.

Qualitative Results

Effort. One of the major themes that arose from participants’ responses to the survey

question was related to the effort required to converse when stuttering was present. As described

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above, participants’ statements related to their own efforts to communicate with PWS were

divided into five categories: employing patience, giving extra time, listening more closely due to

concentration/intelligibility issues, helping or refraining from helping PWS, and figuring out

how to act around someone who stutters. These categories are discussed in further detail below

and are accompanied by direct quotes from participants as a means of providing a deeper

understanding of what participants experience or thought they would experience as they talk with

PWS.

Many statements (32%) that were related to the theme of effort addressed participants’

perceptions regarding the intelligibility of PWS. Participants who had spoken to an individual

who stutters seemed to report the same comprehension difficulties as did people who had never

talked to a person who stutters. For example, one participant who was familiar with PWS wrote,

“At times it can be difficult to focus on what the person is saying instead of their stutter.”

Similarly, a participant who had never talked to someone who stutters wrote, “I might get off

track by paying attention to their stuttering problem rather than paying attention to the actual

meaning of the conversation.” Typical statements about participants’ overall ability to listen and

understand PWS included the following: “It was difficult to listen and pay attention to the

conversation,” “I think it would be hard to follow what he was talking about,” and “I would

imagine it would be very difficult to understand them.” Giving extra attention to the conversation

was sometimes suggested as a remedy for not understanding PWS, as noted by such comments

as: “You have to pay very close attention to make sure you get the whole point that they are

making,” and “I felt like I had to concentrate more on their words so that I could understand

what they were saying.” Other participants engaged in more active listening to ensure that they

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comprehended the person who stutters: “I would ask back the question to make sure I understood

and sometimes I would also repeat the statement or ask them to say it again.”

The effects of not being able to understand PWS or thinking that one will not understand

PWS in future conversations appeared to place some stress on the participants in this study. As

one participant remarked:

“When I have to [ask PWS to repeat themselves] it makes me feel bad because I couldn't

grasp the first time, and it has to have some effect on them as well…Because in their

head I feel like it’s coming out, like they know exactly what they’re asking, but you just

can’t understand it. You can’t grasp it or you’re missing a word that makes it click, to

understand.”

Thus, it would seem that not understanding someone who stutters creates a source of cognitive

confusion as well as negative emotional reactions, such as “feeling bad.” Other listeners may feel

that they are under pressure to understand PWS: “I usually feel responsible for not being able to

understand the person. I feel like it is my problem and I need to figure out how to understand the

person.” Similarly, another participant wrote, “It also is a high-pressure situation for the listener

because you know the other person is embarrassed, and if you ask them to repeat something

because you couldn't understand them, the pressure is on for you to understand so that you don't

have to point out their stuttering by asking them to repeat.” Listeners, therefore, may feel

apprehension about communicating with PWS on the basis that they will not understand the

individual who stutters. As one person who never talked with someone who stutters remarked, “I

would be worried that I would have to ask them to repeat themselves.” These statements indicate

that not understanding, or the anticipation of not being able to understand, someone who stutters

is of concern to the participants in this study.

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Two other types of effort were reported by participants and seem to be related.

Approximately 20% of statements indicated that the participants believed that speaking with

someone who stutters requires more patience than is usually required in typical conversations

with fluent speakers. In addition, approximately 19% of statements indicated that participants felt

that they needed to invest more time in conversations with PWS. These factors (extra time and

patience) seem to be related as the following statements from familiar listeners of PWS indicate:

“When having a conversation with someone who stutters, the key ingredient is patience. It is

easy to become frustrated with the person when it takes them five minutes to answer a simple

question.” “My cousin is a stutterer, conversations with him usually take longer than regular

conversations and [require] a lot of patience.” Even when interactions were described by

participants as being essentially positive, such issues as patience and time emerged: “I work with

someone who stutters…He’s a great guy, you just have to be patient.” “I don’t mind [my friend’s

stuttering]…It might take a while but you just have to be patient when listening to her.” “I felt as

though I needed to be very patient with the person. The conversation took longer than a

conversation without a person who stutters, but the conversation was nonetheless interesting.” It

is interesting to note that most of the statements related to patience and extra time were made by

participants who had conversed with PWS versus those who had not. Thus, for people who have

some degree of familiarity with PWS, the most salient or well-remembered details about

conversing with PWS may be the perceived amount of time and patience that is required. It may

be that people who have never conversed with PWS do not anticipate time and patience as

factors that would affect their interactions with an individual who stutters.

Another form of effort was the concept of helping PWS as reported in approximately

19% of participants’ statements. Participants who had conversed with someone who stutters

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openly acknowledged the strategies that they employed in order to help PWS, particularly

younger siblings or friends. This help came in the form of advice, e.g., “My 5 year old brother

stutters a lot when he is trying to explain things to me. It often times gets to the point where I

have to say, ‘Josh, stop! Breathe. Now start over.’” Another participant wrote, “I have a few

friends who only start stuttering when they get excited or nervous, and usually I just tell them to

stop for a minute, calm down, and try again.” Similarly, one participant noted, “When my

brother was younger, he had a severe stuttering problem. We would often tell him to ‘Slow

down! Think of what you want to say!’” The participants who made these types of statements

seemed to appreciate that their advice was sometimes emotionally upsetting to the PWS. For

example, a participant wrote, “This [advice] usually upset him, but once he would calm down,

his language [e.g., speech] would improve.” Likewise, one participant stated, “If you try to

correct them or fill in what they are trying to say, some get pissed off and stop talking

altogether.” In each of these examples, although the participant reported negative emotional

reactions from the individual who stutters, the end result was perceived as being positive in the

sense that there was a decrease in stuttering (even if the individual stopped talking altogether.)

Participants also reported that they helped PWS by finishing their words. It appears that

participants had different reasons for providing this kind of help. Finishing the words was a way

of alleviating the need to listen to the stuttering or having to pay such close attention to the

speech of the PWS. For example, “It is hard to understand them sometimes, but I just listen

closely and if I know what they are trying to say I try to finish the sentence for them.” Thus,

attempting to finish the sentence seems to be a type of coping mechanism by which this

participant deals with not being able to understand the PWS. Another reason for filling in the

words and sentences of PWS is, of course, that conversations with someone who stutters can take

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longer than usual, as illustrated by the following statements: “I would finish the sentence in my

head, and it would take him so much longer to get it out,” “I want to finish the words for them

because I am used to a much faster speed of communication,” and “I think it would be a slow

conversation and I probably would finish sentences or words for them.” One participant reported

feelings of frustration with a co-worker who took longer to speak when he stuttered, and so

“every once in awhile I would finish his sentences to get to the point of the conversation.” Thus,

finishing the thoughts of PWS appears to result from a desire to speed the conversation up, thus

alleviating frustration, and also to minimize the amount of effort that one must expend to

understand PWS as they speak.

Participants also indicated that they would want to finish the word or sentence of PWS

but felt that they should not do so. It seemed to require a lot of effort for some participants to

refrain from finishing the words of PWS. As one participant wrote:

“I worked with a girl once who studdered [sic] very badly. We worked [together] on

campus. It was very frustrating to have a conversation with her. I always felt like I should

finish what she was saying, if I could even understand [her]. It was very hard to simply

listen and not help her speak.”

This participant does not particularly elaborate on why she does not help her coworker to speak

by finishing words and sentences, but another participant did elaborate more on this point:

“I could envision a situation where I am having a conversation with someone who

stutters. Perhaps I knew the point they are trying to communicate and therefore would be

tempted to finish their thought for them. If I would do that it would 1) not exhibit

patience, 2) communicate to the stutterer that they are not speaking fast or clearly

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enough, and/or 3) create frustration, especially if my finished thought was not the point

they were trying to make.”

One participant indicated that although it seems very natural to finish sentences, she refrains

from doing so because “it’s very rude.” These statements suggest that these and other

participants do not seem to feel that it is appropriate to finish the thoughts of PWS. It does seem

to require considerable restraint for listeners to avoid the “temptation” of completing words and

sentences for PWS. The intrinsic factors that cause one listener to feel that this type of help is

justified and another listener to feel that such help is not appropriate are still unclear at this time.

The final type of effort that was reported in nearly 19% of participants’ statements

involved trying to figure out how to act around PWS or how to not offend them. Participants

reported being confused at first about whether the individual was actually stuttering and thought

the stuttering might have been a joke. For example, one participant wrote, “At first I thought the

person was joking around, so I started laughing. Then when he asked why I was laughing, I told

him because of him stuttering. When I found out it was not on purpose, I felt really bad.”

Similarly, another participant reported that “I was nervous and a bit anxious because I was

waiting for them to respond and I didn’t know if they were joking or actually had a stutter.”

Perhaps these examples suggest that stuttering has been portrayed by the media in such a way

that listeners who encounter real stuttering may experience confusion as they try to reconcile a

stereotypically humorous phenomenon with a speaking disorder that seemingly becomes more

solemn when it is beyond the control of the individual who stutters.

Participants also reported that they would not know how to act in general e.g., “It isn't as

common for me and the people I've had conversations with, so I wouldn't know how to act.”

Another participant wrote:

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“It was a slightly uncomfortable situation because when I greeted him and asked how I

could help, I didn't know he had a stutter and when he didn't quickly respond I started to

ask other questions about what he needed. When I realized the circumstances, I was

unsure of whether to finish his sentences for him when I knew where he was leading, or

let him struggle to get words out when I knew what he was going to say. I maintained eye

contact and smiled, hoping to make him more comfortable.”

Not knowing how to act was paired with not wanting to offend the PWS. One participant

reported being frustrated, “not because of their stutter, but because I did not want to offend them

by unintentionally talking over them or by not giving them enough/giving them too much time to

convey their thoughts before I began to speak.” This participant’s statement conveys the

complexity of her thoughts as she interacted with an individual who stutters. In her efforts to

avoid offending the PWS, it appears that she began to mentally catalogue of all of the ways in

which her actions could be perceived negatively by the PWS. Such thoughts would seem to be

exhausting during any type of prolonged interaction with someone who stutters.

Participants also indicated that ignoring the stuttering or one’s reactions to stuttering was

important. One participant reported that speaking with someone who stutters “would most likely

be annoying, however, I would not let them know that.” Another said that at first the stuttering

“made me slightly uncomfortable. Not because [the PWS] made me uncomfortable, but because

I worried that I would offend him somehow by taking notice of the stutter.” An explanation for

why listeners might feel the need to pretend not to notice the stuttering was provided by this

participant:

“When I had a conversation with someone that stuttered, I felt as though I was trying to

seem as though I had not noticed the stutter. I would guess that it’s because you—or I –

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would want to try to make the person feel as normal as possible. I would guess that when

the person, when they stutter, they feel like they have a disorder or they feel like they

have an abnormal part of their character, I guess. And so [ignoring the stuttering] would

be my attempt to make it seem that I thought of them just like any other person.”

Ignoring the speaker’s stuttering or at least concealing one’s negative reactions to it may

therefore be perceived by participants and other listeners as either a common courtesy to PWS or

as a means of trying to bolster what appears to participants as the low self-esteem of PWS.

Emotions and Thoughts. Of the statements that related to emotions and thoughts,

approximately 80% described the participants’ emotions and thoughts (or anticipated emotions

and thoughts) when speaking with PWS. The remaining 20% of these statements addressed the

perceived emotions and thoughts of PWS and/or the emotions and thoughts of both PWS and

their listeners. These statements were coded primarily as positive, neutral, or negative on the

basis of their effects on the participant rather than on their social appropriateness or their

potential effects on PWS. Thus, if a participant reported feeling frustrated while speaking with an

individual who stutters, this statement was coded as a negative emotion because the participant

appeared to have experienced an unpleasant feeling. It was not coded as negative because the

researcher and peer reviewers felt that listeners should not be frustrated while speaking with

PWS, or because PWS may have negative experiences if listeners have feelings of frustration.

With these guidelines in place, coding statements that addressed emotions and thoughts as

positive or negative was a fairly straightforward process, as it was evident that statements in

which participants reported feeling bad, helpless, confused, or frustrated should be coded as

negative. Statements were coded as positive when participants reported that their thoughts and

emotions when interacting with PWS were or would be no different than when interacting with

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typical speakers. These types of statements were coded as positive because there was little reason

to expect that listening to someone who stutters should inspire “good” or “happy” feelings in

PWS or their listeners. Statements referring to emotions or thoughts were coded as neutral only if

the statement was very ambiguous.

The 102 statements that were coded as positive tended to describe the participants’

emotions and thoughts rather than the perceived emotions and thoughts of PWS. Furthermore,

the positive statements were generally related to participants’ perceptions of conversations with

PWS as being normal, regardless of whether or not the participant had ever conversed with

someone who stutters. As one participant who had never talked to PWS wrote, “I wouldn’t be

bothered and would expect it to be a fairly normal conversation.” Another participant indicated

the need for a bit of time, however brief, in which to adjust to the stuttering: “I have not had a

conversation with someone who stutters, but I can imagine it would be fairly normal. While it

might take a few minutes to get used to the stutter, I think it would just be like any other

conversation.” This participant’s report is very similar to that of a participant who had actually

conversed with someone who stutters:

“My most recent one-on-one conversation with someone who stutters was last week. It

was the first time I introduced myself to my new neighbor at my new apartment. I

quickly introduced myself, and he introduced himself back. His response took me by

surprise but made no difference to me. I told him he was welcome to borrow a cup of

sugar anytime, and he said the same.”

As this participant’s statement indicates, she was surprised by her neighbor’s stuttering but then

went on to experience a pleasant conversation with him. This sentiment is also reflected in

another participant’s response: “At first, I was taken aback because I’ve never heard anyone with

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a stutter, but after a few minutes it didn’t faze me.” These types of statements indicate that

potentially negative emotions such as being surprised or taken aback can be overcome with

increased exposure to PWS. It would also be interesting to learn if some individuals are more

easily able to emotionally adapt to the presence of stuttering than are other listeners.

Negative thoughts and emotions accounted for 109 of participants’ statements about their

interactions, real or imagined, with PWS. Frustration was a term that was used by participants to

describe these interactions, both for themselves and for PWS. For example, one participant

wrote, “I think that I might become frustrated trying to understand, which would make the

person who stutters also frustrated.” Another participant stated, “It is easy to become frustrated

with the person…However, one has to realize that they probably get just as frustrated as you do

because you don’t understand what they are doing or trying to tell you.” Thus, participants

tended to report that communication breakdowns due to listeners’ inability to comprehend the

PWS’ message becomes frustrating not only to the listener but to the individual who stutters as

well. This frustration seems to apply even to adults who interact with children who stutter: “I

have experienced a conversation with a child who stutters and found that it was in fact very hard

to follow him. Both he and I would get frustrated when we were having trouble understanding

each other.” Participants also indicated that increased exposure to individuals who stutter tended

to make interactions go more smoothly, e.g., “as time progressed we were able to effectively

communicate,” and “I think that once I was able to speak to that individual for some time, I

would be able to understand what he/she is saying and the stuttering would no longer be an

issue.” Thus, the perceived mutual frustration that occurs when listeners cannot understand PWS

appears to be alleviated as listeners spend more time with PWS and feel that the stuttered speech

becomes more intelligible.

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Participants also expressed that PWS would feel negative emotions or experience

negative thoughts as a result of their stuttering. Participants appeared to readily note feelings of

frustration in PWS. For example: “When I was in high school, there was someone who had a

stutter. I remember how frustrated he used to get…when he could not get out the words as

quickly as he would have liked to do.” Another participant wrote, “My best friend’s mother

recently had a stroke. Because of this she stutters and cannot pronounce many words right. I can

tell when she talks she gets very frustrated.” It is unclear whether these individuals who stutter

actually feel frustrated or if the listener simply believes him or her to be frustrated. Few if any

participants mentioned PWS being able to overcome or cope with their feelings of frustration.

This omission is interesting because although many participants indicated that they as listeners

would eventually become less frustrated by the stuttering over time, they do not appear to believe

that PWS would also become less frustrated by their own stuttering over time.

Participants also reported that they felt bad or sorry for PWS. One participant wrote, “I

felt very bad and a little awkward just waiting for him to get it out.” Another reported, “I’d feel

awkward and probably have nervous laughter, which is really bad and unfair.” This statement

and others like it seem to indicate that participants feel the need to censor their emotional

reactions to stuttering. Just as the participant above thinks it is “bad and unfair” to have nervous

laughter, another participant wrote about feeling guilty, “because you hear all the time that you're

not supposed to ‘feel sorry’ for someone with an impairment.” Another participant reported

feeling bad because she anticipated that the person who stutters would perceive her negatively:

I think I would feel bad and think that the person with the speech problem would think I

was judging them …because even if you weren’t, the people who stutter are probably

thinking, “I wonder if she’s judging me, thinking that I’m stupid,” or I would assume that

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someone [who stutters] would think that. Not necessarily, but… [People] can stutter for a

number of reasons. It wouldn’t really affect any of [their] abilities, but you wouldn’t want

that person to think that you were judging them, I suppose.

Similarly, another participant stated that “It can be slightly awkward when the person is actually

stuttering…. because you don’t want to make the person feel bad.” Thus, feeling bad seems to be

related to feeling awkward or unsure around PWS, and both emotions appear to indicate

participants’ uncertainty about how one should act in the presence of someone who stutters. The

effort required to figure out how to interact with PWS so as not to offend them appears from

these responses to be one cause of emotional distress for participants.

Another interesting phenomenon as inferred from the responses is the presence of a type

of emotional feedback loop. As previously discussed, sometimes PWS and their listeners are

perceived as sharing certain emotions such as frustration over not being easily understood. In

addition, there were reports that the perceived negative emotions of the individual who stutters

created the same negative emotions in the listener. For example, one participant wrote, “When I

see that the person I am talking to stutters, I associate it with he or she being nervous. That

nervousness and anxiety rubs off on me.” It is interesting to note that this particular participant

reported knowing one person who stutters very well and two PWS not very well, and so would

presumably have experienced multiple interactions with PWS in a variety of contexts. Therefore,

it appears that the emotional stress consisting of nervousness and anxiety has not been alleviated

over time for this participant. Another respondent provided another variation on the emotional

feedback loop: “[I] always act as if nothing is wrong, but I know how embarrassed he must be

taking so long to say a simple word. I feel myself blushing, being embarrassed for him.” Once

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again, the participant has (correctly or incorrectly) perceived that the PWS is feeling a negative

emotion and this thought is mirrored in the participant’s own feelings.

Negative thoughts and emotions appeared to arise because of difficulties understanding

PWS and the extra time required to talk to PWS. For example, one participant who had

conversed with a PWS stated that, “I hate to admit it but I found myself kind of feeling impatient

and wanting to jump in and finish the word or sentence for them. I felt that the conversation was

definitely more time consuming.” Another participant who had also talked to an individual who

stutters reported similar feelings: “It is very difficult and sometimes I become impatient with

them.” In addition to feeling impatient, participants reported annoyance, which also seemed to

stem from increased time or effort while speaking with someone who stutters: “I thought it was

funny at first but then it got very annoying because I just wanted them to hurry up and talk.”

Similarly, another participant wrote, “My conversation with someone who stutters was

somewhat annoying. I started out not caring much about the stuttering but as the conversation

progressed my annoyance grew.” These statements indicate that some listeners may not adapt to

stuttering as readily as others, like those participants who felt that stuttering was frustrating but

eventually became less so. It may be the case that listeners who engage in only a brief

conversation with PWS may not have the opportunity to become accustomed to stuttering, and so

negative feelings about stuttering or PWS may linger after the conversation has ended.

Neutral statements accounted for only 15 responses by participants. These statements

generally seemed ambiguous. For example, one participant who had a friend who developed

neurogenic stuttering wrote that this individual’s speech was “different from how she talked

before.” Similarly, another participant who had conversed with someone who stutters described

the experience as “a little difficult, but not in a harsh way.” Finally, a participant wrote, “It was

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quite similar to speaking with a person with any other speech impediment.” It is interesting that

this particular participant did not indicate that talking with someone who stutters is just like

talking to anybody else; instead a distinction was made which emphasized that the speech of

PWS is just like that of other people with disordered speech. Thus, participants who reported

neutral statements tended to indicate that they did notice speech differences, but the effects of

these differences were not specified. It would also appear that interacting with someone appears

to be rather polarizing—for some listeners stuttering is perceived negatively, whereas for others

it is not considered disturbing or disruptive.

Quantitative Results - Comparisons

Effort. A Multivariate Analysis of Variance (MANOVA) was conducted to determine

whether participants’ responses about the effort required when speaking with PWS were affected

by their gender or level of familiarity with PWS. Table 4 provides a summary of the means and

standard deviations for this analysis. The MANOVA indicated that there was no interaction for

gender and level of familiarity with PWS on all indices of effort, (F[42, 380] = .75, p = .87, 2η =

.08, observed power = .82), nor were there main effects for gender (F[14, 128] = .92, p =.58,

2η =.09, observed power =.56) or familiarity (F[42, 380] = 1.01, p =.46, 2η = .10, observed

power =.94). These findings suggest that participants did not provide significantly different

responses about the effort required to talk to PWS on the basis of their gender or level of

familiarity with PWS.

Emotions/Thoughts. A Multivariate Analysis of Variance (MANOVA) was completed to

compare participants’ statements about their emotions and thoughts about conversing with PWS

on the basis of gender and level of familiarity with PWS. Table 5 provides a summary of the

means and standard deviations for this analysis. No interaction between gender and level of

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familiarity was found for all indices of emotion, (F[27, 389] = 1.45, p =.07, 2η = .09, observed

power =.96), nor were main effects found for gender (F[9, 133] = 1.37, p =.22, 2η = .08,

observed power =.63) or degree of familiarity with PWS (F[27, 389] = 1.03, p =.43, 2η = .06,

observed power = .84). These findings suggest that participants’ responses in general did not

significantly differ based on their gender or level of familiarity with PWS.

Summary of Qualitative and Quantitative Results

Participants who had engaged in conversations with PWS and those who had not

appeared to make similar statements when answering the question, “If you have had a

conversation with someone who stutters, what was it like? If you have not had a conversation

with someone who stutters, what do you think it would be like?” Listeners reported expending a

considerable degree of effort when speaking with PWS. This effort took many forms, although

many participants indicated that increased concentration to understand the speech of PWS is

required. It was also apparent that stuttering was frustrating for many participants due to the

amount of time required to converse with PWS. Therefore, many participants also reported

needing to be more patient with PWS than they would with fluent conversational partners.

Participants generally seemed to be unsure as to how they should act around PWS and often

reported having to refrain from verbally helping PWS to finish their thoughts.

The amount of effort required while conversing with PWS and uncertainty regarding how

to act appeared to create negative emotions for some participants. Although many of the

statements indicated that conversing with PWS was normal or no different than any other

conversation, several participants also indicated that they would feel bad for PWS or bad about

their reactions to the individual and his/her stuttering. Frustration, impatience, annoyance, and

awkwardness were frequently cited negative emotions held by participants. Fewer participants

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described how they perceived PWS to be affected by their stuttering, including the emotions that

PWS would probably feel when interacting with fluent speakers. In general, PWS were

perceived as thinking and feeling negatively about their stuttering.

Some participants’ responses suggested that increased exposure to PWS can have

beneficial effects on listeners’ perceptions of interactions between fluent speakers and PWS.

These participants reported that their feelings of frustration were alleviated somewhat over time

as they became more familiar with the PWS and were able to adjust to the stuttering. These

qualitative responses were not represented in the quantitative analysis, as participants who were

more familiar with PWS did not report significantly more positive responses than did

participants who did not know PWS. In addition, women did not report more positive feelings or

thoughts about PWS than did men. These results suggest that fluent speakers, regardless of

familiarity with PWS or gender, perceive interactions with PWS similarly. It is also possible that

some types of negative emotions or perceived effort may diminish over time, but others remain.

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Table 4

Means and Standard Deviations for Effort Statements by Gender and Familiarity with PWS (n=149)

Ratio/Type of Statement Gender Familiarity Mean SD N

Total Effort Statements* Male None 1.17 0.75 6

Not Very Well 1.47 1.64 15

Well 2.23 1.48 13

Very Well 1.36 1.01 14

Total 1.60 1.36 48

Female None 1.68 1.51 31


Well 2.71 1.63 24

Very Well 1.75 1.25 20

Total 1.17 0.75 6

Ratio Effort Statements to Total Q1 Statements*

Male None 0.42 0.33 6


Well 0.47 0.18 13

Very Well 0.38 0.30 14

Total 0.40 0.24 48



Well 0.50 0.22 24

Very Well 0.42 0.26 20

Total 0.40 0.24 101

* Includes participants’ perceptions of effort for PWS as well as for listeners

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Table 4 (continued) Ratio/Type of Statement Gender Familiarity Mean SD N

Total Statements about Participants’ Own Effort*

Male None 1.17 0.75 6


Well 2.00 1.41 13

Very Well 1.07 1.00 14

Total 1.46 1.34 48



Well 2.42 1.61 24

Very Well 1.65 1.27 20

Total 1.82 1.54 101

Ratio Total Statements about Participants’ Own Effort*

Male None 0.42 0.33 6


Well 0.43 0.19 13

Very Well 0.31 0.30 14

Total 0.37 0.24 48



Well 0.44 0.25 24

Very Well 0.40 0.28 20

Total 0.37 0.25 101

* Subsequent ratios are calculated on the basis of the total number of statements participants made regarding their own efforts when speaking to PWS, as fewer participants included perceptions of PWS’ efforts in their responses.

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Total Patience Statements Male None 0.17 0.41 6


Well 0.08 0.28 13

Very Well 0.29 0.61 14

Total 0.21 0.58 48



Well 0.50 0.72 24

Very Well 0.35 0.49 20

Total 0.37 0.58 101

Ratio Patience to Effort Statements

Male None 0.08 0.20 6


Well 0.04 0.14 13

Very Well 0.18 0.37 14

Total 0.10 0.27 48



Well 0.14 0.21 24

Very Well 0.20 0.30 20

Total 0.16 0.27 101

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Total Time Statements Male None 0.50 0.55 6


Well 0.69 1.11 13

Very Well 0.21 0.58 14

Total 0.38 0.73 48



Well 0.54 0.59 24

Very Well 0.15 0.37 20

Total 0.33 0.49 101

Ratio Time to Effort Statements

Male None 0.33 0.41 6


Well 0.30 0.40 13

Very Well 0.11 0.29 14

Total 0.20 0.34 48



Well 0.22 0.30 24

Very Well 0.08 0.18 20

Total 0.17 0.30 101

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Total Concentration / Intelligibility Statements

Male None 0.33 0.52 6


Well 0.54 0.78 13

Very Well 0.29 0.47 14

Total 0.42 0.58 48



Well 0.67 0.87 24

Very Well 0.45 0.76 20

Total 0.60 1.12 101

Ratio Concentration / Intelligibility to Effort Statements

Male None 0.33 0.52 6


Well 0.28 0.40 13

Very Well 0.24 0.42 14

Total 0.31 0.43 48



Well 0.30 0.38 24

Very Well 0.23 0.34 20

Total 0.26 0.37 101

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Total Help Statements Male None 0.00 0.00 6


Well 0.54 0.66 13

Very Well 0.14 0.36 14

Total 0.25 0.53 48



Well 0.38 0.65 24

Very Well 0.45 0.60 20

Total 0.35 0.59 101

Ratio Help to Effort Statements

Male None 0.00 0.00 6


Well 0.20 0.30 13

Very Well 0.06 0.15 14

Total 0.10 0.23 48



Well 0.12 0.23 24

Very Well 0.26 0.38 20

Total 0.16 0.30 101

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Total How to Act Statements Male None 0.17 0.41 6


Well 0.15 0.38 13

Very Well 0.21 0.43 14

Total 0.23 0.52 48



Well 0.33 0.56 24

Very Well 0.25 0.55 20

Total 0.19 0.46 101

Ratio How to Act to Effort Statements

Male None 0.08 0.20 6


Well 0.10 0.28 13

Very Well 0.13 0.29 14

Total 0.12 0.29 48



Well 0.14 0.26 24

Very Well 0.09 0.19 20

Total 0.08 0.20 101

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Table 5

Means and Standard Deviations for Emotion Statements by Gender and Familiarity with PWS (n=149)

Ratio/Type of Statement Gender Familiarity Mean SD N Total Emotion Statements* Male None 0.83 1.17 6


Well 1.77 0.60 13

Very Well 1.64 1.08 14

Total 1.63 0.94 48



Well 2.38 2.26 24

Very Well 1.80 1.32 20

Total 2.00 1.54 101

Ratio Emotions to Total Q1 Statements*

Male None 0.19 0.22 6


Well 0.47 0.21 13

Very Well 0.43 0.25 14

Total 0.43 0.23 48



Well 0.38 0.25 24

Very Well 0.38 0.23 20

Total 0.41 0.24 101

*These statements include participants’ perceptions of the thoughts and emotions that listeners and/or PWS experience when speaking.

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Table 5 (continued) Ratio/Type of Statement Gender Familiarity Mean SD N Total Statements with Participants' Emotions Only*

Male None 0.50 1.22 6


Well 1.85 1.07 13

Very Well 1.64 1.01 14

Total 1.54 1.07 48



Well 1.50 1.44 24

Very Well 1.35 1.14 20

Total 1.49 1.14 101

Ratio Participants’ Emotions to Total Statements*

Male None 0.15 0.37 6


Well 0.77 0.29 13

Very Well 0.65 0.50 14

Total 0.64 0.44 48



Well 0.54 0.42 24

Very Well 0.70 0.76 20

Total 0.65 0.48 101

* Subsequent ratios are calculated on the basis of the total number of statements participants made regarding their own emotions when speaking to PWS, as fewer participants included perceptions of PWS’ emotions in their responses.

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Table 5 (continued) Ratio/Type of Statement Gender Familiarity Mean SD N Total Positive Statements Male None 0.17 0.41 6


Well 0.77 0.93 13

Very Well 0.93 0.73 14

Total 0.75 0.76 48



Well 0.79 0.98 24

Very Well 0.55 0.76 20

Total 0.64 0.89 101

Ratio Positive to Total Male None 0.06 0.14 6


Well 0.39 0.43 13

Very Well 0.50 0.38 14

Total 0.42 0.41 48



Well 0.37 0.44 24

Very Well 0.38 0.46 20

Total 0.37 0.44 101

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Table 5 (continued) Ratio/Type of Statement Gender Familiarity Mean SD N Total Negative Statements Male None 0.33 0.82 6


Well 1.08 0.95 13

Very Well 0.64 0.63 14

Total 0.71 0.80 48



Well 0.63 0.88 24

Very Well 0.55 1.00 20

Total 0.73 0.92 101

Ratio Negative to Total Male None 0.11 0.27 6


Well 0.53 0.44 13

Very Well 0.29 0.30 14

Total 0.35 0.40 48



Well 0.31 0.42 24

Very Well 0.24 0.38 20

Total 0.41 0.47 101

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Table 5 (continued) Ratio/Type of Statement Gender Familiarity M SD N

Total Neutral Statements Male None 0.00 0.00 6


Well 0.00 0.00 13

Very Well 0.07 0.27 14

Total 0.08 0.28 48



Well 0.08 0.28 24

Very Well 0.25 0.55 20

Total 0.11 0.34 101

Ratio Neutral to Total Male None 0.00 0.00 6


Well 0.00 0.00 13

Very Well 0.04 0.13 14

Total 0.05 0.18 48

Male None 0.01 0.06 31


Well 0.02 0.07 24

Very Well 0.13 0.29 20

Total 0.05 0.18 101

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Survey Question 2: How would you describe someone who stutters? Why did you choose these

words?

The second survey question asked participants to describe PWS and to provide an

explanation for their responses. This question was necessary in order to gain a deeper

understanding of students’ attitudes toward PWS, as other studies have asked for written

descriptions of PWS but have neglected to give participants the opportunity to explain their

responses (Lass et al., 1989, 1992, 1994; Ruscello et al., 1994; Woods & Williams, 1971; Yairi

& Williams, 1970).

Descriptive Findings – Qualitative and Quantitative

Qualitative. Participants’ responses consisted of their descriptions of PWS (coded as

“Descriptions”) and explanations for these descriptions (coded as “Explanations”). The

descriptions of PWS were further subdivided into five basic themes, including (1) positive

descriptions, coded as “Positive,” (2) negative descriptions, coded as “Negative,” (3) neutral

descriptions, coded as “Negative,” (4) descriptions of PWS on the basis of their

speech/stuttering, coded as “Speech,” and (5) descriptions of PWS according to their perceived

intelligence or mental capacity, coded as “Intelligence.” Table 6 on the following page lists these

descriptions and gives examples of the types of statements that can be found under each theme.

Explanations for participants’ descriptions of PWS consisted of six themes: (1) the

perceived emotions that PWS seem to experience when they communicate, coded as “Emotions,”

(2) experiences with PWS or inferences about PWS based on participants’ own speaking

experiences, coded as “Experiences/Inferences,” (3) reluctance to answer the question or

uncertainty about how to answer, often related to a desire to avoid stereotyping PWS, coded as

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“Reluctant/Uncertain,” (4) non-specific explanations, coded as “Non-specific,” (5) the perceived

intelligence of PWS, coded as “Perceived Intelligence,” and (6) media portrayals of PWS, coded

as “Media.” Table 7, also on the following page, provides a list of these explanations and the

types of statements that can be found under each theme.

Table 6

Participants’ Descriptions of PWS with Representative Statements

Themes Examples

Positive Descriptions Normal, just like anyone else

Caring, compassionate, accepting, patient, kind, etc.

Neutral Descriptions Not overtly positive or negative

Examples: “Pensive,” “Tries really hard to fit in.”

Negative Descriptions Frustrated, impatient or angry

Shy, reserved, quiet

Funny, annoying, frustrating

Speech Descriptions PWS associated with the characteristics of stuttering

PWS identified as people who “have trouble talking.”

Intelligence Descriptions Positive descriptions such as smart, genius, intelligent

Negative descriptions such as mentally impaired, slow

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Table 7

Participants’ Explanations for their Descriptions of PWS

Themes Examples

Emotions Perceived emotional reactions of PWS to their stuttering

Often based on fear of negative listener reactions

E.g., “PWS are shy because they are afraid they might get teased.”

Experiences/Inferences Experiences with PWS, e.g., “My brother stutters when he’s nervous.”

Participants’ inferences, e.g., “I stutter when I’m nervous, so are PWS.”

Reluctant/Uncertain Often due to a desire to avoid stereotyping.

E.g., “I’m not sure how to answer this question. PWS are all different.”

Non-specific E.g., “I chose these words based on my perceptions.”

Perceived intelligence Comments about how PWS are as intelligent or less intelligent than others

Media State that the media accounted for their perceptions of PWS

Cite famous PWS

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Quantitative. Participants provided a total of 475 statements (M = 3.17, SD = 1.55), of

which 262 (55.16%) were descriptions of PWS and 213 (44.84%) were participants’

explanations for their descriptions. Participants provided an average of 1.75 (SD = .97)

descriptive, and 1.42 (SD = .98) explanatory statements. The ratio of descriptive statements to

total statements was .44 (SD = .23) and the ratio of explanatory to total statements was .56 (SD =

.23). Participants provided a total of 80 positive descriptions (M = .53, SD = .71) with a ratio of

positive to total descriptive statements of 43.5 (M = .29, SD = .38). Two neutral statements were

reported (M = .01, SD = .12), with a ratio of 2.42 (M = .01, SD = .05), and 91 negative

statements were reported (M=.61, SD = 1.02) with a ratio of 39.83 (M = .28, SD = .41). Paired

samples t-tests indicated that there was no significant difference between the number of positive

and negative statements (t = -.71, p = .48) or the ratios of positive and negative statements (t =

.26, p = .80). It is important to note that participants reported multiple descriptions and

explanations. For example, participants did not always report all positive traits or all negative

traits; instead, a combination of positive, negative, and other types of descriptions of were

sometimes reported.

People who stutter were also described on the basis of their speech or stuttering for a total

of 76 statements (M = .51, SD = .61) with a ratio of 51.5 (M = .34, SD = .42). Finally, 13

statements (M = .09, SD = .31) described PWS according to their intelligence for a ratio of 5.75

(M = .04, SD = .14). The perceived emotions of PWS accounted for 61 statements (M = .41, SD

= .74) with a ratio of emotion explanations to total explanatory statements of 33.42 (M = .22,

SD=.37). Thirty-eight statements (M = .25, SD = .48) referred to participants’ speaking

experiences or interactions with PWS with a ratio of 28.75 (M = .19, SD = .34). Participants’

desire to avoid stereotyping PWS or uncertainty about the question consisted of 33 statements

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(M = .22, SD = .48) with a ratio of 23.25 (M = .16, SD=.33). Fifteen of the explanatory

statements (M =.10, SD = .30) were nonspecific with a ratio of 12.5 (M = .08, SD = .26). Seven

statements (M = .05, SD = .21) indicated the intelligence of PWS as an explanation for their

descriptions of PWS for a ratio of 4.33 (M = .03, SD = .14). Finally, only five participants (M =

.03, SD = .18) indicated that the media had influenced their descriptions of PWS for a ratio of

3.83 (M = .03, SD = .15).

Qualitative Results

Examples of participants’ statements are provided below to illustrate these descriptions

and explanations. The five themes related to descriptions of PWS are listed as separate

subheadings, with explanations for these descriptions integrated into the discussion of each

description.

Positive Descriptions. Most participants (64%) who provided positive statements about

PWS simply wrote that PWS were “normal” or “just like anyone else.” As one participant stated,

“I believe they are people just like anyone else. People are people that have similar wants, needs,

desires, and feelings.” These types of statements were not necessarily followed by an

explanation. A few participants, however, did provide explanations that generally were

associated with personal experiences with PWS, e.g., “Normal. My friend stutters.” Similarly,

another participant described PWS as normal because, “I chose these descriptors based on how

my friend truly is. I’m sure many other people that stutter are just like my friend.” Another

participant wrote “[PWS are] normal. I chose normal because they’re fully aware and capable of

interpreting and giving a conversation. I know people who stutter, and I could clearly understand

what they’re saying.” Thus, this particular participant felt that PWS are normal because, in her

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experience, PWS are basically intelligent (e.g., “fully aware”) and their stuttering does not

prevent them from conducting meaningful conversations.

Descriptions of PWS as normal were sometimes accompanied by descriptions of PWS as

people with speaking difficulties that may set them apart from society in general:

“[PWS are] normal, but [they] have a flaw that makes their appearance seem very

incapable of effective communication. This isn’t a true statement because they are

communicating effectively, but ordinarily people are quick to make that assumption.”

Similarly, one participant reported, “The man I met who stuttered seemed no different from

anyone else, he just spoke different but asked the same kinds of questions any of my customers

might ask.” These types of statements appear to indicate that although some participants

acknowledge stuttering as a difference between PWS and fluent speakers, participants’

perceptions about the inherent personality of the individual who stutters appears to remain

unchanged. More detailed information regarding descriptions of PWS on the basis of their

speech or stuttering is provided below.

Other positive descriptions consisted of miscellaneous adjectives such as kind, caring,

and compassionate, among others. The rationale for these descriptions seemed to be related to

the perceived difficulties that PWS have when speaking or emotional reactions that are the result

of these difficulties. For example:

“I think [PWS] are patient because it takes more time for them to talk. I also think they

are more compassionate and accepting. They have most likely been teased and

stereotyped all their life and probably don’t want to do it to others.”

Similarly, another participant who described PWS as patient indicated that:

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“They are more patient because if they weren’t they would have been frustrated with

themselves the whole time rather than working towards getting what they were trying to

say out. I don’t believe they’re never frustrated, just that they learned they can’t force it

and so they just do what they can.”

One participant wrote that PWS are “understanding and patient, because it takes patience to be

the one who stutters, and [PWS] tend to understand everyone’s situation when it comes down to

having a conversation with others.” It would appear from these types of statements that some

participants believe that PWS have gained a unique perspective because of their stuttering and

thus, have developed good insights and are generally sympathetic to others during

communicative interactions.

One of the five participants who indicated that the media had influenced his perceptions

of PWS indicated that PWS are hardworking, because:

“I do not know many people who stutter but my perception (articles, movies, etc.)

suggest that there are those who eliminate stuttering and/or overcome stuttering as a

barrier and have great success (James Earl Jones). In either case, I have a sense of

tremendous hard work by those who stutter.”

Interestingly, another participant discussed the actor James Earl Jones during an interview with

the researcher and cited him as a positive role model for PWS to overcome their stuttering. This

participant seemed to be very surprised when informed that James Earl Jones, does, in fact,

continue to stutter “in real life” when not acting. From these few responses it seems as though

celebrities who stutter and examples of people who rise above or overcome their stuttering in the

popular media have the potential to positively influence perceptions of PWS in general.

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Neutral Descriptions. Only two participants provided a neutral description of PWS. One

participant described PWS as someone who “tries really hard to fit in.” This trait was judged to

be neutral, as was the description of PWS as “pensive” by another participant. The lack of

neutral descriptions in this study suggests that it is possible for researchers to more accurately

gauge the connotations of participants’ descriptions of PWS when survey respondents are given

the opportunity to provide explanations for their descriptions.

Negative Descriptions. Some, but by no means a majority of the participants in this study

(32%) provided negative adjectives to describe PWS. Typically these adjectives consisted of

such traits as shy, anxious, nervous, or frustrated. For example, one participant who described

PWS as shy did so because “I think having a ‘visible’ flaw naturally makes a person shy.”

Similar statements were made in this regard and seemed to indicate that participants felt that

listeners’ negative reactions, or fear of such reactions, can cause PWS to exhibit shyness,

anxiety, or other negative emotions. One participant reported that PWS were unconfident

because they “are reluctant to express themselves in the presence of others. Gradually they lose

their confidence to do things, especially make friends with others.” This same participant also

described PWS as sensitive, because “they are afraid of being laughed at by others.” Similarly,

another participant stated that “A person who stutters is shy, maybe embarrassed. I think that

they are embarrassed because they feel people will either judge them or laugh at them, and I

think they are shy because they don’t want to feel embarrassed.”

Participants also reported that sometimes PWS, rather than listeners, are more concerned

about the presence of stuttering. This concern was perceived to have subsequent effects on the

speech and personality traits of PWS. For example, one participant wrote, “I would describe

them as often insecure (at least when they’re young.) It seems as if they are not only worried

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about how they say things, but even more what they say, more so than others.” This statement

seems to indicate that PWS notice their stuttering more than do fluent conversational partners;

also that PWS feel some anxiety regarding the content as well as the fluency of their speech.

Other statements would appear to support this viewpoint. One participant who described PWS as

pensive, deliberate, and cautious chose these words because, “it appears that a person who

stutters is more intentional about the words he or she uses. Like they are avoiding words that are

difficult to say, or trying to control their stutter.” Like many others’ statements, these

participants’ responses would still appear to have fear of listeners’ reactions at their root.

Approximately 17% of participants who reported negative descriptions perceived PWS as

being frustrated. Often statements about frustration were accompanied by generally positive

traits. For example, one participant described PWS as being unique, valuable, hardworking, and

frustrated. The rationale for the “frustrated” description is as follows:

“I would think those who stutter will encounter folks who simply are impatient and rude

regarding the situation. Not being able to complete your thoughts, seeing people become

impatient, or being shuffled to the next person so they wouldn’t have to be ‘dealt’ with

would be a very frustrating experience, I think.”

Likewise, one participant wrote, “I would say that they are unhappy or frustrated. I chose these

words because I feel that people who stutter have to repeat themselves often and get frustrated

when others do not understand them.” Thus, like the rationales provided for other types of

negative descriptions, these statements indicate that listener reactions provided one possible

explanation for participants’ perceptions of PWS as frustrated individuals. Despite the negative

overtone of the word frustrated, participants who described PWS in this way generally did not

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appear to find this trait to be the fault of PWS. Instead, being frustrated was seen as a natural

consequence of having difficulty communicating:

“I would say that for the most part they are just like anyone else. Sometimes they can be

very frustrated individuals, but most people are like that from time to time. Stuttering is

one of many slight abnormalities a person can have. Nobody is perfect.”

Thus, frustration seemed to be perceived an emotion that many people must cope with during the

course of their lives, regardless of whether they stutter or not.

In addition to negative descriptions that were related to speaking difficulties or perceived

emotional reactions of PWS, participants explained their negative descriptions on the basis of

their acquaintance with PWS or their own experiences while speaking. Participants who made

inferences about PWS based on their own speaking experiences generally provided positive or

other types of descriptions of PWS, however, one participant who described PWS as nervous,

uncomfortable, and frustrated did so because, “I’ve stuttered before when I’m nervous, and so

maybe people who stutter are nervous as well. Maybe they have anxiety issues.” This would

support White and Collins’ (1984) findings that fluent speakers stereotype PWS on the basis of

such inferences. Many more participants, however, reported on their experiences with PWS.

Participants who were familiar with PWS seemed to provide relatively negative impressions: “I

can only describe the person I’ve encountered, as I don’t want to stereotype. He seemed very shy

and embarrassed of his stuttering. He didn’t participate much in class discussions.” A participant

whose brother stutters wrote, “I believe they are nervous. My brother stutters and from that I

base my opinion. He really only stuttered when he was uncomfortable or nervous.” It is also

interesting to note that some of the most overtly negative descriptions of PWS came from

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participants who had interacted with PWS. A participant who reported knowing one person who

stutters very well wrote:

“I would describe someone who stutters as annoying and funny. I chose annoying

because stuttering can make it difficult to actually care about what the person is saying as

the listener is focused more on the stuttering. I also said it can be funny because I have

had experiences where someone is trying to tell me a story and they stutter when they

start going too fast and it can honestly be a bit humorous.”

This particular statement seems to indicate that for some participants, interacting with PWS can

be a source of both amusement and annoyance. Another participant who reported knowing a total

of two PWS (one well and one not very well) wrote, “Some of the people I know who stutter are

easily irritated. I say this because if you try to correct them or fill in what they are trying to say,

some get pissed off and stop talking altogether.” Thus, there appears to be the potential for

conflict and misunderstanding between people who stutter and their fluent listeners, particularly

if the listener is not familiar with common rules of etiquette for speaking with someone who

stutters, such as letting PWS finish their sentences. Finally, although some participants were

hesitant to stereotype all PWS, they occasionally reported negative descriptions of individuals

who stutter. For example:

“They’re usually just like anyone else. The few people I know that stutter though were

angry and not the most intelligent. I don’t make the stereotype about all people who

stutter but I chose these words because it’s just the people I know.”

In general, negative descriptions of PWS did not seem to indicate that participants view

individuals who stutter as suffering from inherent personality or temperamental defects that

cause them to be anxious, nervous, frustrated, etc. It appears instead that participants perceive

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that PWS come to possess these seemingly negative traits over time, because they fear negative

listener reactions or have experienced such negative reactions from society in general. Those

participants who had the most overtly negative perceptions of PWS appeared to feel personally

inconvenienced by the stuttering or described PWS on the basis of the participant’s

acquaintanceship with one or two PWS.

Descriptions of PWS based on speaking or communication difficulties. Approximately

45% of participants did not describe PWS solely on the basis of positive or negative adjectives.

Instead, they also provided descriptions of PWS in relation to their speaking difficulties. For

example, PWS were described as “either someone who cannot start saying words right away and

has to pause between words, or someone that repeats the first letter of the word.” Similarly, “I

would basically describe such a person as one who experiences prolonged or frequent repetition

of words or having irregular speech.” These are relatively sophisticated descriptions of

stuttering; however, other types of descriptions included such statements as “someone with a

minor speech problem” and “someone who has a hard time saying words sometimes.”

Participants who described PWS in this way often reported non-specific rationales for their

beliefs, e.g., “I chose these words because they came to my mind when I thought of how to

describe someone who stutters.” Two participants reported that the media’s portrayal of

stuttering influenced their responses:

“Someone who stutters differs from others in the manner of their speech. The flow of

their words may be broken and facial or body movements may accompany difficulties in

speaking…One may seem to hesitate when speaking or repeating parts of words. This is

how stuttering is portrayed in the media…”

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Another participant wrote a similar description of stuttering and reported doing so “based mostly

on what I’ve seen on TV or movies.”

Other participants who described PWS according to their speaking difficulties explained

their answers by saying that they did not want to stereotype PWS or were unsure of how to

answer the question without doing so. In fact, one participant seemed almost to be offended on

behalf of the person who stutters that such a question should be asked:

“How can I describe someone who stutters? I do not like this question, and here’s why. I

think that it is set up so that nothing is clear. For example, I would describe someone who

stutters as a man…about 6’0” tall, with brown hair, and a medium/large build. Now that’s

not exactly what you were looking for, is it? I chose these words because I believe that

any generic person…could have a stuttering problem.”

Other participants took a milder approach:

“I find this a difficult question. I would describe someone who stutters as someone with a

disability. I think stuttering is a disability that only affects one’s verbal communication,

nothing more. I think any person can have a stuttering problem and there is no way to

describe [PWS]. I chose these words because they are person first and that’s what I

believe.”

These statements indicate that participants who chose to describe PWS according to their

speaking difficulties were also likely to be hesitant to answer the question because they wanted

to avoid stereotyping PWS. This desire to avoid stereotyping was also noted by participants who

reported positive descriptions of PWS, e.g., “A person who stutters is no different than any other

person. They should be described by their overall character, not have their overall character

described by stuttering.”

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Descriptions of PWS based on perceived intelligence. Fewer participants (6%) chose to

describe PWS according to their intelligence as compared to the other types of descriptions;

however, participants’ reports on this topic are still of interest and illuminate the various ways in

which PWS are perceived by fluent speakers. For example, one participant described PWS as

someone who “maybe has a learning problem” because that was “just the first thing that came to

my mind.” Another participant wrote that a person who stutters is “someone who already has a

mental handicap, and that is what impairs their speech.” In this case, the participant reported that

two of the three PWS she knew had a “mental disorder.” These statements illustrate non-specific

and experiential explanations, respectively, and indicate that participants are generally unable to

provide any type of logical explanation for their perceptions of all PWS as less intelligent or

mentally impaired.

Some participants reported the opposite viewpoint and described PWS as being “smart”

or “intelligent human beings.” The rationale for such descriptions often consisted of a type of

somewhat circular reasoning. For example, PWS were described as smart by one participant

because “stuttering does not make a person stupid.” Another explanation was that “just because

someone stutters doesn’t mean they are any different or less intelligent.” It would appear that

some participants, perhaps in an attempt to view PWS positively, tend to refer to PWS as smart

or intelligent, even though, upon closer inspection, these participants may really mean something

along the lines of “People who stutter are not less intelligent than anyone else.” In one notable

exception, an individual wrote that PWS are "genius. I hear stuttering comes from your brain

working overtime.” In this participant’s case, stuttering actually seems to coexist with or be

caused by superior intelligence.

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The somewhat conflicting set of viewpoints as noted above seems to indicate that

participants are not entirely sure about the intelligence of PWS. As one participant wrote, “Most

likely you would assume they are not intelligent or possibly have some type of mental condition.

Although it’s not necessarily true, you assume this, because they have trouble speaking or getting

their thoughts out.” Some participants, therefore, may be unsure as to the mental capabilities of

PWS. One factor for this uncertainty may be explained by the influence of the media: “I think

that some people who stutter are perfectly normal and they just have a speech impediment. I

think that others are mentally slow. I say that because of how they have been portrayed in the

media.” The influence of the media is an interesting factor that was mentioned by only a few

participants as an explanation for their descriptions of PWS; however, it does seem likely from

this particular participant’s statement that the media is one factor that affects perceptions of

PWS.

Quantitative Results

A Multivariate Analysis of Variance (MANOVA) was conducted to determine whether

gender, familiarity, or an interaction between gender and familiarity influenced any of the

indices listed above, including the total number of statements, the total number and types of

descriptive and explanatory statements, and the ratio of each type of descriptive and explanatory

statement. The MANOVA indicated that there were no significant differences for gender (F[25,

118] = .94, p = .54, 2η = .17, observed power = .74), level of familiarity with PWS (F(75, 354] =

.70, p = .54, 2η = .13, observed power = .92), or the interaction between gender and familiarity

(F[75, 354] = 1.17, p = .18, 2η = .20, observed power = 1.0). Table 8 provides the means and

standard deviations for this analysis. These results indicate that men and women did not

significantly differ in the types of statements they provided to describe PWS or the explanations

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associated with these descriptions. People who were more familiar with PWS also did not

significantly differ in their responses as compared to people who had little or no familiarity with

PWS.

Correlations between participants’ descriptions of PWS and their explanations for their

descriptions were calculated using a Pearson’s Product Moment Correlation. Ratios were used

for this analysis instead of the total number of each type of statement in order to account for

variations in the total number of responses provided by participants. The complete results of this

analysis are provided in Table 9. A positive correlation was observed for negative descriptions of

PWS and explanations that were coded as relating to the perceived emotions of PWS (r =

.46[148], p < .001). This finding indicates that negative descriptions of PWS were more likely to

be associated with statements about the perceived emotions of PWS. Conversely, descriptions of

PWS according to their speech (e.g., “PWS have problems with their speech,” or some variation

thereof) had a low, negative correlation with emotional explanatory statements (r = -.31[148], p

< .001). Statements in which participants indicated that they did not know how to answer the

question, or did not want to answer the question to avoid stereotyping, were positively correlated

with positive descriptions of PWS (r = .18[148], p = .03) and negatively correlated with negative

descriptions of PWS (r = -.24[148], p < .001). Both of these correlations were fairly weak;

however, they indicate that statements in which participants expressed a desire to avoid

stereotyping were associated with positive rather than negative descriptions of PWS. Another

correlation was found between nonspecific explanations and statements that described PWS

according to their speech (r = .23[148], p = .01). This finding seems appropriate, as many

participants who described PWS as having repetitions or other speech difficulties often stated

that they did so because that was their simply their perception of stuttering. Perhaps not

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surprisingly, statements that described PWS in terms of their intelligence were observed to have

a positive, low degree of correlation with explanations that concerned the intelligence of PWS (r

= .21[148], p = .01). For example, some participants may have indicated that PWS are smart

(description of intelligence) because PWS are as intelligent as anyone else (explanation). The

generally low degree of correlations between descriptions and explanations may have occurred

because many participants provided responses that were classified as belonging to more than one

type of theme, e.g., both positive and negative descriptions of PWS, or multiple explanations for

their descriptions.

Qualitative and Quantitative Summary of Results

Although many decades of research with university students have suggested that PWS are

stereotyped negatively, the responses to question two of this study indicate that PWS are equally

likely to be positively stereotyped, or at least perceived as being normal or like anyone else.

Some participants described PWS according to their speech difficulties. In general, such

participants were also likely to provide positive rather than negative descriptions of PWS. An

important consideration is that a number of participants expressed their discomfort with this

question on the basis that they were unsure of how it should be answered or because they thought

that providing a response was likely to stereotype PWS. Participants who reported such an

objection sometimes went on to note positive descriptions of PWS. This consideration is an

important one, as it suggests that some participants in attitude research studies are uncomfortable

when asked to describe entire groups of people. This discomfort may help to explain why there is

a tendency for research participants to provide answers that range from neutral to positive on

Likert-type scales while excluding more negative responses (Baron, 1996; Gabel, 2006; Healey

et al., 2007).

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A number of explanations for participants’ descriptions of PWS were provided. The

majority of participants’ explanations consisted of the perceived emotions of PWS or the

difficulties that can arise when one has a speaking difficulty. Some descriptions of PWS were not

specific, and were simply the first descriptions that came to mind for participants. This finding

may suggest that stereotypes about PWS are deeply ingrained but not fully understood by the

participants who hold these stereotypes. Other explanations have a basis in the literature. First,

although the reports of participants who had familiarity with PWS were not statistically different

than participants who were less familiar with PWS, the descriptions that some participants who

knew PWS provided were among the most negative and most strongly worded responses to the

survey question. In general, however, some participants who knew PWS reported positive

descriptions, and some reported negative descriptions. Thus, the findings of Klassen (2001,

2002) did not appear to be represented in this study, as familiarity with PWS did not appear to

play a significant role in participants’ descriptions of PWS. Second, White and Collins (1984)

reported that people make inferences about PWS based on their own speaking experiences. The

participants in this study rarely reported such considerations, suggesting that for many

participants, inferences of this type were not as important as were other, perhaps more overt or

salient explanations for their perceptions of PWS. Finally, given the number of movies and other

forms of popular media that portray stuttering, (Tanner, 2002), it was surprising that so few

participants mentioned the media in their explanations. Perhaps knowing PWS, as a large

percentage of participants did, is a more salient explanation for one’s description of PWS than

the media.

In any case, the participants in the present study were able to provide often detailed

explanations about their descriptions of PWS. Asking participants to provide a rationale for their

124

descriptions provides much needed information about the thought processes of fluent speakers

and their attitudes toward PWS.

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Table 8

Means and Standard Deviations for Descriptive and Explanatory Statements by Gender and

Familiarity with PWS (n = 150)

Statement Type Familiarity Gender M SD N

Total Descriptions None Male 1.50 0.84 6

Female 1.74 1.00 31

Total 1.70 0.97 37

Not Very Well Male 1.53 0.92 15

Female 1.88 0.99 26

Total 1.76 0.97 41

Well Male 1.92 1.12 13

Female 1.76 0.83 25

Total 1.82 0.93 38

Very Well Male 1.43 1.16 14

Female 1.90 0.97 20

Total 1.71 1.06 34

Ratio Descriptions to Total None Male 0.37 0.19 6

Female 0.45 0.28 31

Total 0.43 0.27 37


Female 0.46 0.24 26

Total 0.46 0.21 41

Well Male 0.47 0.15 13

Female 0.36 0.25 25

Total 0.40 0.23 38


Female 0.46 0.16 20

Total 0.46 0.23 34

126

Table 8 (cont.)


Total Explanations None Male 1.00 0.63 6

Female 1.23 0.92 31

Total 1.19 0.88 37


Female 1.69 1.05 26

Total 1.59 0.95 41

Well Male 1.62 0.77 13

Female 1.20 0.96 25

Total 1.34 0.91 38


Female 1.80 1.28 20

Total 1.56 1.16 34

Ratio Explanations to Total None Male 0.63 0.19 6

Female 0.55 0.28 31

Total 0.57 0.27 37


Female 0.54 0.24 26

Total 0.54 0.21 41

Well Male 0.53 0.15 13

Female 0.64 0.25 25

Total 0.60 0.23 38


Female 0.54 0.16 20

Total 0.54 0.23 34

127

Table 8 (cont.)


Total Positive Descriptions None Male 0.50 0.84 6

Female 0.35 0.55 31

Total 0.38 0.59 37


Female 0.73 0.87 26

Total 0.68 0.85 41

Well Male 0.62 0.65 13

Female 0.48 0.71 25

Total 0.53 0.69 38


Female 0.50 0.83 20

Total 0.53 0.71 34

Ratio Positive to Total Descriptions None Male 0.28 0.44 6

Female 0.16 0.26 31

Total 0.18 0.29 37


Female 0.40 0.45 26

Total 0.38 0.43 41

Well Male 0.37 0.41 13

Female 0.23 0.32 25

Total 0.28 0.36 38


Female 0.18 0.31 20

Total 0.31 0.41 34

128

Table 8 (cont.)


Total Negative Descriptions None Male 0.50 0.55 6

Female 0.35 0.88 31

Total 0.38 0.83 37


Female 0.81 1.20 26

Total 0.66 1.04 41

Well Male 0.77 1.17 13

Female 0.52 0.96 25

Total 0.61 1.03 38


Female 0.85 0.88 20

Total 0.71 1.12 34

Ratio Negative to Total Descriptions None Male 0.42 0.49 6

Female 0.12 0.30 31

Total 0.17 0.35 37


Female 0.35 0.45 26

Total 0.31 0.42 41

Well Male 0.37 0.46 13

Female 0.20 0.36 25

Total 0.26 0.40 38


Female 0.45 0.45 20

Total 0.33 0.44 34

129

Table 8 (cont.)


Total Neutral Descriptions None Male 0.00 0.00 6

Female 0.03 0.18 31

Total 0.03 0.16 37


Female 0.08 0.27 26

Total 0.05 0.22 41

Well Male 0.00 0.00 13

Female 0.00 0.00 25

Total 0.00 0.00 38


Female 0.10 0.31 20

Total 0.06 0.24 34

Ratio Neutral to Total Descriptions None Male 0.00 0.00 6

Female 0.03 0.18 31

Total 0.03 0.16 37


Female 0.03 0.12 26

Total 0.02 0.09 41

Well Male 0.00 0.00 13

Female 0.00 0.00 25

Total 0.00 0.00 38


Female 0.03 0.09 20

Total 0.02 0.07 34

130

Table 8 (cont.)


Total Speech-Related Descriptions None Male 0.50 0.55 6

Female 0.87 0.72 31

Total 0.81 0.70 37


Female 0.23 0.51 26

Total 0.29 0.51 41

Well Male 0.38 0.65 13

Female 0.72 0.54 25

Total 0.61 0.59 38


Female 0.35 0.49 20

Total 0.32 0.47 34

Ratio Speech-Related to Total Descriptions None Male 0.31 0.40 6

Female 0.50 0.39 31

Total 0.47 0.39 37


Female 0.15 0.34 26

Total 0.23 0.40 41

Well Male 0.21 0.38 13

Female 0.51 0.42 25

Total 0.41 0.43 38


Female 0.29 0.44 20

Total 0.27 0.43 34

131

Table 8 (cont.)


Total Intelligence Descriptions None Male 0.00 0.00 6

Female 0.13 0.34 31

Total 0.11 0.31 37


Female 0.04 0.20 26

Total 0.07 0.35 41

Well Male 0.15 0.38 13

Female 0.04 0.20 25

Total 0.08 0.27 38


Female 0.10 0.31 20

Total 0.09 0.29 34

Ratio Intelligence to Total Descriptions None Male 0.00 0.00 6

Female 0.06 0.16 31

Total 0.05 0.15 37


Female 0.02 0.10 26

Total 0.04 0.17 41

Well Male 0.04 0.11 13

Female 0.02 0.10 25

Total 0.03 0.10 38


Female 0.04 0.13 20

Total 0.04 0.13 34

132

Table 8 (cont.)


Total Intelligibility / Speaking Difficulty Explanations None Male 0.50 0.55 6

Female 0.32 0.54 31

Total 0.35 0.54 37


Female 0.35 0.56 26

Total 0.34 0.57 41

Well Male 0.46 0.52 13

Female 0.28 0.54 25

Total 0.34 0.53 38


Female 0.45 0.69 20

Total 0.41 0.66 34

Ratio Intelligibility / Speaking Difficulty to Total Explanations None Male 0.42 0.49 6

Female 0.22 0.38 31

Total 0.25 0.40 37


Female 0.16 0.27 26

Total 0.17 0.30 41

Well Male 0.35 0.43 13

Female 0.17 0.34 25

Total 0.23 0.38 38


Female 0.28 0.44 20

Total 0.25 0.41 34

133

Table 8 (cont.)


Total Emotion-Based Explanations

None Male 0.17 0.41 6

Female 0.23 0.56 31

Total 0.22 0.53 37


Female 0.58 0.86 26

Total 0.54 0.78 41

Well Male 0.38 0.77 13

Female 0.40 0.71 25

Total 0.39 0.72 38


Female 0.70 1.03 20

Total 0.47 0.90 34

Ratio Emotion-Based to Total Explanations None Male 0.17 0.41 6

Female 0.10 0.24 31

Total 0.11 0.27 37


Female 0.26 0.35 26

Total 0.27 0.37 41

Well Male 0.18 0.35 13

Female 0.19 0.33 25

Total 0.18 0.33 38


Female 0.29 0.39 20

Total 0.20 0.36 34

134

Table 8 (cont.)


Total Experience Explanations None Male 0.00 0.00 6

Female 0.06 0.25 31

Total 0.05 0.23 37


Female 0.46 0.65 26

Total 0.34 0.57 41

Well Male 0.46 0.52 13

Female 0.24 0.44 25

Total 0.32 0.47 38


Female 0.35 0.59 20

Total 0.29 0.52 34

Ratio Experience to Total Explanations None Male 0.00 0.00 6

Female 0.02 0.10 31

Total 0.02 0.09 37


Female 0.27 0.38 26

Total 0.21 0.36 41

Well Male 0.28 0.37 13

Female 0.20 0.38 25

Total 0.23 0.38 38


Female 0.18 0.33 20

Total 0.18 0.34 34

135

Table 8 (cont.)


Total Intelligence Explanations None Male 0.00 0.00 6

Female 0.03 0.18 31

Total 0.03 0.16 37


Female 0.04 0.20 26

Total 0.02 0.16 41

Well Male 0.08 0.28 13

Female 0.04 0.20 25

Total 0.05 0.23 38


Female 0.05 0.22 20

Total 0.09 0.29 34

Ratio Intelligence to Total Explanations None Male 0.00 0.00 6

Female 0.03 0.18 31

Total 0.03 0.16 37


Female 0.02 0.10 26

Total 0.01 0.08 41

Well Male 0.04 0.14 13

Female 0.04 0.20 25

Total 0.04 0.18 38


Female 0.03 0.11 20

Total 0.04 0.13 34

136

Table 8 (cont.)


Total Nonspecific Explanations None Male 0.00 0.00 6

Female 0.23 0.43 31

Total 0.19 0.40 37


Female 0.04 0.20 26

Total 0.05 0.22 41

Well Male 0.00 0.00 13

Female 0.08 0.28 25

Total 0.05 0.23 38


Female 0.10 0.31 20

Total 0.12 0.33 34

Ratio Nonspecific to Total Explanations None Male 0.00 0.00 6

Female 0.19 0.38 31

Total 0.16 0.35 37


Female 0.02 0.10 26

Total 0.04 0.17 41

Well Male 0.00 0.00 13

Female 0.08 0.28 25

Total 0.05 0.23 38


Female 0.08 0.24 20

Total 0.09 0.26 34

137

Table 8 (cont.)


Total Reluctant Explanations None Male 0.33 0.52 6

Female 0.23 0.43 31

Total 0.24 0.43 37


Female 0.23 0.65 26

Total 0.27 0.59 41

Well Male 0.23 0.44 13

Female 0.16 0.47 25

Total 0.18 0.46 38


Female 0.15 0.37 20

Total 0.18 0.39 34

Ratio Reluctant to Total Explanations None Male 0.25 0.42 6

Female 0.19 0.38 31

Total 0.20 0.38 37


Female 0.13 0.31 26

Total 0.17 0.35 41

Well Male 0.15 0.32 13

Female 0.09 0.25 25

Total 0.11 0.27 38


Female 0.10 0.26 20

Total 0.13 0.31 34

138

Table 8 (cont.)


Total Media Explanations None Male 0.00 0.00 6

Female 0.13 0.34 31

Total 0.11 0.31 37


Female 0.00 0.00 26

Total 0.02 0.16 41

Well Male 0.00 0.00 13

Female 0.00 0.00 25

Total 0.00 0.00 38


Female 0.00 0.00 20

Total 0.00 0.00 34

Ratio Media to Total Explanations None Male 0.00 0.00 6

Female 0.11 0.31 31

Total 0.09 0.28 37


Female 0.00 0.00 26

Total 0.01 0.05 41

Well Male 0.00 0.00 13

Female 0.00 0.00 25

Total 0.00 0.00 38


Female 0.00 0.00 20

Total 0.00 0.00 34

139

Table 8 (cont.)


Total # Question 2 Statements None Male 2.50 1.38 6

Female 2.97 1.52 31

Total 2.89 1.49 37


Female 3.58 1.45 26

Total 3.34 1.48 41

Well Male 3.54 1.39 13

Female 2.96 1.40 25

Total 3.16 1.41 38


Female 3.70 2.00 20

Total 3.26 1.85 34

140

Table 9

Correlations for Types of Descriptions and Types of Explanations (n=150; 475 total statements)

Explanations Participants’ Descriptions of PWS Positive Negative Neutral Speech of

PWS Intelligence Descriptions

Speech Difficulties Pearson Correlation -0.07 -0.07 -0.05 0.13 0.11 Sig. (2-tailed) 0.39 0.41 0.51 0.10 0.18 Emotions of PWS Pearson Correlation -0.14 0.51 0.14 -0.31 -0.13 Sig. (2-tailed) 0.08 0.00* 0.09 0.00* 0.10 Experiences / Inferences Pearson Correlation 0.12 0.08 -0.08 -0.13 0.02 Sig. (2-tailed) 0.14 0.35 0.49 0.11 0.77 Intelligence Explanations Pearson Correlation 0.08 -0.14 -0.02 0.02 0.21 Sig. (2-tailed) 0.32 0.09 0.78 0.85 0.01* Nonspecific Explanations Pearson Correlation -0.13 -0.06 -0.04 0.23 -0.04 Sig. (2-tailed) 0.13 0.47 0.66 0.01* 0.61 Reluctant to Answer/Uncertain

Pearson Correlation 0.18 -0.24 -0.05 -0.13 -0.06

Sig. (2-tailed) 0.03* 0.00* 0.51 0.12 0.49 Media Explanations Pearson Correlation -0.03 -0.08 -0.02 0.11 0.06 Sig. (2-tailed) 0.68 0.33 0.81 0.18 0.47 * Significant at p < .05

141

Survey Question 3: How do you think people who stutter are affected by their stuttering? Please

explain.

The third survey question asked participants to report their perceptions of the effects of

stuttering upon the lives of PWS. This question was meant to identify any barriers or limitations

that participants associated with being a person who stutters.


Qualitative. Four themes emerged from participants’ responses, including: (1) the

speaking difficulties that PWS experience, often associated with negative emotions and coping

mechanisms, coded as “Speaking difficulties;” (2) listener responses to stuttering and the

subsequent consequences of these listener reactions for PWS, coded as “Reactions to stuttering;”

(3) effects of stuttering on the lives of PWS, especially socially, academically or vocationally,

coded as “Life effects;” and (4) variations in the effects of stuttering due to individual

differences among PWS, coded as “Individual variations.”

Quantitative. The 146 participants who responded to this survey question provided a total

of 419 statements (M = 2.87, SD = 1.35). The ratios of each type of statement to the total number

of statements were also calculated to account for variations in the number of responses made by

participants, which ranged from one to six statements. Statements coded as “Speaking

difficulties” accounted for 43.7% of participants’ statements (n = 183, M = 1.25, SD = 1.19),

with a ratio of 65.8 (M =.45, SD = .38). “Reactions to stuttering” statements accounted for

31.5% of the total statements (n = 132, M = .90, SD = 1.0), with a ratio of 48.4 (M = .33, SD =

.35). “Life effects” statements accounted for 18.1% of the total statements (n = 76, M = .52, SD

= .84), with a ratio of 22.3 (M = .15, SD = .25). “Individual variations” statements accounted for

6.7% of the total statements (n = 28, M = .16, SD = .69), with a ratio of 9.6 (M = .07, SD = .21).

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Qualitative Results

Speaking difficulties. Over 40% of the participants who provided an answer to the third

survey question made statements that were coded as “Speaking difficulties.” These types of

statements indicated that PWS were believed to experience great difficulties when speaking and

as a result experienced negative emotions and employed various negative coping mechanisms.

General speaking difficulties that were mentioned by participants included such statements as

“Stuttering affects [PWS] because they can’t say a thought without stuttering,” and “Because

[stuttering] has more to do with word uttering, they find it difficult to communicate effectively.”

Participants tended to perceive the emotional effects of such speaking difficulties as being

severe, e.g., “They probably get discouraged and depressed trying to say words that just won’t

come out right,” and “I imagine stutterers can become frustrated because they know what they

want to say but just can’t get it out.” Similarly, “People who stutter would experience much

frustration in life whether it’s ordering at a restaurant or at work or being with friends,” and “I

think they’re angry and impatient with themselves.” It is interesting to note that these perceived

emotional reactions of PWS to their stuttering are similar to the responses that many participants

provided to the second survey question, in which PWS were described as being frustrated,

impatient or unhappy because of their stuttering.

Difficulty speaking and its accompanying emotional effects were also related to the use

of coping mechanisms by PWS. These coping mechanisms tended to be adverse in nature, so that

PWS were perceived as talking less and withdrawing from communication with others,

especially in public speaking situations and types of group social interactions. For example, one

participant wrote, “They probably are quiet because it takes so much effort to talk. I feel that

their willingness to speak in public is very minimal.” “They probably aren’t as outgoing because

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it is harder to speak to people when you stutter,” remarked another participant. Participants also

reported that PWS use coping mechanisms to help them be more easily understood. For example,

the use of “body language, writing, or sign language” was suggested, as was the use of “shorter

sentences and more basic words.” Thus, participants believed that PWS employ negative coping

mechanisms, such as withdrawing from verbal communication with others, as a response to

difficulty when speaking. These beliefs reflect participants’ descriptions of PWS as shy,

withdrawn, and quiet on the second survey question.

Reactions to stuttering. Another theme consisted of participants’ beliefs about the

reactions of fluent listeners to stuttering and/or the reactions of PWS to fluent listeners’

reactions. This theme accounted for approximately 30% of participants’ statements. Some

participants suggested that listeners react negatively toward stuttering and will tease PWS, not

take them seriously, and be impatient during conversations. Other negative listeners’ reactions

were mentioned, such as, “I notice that people also try to identify them as ‘oh, the one that

stutters,’” and “They get looked at as different and people choose not to be around them because

they do not want to deal with the stuttering.” Participants felt that listeners’ reactions resulted in

negative consequences for PWS: “I think they feel out of place and feel like they shouldn’t talk

because someone will make fun of them,” and “They are frustrated because of how other people

may treat them (i.e., trying to finish their sentences or people may not think they are smart.”).

Participants also made comments about PWS anticipating negative reactions from listeners, even

if actual negative reactions were not mentioned. For example, “I think sometimes [PWS] may be

nervous or quiet around others. People who stutter, along with many others who don’t stutter,

still can worry about how others think about them,” and “They probably fear judgment by people

who may consider them unintelligent due to their speech impediment.” Participants also used

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these types of adjectives (e.g., nervous, quiet, fearful) to describe PWS in the second survey

question. These responses indicate that participants believed that PWS encounter mostly negative

reactions from listeners. These negative reactions were presumed to have an adverse effect on

the personality and emotions of PWS. Consequently, participants tended to report negative

personality traits for PWS on the basis of these assumptions.

Life effects. Slightly less than 20% of the total number of statements consisted of the

perceived effects of stuttering on the lives of PWS. Of these “Life effects” statements,

approximately 19.7% (n = 15) suggested that PWS experience general life difficulties because of

their stuttering. For example, “I think they are affected every day of their life,” and “I can

imagine situations where their speech would have negative effects, almost every day.” Another

participant wrote that stuttering “affects their lives because they have to hold in all their

feelings.” Two participants wrote similar responses: “Stuttering can be detrimental to a person’s

mental and emotional health, and maybe even physical health,” and “They are probably affected

socially, mentally, and emotionally.” Stuttering was also perceived as having negative life effects

because PWS “tend to shy away from what they do best and take the back seat in areas of their

interest.”

More than one-third of statements (34.2%, n = 26) that were coded as “Life effects”

indicated that social opportunities for PWS were probably limited, and that PWS experience

difficulties making friends and forming intimate relationships. For example, “Stuttering causes

social anxiety which will lead to a low social life. They may not have a lot of friends and they

may not have girl/boyfriends.” Similarly, “I think it affects their personal communication and

therefore personal intimacy. It must be difficult to make the jump from acquaintance to friend

[when one has] a hard time verbally communicating.” Participants also mentioned the effects of

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stuttering on childhood friendships and socialization: “Sometimes when they are younger it

seems like it’s hard for them to make friends because all the other kids make fun of the way they

talk,” and “Stuttering causes many children and teens to stay away from social situations, thus

having an impact on their social lives. This also makes them feel alone.” These statements about

the negative effects of stuttering on the formation of friendships and intimate relationships reflect

the literature on this topic (e.g., Boberg & Boberg, 1990; Linn & Caruso, 1998; Shears &

Jensema, 1969).

Approximately 9% (n = 7) of statements coded as “Life effects” consisted of participants

beliefs that PWS are affected academically by their stuttering. For some participants these effects

occurred because of the emotional reactions of PWS to their stuttering, e.g., “I think their

academics suffer because they don’t feel as confident in all areas,” and “They probably have low

self-esteem and feel less self-confident during school.” Difficulties with oral communication

were also mentioned as having a negative academic effect for PWS. For example, “School might

be difficult, as many classes require presentations, and that could be very frustrating and difficult

for someone with a stutter.” Likewise, “It may affect how they do in school regarding speeches

and reading.” Another participant remarked that “At a young age stuttering can affect a child’s

ability to learn.” These responses suggest that participants believe that school can be difficult and

challenging for PWS. This sentiment may be appropriate given the predominantly stereotypical

attitudes reported by teachers in the literature, (Crowe & Walton, 1981; Dorsey & Guenther,

2000; Lass et al. 1992, 1994; Ruscello, Lass, Schmitt, & Pannbaker, 1994; Turnbaugh, Guitar, &

Hoffman, 1981), and the self-reported negative experiences of PWS in school (Daniels, 2007).

In addition to academic difficulties, approximately 30% (n = 24) of “Life effects”

statements suggested that PWS would experience difficulty obtaining a job, particularly those

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jobs that involve oral communication. For example, “Because of their difficulties in

communication, it’s hard for them to get a good job, like teaching. As a result they are likely to

live in poverty.” Sometimes this difficulty was perceived as resulting from the insecurities of the

PWS, e.g., “People who stutter do not speak up as much as others. They choose careers with

little communication. They may have less self-confidence because they don’t communicate,” and

“My brother does not look for jobs because he feels embarrassed by the interview process.”

Other participants believed that the reactions of employers to PWS would prevent them from

obtaining jobs that require high levels of verbal communication. For example, one participant

who had a history of working in sales wrote, “I believe [people who stutter] become limited in

jobs as well. Many will not be hired into telemarketing, sales, or customer service positions

because employers may be afraid of customer reactions to someone that stutters.” Thus, it

appears that PWS are perceived as being a potential liability to companies in which

communication is essential, such as sales or telemarketing. Other participants wrote similar

opinions: “I would assume they are limited in occupations and discriminated as unintelligent

when attending interviews,” and “These people may not be able to get a lot of communication

jobs, too, which isn’t necessarily fair.” The overall life effects of not being able to obtain a high-

paying job in a communications-related field seemed to impact the ability of PWS to succeed

financially, e.g., “They are probably not accepted too much by society. As a result of this their

self esteem is probably lower than it was to start out with. This could make it hard for these

people to get a job, and to be able to survive out in the real world.” In one extreme case, a

participant who did not know anyone who stutters wrote that PWS are probably put in “special

homes that support them since they have a hard time getting a job.” Thus, several participants

believed that PWS may have difficulty finding jobs, whether because of their own insecurities or

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the prejudices of employers, and as a result they may not obtain financial security or maintain

their autonomy. These statements reflect the findings of other studies in which university

students have reported that PWS are less suitable for careers that require large amounts of verbal

communication (e.g., Gabel, et al., 2004; Schlagheck, Gabel, & Hughes, in press).

Individual variations. A relatively small percentage of responses to the third survey

question (6.7%, n = 28) indicated that PWS could be affected in different ways by their

stuttering, or that the effects of stuttering could vary depending on the characteristics of

individuals who stutter. In some cases these variations were the result of the ability of PWS to

accept their stuttering or to cope with the stuttering, e.g., “Their social life may be hindered, but

if they are OK with their stuttering, their friend base can be as they want.” Similarly, “It may

also depend on their personality and resilience in terms of if speaking is something they let get in

the way of their goals and identity, or something they ‘cope’ with and refuse to let be seen as a

disability or barrier to confidence and success in life (relationships, career, etc.).” Other

participants seemed to think that the life effects of stuttering depended on such factors as the

severity of stuttering or the age of the person who stutters: “It all depends on the person, and how

bad they stutter. Their age may affect this too, but it is different in all cases.” Similarly, “Having

normal conversations may be difficult depending on the severity of the stutter.” One participant

wrote quite a bit on this topic and emphasized that the effects of stuttering on individuals can

vary based on a number of factors:

“I think it depends on how long they have stuttered, if they have had any type of therapy,

and how they have been treated. If it was a new condition that came on for whatever

reason—that person would probably not be comfortable with speaking much. I would

also say the same for a person that had a really bad experience growing up and was

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constantly made fun of. They probably wouldn’t want to speak much around people that

don’t know them well. If they had therapy to work on their condition or grew up in an

environment that was very supportive, they may not be affected much by stuttering at all.

They might be very confident in their speaking abilities and it isn’t really an issue.

Regardless, it is something that they have to be cognizant of at some point in their life,

and depending on [their] reactions they embrace it and deal with it well or else they have

a hard time dealing with it.”

Though there were fewer statements that addressed the issue of variations in the effects of

stuttering among PWS, these comments suggest that not all of the participants perceived

stuttering as having the same negative effects on the lives of PWS. Instead, some participants

recognized that the emotional resilience of individuals who stutter can lessen or negate the

effects of stuttering on the lives of PWS.


A Multivariate Analysis of Variance (MANOVA) was conducted to determine if

responses differed according to gender, familiarity, or interactions between gender and

familiarity for all of the themes and the total number of statements. The means and standard

deviations for this analysis are presented in Table 10. There was no significant difference for any

of the themes according to gender (F[8, 131] = .76, p = .64, 2η = .04, observed power = .34),

level of familiarity (F[24, 381] = .94, p = .55, 2η = .05, observed power = .76), or

gender/familiarity interaction (F[24, 381] = .87, p = .65, 2η = .05, observed power = .71). These

findings suggest that men and women did not vary in terms of the responses they provided to the

survey question; nor did responses differ on the basis of how well participants knew PWS.


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When asked to write about how people who stutter are affected by their stuttering,

participants in this study generally indicated that all aspects of a person’s life could be negatively

impacted. Difficulty expressing oneself was cited as a cause of frustration and other negative

emotions for PWS. PWS were sometimes perceived as coping with these speaking difficulties by

withdrawing from society and using less verbal communication. The reactions of listeners were

perceived to be negative and consisted of avoidance of PWS, teasing, discrimination. The

participants suggested that PWS become shy, quiet, frustrated, or withdrawn as a reaction to

these negative listener responses.

In addition to experiencing negative listener reactions, the participants indicated that

stuttering would have many effects on the lives of PWS. Making friends and dating were

perceived to be difficult for PWS, as was finding and maintaining employment. Careers that

required high levels of oral communication, such as teaching, telemarketing, and sales were

perceived as being especially unobtainable for PWS, often because of the discriminatory

practices of employers. Conversely, some participants believed that the confidence and self-

esteem of PWS would be so low as to prevent them from seeking out jobs that required oral

communication. Finally, participants suggested that there were negative academic consequences

for being a person who stutters. Teasing and bullying by peers, as well as lower grades from poor

performance during presentations and while reading aloud were described as negative effects of

stuttering for children and adolescents in school settings.

Fewer participants reported that the effects of stuttering would depend on the individual

who stutters. One important consideration was the ability of the person who stutters to accept his

or her stuttering and to not be bothered by it. Other factors included age, severity of stuttering,

and whether the person who stutters was receiving speech therapy. Thus, small numbers of

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participants appeared to report less stereotypical answers to this survey question by recognizing

that PWS will experience their stuttering in diverse ways based on individual differences.

What is perhaps most striking about these results is how well the issues raised by

participants correspond with the work of Yaruss and Quesal (2004) regarding the World Health

Organization’s International Classification of Functioning, Disability, and Health (ICF). The

ICF was designed to provide a common language for discussing the bodily impairments, activity

limitations, and participation restrictions that people with many kinds of disabilities may

experience. Yaruss and Quesal (2004, p. 50) found that:

The ICF is particularly relevant to stuttering because it focuses on more than just the

observable characteristics of disorders. For stuttering, the ICF supplements information

on observable characteristics (such as repetitions, prolongations, and hesitations that may

characterize stuttering) with information about the overall impact of disorder (including

negative communication attitudes, shame, embarrassment, and limitations in an

individual’s ability to participate in society). In addition, the ICF allows the description

of both hindering factors (such as negative responses to a person’s stuttering) and

facilitating factors (such as speech therapy, support groups, and an accepting

environment).

Thus, when asked to consider how PWS are affected by their stuttering, the participants in this

study were able to go beyond the most obvious, surface characteristics of stuttering. Many

participants perceived that PWS, as a group, may be affected in similar ways by their stuttering;

however, some participants were also able to recognize that the kinds of individual differences

and facilitating factors suggested in the ICF model would result in less stereotypically negative

effects on the lives of PWS.

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Table 10

Means and Standard Deviations for Question 3 Themes by Gender and Familiarity (n=146)

Theme

Gender

Familiarity

M

SD

N

Speaking Difficulties Male None 0.60 0.89 5


Well 1.67 1.37 12

Very Well 1.17 1.53 12

Total 1.25 1.28 44



Well 0.96 0.98 25

Very Well 1.05 1.10 20

Total 1.25 1.15 102

Ratio Speaking Difficulties Male None 0.27 0.43 5


Well 0.54 0.44 12

Very Well 0.32 0.37 12

Total 0.44 0.41 44



Well 0.42 0.39 25

Very Well 0.37 0.38 20

Total 0.45 0.36 102

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Table 10 (continued)

Theme

Gender

Familiarity

M

SD

N

Reactions to Stuttering Male None 1.60 1.14 5


Well 0.42 0.67 12

Very Well 0.92 0.90 12

Total 0.75 0.87 44



Well 0.96 1.10 25

Very Well 1.15 1.09 20

Total 0.97 1.05 102

Ratio Reactions to Stuttering Male None 0.68 0.41 5


Well 0.16 0.31 12

Very Well 0.38 0.37 12

Total 0.32 0.38 44



Well 0.30 0.33 25

Very Well 0.42 0.39 20

Total 0.34 0.35 102

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Theme

Gender

Familiarity

M

SD

N

Life Effects Male None 0.20 0.45 5


Well 0.92 1.24 12

Very Well 0.75 0.87 12

Total 0.66 0.91 44



Well 0.48 1.00 25

Very Well 0.55 0.76 20

Total 0.46 0.80 102

Ratio Life Effects Male None 0.05 0.11 5


Well 0.27 0.39 12

Very Well 0.22 0.24 12

Total 0.21 0.28 44



Well 0.12 0.22 25

Very Well 0.18 0.28 20

Total 0.13 0.23 102

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Theme

Gender

Familiarity

M

SD

N

Individual Variations Male None 0.00 0.00 5


Well 0.08 0.29 12

Very Well 0.33 1.15 12

Total 0.14 0.63 44



Well 0.52 1.29 25

Very Well 0.05 0.22 20

Total 0.22 0.71 102

Ratio Individual Variations Male None 0.00 0.00 5


Well 0.03 0.10 12

Very Well 0.08 0.29 12

Total 0.04 0.16 44



Well 0.15 0.31 25

Very Well 0.03 0.11 20

Total 0.08 0.22 102

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Theme Gender Familiarity M SD N

Total Comments Male None 2.40 1.14 5


Well 3.08 1.38 12

Very Well 3.17 1.11 12

Total 2.80 1.19 44



Well 2.92 1.58 25

Very Well 2.80 1.51 20

Total 2.90 1.42 102

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Survey Question 4: If you were a person who stutters, how would your life be different, and why? The fourth survey question asked participants to reflect on how their lives would be

different if they stuttered. Like the third survey question that asked participants to write about

how PWS are affected by their stuttering, this question was meant to identify any barriers or

limitations that participants associated with being a person who stutters. The purpose of this

question was also to learn if participants would report any differences between the perceived

effects of stuttering on PWS versus the more personalized effects of stuttering on the lives of the

participants. When appropriate, comparisons are made between participants’ responses for

question three and question four.


Qualitative. The participants’ responses were coded into the same four themes as

question three. Thus, participants felt that they would experience: (1) speaking difficulties with

associated negative emotions and coping mechanisms, coded as “Speaking difficulties;” (2)

generally negative listeners’ responses to stuttering which would cause participants to experience

negative emotional reactions and withdraw from speaking situations, coded as “Reactions to

stuttering;” (3) life effects resulting from stuttering, especially socially, academically or

vocationally, coded as “Life effects;” and (4) variations in the effects of stuttering due to

individual differences coded as “Individual variations.”




participants, which ranged from one to nine statements. Statements coded as “Speaking

difficulties” accounted for 15.2% of participants’ statements (n = 60, M = .41, SD = .65), with a

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ratio of 23.39 (M =.16, SD = .28). “Reactions to stuttering” statements accounted for 38.6% of

the total statements (n = 152, M = 1.04, SD = .95), with a ratio of 62.9 (M = .43, SD = .39). “Life

effects” statements accounted for 37.9% of the total statements (n = 149, M = 1.02, SD = 1.29),

with a ratio of 44.65 (M = .31, SD = .33). “Individual variations” statements accounted for 7.9%

of the total statements (n = 31, M = .21, SD = .51), with a ratio of 13.4 (M = .09, SD = .24).

Qualitative Results

Speaking difficulties. Approximately 15% of the participants who provided an answer to

this survey question made statements that were coded as “Speaking difficulties.” These types of

statements indicated that participants would find it hard to speak because of stuttering, and as a

result, would experience negative emotions and use various coping mechanisms. Speaking

difficulties that were mentioned by participants included such statements as “I would likely have

trouble communicating effectively with others,” and “I would have a hard time trying to talk to

people.” Specific communication situations were also regarded as difficult, e.g., “I would have a

hard time on the phone or ordering food.” These types of statements are consistent with the

speaking difficulties for PWS as reported in question three.

In addition, participants also tended report that they were likely to experience the same

types of negative emotional effects from stuttering that were mentioned in question three. For

example, participants thought that if they stuttered they would feel frustrated: “I’m an outspoken

person and I would be easily frustrated by the inability to get my thoughts across in an organized

and timely fashion.” Similarly, “I would probably get frustrated with myself because I would talk

more choppy.” Other negative emotional effects were related to speaking difficulties, e.g., “I

might feel inadequate due to my relative deficiency, and would, possibly, suffer from deep-

seated psychological problems such as clinical depression.” Only one participant wrote of

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positive emotional outcomes as a result of stuttering: “I would be more patient and probably less

annoyed by little things in other people because I would be more aware of my own flaws.”

Difficulty speaking and its accompanying emotional effects were also thought to be

related to the use of coping mechanisms by participants if they stuttered. As with the responses

made for question number three, participants tended to report coping mechanisms that involved

talking less and withdrawing from communication with others. For example, “I’m pretty open

now with people so having a stutter I probably wouldn’t want to talk as much,” and “I would

have to conceal my extroverted nature.” Another participant wrote, “It would take so long to say

something that I wouldn’t say as much when I talked.” In addition to withdrawing from speaking

situations, participants also reported that they would need to think carefully about how they

spoke. For example, “I'd have to learn to be patient and remember to think about what I wanted

to say, take my time, and speak slowly,” and “I’d have to prepare for [speaking situations] a lot

more.” These types of statements were not mentioned in question three as ways in which PWS

cope with their stuttering.

Reactions to stuttering. Participants reported that if they were a person who stutters they

would experience generally negative reactions from listeners. Consequently, participants stated

that they would experience negative emotions and would tend to respond to listener reactions by

withdrawing from social situations. This theme accounted for almost 40% of participants’

statements. The responses were very similar to those for the third survey question, in which

participants described how PWS are affected by negative listener reactions. Participants provided

examples of negative listener responses, such as “People would probably make comments about

my disability. Strangers might even get annoyed with speaking to me. I would be more self-

conscious about speaking to others in public.” Similarly, “My family, friends, and classmates

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would probably all treat me differently.” Other participants remarked that they would anticipate

negative listener reactions if they stuttered, e.g., “I would not be as outgoing in fear of what

others would do,” and “I would be self conscious and I would not want to give any one an

opportunity to poke fun at something that I am not able to control.” Another participant wrote: “I

might also have a negative view of people, anticipating their awkwardness around me or their

unwillingness to talk with me.” Participants generally tended to believe that because they would

anticipate negative reactions to their stuttering, they would withdraw as much as possible from

speaking situations. For example:

“I would feel like people are focusing on my stuttering and not me. I think I would try not

to talk so much. I would be too embarrassed that people were going to laugh at me and

make fun of me. So I probably wouldn’t be as outgoing as I am today. I would probably

pretty much keep to myself.”

Thus, the participants in this study felt that they would experience negative listener reactions if

they were a person who stutters and would subsequently withdraw from engaging in

conversations and other social situations with people as a result.

Life effects. Slightly less than 40% of the total number of statements for question four

consisted of the perceived effects of stuttering on the lives of participants if they stuttered.

Approximately 11% of these responses (n = 16) indicated that participants would not experience

major changes to their lives if they were a person who stutters. For example, one participant

wrote, “I don’t believe [my life] would be [different if I stuttered]. It is not like a debilitating

disease (expect for some serious cases). I mean, I can still drive, go to work, school, the bar. It

doesn’t make me less attractive, or any less of a person.” Other participants reported similar

feelings and wrote that their relationships with friends and family would not be affected.

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Several participants, however, wrote that their lives would be different if they stuttered.

Approximately 17% (n = 26) of the statements coded as “Life effects” suggested that participants

would experience generic life changes or difficulties if they stuttered. For example, “I feel I

would have a completely different life,” and “If I had a stuttering problem, my life would be

different and I think complicated.” Similarly, “I would imagine that I would not have done many

of the things I have done thus far in my life.” Participants tended to describe their lives as being

“completely different” and “totally different,” if they stuttered, suggesting that stuttering was

believed to have far-reaching consequences for some of the participants in this study.

Limited social opportunities and decreased socialization in general were reported in

several of the participants’ statements (21.5%, n = 32). These statements were similar to survey

responses for question three, in which participants indicated that PWS engage in fewer social

situations and experience difficulties making friends and forming intimate relationships. One

participant wrote about her ability to maintain her friendships and intimate relationships if she

were a person who stutters:

“I do not think that I would attract the kind of guys I do now or have the same friends,

only because first impressions are everything, and because my friends are nice they

would have been nice to me but maybe not have gotten close to me. As for the guys,

some of them tend to be a little shallow but nice, so I don’t think that I would attract the

same men.”

A male participant wrote that he would find it equally difficult to form intimate relationships if

he stuttered: “I also don’t think that I would have friends as I do [now], let alone a girlfriend. I

think even if I looked wonderful to make a boyfriend for someone, because I stutter, the same

lady won’t have accepted my proposal.” Lack of friends and the inability to participate in

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hobbies such as singing, debate, and acting were also cited by participants as being particularly

problematic.

Participants also felt that they would be affected academically if they were to stutter.

Twenty percent of statements (n = 30) indicated that stuttering would result in negative academic

experience for participants. Poor academic performance was one example, e.g., “[Stuttering]

would definitely affect my class participation grades,” and “I wouldn't feel like I could speak up

in class because I’d feel like I'm slowing down the conversation or debate.” Participants also

reported that they had been fairly active in extracurricular activities in school and would

probably not have been if they stuttered. For example:

“I was very active in high school, president of the student body at one point, which

required speaking in public in front of large groups of people on an almost daily [basis],

certainly weekly. In fact, I'm sure I would have been scared back in grade school (Pre-K

through 5th grade) as I'm positive that other children would have made fun of me. Once

again I was very active in college, taking on several leadership positions which I doubt I

would have done on such a public level had I stuttered.”

The ability of participants to attend college if they stuttered was also questioned. For

example, one participant shared that “If I communicated with people at all, it probably would be

in the form of letters, e-mails, and Facebook, but I don't think I would have Facebook, because I

would not be in college.” Similarly, another participant stated that “I don’t think I would be in

school and I probably would still be living with my parents.” These statements suggest that

stuttering was perceived as having a negative impact on participants’ ability to not only achieve

educational goals, but also to live independently.

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Contrary to the academic limitations caused by stuttering, only one participant indicated

that stuttering would actually help academic performance. This participant reported that

stuttering would limit social opportunities and friendships, resulting in more time to focus on

school and academic success.

In addition to academic difficulties and decreased social opportunities, 32.9% (n = 49) of

the “Life effects” statements suggested that participants felt they would need to change their

career plans if they stuttered. As with responses to question three, participants reported that jobs

that required high levels of communication would be especially difficult if they stuttered. A

relatively high percentage of survey respondents (34%) were education majors and anticipated a

teaching career. It was interesting to note that many of these participants felt that they should not

or could not go into teaching if they were a person who stutters, e.g., “I would also have to

change my major because I wouldn't be able to be an early childhood teacher with a stutter.”

Future teachers seemed especially concerned about the ability of students to understand and learn

from educators who stutter: “If I had a severe case of stuttering then I don’t think that I would

want to stand in front of a class and try to teach. I don’t think that it would be fair to my students

or if they had a hard time following and understanding what it was I was trying to say.” It is

possible that the reported reluctance of education majors to pursue teaching careers if they

stuttered may somehow relate to the often stereotypically negative views of teachers toward

PWS that has been reported in the literature (Crowe & Walton, 1981; Dorsey & Guenther, 2000;

Lass et al. 1992, 1994; Ruscello, Lass, Schmitt, & Pannbaker, 1994; Turnbaugh, Guitar, &

Hoffman, 1981).

Other participants who planned on going into medicine, psychology, journalism, and

business reported similar sentiments, e.g., “I think my life would be different slightly, when

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trying to get a job. I think communication is very important in major companies, so having

someone who stutters would be a major problem to the company's staff when presenting

information.” Also of concern to participants was the interview process required to proceed to

advanced training programs for certain careers, e.g., “I also could possibly be discriminated

against during my upcoming interviews for graduate school for physical therapy.” Participants

who had less prestigious part-time jobs also felt that their jobs would be affected by their

stuttering: “I would not be able to be a waitress because I would have trouble talking,” and “I

work at a clothing store where I help men and women pick out clothes. If I stuttered, I may be a

little apprehensive to simply go up to someone and ask if they need help.”

Thus, occupations that were perceived by participants as requiring large amounts of

verbal communication were reported as difficult or even inappropriate by some participants.

These findings are similar to participants’ responses for question three and have been reported

elsewhere in the literature (e.g., Gabel, et al., 2004; Schlagheck, et al., in press). In one notable

exception, a participant wrote “I would have a career that would involve speaking to a lot of

patients in hospitals. I would probably just start talking and if they had a question about my

stutter, I would answer it.” Research is needed that explores the intrinsic personal factors that

cause some individuals to report that they would shun public speaking careers if they stuttered,

whereas other individuals would welcome the opportunity to communicate with others and

educate them about stuttering.

Individual variations. Some survey responses (7.9%, n = 31) indicated that the effects of

stuttering on individual participants would vary depending on a number of factors. As with

question three, participants reported that the severity of the stuttering would play a large role in

the effects of stuttering: “I think it would depend on the [severity] of the stutter because I know

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someone whose stutter is very bad. It is hard for them to get through sentences, whereas one of

my friends stutters [only] on occasion, like when he’s talking too fast.” Similarly, “Depending on

the severity of my stuttering, I many not have changed my major to teaching.” Variability among

listeners was also mentioned. One participant reported that most listeners would not react

negatively to stuttering:

“I think if [stuttering] suddenly came up, I would for sure be thrown off initially and take

time to adjust. I think I may not be comfortable in social situations, etc. But then I think

most people are NOT crass, they are generous and understanding of someone’s problems,

so I would go on.”

In addition, the fortitude of the participants themselves and their ability to cope with

stuttering were reported. For example, one participant indicated that acceptance of stuttering

would be important: “I think that you have to learn to understand and love yourself the way you

are. It is also important to learn to overcome people’s criticisms.” Similarly, participants

mentioned working to overcome their stuttering. For example, “I think that I would be able to

work through the problem and not let it affect my life,” and “[My life] would be no different

beyond the work I would have to do to overcome my stuttering.” In general, these responses

were positive and reflected participants’ beliefs that they could move past their stuttering, e.g., “I

would not let this challenge define me as a person!” Thus, when compared to the larger sample

of participants, a small number of survey respondents reported that stuttering would not

necessarily affect them negatively, depending on such factors as severity of stuttering, listener

reactions, and one’s personal ability to cope with and overcome stuttering.

165


Gender and familiarity. A Multivariate Analysis of Variance (MANOVA) was conducted

to determine if responses differed according to gender, familiarity, or interactions between

gender and familiarity for all of the themes and the total number of statements. The means and

standard deviations for this analysis are presented in Table 11. There was no significant

difference for any of the themes according to gender (F[9, 130] = .47, p = .89, 2η = .03, observed

power = .22), level of familiarity (F[27, 380] = .68, p = .89, 2η = .04, observed power = .61), or

gender/familiarity interaction (F[27, 380] = 1.25, p = .18, 2η = .08, observed power = .92). These



Question three comparisons. Quantitative comparisons were also made between

participants’ responses to survey question three (How do you think people who stutter are

affected by their stuttering?) and question four (If you were a person who stutters, how would

your life be different?). Paired samples t-tests were conducted to determine if the participants

provided quantitatively different responses to questions three and four, even though the

responses for both questions were qualitatively similar. Table 12 displays the means and standard

deviations for this analysis. The results indicated that the total number of statements made by

participants did not differ from question three to question four (t = -1.44, p = .15), nor did the

number of “Individual variations” statements (t = .90, p = .37) and the ratio of “Individual

variations” statements to the total number of statements (t = .19, p =.85). The total number of

“Speaking difficulties” statements decreased significantly from question three to question four (t

= -8.28, p < .001), as did the ratio of “Speaking difficulties” statements to the total number of

statements (t = -8.01, p < .001). Though the total number of “Reactions to stuttering” statements

166

was not significantly different for questions three and four, (t = 1.44, p = .15), the ratio of

“Reactions to stuttering” statements to the total number of statements was significantly greater

for question four than for question three (t = 2.86, p < .001). “Life effects” statements were

significantly different for both the number of statements and the ratio of “Life effects” statements

to the total number of statements. Specifically, participants reported significantly more “Life

effects” statements for question four than question three (t = 4.38, p < .001). The ratio of “Life

effects” statements to total statements also was greater for question four than for question three (t

= 4.83, p < .001).

These results appear to indicate that although participants reported similar themes for

questions three and four, they felt that some life changes due to stuttering were more salient

when regarded from a personal standpoint. Thus, when participants considered the effects of

stuttering on their own lives, they were more likely to focus on the effects of negative listener

responses and disruptions to their social lives, career plans, and academic performance. Factors

such as the core behaviors of stuttering and their effects (e.g., increased time to speak, frustration

over disfluencies, use of coping mechanisms) as well as individual variations in the effects of

stuttering were reported less often for both questions but seemed to be equally important

considerations for PWS and participants who imagined themselves to be PWS.


Participants’ beliefs about how stuttering would affect their own lives were thematically

similar to their beliefs about how PWS in general are affected by their stuttering as reported in

question three. Most participants believed that they would experience speaking difficulties,

negative listener reactions, limited social opportunities, career restrictions, and negative

academic experiences if they stuttered. Interestingly, when compared to their responses about

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how PWS are affected by their stuttering, participants reported significantly more statements

about how their own lives would be affected by the reactions of listeners. They also wrote

significantly more about how their lives would be affected by stuttering in terms of their social

lives, careers, and schooling.

The responses to this question would appear to confirm that participants are capable of

considering the effects of stuttering from a multidimensional framework, such as that of the

World Health Organization’s International Classification of Functioning, Disability, and Health

(Yaruss & Quesal, 2004). Small numbers of participants also indicated stuttering would not

necessarily affect their lives negatively. These results suggest that some participants believe that

stuttering does not have uniform consequences and could impact individuals differently based on

personal factors, including one’s acceptance of stuttering.

168

Table 11


Theme

Gender

Familiarity

M

SD

N

Speaking Difficulties Male None 0.80 1.10 5


Well 0.46 0.88 13

Very Well 0.43 0.65 14

Total 0.47 0.75 47



Well 0.28 0.46 25

Very Well 0.53 0.77 19

Total 0.38 0.60 99

Ratio Speaking Difficulties Male None 0.23 0.33 5


Well 0.18 0.35 13

Very Well 0.20 0.32 14

Total 0.18 0.31 47



Well 0.10 0.24 25

Very Well 0.23 0.37 19

Total 0.15 0.27 99

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Theme

Gender

Familiarity

M

SD

N

Reactions to Stuttering Male None 1.20 1.10 5


Well 1.31 1.03 13

Very Well 0.57 0.85 14

Total 0.94 0.92 47



Well 1.12 1.09 25

Very Well 1.00 0.88 19

Total 1.09 0.97 99

Ratio Reactions to Stuttering Male None 0.50 0.50 5


Well 0.53 0.39 13

Very Well 0.24 0.36 14

Total 0.39 0.40 47



Well 0.41 0.40 25

Very Well 0.47 0.40 19

Total 0.45 0.39 99

170


Theme

Gender

Familiarity

M

SD

N

Life Effects Male None 1.00 1.00 5


Well 0.69 0.95 13

Very Well 1.14 0.95 14

Total 0.96 1.04 47



Well 1.52 2.04 25

Very Well 0.84 0.96 19

Total 1.05 1.38 99

Ratio Life Effects Male None 0.27 0.25 5


Well 0.27 0.34 13

Very Well 0.42 0.34 14

Total 0.32 0.32 47



Well 0.33 0.34 25

Very Well 0.30 0.34 19

Total 0.30 0.34 99

171


Theme

Gender

Familiarity

M

SD

N

Individual Variations Male None 0.00 0.00 5


Well 0.00 0.00 13

Very Well 0.36 0.63 14

Total 0.21 0.51 47



Well 0.32 0.56 25

Very Well 0.00 0.00 19

Total 0.21 0.52 99

Ratio Individual Variations Male None 0.00 0.00 5


Well 0.00 0.00 13

Very Well 0.14 0.23 14

Total 0.10 0.25 47



Well 0.12 0.24 25

Very Well 0.00 0.00 19

Total 0.09 0.23 99

172





Well 2.54 1.13 13

Very Well 2.50 1.02 14

Total 2.60 1.12 47



Well 3.24 2.17 25

Very Well 2.37 0.96 19

Total 2.75 1.57 99

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Table 12

Comparison of Questions 3 and 4 with Means and Standard Deviations (n= 142)

Type of Measure M SD

Q3 Speaking Difficulties 1.26* 1.16

Q4 Speaking Difficulties 0.41* 0.64

Q3 Ratio Speaking Difficulties 0.45* 0.38

Q4 Ratio Speaking Difficulties 0.16* 0.28

Q3 Reactions to Stuttering 0.90 1.01

Q4 Reactions to Stuttering 1.06 0.95

Q3 Ratio Reactions to Stuttering 0.32* 0.35

Q4 Ratio Reactions to Stuttering 0.44* 0.39

Q3 Life Effects of Stuttering 0.52* 0.85

Q4 Life Effects of Stuttering 1.01* 1.29

Q3 Ratio Life Effects of Stuttering 0.15* 0.25

Q4 Ratio Life Effects of Stuttering 0.30* 0.33

Q3 Individual Variations 0.20 0.70

Q4 Individual Variations 0.21 0.52

Q3 Ratio Individual Variations 0.07 0.21

Q4 Ratio Individual Variations 0.09 0.24

Q3 Total Comments 2.88 1.34

Q4 Total Comments 2.70 1.45

* Significant difference between Q3 and Q4 responses at p < .05

174

Survey Question 5: What is a good way to act around someone who stutters? Please explain.

The fifth survey question asked participants to give examples of how fluent speakers

should behave in the presence of PWS. The purpose of this question was to gain a better

understanding of participants’ beliefs regarding fluent speakers’ acceptable and unacceptable

behaviors toward PWS. The recommendations that participants provided for this survey question

may ultimately be used as the basis for future research in which fluent speakers’ beliefs about

appropriate behaviors while interacting with PWS are correlated with fluent speakers’ actual

behaviors toward PWS in real life situations.


Qualitative. The participants provided examples of acceptable and unacceptable listener

reactions to stuttering and explained why these behaviors were or were not recommended for

fluent speakers as they interact with PWS. With the exception of six miscellaneous statements

that were not associated with any theme, four major themes emerged from participants

responses: (1) Intangible behaviors that could not be readily observed, such as having patience or

acting normally, coded as “Intangible behaviors;” (2) Observable behaviors such as eye contact

or finishing words for PWS, coded as “Observable behaviors;” (3) Explanations that consisted of

participants’ beliefs about the emotional reactions of PWS to the behaviors of fluent speakers,

coded as “Emotional Reactions of PWS;” and (4) Explanations that focused on the humanity or

normality of PWS, coded as “PWS are normal.”


of 472 statements (M = 3.17; SD = 1.50). The ratios of each type of statement to the total number


participants, which ranged from one to 10 statements. Statements coded as “Intangible

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behaviors” accounted for 59.1% of participants’ statements (n = 279, M = 1.87, SD = 1.05), with

a ratio of 90.4 (M =.61, SD = .26). “Observable behaviors” statements accounted for 16.10% of

the total statements (n = 76, M = .51, SD = .84), with a ratio of 21.1 (M = .14, SD = .22).

“Emotional reactions of PWS” statements accounted for 12.1% of the total statements (n = 57, M

= .38, SD = .55), with a ratio of 17.1 (M = .11, SD = .17). “PWS are normal” statements

accounted for 11.2% of the total statements (n = 53, M = .36, SD = .63), with a ratio of 17.3 (M

= .12, SD = .20). Miscellaneous statements not associated with any theme accounted for 1.3% of

the total statements (n = 6, M = .04, SD = .20), with a ratio of 2.8 (M = .02, SD = .12).

Qualitative Results

Intangible behaviors. Nearly 60% of participants indicated that fluent speakers should

employ types of behaviors that were coded as “Intangible.” These behaviors were unlikely to be

directly observable by PWS during conversations with fluent speakers. Over one third (n = 97,

34.8%) of these “Intangible behaviors” statements indicated that listeners should act normally or

naturally around PWS, or that PWS should be treated like anyone else. For example, “I think it is

good to just act normal,” and “A good way to act would be the same way as you act with other

people.” Other types of intangible behaviors consisted of being patient with a conversational

partner who stutters (n = 48, 17.2%). For example, “You would just have to be more patient,”

and “It’s my understanding that it takes someone who stutters longer to express their

statements/thoughts. To this extent, listeners should act and be patient.” It was not clear whether

participants who reported needing patience to speak with PWS considered this to be a burden or

limitation of interacting with PWS. Participants also made statements about ignoring the

stuttering or focusing instead on the speaker’s message rather than his or her stuttering (n = 21,

7.5%). One participant wrote, “I think a good way to act is to act as though the person doesn't

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have a stutter.” Similarly, another participant stated, “I think that a good way to act is to ignore

the stutter and focus on what the person is saying.”

In addition to acting normally, being patient, and ignoring stuttering, the remaining

statements (n = 113, 40.5%) provided miscellaneous types of non-observable behaviors for fluent

speakers who interact with PWS. These statements were typically positive but non-specific, such

as “Care and be legitimate,” “Give respect,” and “Not judgmental!” These results suggest that

because the majority of the responses to this survey question were coded as “Intangible

behaviors,” it may be difficult for researchers, and indeed, PWS, to gauge listeners’ reactions to

stuttering via the use of direct observation techniques. Furthermore, it is very possible that such

listener behaviors as acting normally, being patient, or ignoring stuttering would manifest

themselves in differently among various fluent listeners during actual conversations with PWS.

Observable behaviors. In direct contrast to intangible behaviors, 16% of the participants’

statements indicated that there are behaviors that fluent listeners should employ when interacting

with PWS. These behaviors would be observable by PWS and could be directly measured in

research studies. In general, participants’ statements were not clustered around specific sub-

themes and were seemingly random, e.g., “The listener, when speaking, could also speak more

slowly and pause often,” and “If [PWS] are nervous, maybe take them to a safe place where they

are more comfortable.” There were, however, some participant trends in terms of reporting such

behaviors as making eye contact, not laughing at PWS, asking/not asking for clarification when

the listener does not understand, and finishing/not finishing words for PWS.

Only four participants mentioned eye contact. Their statements, however, unanimously

indicated that fluent speakers should make increased or good eye contact with PWS, e.g., “A

good way to act around someone who stutters is to keep good eye contact.” Refraining from

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laughing at PWS was also advocated by nine participants, e.g., “Don’t stare or laugh or make

fun.” Unlike eye contact and not laughing at PWS, participants reported mixed beliefs regarding

the acceptability of asking PWS for clarification or finishing words for PWS. For example, of the

eight participants who mentioned asking PWS to repeat themselves, four indicated that it was

acceptable to ask for clarification, e.g., “If you didn't catch something they said, ask them to

repeat it. If you didn't hear what a person with normal speech said you would ask them to repeat

it, so why treat someone who stutters any different?” The other four participants indicated that it

would be best not to ask PWS to repeat themselves, e.g., “It may be more respectful not to ask

questions (“Can you repeat that?” or “I don’t understand).” Similarly, 13 participants reported

that you should not finish words or sentences for PWS, but 5 participants suggested that listeners

could “try to fill in gaps or sentences for them,” “suggest synonyms of the words, so that [PWS]

would choose the words more easily,” and “ask questions that needed a shorter response.” These

responses indicate that as a group, participants felt some confusion over certain behaviors, such

as whether one should ask PWS to repeat themselves and whether to fill in words or otherwise

“help” PWS.

It is interesting to note that only one participant reported that it would be acceptable to

discuss one’s role as a listener with the person who stutters:

“I think if I was with somebody with whom I needed to interact on a prolonged basis, and

if I became close enough friends with them, I would try to ask them if I could do

anything to make them more comfortable talking to me. I would ask them to coach me so

that I could be a part of their environment in which they feel comfortable.”

Thus, it is possible that the participants in this study did not believe that it is acceptable to

discuss stuttering with PWS, or that participants had never considered such a possibility. The

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small number of reported observable behaviors as compared to intangible behaviors also

indicates that participants may believe that it is more important to have a good attitude toward

PWS than to verbally express or overtly demonstrate these positive attitudes to PWS.

Emotional Reactions of PWS. Approximately 12% of the total number of statements for

the fifth survey question consisted of participants’ perceptions about the emotions that PWS

experience because of fluent listeners’ behaviors. Participants reported that PWS experience

negative emotions when listeners act inappropriately, or that PWS are spared from negative

emotions when listeners act appropriately. Thus, participants appeared to believe that fluent

listeners often act as the emotional caretakers of PWS. For example, one participant wrote,

“People who stutter should be treated with respect, and therefore I should be cognizant of their

needs without violating them or making them feel different.” Similarly, other participants stated,

“Don’t treat them different or you could hurt their self-esteem,” and “Just treat them normal so

they don’t feel like they are some sort of a freak.” Listeners were also perceived as impacting the

independence of PWS, e.g., “It is best to remain patient and let [PWS] finish their words. It is

their idea, their thoughts, and finishing their words takes away that autonomy a little.” Other

statements that were representative of this theme included, “Be understanding and don’t make

them feel ignorant or disabled,” and “I’d imagine they’d feel awkward enough. They don’t need

me to add to it.” One participant even wrote that listener responses to stuttering could “promote,

in some meager way, [PWS] overcoming their condition.” In general, these statements indicate

that the participants in this study assigned much importance to listeners’ reactions to stuttering

and perceived that listeners have the potential to positively or negatively affect the lives of PWS.

PWS are normal. Approximately 11% of the total statements made by participants

indicated that PWS are no different from anyone else. PWS were perceived as human beings

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who are normal with the exception of a communication problem that they cannot control and did

not ask for. Examples of these statements included: “Act normal. They are just like you and I,”

and “[Act] like you would around someone who doesn't stutter. Just because someone stutters, it

doesn't make them any less intelligent or any less of a person.” Likewise, one participant wrote,

“A good way to act around someone who stutters is just to be patient and understanding because

they didn’t ask to be that way.” These statements suggest that participants believe that PWS,

though sometimes challenged by their stuttering, are essentially the same as anyone else and

should be treated as such. These responses also correspond with participants’ statements on the

second survey question, in which PWS were described as being normal or just like anyone else.






of the themes according to gender (F[11, 131] = 1.36, p = .20, 2η = .10, observed power = .70),


gender/familiarity interaction (F[33, 387] = .71, p = .88, 2η = .06, observed power = .71). These




When asked to describe how fluent listeners should act around PWS, participants

generally responded with intangible behaviors that would not be directly observable to others.

These intangible behaviors were generally positive and mostly consisted of such behaviors as

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acting normally, focusing on the message of the person who stutters rather than his or her

stuttering, and being understanding, accepting, and kind to PWS. Participants also reported that it

is important to be patient when interacting with someone who stutters. The extent to which

needing to be patient during conversations with PWS was perceived as burdensome to

participants is not certain at this time and would be an interesting topic for future research. Fewer

participants reported observable behaviors such as making eye contact, not laughing at PWS,

finishing or not finishing words or sentences for PWS, and asking or not asking PWS to repeat

themselves. There was some disagreement among participants as a whole regarding whether

listeners should ask PWS to repeat themselves or whether it is acceptable to finish words or

sentences for PWS. Explanations for these intangible and observable behaviors consisted of

participants’ beliefs that PWS can be greatly affected by the actions of listeners to their

stuttering, often in negative ways, and beliefs about the normalcy of PWS despite their stuttering.

Thus, although participants appeared believe that treating PWS like anyone else and with

patience and respect were appropriate behaviors for fluent listeners, there was some confusion

regarding the ways in which these behaviors should manifest themselves in more tangible,

observable ways.

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Table 13


Theme

Gender

Familiarity

M

SD

N

Intangible Behaviors Male None 1.83 0.75 6


Well 1.92 1.26 13

Very Well 1.80 0.86 15

Total 1.80 1.06 49



Well 2.24 1.23 25

Very Well 1.94 1.00 18

Total 1.91 1.05 100

Ratio Intangible Behaviors Male None 0.65 0.23 6


Well 0.58 0.26 13

Very Well 0.62 0.28 15

Total 0.58 0.28 49



Well 0.67 0.21 25

Very Well 0.63 0.26 18

Total 0.62 0.24 100

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Theme

Gender

Familiarity

M

SD

N

Observable Behaviors Male None 0.17 0.41 6


Well 0.54 0.66 13

Very Well 0.60 1.12 15

Total 0.49 0.82 49



Well 0.56 0.92 25

Very Well 0.67 0.77 18

Total 0.52 0.85 100

Ratio Observable Behaviors Male None 0.04 0.10 6


Well 0.16 0.21 13

Very Well 0.16 0.28 15

Total 0.15 0.26 49



Well 0.13 0.17 25

Very Well 0.23 0.27 18

Total 0.14 0.20 100

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Theme

Gender

Familiarity

M

SD

N

Emotions of PWS Male None 0.67 0.82 6


Well 0.54 0.66 13

Very Well 0.40 0.51 15

Total 0.47 0.58 49



Well 0.36 0.57 25

Very Well 0.17 0.38 18

Total 0.34 0.54 100

Ratio Emotions of PWS Male None 0.22 0.27 6


Well 0.13 0.17 13

Very Well 0.12 0.17 15

Total 0.14 0.18 49



Well 0.11 0.18 25

Very Well 0.06 0.14 18

Total 0.10 0.17 100

184


Theme

Gender

Familiarity

M

SD

N

PWS are normal Male None 0.17 0.41 6


Well 0.15 0.38 13

Very Well 0.27 0.46 15

Total 0.22 0.47 49



Well 0.28 0.54 25

Very Well 0.28 0.57 18

Total 0.42 0.68 100

Ratio PWS are normal Male None 0.08 0.20 6


Well 0.05 0.15 13

Very Well 0.09 0.17 15

Total 0.08 0.17 49



Well 0.09 0.18 25

Very Well 0.08 0.18 18

Total 0.13 0.22 100

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Theme

Gender

Familiarity

M

SD

N



Well 3.23 1.92 13

Very Well 3.13 1.68 15

Total 3.04 1.49 49



Well 3.44 1.98 25

Very Well 3.06 0.80 18

Total 3.23 1.52 100

186

Survey Question 6: What can people who stutter do to help their listeners? Please explain.

The sixth survey question asked participants to give examples of how people who stutter

could help their fluent listeners. The purpose of this question was to examine participants’ beliefs

about whether there are facilitative techniques that PWS can employ in the presence of fluent

listeners in order to promote more effective communication. These data may presumably identify

those behaviors of PWS that are perceived to be helpful or unhelpful to fluent listeners.


Qualitative. Five themes emerged from participants’ responses. These themes included

(1) Strategies for more effective communication or increased intelligibility, coded as

“Communication strategies;” (2) Self-advocating behaviors, including acknowledging one’s

stuttering and educating others about stuttering, coded as “Advocacy;” (3) Advice to PWS to

control their emotions or to tolerate the negative behaviors of fluent listeners, coded as

“Emotional control;” (4) Statements in which participants indicated that they were uncertain of

what, if anything, PWS could do to help their listeners, or statements in which participants

indicated that nothing could be done by PWS to help listeners, coded as “Uncertainty/Nothing;”

and (5) Statements in which participants indicated that it is the listener’s responsibility, rather

than that of the person who stutters, to ensure that the communicative interaction goes smoothly,

coded as “Listener Responsibility.”




participants, which ranged from one to eight statements. Statements coded as “Communication

strategies” accounted for 44.3% of participants’ statements (n = 140, M = .96, SD = .97), with a

187

ratio of 67 (M =.41, SD = .43). “Advocacy” statements accounted for 21.2% of the total

statements (n = 67, M = .46, SD = .87), with a ratio of 30.7 (M = .23, SD = .38). “Emotional

control” statements accounted for 20.9% of the total statements (n = 66, M = .46, SD = .77), with

a ratio of 26.2 (M = .18, SD = .30). “Uncertainty/nothing” statements accounted for 7.6% of the

total statements (n = 24, M = .17, SD = .43), with a ratio of 13.9 (M = .10, SD = .28). “Listener

responsibility” statements accounted for 6.3% of the total statements (n = 20, M = .14, SD = .42),

with a ratio of 8.1 (M = .06, SD = .17).

Qualitative Results

Communication strategies. Nearly 40% of participants indicated that PWS should employ

strategies that would make them more effective communicators. More effective communication

appeared to be related to less stuttering. Furthermore, reduced stuttering appeared to be

associated with more intelligible speech. For example, one participant wrote, “A way that people

who stutter can help their listeners is by talking slower, because that way the listener can make

out what the person is trying to say instead of trying to guess what the person said.” Similarly,

another participant wrote that listeners would appreciate it if “people who stutter can try to speak

slowly and think about what they are trying to say before they actually began a conversation.”

Talking more slowly and thinking before speaking were not the only suggestions offered

by participants. Other examples of strategies that were perceived to lead to more effective

communication included talking less, avoiding problematic words, and using gestures or writing.

For example, one participant wrote, “I think that people who stutter can help their listeners by

expressing their thoughts completely yet briefly. If possible, it might help if they are able to

compound their thoughts. This would help a listener know what the person who stutters is

saying.” Another participant stated, “I know that with some people who stutter they have a

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problem with certain letters. My advice would be to try and avoid words with these particular

letters.” The use of gestures was also mentioned, e.g., “I think that they can use gestures so that

the listener knows what they are saying.” Similarly, one participant stated that PWS could “talk

with their hands and move around so that people don’t just focus on the stuttering.” The use of

writing was also suggested in addition to the use of gestures: “I think that if it’s an emergency

situation that requires immediate attention, a stuttering person could write down a few words

like, ‘Call 911 now, woman heart attack!’ or act out or point to something really quickly to show

whoever they are trying to tell.” One participant suggested that PWS “could carry a pen and note

pad around to write things down for the people who can’t understand them at all.”

Only thirteen participants (9%) indicated that PWS could seek some form of treatment

for their stuttering. These participants stated that PWS could visit a “speech pathologist,”

“speech therapist,” or a “speech coach” in order to speak more clearly. Participants also

mentioned that PWS could try to use therapeutic devices, e.g., “I've heard of an experimental

device that, when inserted in the ear, eliminates the problem of stuttering completely.” People

who stutter were also advised to “take public speaking classes,” presumably as a way to gain

more experiences with speaking in public. Thus, very few participants appeared to believe that

PWS may benefit from the services of a speech therapist. These results support Ham’s (1990)

finding that members of the general public had a decreased awareness of the availability of

speech therapy services for PWS.

In general, participants’ statements suggest that PWS should employ whatever strategies

are necessary to avoid stuttering, thus increasing their intelligibility for listeners. The use of

gestures to distract listeners from stuttering, not talking as much, and avoiding certain sounds or

words are all examples of classic avoidance behaviors that are frequently employed by PWS but

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are ultimately unhelpful (e.g., Guitar, 2006). Likewise, the advice of participants to “slow down”

and “think before you speak,” have been found to be equally unhelpful and frustrating for PWS

(e.g. Guitar, 2006; Manning, 2001). Thus, there appears to be a discrepancy between

participants’ desires for people who stutter to demonstrate increased fluency and intelligibility

versus the therapeutic techniques that PWS may employ that do not focus solely on increased

fluency. Therapy goals such as open and honest stuttering without avoidance behaviors (e.g.,

Van Riper, 1982), may not be perceived as helpful by participants and may explain why research

participants in other studies have not demonstrated increased positive regard for individuals who

utilize such therapeutic techniques (Manning, et al, 1999). The limited number of participants

who believed that speech therapy services are of use to PWS is also of concern.

Advocacy. Approximately 21% of the participants’ statements indicated that PWS should

engage in advocacy behaviors such as acknowledging one’s stuttering and educating others about

stuttering. For example:

“[PWS] maybe should inform their listener that they have a stuttering problem, and if the

listener doesn’t understand what stuttering is, explain it to them. Once the listener is

informed it will be easier for them to communicate with a person who stutters and to be

patient.”

Similarly, another participant wrote, “I think people who stutter can help their listeners by

explaining if they have any special needs or by being willing to answer their listeners’ questions

about stuttering.”

As empowering and beneficial as it may be for PWS to express that they stutter and

educate others, participants appeared to consider the benefits of acknowledgement only from the

perspective of fluent listeners. From this viewpoint, acknowledging one’s stuttering is seen as

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helpful because it eliminates the element of surprise that some participants experience when

speaking with someone who stutters. For example, one participant stated, “Possibly [PWS] could

warn the listeners of their stuttering problem before the conversation starts. I think this will help

because the listener will not be surprised when they stutter.” The word “warning,” significant

because it connotes the presence of imminent danger, was also used by another participant in a

similar context. Likewise, one participant suggested that PWS should interact with young

children to “minimalize the shock” that these children may otherwise experience as they grow up

and are exposed to someone who stutters for the first time. Thus, stuttering appears to be

perceived by some participants as a disconcerting experience for which forewarning is

appreciated. This finding would appear to confirm that listeners are more comfortable with PWS

when stuttering is acknowledged (e.g., Collins & Blood, 1990; Healey et al., 2007).

Other suggestions included the use of humor in addition to acknowledging one’s

stuttering:

“Perhaps break the ice with something like, ‘I stutter. You smell funny. We all have our

issues.’ Honestly, I would think that acknowledging the proverbial elephant in the room

can be a good thing. Maybe [the person who stutters could] communicate to the listener

things that will enhance communication.”

Examples of advocacy described by participants also included simply being oneself, e.g., “Be

yourself. Express who you are just as anyone else would. This should dispel some of the

myths/preconceived notions about those who stutter.” In addition to being one’s self, continuing

to talk despite one’s stuttering was reported, e.g., “Just be yourself. Say something if it is on your

mind.” One participant simply wrote “Talk!” Thus, participants reported that PWS can advocate

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for themselves in diverse ways, some of which are perceived as having direct benefits for

listeners.

Emotional Control. Approximately 21% of the total number of statements consisted of

participants’ beliefs that PWS should exert effort to control their emotional reactions to (1) their

own stuttering, (2) the often negative or frustrating reactions of listeners, or (3) both their own

and listeners’ emotional reactions. Forty statements indicated that PWS should work to control

their own emotions. For example, one participant reported that PWS should try “not be so

insecure when they speak to people.” Likewise, another participant stated that PWS should

“appear confident, because [listeners] are less likely to feel awkward and judged if someone is

confident or unashamed of a disability.” These types of statements appear to indicate that PWS

are perceived as being shy, insecure, or unconfident, and that these characteristics can negatively

impact the interactions of PWS and fluent speakers. Similarly, PWS were perceived as being

excitable, anxious, or frustrated because of their stuttering. For example, “People who stutter can

just stay calm and try not to get so frustrated,” and “Try not to get frustrated as they speak so as

to make it worse.” Presumably, participants’ descriptions of PWS as frustrated, anxious, or shy

as reported on the second survey question appear to correspond with participants’ beliefs that

these negative characteristics are apparent in conversations with PWS.

Some statements (n = 21) indicated that PWS should try to control their emotional

reactions to the sometimes unhelpful behaviors of listeners. Listeners were perceived as being

frustrating, often because they cannot comprehend the message of PWS. For example, one

participant wrote, “Be patient with someone who has trouble understanding [the person who

stutters] because that could encourage more interaction.” Similarly, another participant advised,

“Do not get frustrated or upset if [listeners] don't understand what is being said at first.” In

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addition to being patient with fluent listeners, a relatively small number of statements (n=5)

advised that both PWS and listeners need to work on controlling their emotions so that the

conversation goes smoothly. For example, “Both listeners and people who stutter need to not

become frustrated if they are not connecting, and [they should] be willing to talk it out, as this

also happens when talking to lots of other people whether they stutter or not.” Thus, participants

tended to perceive listeners as being one source of frustration and other negative emotions for

PWS. They suggested that PWS may help their fluent listeners by being patient with them as

listeners struggle to comprehend PWS in conversational interactions.

Uncertainty/Nothing. Approximately 8% of the total statements made by participants

indicated that participants were unsure of what PWS could do to help their fluent listeners or felt

that nothing could be done in this respect. For example, one participant wrote, “I'm not really

sure if there is anything they can do, although I really don't know much about it. I've never

known a person who stutters.” Similarly, another participant stated, “I’m not sure exactly. I don’t

know if there are strategies to it or if it is just trying to say the words fast and clear.” Other

examples included such statements as, “I think that not much can be done,” and “I really don’t

know. Nothing, I guess.” These statements indicate that some participants may not have thought

about this question and were not willing or able to provide suggestions or advice for PWS on this

topic.

Listener Responsibility. Approximately 6% of the total statements made by participants

indicated that listeners, not PWS, should take responsibility for ensuring the effectiveness of

conversational interactions between fluent speakers and PWS. Patience on the part of the listener

was reported, e.g., “Listeners should be more patient, but a stutterer can’t help someone be a

better listener. Listeners should do this themselves.” Other statements regarding the importance

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of listener patience included, “I just think the listeners need to be patient and pay attention,” and

“Based on my experiences it is more incumbent on the listener to be patient and ask for

clarification if [they are] confused or unsure.” In addition to having patience, one participant

reported, “I think it is up to the listeners themselves to give people who stutter a chance to speak.

[Listeners should be] open to take the time to allow people who stutter to express their feelings

without putting pressure on them to speak faster or clearer.” Thus, although the majority of

participants indicated that PWS could take steps to help their listeners during conversations, a

small number of participants felt that listeners themselves should take this responsibility.






of the themes according to gender (F[11, 127] =1.04, p = .41, 2η = .08, observed power = .56),


gender/familiarity interaction (F[33, 375] = 1.47, p = .051, 2η = .11, observed power = .98).

These findings suggest that men and women did not vary in terms of the responses they provided

to the survey question; nor did responses differ on the basis of how well participants knew PWS.

The interaction between the gender and familiarity variables was noted to be approaching

significance.


Participants provided many types of suggestions for the ways in which PWS may help

their fluent listeners. The most common of these suggestions was for PWS to engage in any

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behaviors that would alleviate or eliminate stuttering. Thus, common suggestions included

avoiding problem sounds and words, writing instead of persevering through instances of severe

stuttering, using gestures as a means of making one’s point or distracting the listener from the

stuttering, and simply speaking less. These avoidance behaviors were regarded as having a

beneficial effect for listeners because they would decrease stuttering and therefore increase the

intelligibility of individuals who stutter. Other suggestions included organizing one’s thoughts

before speaking and talking slower. Despite participants’ reports that PWS should attempt to

reduce or eliminate their stuttering, less than 10% of participants’ statements indicated that

speech therapy was a viable form of remediation for stuttering.

Participants also reported that PWS should try to control their often negative emotional

responses toward their stuttering. Such advice generally consisted of remaining calm, e.g.,

“relax” and not becoming frustrated. These suggestions may indicate that PWS tend to be

perceived as frustrated, excited, or anxious about their stuttering because these characteristics are

perceived by listeners during conversations with PWS. Other participants indicated that PWS

should have patience and be understanding toward their listeners, many of whom will have

difficulty comprehending the message of the person who stutters and will ask him or her to

repeat this message frequently. Fewer participants reported that it is the responsibility of PWS

and their listeners to be patient with each other and ensure that the interaction is a smooth one.

Similarly, a small number of participants indicated that it is not the responsibility of the person

who stutters to help the listener, rather it is the reverse. These participants felt that listeners

should be more patient with PWS.

Other suggestions by participants indicated that PWS should be advocates for themselves

and educate others about stuttering. A commonly suggested form of advocacy, acknowledging or

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disclosing that one stutters, was perceived as being helpful to listeners because they would then

be better equipped emotionally to interact with that person who stutters. Some participants

reported that PWS should use humor, be themselves, or not stop talking just because they stutter.

Participants also reported that it is helpful for PWS to willingly discuss their stuttering with

listeners, to educate listeners as to the causes of stuttering, and to provide listeners with

suggestions regarding how the individual who stutters would like to be treated.

Finally, participants’ responses did not differ in terms of gender or level of familiarity

with PWS. These findings suggest that the participants as a whole were likely to believe that

individuals who stutter can provide the most help to fluent listeners by working to reduce or

eliminate their stuttering or controlling such negative emotions as frustration and anxiety. Fewer

participants indicated that PWS can help listeners by employing advocacy behaviors such as

educating others about stuttering.

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Table 14


Theme

Gender

Familiarity

M

SD

N

Communication Strategies Male None 0.33 0.52 6


Well 1.31 1.11 13

Very Well 1.21 0.58 14

Total 1.15 0.97 48



Well 0.95 0.90 22

Very Well 0.84 0.90 19

Total 0.88 0.95 97

Ratio Communication Strategies Male None 0.17 0.26 6


Well 0.61 0.45 13

Very Well 0.51 0.39 14

Total 0.53 0.43 48



Well 0.46 0.42 22

Very Well 0.50 0.53 19

Total 0.43 0.44 97

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Theme

Gender

Familiarity

M

SD

N

Advocacy Male None 0.67 0.82 6


Well 0.38 0.65 13

Very Well 0.50 1.61 14

Total 0.48 1.07 48



Well 0.27 0.55 22

Very Well 0.58 0.90 19

Total 0.45 0.76 97

Ratio Advocacy Male None

0.42 0.49 6 Not Very Well

0.18 0.36 15 Well

0.21 0.38 13 Very Well

0.13 0.32 14 Total

0.20 0.37 48 Female None

0.21 0.37 30 Not Very Well

0.29 0.42 26 Well

0.14 0.28 22 Very Well

0.31 0.45 19 Total

0.24 0.38 97

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Theme

Gender

Familiarity

M

SD

N

Emotional Control Male None 0.17 0.41 6


Well 0.23 0.44 13

Very Well 0.57 0.65 14

Total 0.35 0.56 48



Well 0.55 1.01 22

Very Well 0.53 0.90 19

Total 0.51 0.86 97

Ratio Emotional Control Male None 0.08 0.20 6


Well 0.06 0.12 13

Very Well 0.26 0.36 14

Total 0.14 0.25 48



Well 0.21 0.34 22

Very Well 0.18 0.30 19

Total 0.20 0.33 97

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Theme

Gender

Familiarity

M

SD

N

Uncertainty/Nothing Male None 0.33 0.52 6


Well 0.00 0.00 13

Very Well 0.14 0.36 14

Total 0.13 0.39 48



Well 0.27 0.55 22

Very Well 0.05 0.23 19

Total 0.19 0.44 97

Ratio Uncertainty/Nothing Male None 0.08 0.20 6


Well 0.00 0.00 13

Very Well 0.06 0.15 14

Total 0.05 0.18 48



Well 0.19 0.37 22

Very Well 0.09 0.39 19

Total 0.12 0.31 97

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Theme

Gender

Familiarity

M

SD

N

Listener Responsibility Male None 0.17 0.41 6


Well 0.23 0.60 13

Very Well 0.14 0.36 14

Total 0.13 0.39 48



Well 0.00 0.00 22

Very Well 0.26 0.56 19

Total 0.14 0.43 97

Ratio Listener Responsibility Male None 0.08 0.20 6


Well 0.12 0.30 13

Very Well 0.05 0.12 14

Total 0.06 0.18 48



Well 0.00 0.00 22

Very Well 0.09 0.18 19

Total 0.06 0.17 97

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Table 14 (continued) Theme

Gender

Familiarity

M

SD

N



Well 2.15 1.07 13

Very Well 2.57 1.83 14

Total 2.23 1.29 48



Well 2.05 0.90 22

Very Well 2.21 1.13 19

Total 2.15 0.97 97

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Survey Question 7: What do you think causes stuttering?

Participants were asked to provide the cause(s) of stuttering for several reasons. First, this

question has been virtually ignored in the literature. Ham (1990) briefly touched on this topic

when he asked participants to describe stuttering as part of a larger study, but his purpose in

doing so was not to gain information about people’s knowledge of the causes of stuttering.

Second, and perhaps most importantly, it was deemed necessary to explore how participants’

beliefs about the causes of stuttering might relate to their attitudes toward PWS in general.


Qualitative. Participants’ responses generated six themes about the cause of stuttering.

These themes included organic causes, (e.g., physiological causes, neurological causes, disease

processes), genetic causes, psychological or emotional causes, developmental or environmental

causes, miscellaneous causes/statements, and statements in which participants indicated that they

were uncertain as to the cause of stuttering.

Quantitative. All of the 150 participants responded to the question for a total of 251

statements about the causes of stuttering (M = 1.67, SD = .92). Fifty-eight participants (38.7%)

provided multiple statements that represented more than one theme. Organic causes of stuttering

accounted for 41.4% of participants’ statements (n = 104, M = .69, SD = .69). Psychological or

emotional causes accounted for 24.3% of statements (n = 61, M = .21, SD = .44), whereas 12.4%

of statements related to genetic causes of stuttering (n = 31, M = .41, SD = .61). Developmental

or environmental causes of stuttering accounted for 10.8% of participants’ responses (n = 27, M

= .18, SD = .42). Miscellaneous statements accounted for 11.9% of statements (n = 30, M = .20,

SD = .46). Finally, 20.3% of statements indicated that participants were unsure about the cause

of stuttering (n = 51, M = .34, SD = .48).

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Qualitative Results

The most strongly represented theme (41.4%) was that stuttering was organic in nature.

These types of statements ranged from relatively unsophisticated answers such as “something in

the brain” or “a neurological problem,” to more complex answers. For example, one participant

wrote that, “Maybe [stuttering is caused because] something in the brain didn’t develop all the

way or the brain has trouble sending a message to the muscles used for speaking.” Another

participant gave a similar answer: “I honestly have no clue, but I am guessing it has to do with

the sending and receiving of codes from the brain. I could be very wrong.” This participant’s

obvious uncertainty about the cause of stuttering was also reflected in other participants’

statements. In addition to beliefs that stuttering is neurological in nature, other types of

miscellaneous yet organic causes of stuttering were provided. Participants indicated that

stuttering is related to hearing, so that stuttering “has something to do with your hearing and how

you do or don’t hear yourself;” breathing patterns, problems with the “voice box,” and

abnormalities with the speech musculature were also suggested as causes of stuttering. The

effects of drug use on the body, disease processes, and physical trauma were also mentioned by

participants. These responses suggest that these participants believe that stuttering is, at least in

part, caused by neurological, physiological or neurophysiological differences. It may be

supposed that people who feel that stuttering has an entirely physiological basis will be less

likely to blame PWS for their stuttering and will report more positive attitudes toward them.

The second most reported belief about the cause of stuttering (24.3%) was that it is due to

psychological or emotional factors. Nervousness, anxiety, and strong emotions all seemed to

feature prominently in the responses of participants who indicated that stuttering had a

psychological basis. For example, one participant simply wrote that stuttering was caused by,

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“just nervousness, I guess.” Other participants indicated that stuttering was caused by nerves,

anxiety disorders, or low self-esteem. These types of responses and others like it suggest that for

some participants, stuttering appears to be directly related to or occur simply because of the

emotional state of individuals who stutter. It would, therefore, seem to indicate that PWS are

perceived as chronically nervous, so that this characteristic is a part of their basic temperament,

or that every time people stutter they do so because they are nervous. One participant reported

that stuttering appears to be the result of “manifested social stress”:

“I believe stuttering is possibly a nervous reaction to a social situation. Similar to the

comic version of a guy being unable to speak to a girl he finds attractive. The more

nervous they get the more they stutter, so I believe people who stutter may be under the

same type of manifested social stress.”

Thus, according to this and other participants’ beliefs, PWS are perceived as being pressured and

stressed as they speak to others, and so stuttering is a tangible manifestation of this nervousness

and discomfort.

In addition to stuttering being caused solely by psychological issues and emotions such as

nervousness and anxiety, 10 participants indicated that stuttering could be caused by both

psychological/emotional and organic causes. For example, one participant reported: “I’m not at

all educated in the disability, so I’m guessing stuttering is caused by a blocked pathway in the

brain. I have heard that if the person has been through a traumatic event, that could also trigger

stuttering.” Similarly, another participant stated that, “Sometimes it might be a psychological

problem where they are nervous or insecure of themselves. Other times it might be a physical

problem where the brain has trouble sending messages to speak the right way.” These types of

either/or statements appear to indicate that these participants believe that stuttering can have

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more than one cause. Other participants suggested that stuttering was already present in

individuals because of some organic cause, but that it could be exacerbated due to nervousness or

anxiety. For example:

“I think it’s a problem with something in the brain that cannot be helped, but I think the

problem is exacerbated when the person gets nervous as he or she is stuttering. Therefore,

stuttering (and worrying about it) causes more stuttering.”

Similarly, another participant reported:

“I’m guessing [stuttering is caused by] some sort of problem with the brain not firing

correctly so that a person’s motor and verbal skills aren’t on cue with each other.

Stressors can probably increase this misfiring to make it worse.”

Thus, participants appeared to have an appreciation for the complex interaction of biology and

psychology that can cause or exacerbate stuttering. These types of statements are consistent with

recent multi-factorial theories about the causes of stuttering that have been proposed in the

stuttering literature (e.g., Smith & Kelly, 1997).

In addition to physiological and psychological/emotional causes of stuttering, 12.4% of

participants’ statements indicated that they believed stuttering to be genetic. Most of these types

of statements were simple one-word answers, such as “genetics.” Other types of responses that

were coded as genetic included such answers as “a genetic mutation,” “inherited,” or “present

from birth.” Participants who indicated genetic or inherited causes of stuttering were typically

straightforward in their answers; however, there was still a degree of uncertainty attached to

some participants’ responses. For example, “It could be passed from one generation to another. I

really am not sure but I know that it is not that person’s fault that they stutter.” Similarly, “I

don’t know for sure, but I assume it is tied to genetics.” One participant wrote, “Some sort of

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birth defect?!” These types of responses suggest that participants are as unsure about whether

stuttering is genetic as they are about other types stuttering etiologies.

Stuttering as a developmental disorder that is learned or the result of environmental

factors, particularly in childhood, was also suggested as a cause of stuttering (n = 27, 10.7%).

These environmental factors seemed to suggest that caregivers’ actions can lead to stuttering in

children. For example, one participant wrote that stuttering results “from children being abused

at an early age of their childhood and when children are tickled at their feet a lot at the ages of

one and three.” “Baby talk from parents,” was suggested as a potential cause of stuttering, as was

“a lack of support or interest from parents (and other rearing parties).” Sometimes these opinions

seem to stem from the media:

“I read an article a few weeks ago that stated a link had been discovered that would

damage or diminish self-confidence—such as overcritical parents or teachers in early

childhood—and the development of stuttering problems later in life. I think this study

may be on the right track.”

Thus, it would appear that older theories about stuttering that in part reflect Johnson’s (1942)

diagnosogenic theory are still being perpetuated in the media despite more widely accepted

theories about how stuttering develops in childhood (e.g., Starkweather, Gottwald, & Halfond,

1990).

Other environmental factors included children who were exposed to adults, especially

parents, who stutter, as they were learning to speak. Thus, stuttering was perceived as both an

environmental and learned behavior. For example, one participant wrote that stuttering occurs

“when a child is taught to talk and their parent stutters, [and] they pick up the trait too.”

Participants recognized that stuttering is largely developmental, in that it occurs as children are

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developing expressive language skills. One participant stated: “I’m not really sure [what causes

stuttering]. At some point when a person learns to speak, maybe they have trouble saying words

but can never quite properly develop saying them.” Similarly, another participant wrote, “I think

people develop stuttering from not being able to speak properly. Stuttering, I believe, is a speech

impediment that people develop when they are young.” These types of statements indicate that

some participants believe stuttering to be the result of improperly learned speaking skills rather

than being caused by organic, genetic, or psychological causes. Why one should fail to learn to

speak properly was vaguely defined by these participants, and again seems to indicate

uncertainty about participants’ perceptions of the causes of stuttering.

Participants gave general or miscellaneous comments about the causes of stuttering

which did not fit into any of the established themes (n = 30, 12%). Some responses indicated that

PWS do not have clear thoughts, lack of verbal communication skills, or speak too quickly.

Others stated that PWS did so because they were interrupted, did not know the answer to a

question, or were trying to get someone’s attention but were ignored. One person stated that

stuttering is “just a disability” that does not have a cause; other participants also indicated that

stuttering is a general speaking impairment and did not suggest a cause. Likewise, one

participant indicated that stuttering was caused by God, so that it was just one of the many

variations that people can have. That so few people offered miscellaneous causes of stuttering

while the rest of the responses fell into one or more of the established themes indicates that there

is consistency among the participants’ perceptions regarding the causes of stuttering, even if

people are not entirely sure about the accuracy of their beliefs.

The final theme consisted of responses in which participants indicated that they were

unsure about the cause of stuttering (n = 51, 20.3%). These statements indicated that participants

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had “no idea” or “no clue” about what causes stuttering. Participants were also likely to stipulate

that they did not know what causes stuttering even if they provided their “best guess.” These

types of statements confirm that the participants in this study were unsure about the cause of

stuttering, and that those participants who did provide a cause were hesitant about the accuracy

of their answers.




familiarity for participants’ statements about the causes of stuttering and the total number of

statements provided by participants. There was no significant difference for any of the themes

according to gender (F[7, 136] = 1.71, p = .11, 2η = .08, observed power = .68), level of

familiarity (F[21, 391] = 1.07, p = .38, 2η = .05, observed power = .78), or gender/familiarity

interaction (F[21, 391] = 1.12, p = .32, 2η = .05, observed power = .81). Table 15 provides

means and standard deviations for this analysis. These findings suggest that men and women did

not vary in terms of the responses they provided to the survey question; nor did responses differ

on the basis of how well participants knew PWS.

Summary of Qualitative and Quantitative Results

These findings indicate that the participants in this study, as a group, were able to

describe many of the causes of stuttering that have been theorized in the stuttering literature over

the past several decades (e.g., Bloodstein & Bernstein Ratner, 2008). Accordingly, the majority

of participants believed that stuttering has at its core a physical or organic cause and is typically

neurological in nature. In addition, psychosocial or temperamental issues were the second-most

reported cause of stuttering, and seemed to indicate that participants believed that people stutter

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because they are nervous or anxious, or that stuttering is exacerbated by such emotions, even if

an organic cause is at its root. Fewer participants tended to believe that stuttering is a result of

the actions or behaviors of caregivers or parents; however, these environmental factors often

indicated that parents and caregivers are essentially to blame for the development of stuttering

(e.g., parents are not supportive or attentive). Regardless of which types of etiologies were

identified, it is clear that many participants had only a vague sense of what causes stuttering. The

limited sample size prohibits generalization of these results to the larger population; however, it

may be possible that many people in the general public are equally uncertain as to the cause of

stuttering. If this is the case, then perhaps public service announcements or other attempts to

educate the public would be beneficial, particularly because participants in the present study

indicated curiosity toward the causes of stuttering and requested more information on the topic.

The purpose of asking participants for their opinions on what causes stuttering was also

to gain some perspective on how the perceived causes of stuttering might impact participants’

attitudes toward PWS. The disabilities literature would suggest that people who have mental

disabilities are perceived more negatively by society than those who have only physical

disabilities (Smart, 2001). Thus, it may be plausible that participants who indicated that

stuttering is the result of organic causes, including genetics, may be less likely to hold negative

attitudes toward PWS. Conversely, participants who felt that stuttering was caused because of

psychological issues or factors in childhood that could cause psychological maladjustment (e.g.,

being ignored by parents or caregivers) could hold more negative attitudes toward PWS.

Participants’ answers in the present study make this type of analysis difficult because over one-

third of participants provided multiple statements that fell into more than one category, e.g., both

organic and psychological causes of stuttering. Many participants reported that they were also

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uncertain about the cause of stuttering but “guessed” anyway. Given these issues, it seems that

completing a statistical analysis in which participants’ attitudes toward PWS are correlated with

their perceptions about the causes of stuttering would have dubious validity at best. Future lines

of research may wish to further explore this topic, as it remains unclear at this time whether

people’s perceptions of the causes of stuttering influence their attitudes toward PWS.

211

Table 15


Themes/Types of Statements Gender Familiarity Level M SD N

Total # Statements Male None 1.17 0.41 6


Well 1.69 0.95 13

Very Well 1.21 0.43 14

Total 1.50 0.83 48



Well 1.64 0.70 25

Very Well 2.05 1.00 20

Total 1.75 0.96 102

Organic Causes Male None 0.67 0.82 6


Well 0.38 0.51 13

Very Well 0.50 0.52 14

Total 0.60 0.64 48



Well 0.68 0.69 25

Very Well 1.00 0.86 20

Total 0.74 0.72 102

212

Table 15 (continued) Themes/Types of Statements Gender Familiarity Level M SD N

Psychosocial/Temperament Causes Male None 0.00 0.00 6


Well 0.38 0.65 13

Very Well 0.14 0.36 14

Total 0.21 0.46 48



Well 0.12 0.33 25

Very Well 0.15 0.37 20

Total 0.21 0.43 102

Genetic Causes Male None 0.33 0.52 6


Well 0.38 0.51 13

Very Well 0.21 0.43 14

Total 0.35 0.53 48



Well 0.52 0.71 25

Very Well 0.40 0.50 20

Total 0.43 0.65 102

213


Developmental/Environmental Causes Male None 0.17 0.41 6


Well 0.31 0.63 13

Very Well 0.21 0.58 14

Total 0.23 0.52 48



Well 0.12 0.33 25

Very Well 0.10 0.31 20

Total 0.18 0.42 150

Miscellaneous Male None 0.00 0.00 6


Well 0.23 0.60 13

Very Well 0.14 0.36 14

Total 0.10 0.37 48



Well 0.20 0.41 25

Very Well 0.40 0.68 20

Total 0.25 0.50 102

214


Uncertain about Cause Male None 0.00 0.00 6


Well 0.31 0.48 13

Very Well 0.29 0.47 14

Total 0.25 0.44 48



Well 0.44 0.51 25

Very Well 0.10 0.31 20

Total 0.38 0.49 102

215

Survey Question 8: What kinds of experiences have you had with people who stutter? Please be

as specific as possible.

The eighth survey question asked participants to elaborate on their relationships with

PWS and to describe the contexts in which these relationships occurred. The purpose of this

question was to gain insight into the types of relationships that participants had with PWS and to

compliment the quantitative information gathered from the demographic portion of the survey in

which participants indicated the number of people they knew who stutter and how well they

know these people.


Qualitative. Two major themes, both with sub-themes, emerged from participants’

responses to the survey question. For the first theme, participants discussed their relationships

with PWS. Seven sub-themes resulted from these statements: (1) participants who had never or

only rarely interacted with someone who stutters, coded as “No interaction;” (2) participants who

had interacted with PWS in an academic setting, coded as “School;” (3) participants who had one

or more family members who stutter, coded as “Family;” (4) participants who had a professional

or working relationship with PWS, coded as “Professional;” (5) participants who had engaged

socially with PWS at church, on sports teams, or while enjoying the same hobby, coded as

“Social acquaintance;” (6) participants who indicated that they had friends who stuttered or were

romantically involved with a person who stutters, coded as “Friend;” and (7) participants who

had seen stuttering depicted on television or in the movies, coded as “Media.”

The second theme consisted of statements in which participants described their

experiences as a result of their relationships with PWS. Four sub-themes emerged from these

responses and included: (1) participants’ generic descriptions of their interactions with PWS,

216

coded as “Generic descriptions;” (2) participants descriptions of their own thoughts, emotions,

and behaviors, coded as “Participants’ attitudes;” (3) participants’ perceptions regarding the

thoughts, emotions, and behaviors of the person who stutters with whom they were familiar,

coded as “Attitudes of PWS;” and (4) participants’ perceptions regarding the reactions of other

people to the person who stutters with whom they were familiar, coded as “Societal reactions.”


of 330 statements (M = 2.26; SD = 1.64). Statements related to the relationships of participants

to PWS accounted for 45.5% of the total number of statements (n = 150, M = 1.03, SD = .66).

“No interaction” statements accounted for 30% of these statements (n = 45, M = .31, SD = .46),

“School” relationships for 22.7% (n = 34, M = .23, SD = .46), “Family” relationships for 14% (n

= 21, M = .14, SD = .35), “Professional” relationships for 12% (n = 18, M = .12, SD = .37),

“Social acquaintances” for 9.3% (n = 14, M = .10, SD = .32), and “Friend” relationships for

8.7% (n = 13, M = .09, SD = .29). Additionally, 3.3% of statements (n = 5, M = .03, SD = .18)

indicated that participants were familiar with PWS based on depictions of stuttering in the

popular media.

Statements that described the interactions of participants based on their relationships with

individuals who stutter accounted for 54.5% (n = 180, M = 1.23, SD = .66) of the total number of

responses. The ratios of each type of statement to the total number of statements were also

calculated to account for variations in the number of responses made by participants, which

ranged from one to 10 statements. Statements coded as “Generic descriptions” of the interactions

of participants with individuals who stutter accounted for 18.9% of participants’ descriptive

statements (n = 34, M = .23, SD = .48), with a ratio of 19.8 (M =.14, SD = .31). “Participants’

attitudes” statements accounted for 43.3% of the total statements (n = 78, M = .53, SD = .79),

217

with a ratio of 24.7 (M = .27, SD = .39). “PWS’ attitudes” statements accounted for 32.8% of the

total statements (n = 59, M = .40, SD = .87), with a ratio of 39 (M = .17, SD = .32). “Societal

reactions” statements accounted for 5% of the total statements (n = 9, M = .06, SD = .24), with a

ratio of 5.5 (M = .04, SD = .17).

The descriptions of participants’ experiences with PWS were also coded as positive,

neutral, and negative. The results of this analysis indicated that of the 180 statements related to

these descriptive statements, 41.7% (n = 75, M = .51, SD = .86) were positive with a ratio of

35.2 (M = .24, SD = .39). Neutral statements accounted for 29.4% of statements (n = 53, M =

.36, SD =.80) with a ratio of 28.3 (M = .19, SD = .36). Negative statements accounted for 28.9%

of statements (n = 52, M = .36, SD = .71) with a ratio of 24.8 (M = .17, SD = .31).

Qualitative Results

Relationships with PWS. Approximately 45% of the responses indicated the types of

relationships that the participants had with PWS. In some cases (30%), participants had never

interacted with someone who stutters, or had very vague memories of doing so only once or

twice. Other participants (22.7%) recalled interacting with or observing PWS during elementary

school, high school, or college. Some participants (14%) reported that they had family members

who stutter, particularly younger siblings, whereas other participants indicated that they had

working or professional relationships with PWS (12%). Friendships with PWS were also

mentioned and included dating relationships (8.7%). A small number of statements (3.3%)

indicated that depictions of stuttering in the popular media were responsible for participants’

perceptions of PWS. Participants’ statements regarding their relationships with PWS are

discussed in greater detail below in order to provide contextualized examples of how these

218

relationships with individuals who stutter are related to participants’ descriptions of their

experiences with PWS.

Generic descriptions of experiences with PWS. About 19% (n = 34) of the total number

of descriptive statements included fairly simple or vague examples of participants’ interactions

with PWS. Approximately 32.4% (n = 11) of these generic responses were positive, e.g., “I have

had normal conversations with people who stutter. I play on basketball teams with people who

stuttered, and everything was normal.” Other statements (50%, n = 17) were neutral, e.g., “Just

listening to them talk.” Some of these types of statements were negative (17.6%, n = 6), e.g.,

“My freshman year I had asked a boy directions, but he refused to answer me, so his friend did

instead.” Thus, it would appear that participants who provided these types of generic descriptions

about their experiences with an individual who stutters were more likely to give positive or

neutral descriptions rather than negative ones.

Participants’ attitudes. Approximately 43% (n = 78) of the descriptive statements

indicated that the participants experienced positive, neutral, or negative emotions, thoughts, or

beliefs (attitudes) about the individual who stutters with whom they were familiar. Participants’

positive attitudes accounted for 56.4% (n = 44) of these statements. For example, one participant

wrote:

“I have had only limited experience with people who stutter, all of which was during my

time in grade, middle, and high school. In each case, I tried to give the person respect and

have patience. I also made sure they had their chance to speak in whatever conversations

of which they were a part.”

Another participant, who wrote that she was familiar with PWS due to interactions with

classmates, a friend’s child, and customers at her retail job who stutter, indicated that “all

219

experiences were positive. The more experience I have with people who stutter the more I

understand about it and it gets easier to communicate.” Similarly, a participant who grew up with

a cousin who stuttered reported that “I was so accustomed to [the stuttering that] it didn't impact

me one way or another as I grew up and was exposed to others [who stutter].” Thus, for some

participants, increased exposure to PWS may result in more positive attitudes.

In other cases, it seemed more difficult for participants to readily adjust to the stuttering

of the individuals with whom they came into contact. Neutral statements to this effect were

reported by participants (19.2%, n =15). For example, one participant wrote, “I worked with a

chemical engineer who had a stutter. I was the manager of a pool and he was on the board. It was

very difficult to grow accustomed to him taking much longer than everyone else to get his point

across, but I eventually did.” Another participant reported, “My brother’s friend stutters a lot.

Usually [during] the conversations we have he does. It is difficult but I have become more

understanding with it and it doesn’t bother me too much anymore.” Similarly, other participants

reported that stuttering is not “too bad” or “too annoying” if one has patience, e.g., “I had a

casual talk with someone who stutters, just meeting them for the first time. People who stutter act

and even say the same things others would, it just took him a while to put it out there which was

not too bad, [you] just have to be patient.” Thus, some participants seemed to experience

difficulty when speaking with someone who stutters but have come to tolerate this difficulty after

increased exposure to PWS. These neutral statements also appear to indicate that some

participants hold ambiguous attitudes toward PWS, so that generally positive descriptions of

PWS are qualified or tempered by participants’ beliefs that one has to be patient or otherwise

exhibit effort in order to maintain positive interactions with PWS.

220

Participants also reported negative attitudes as a result of their experiences with

individuals who stutter (24.4%, n = 19). As with the analysis for survey question one, in which

participants described what it was like to have a conversation with PWS, negative statements

were judged as emotions, thoughts, or behaviors that were perceived to be unpleasant for the

participant. For example, one participant wrote, “I have not had too many experiences [with

PWS]. But sometimes I felt that maybe I was making the other person nervous/anxious so I felt

self-conscious…. [I become] frustrated when I don’t have time to try and understand what they

are saying.” Similarly, a participant who worked at a restaurant stated, [The customer] stumbled

over words and it seemed like he almost stopped breathing when he could not get the words out.

It was kind of scary.” Likewise, “I have only been around a few people [who stutter] and it was

very short and uncomfortable.” Feeling bad for PWS was also reported:

“This one time, my boyfriend forewarned me that his friend had a stuttering problem

before I met him, and when I finally met him, I noticed it right off the bat. The first words

out of his mouth were all stuttered and crackled. I felt bad for him because he couldn’t

help it but I did not make him feel uneasy.”

Feeling bad or sorry for PWS was consistently reported in the first survey question and appears

to be a sentiment which can make interacting with PWS unpleasant or uncomfortable for some

participants. In general, the negative attitudes reported by participants seem to be based not on

overt reactions to the individual who stutters, as might be identified by teasing, laughing, or

mocking, but by more internalized feelings of discomfort.

Attitudes of PWS. In addition to describing their own attitudes, participants also wrote

about their perceptions of PWS during interactions with fluent speakers. These statements

accounted for 32.8% of the total number of descriptive comments (n = 59). Positive statements

221

(n = 17) accounted for 28.8% of these descriptions. For example, one participant reported that

“An individual came into one of my classes at the university and provided our class with

information from a professor. It was very reassuring that he seemed positive with himself, and

confident.” Other participants provided similar responses, such as, “On the first floor in my

dorm, I know a girl who stutters and we have similar hobbies. During our floor meeting she was

very outspoken about things to help with the floor and didn’t let the stutter get in the way,” and

“The student talked a lot and always participated in class, so obviously his stutter didn’t shy him

away from people. Because of his confidence with talking in front of everyone, I didn’t even

think about the stutter, [only] that he was such a good communicator.” Thus, these statements

indicate that when PWS are viewed as being confident in their own abilities, listeners’ reactions

seem to become more positive.

Twenty statements (33.9%) were judged to be neutral. These statements generally

indicated that participants believed that stuttering is variable and its effects depend on the

emotional state of the person who stutters. For example, a participant wrote:

“He stuttered more when he got in trouble or was trying to explain something. If he felt

comfortable around people would stutter less than if he was around a new group of

people. He also stuttered less when he was in control of the conversation (when he asked

all the questions or answered at his free will), but when someone else asked the questions

or made him answer questions he would stutter more.”

Another participant believed that her classmate “stuttered, but not a lot, only when he wanted to

be funny (he was a class clown) and intimidated. I now see him sometimes but he is not always

stuttering.” Similarly, “To me it's just part of their personalities, as it almost always appears that

they are very excited about whenever they are trying to say.” These statements, while not overtly

222

positive or negative, indicate that participants believe that stuttering is a behavior that is

worsened or alleviated by the emotional contexts in which PWS communicate. Thus, it is

possible that some participants may be more likely to believe that individuals who stutter

severely experience more negative attitudes toward their stuttering and themselves versus people

who stutter covertly or mildly.

Participants also indicated that some PWS experience negative behaviors, thoughts, and

emotions when conversing. The negative attitudes of PWS accounted for 37.3% of statements

(n = 22). One participant whose boss stutters stated, “He is a powerful man, and I think it bothers

him that he stutters, making him appear less powerful.” Another participant who reported having

friends and family members who stutter wrote, “Some of them get very frustrated when they

can't quite convey what they are trying to say.” Other manifestations of frustration by PWS over

their stuttering were expressed: “It was really just like working with anybody else personality-

wise, though he would sometimes sigh or roll his eyes at his own stuttering.” People who stutter

were also reported as being quiet, self-conscious, and anxious. In general participants’

perceptions regarding the negative attitudes of PWS toward their stuttering corresponded with

responses to the third survey question, in which participants indicated that stuttering can affect

the lives of PWS because it results in negative emotions.

Societal Reactions. A smaller percentage of participants (5%, n = 9) reported that they

had witnessed societal reactions to PWS. Some of these statements were positive (33.3%, n = 3),

such as, “I was in a discussion-based class [with someone who stuttered]. Everyone acted a

though she didn’t have anything wrong with her which I think was best.” Similarly, “I have had

classes in which one of my fellow classmates stuttered. Whenever the person would want to

answer or asked questions the professor and class would just remain patient.” Only one statement

223

(11.1%) was neutral, e.g., “I have not had any experiences with someone who stutters. I have

only seen movies and the audience either laughs at it or thinks it’s cute depending on the age of

the stuttering person.”

Negative societal reactions were also reported, (55.6%, n = 5), and took place in a variety

of contexts. For example, one participant worked at a restaurant and reported that his co-worker

who stutters was always “stuck in the back.” Another participant stated that on the day a fellow

student who stutters was scheduled to give an in-class presentation, “half the class didn’t show

up because they were embarrassed for him.” Childhood experiences with PWS were also

reported, e.g., “I had a classmate in sixth grade who stuttered. He also wore very thick glasses

that made his eyes look very small, and children frequently made fun of him. I was very patient

with him and kind.” Similarly, “I had a very distant cousin (whom I only met once) who

stuttered and I remember him getting teased by some older kids who I yelled at.” As with

responses to the third survey question, in which participants indicated how stuttering would

affect the lives of PWS, these statements suggest that some participants believe that others in

society are cruel to PWS. In addition, few, if any, of the participants’ responses throughout the

survey reported that participants themselves had ever demonstrated such negative behavior

toward PWS. Thus, it may be that participants who chose to take the survey were more likely to

report positive attitudes toward PWS, (or at least more socially desirable ones), or that students

declined to be recruited for the study if they held negative attitudes toward PWS.




familiarity for participants’ descriptions of their interactions with individuals who stutter. The

224

means and standard deviations for this analysis are presented in Table 16. There was no

significant difference for any of the themes according to gender (F[13, 126] = 1.63, p = .08, 2η =

.14, observed power = .84), level of familiarity (F[39, 374] = .1.42, p = .053, 2η = .13, observed

power = .99), or gender/familiarity interaction (F[39, 374] = .80, p = .87, 2η = .07, observed

power = .77). These findings suggest that men and women did not vary in terms of the responses

they provided to the survey question; nor did responses differ on the basis of how well

participants knew PWS. It is interesting to note, however, that the familiarity variable was

approaching significance at p = .053.

A t-test was conducted to determine if the total number of positive, neutral, and negative

descriptive statements provided by participants differed significantly. The results of this analysis

indicated that there were significant differences at p < .001 for both the total number of positive,

neutral, and negative statements, and the ratios for each of these types of statements. Thus,

participants were more likely to report positive descriptions of their interactions with PWS (t =

7.24, p < .001, M = .51, SD = .86) than neutral descriptions (t = 5.51, p < .001, M = .36, SD =

.80) and negative descriptions (t = 6.05, p < .001, M = .36, SD = .71). Analysis of the ratios of

each type of statement to the total number of descriptive statements also indicated more positive

descriptions (t = 7.45, p < .001, M = .24, SD = .39) than neutral descriptions (t = 6.53, p < .001,

M = .19, SD = .36) and negative descriptions (t = 6.172, p < .001, M = .17, SD = .33). These

results indicate that, as a group, participants tended to provide more positive descriptions of their

interactions with specific individuals who stutter.

In addition, a Pearson Product Moment Correlation was conducted for participants’

relationships with individuals who stutter, (e.g., family members, friends, social acquaintances,

etc.), and positive, neutral, and negative descriptions of participants’ interactions with these

225

individuals. The complete results of this analysis are provided in Table 17. The results indicate a

weak, positive correlation between positive statements and the statements of participants who

knew PWS through school experiences (r = .17[146], p = .04) and through friendships (r =

.26[146], p < .001). The ratio of positive statements to the total number of descriptive statements

were correlated for school relationships (r = .17[146], p = .04) but not for friendships (r =

.15(146), p = .07). These results may indicate that participants provided more positive

descriptions of interactions with classmates or friends who stutter across the four descriptive

themes (e.g., generic descriptions of the interaction, participants’ attitudes, PWS’ attitudes, and

societal reactions). Somewhat surprisingly, the statements of participants with family members

who stutter had a weak, positive correlation with negative descriptions (r = .18[146], p = .03)

and also the ratio of negative descriptions to the total number of descriptive statements (r =

.19[146], p = .02). These results may indicate that participants tended to report more negative

descriptions of their interactions with family members who stutter across the four descriptive

themes.

The statements of participants who had other types of relationships with PWS, including

social acquaintances and co-workers, were not correlated with positive, neutral, or negative

descriptions of individuals who stutter at p < .05. These results indicate that school relationships,

friendships, and familial relationships may have had a greater impact on participants’

descriptions of their interactions with PWS than other types of relationships.


The majority of participants knew at least one individual who stutters and reported

diverse types of relationships with PWS, including school acquaintances, family members,

friends, co-workers, and social acquaintances. A small number of participants reported that they

226

were only familiar with PWS from seeing stuttering depicted in the popular media; however,

only one participant elaborated on the effects of stuttering in the media. Those participants who

knew one or more PWS also provided descriptions of their interactions with these individuals.

These interactions were described in general terms or on the basis of the emotions, thoughts, and

behaviors of the participant, the person who stutters, or society in general. Participants reported

positive, neutral, and negative descriptions of their interactions with PWS. Significantly more

positive descriptions were reported than neutral or negative descriptions; however when level of

familiarity and gender were considered, there were no significant differences among participants’

responses.

An examination of participants’ relationships with PWS and the positive, neutral, and

negative statements provided by participants indicated that in some cases, the type of relationship

that participants had with the individual who stutters was correlated with either positive or

negative responses. For example, participants who had a classmate who stutters or were friends

with someone who stutters made statements that were correlated with positive descriptions of

their interactions with that individual. Conversely, participants who had a family member who

stutters tended to provide statements that were correlated with negative descriptions of their

interactions with that family member. In general, these findings only partially support Klassen’s

(2001) work, in which friends, family members, and colleagues reported less stereotypical

attitudes toward PWS than the general population. The findings also appear to contradict a later

study in which Klassen (2002) found that family members of PWS were less likely to report

stereotypical attitudes toward PWS than society in general. The present study’s results may

support the findings of Hughes (2007), who reported that PWS wish for better communication

and support from their family members. More research is needed to explore how types of

227

listeners’ relationships with PWS influence attitudes toward individuals who stutter and PWS in

general.

228

Table 16

Means and Standard Deviations for Selected Question 8 Themes by Gender and Familiarity (n = 146)

Theme

Gender

Familiarity

M

SD

N

Descriptions of Interactions with PWS Male None 0.00 0.00 5.00

Not Very Well 0.27 0.59 15.00

Well 0.33 0.49 12.00

Very Well 0.20 0.41 15.00

Total 0.23 0.48 47.00

Female None 0.10 0.31 30.00

Not Very Well 0.22 0.51 27.00

Well 0.25 0.44 24.00

Very Well 0.44 0.70 18.00

Total 0.23 0.49 99.00

Ratio Descriptions of Interactions Male None 0.00 0.00 5.00

Not Very Well 0.17 0.36 15.00

Well 0.22 0.38 12.00

Very Well 0.16 0.35 15.00

Total 0.16 0.34 47.00

Female None 0.06 0.21 30.00

Not Very Well 0.15 0.33 27.00

Well 0.13 0.29 24.00

Very Well 0.19 0.34 18.00

Total 0.12 0.29 99.00

229


Theme

Gender

Familiarity

M

SD

N

Positive Descriptions Male None 0.2 0.45 5.00

Not Very Well 0.6 0.83 15.00

Well 1 1.04 12.00

Very Well 0.53 0.92 15.00

Total 0.64 0.90 47.00

Female None 0.07 0.25 30.00

Not Very Well 0.56 0.85 27.00

Well 0.71 1.08 24.00

Very Well 0.61 0.92 18.00

Total 0.45 0.84 99.00

Ratio Positive Descriptions Male None 0.20 0.45 5.00

Not Very Well 0.36 0.48 15.00

Well 0.41 0.48 12.00

Very Well 0.33 0.49 15.00

Total 0.35 0.47 47.00

Female None 0.05 0.20 30.00

Not Very Well 0.27 0.40 27.00

Well 0.25 0.36 24.00

Very Well 0.24 0.38 18.00

Total 0.19 0.34 99.00

230


Theme

Gender

Familiarity

M

SD

N

Neutral Descriptions Male None 0.00 0.00 5.00

Not Very Well 0.13 0.35 15.00

Well 0.42 0.90 12.00

Very Well 0.20 0.41 15.00

Total 0.21 0.55 47.00

Female None 0.13 0.35 30.00

Not Very Well 0.22 0.51 27.00

Well 0.63 0.88 24.00

Very Well 1.00 1.50 18.00

Total 0.43 0.88 99.00

Ratio Neutral Descriptions Male None 0.00 0.00 5.00

Not Very Well 0.09 0.27 15.00

Well 0.31 0.47 12.00

Very Well 0.20 0.41 15.00

Total 0.17 0.37 47.00

Female None 0.09 0.27 30.00

Not Very Well 0.15 0.33 27.00

Well 0.29 0.36 24.00

Very Well 0.36 0.44 18.00

Total 0.20 0.35 99.00

231


Theme

Gender

Familiarity

M

SD

N

Negative Descriptions Male None 0.20 0.45 5.00

Not Very Well 0.33 0.62 15.00

Well 0.33 0.49 12.00

Very Well 0.13 0.52 15.00

Total 0.26 0.53 47.00

Female None 0.07 0.37 30.00

Not Very Well 0.37 0.69 27.00

Well 0.50 0.72 24.00

Very Well 0.89 1.18 18.00

Total 0.40 0.78 99.00

Ratio Negative Descriptions Male None 0.20 0.45 5.00

Not Very Well 0.22 0.41 15.00

Well 0.19 0.39 12.00

Very Well 0.07 0.26 15.00

Total 0.16 0.36 47.00

Female None 0.02 0.12 30.00

Not Very Well 0.22 0.39 27.00

Well 0.18 0.26 24.00

Very Well 0.35 0.41 18.00

Total 0.17 0.32 99.00

232


Theme

Gender

Familiarity

M

SD

N

Generic Descriptions Male None 0.00 0.00 5.00

Not Very Well 0.27 0.59 15.00

Well 0.33 0.49 12.00

Very Well 0.20 0.41 15.00

Total 0.23 0.48 47.00

Female None 0.10 0.31 30.00

Not Very Well 0.22 0.51 27.00

Well 0.25 0.44 24.00

Very Well 0.44 0.70 18.00

Total 0.23 0.49 99.00

Ratio Generic Descriptions Male None 0.00 0.00 5.00

Not Very Well 0.17 0.36 15.00

Well 0.22 0.38 12.00

Very Well 0.16 0.35 15.00

Total 0.16 0.34 47.00

Female None 0.06 0.21 30.00

Not Very Well 0.15 0.33 27.00

Well 0.13 0.29 24.00

Very Well 0.19 0.34 18.00

Total 0.12 0.29 99.00

233


Theme

Gender

Familiarity

M

SD

N

Participants’ Attitudes Male None 0.20 0.45 5.00

Not Very Well 0.53 0.64 15.00

Well 0.67 0.78 12.00

Very Well 0.47 0.74 15.00

Total 0.51 0.69 47.00

Female None 0.10 0.31 30.00

Not Very Well 0.63 0.93 27.00

Well 0.79 0.93 24.00

Very Well 0.83 0.92 18.00

Total 0.55 0.84 99.00

Ratio Participants’ Attitudes Male None 0.20 0.45 5.00

Not Very Well 0.39 0.47 15.00

Well 0.31 0.39 12.00

Very Well 0.33 0.49 15.00

Total 0.33 0.44 47.00

Female None 0.06 0.21 30.00

Not Very Well 0.30 0.40 27.00

Well 0.28 0.33 24.00

Very Well 0.36 0.42 18.00

Total 0.24 0.35 99.00

234


Theme

Gender

Familiarity

M

SD

N

Attitudes of PWS Male None 0.00 0.00 5.00

Not Very Well 0.20 0.56 15.00

Well 0.58 0.79 12.00

Very Well 0.20 0.56 15.00

Total 0.28 0.62 47.00

Female None 0.03 0.18 30.00

Not Very Well 0.30 0.54 27.00

Well 0.71 0.95 24.00

Very Well 1.11 1.64 18.00

Total 0.46 0.96 99.00

Ratio Attitudes of PWS Male None 0.00 0.00 5.00

Not Very Well 0.09 0.27 15.00

Well 0.22 0.32 12.00

Very Well 0.11 0.30 15.00

Total 0.12 0.28 47.00

Female None 0.01 0.06 30.00

Not Very Well 0.18 0.34 27.00

Well 0.30 0.37 24.00

Very Well 0.37 0.42 18.00

Total 0.19 0.34 99.00

235


Theme

Gender

Familiarity

M

SD

N

Societal Reactions Male None 0.20 0.45 5.00

Not Very Well 0.07 0.26 15.00

Well 0.17 0.39 12.00

Very Well 0.00 0.00 15.00

Total 0.09 0.28 47.00

Female None 0.03 0.18 30.00

Not Very Well 0.00 0.00 27.00

Well 0.08 0.28 24.00

Very Well 0.11 0.32 18.00

Total 0.05 0.22 99.00

Ratio Societal Reactions Male None 0.20 0.45 5.00

Not Very Well 0.02 0.09 15.00

Well 0.17 0.39 12.00

Very Well 0.00 0.00 15.00

Total 0.07 0.25 47.00

Female None 0.03 0.18 30.00

Not Very Well 0.00 0.00 27.00

Well 0.03 0.12 24.00

Very Well 0.02 0.06 18.00

Total 0.02 0.12 99.00

Exploring Attitudes 236

Table 17

Correlations for Types of Relationships with PWS and Descriptions of Participants’ Interactions with PWS (n=146, 330 statements)

Type of Relationship

Positive

Descriptions

Ratio Positive Descriptions

Neutral

Descriptions

Ratio Neutral Descriptions

Negative

Descriptions

Ratio Negative Descriptions

School Acquaintance

Pearson Correlation 0.17 0.17 0.11 -0.05 0.15 0.06

Sig. (2-tailed) 0.04* 0.04* 0.20 0.56 0.08 0.51 Professional Relationship

Pearson Correlation -0.01 -0.04 -0.06 -0.04 -0.04 -0.06

Sig. (2-tailed) 0.95 0.60 0.48 0.60 0.66 0.45

Friendship Pearson Correlation 0.26 0.15 0.10 0.12 0.05 -0.01

Sig. (2-tailed) 0.00* 0.07 0.23 0.15 0.58 0.92

Social Acquaintance Pearson Correlation 0.07 0.14 -0.06 -0.05 0.00 0.00

Sig. (2-tailed) 0.39 0.10 0.50 0.52 1.00 0.97

Family Relationship Pearson Correlation 0.03 0.00 0.13 0.01 0.18 0.19

Sig. (2-tailed) 0.74 0.98 0.11 0.91 0.03* 0.02*

Media Exposure Pearson Correlation -0.11 -0.12 -0.04 0.00 -0.09 -0.10

Sig. (2-tailed) 0.17 0.16 0.64 0.97 0.26 0.25

* Significant at p < .05


Survey Question 9: Please share any comments you have about stuttering or your reactions to

these questions.

For question nine, participants were given a final opportunity to elaborate on their survey

responses or to provide their opinions on topics that were not addressed by specific survey

questions. This question also allowed participants to summarize their thoughts or write about the

survey in general. Many of the comments provided the researcher with a sense of what topics or

concepts were most important to the participants and will help provide modifications to the

survey should it be given again to different populations.


Qualitative. Participants’ responses were divided into six themes: (1) no response; (2)

survey promotes reflection/participant requests more information, coded as

“Reflection/Information;” (3) participant is supportive of PWS, coded as “Supportive;” (4)

participant feels bad for PWS or bad about their attitudes toward PWS, coded as “Negative

feelings,” (5) Message to the researcher or comments on survey questions, coded as

“Message/Comments;” and finally, (6) miscellaneous statements.

Quantitative. A total of 154 statements were made by participants for an average of 1.03

comments per participant (SD = 1.04). A total of 57 participants (38%) did not provide a

response to the question, or indicated that they did not have anything else to add to their

responses to survey questions 1-8. Statements coded as “Reflection/information” accounted for

23.4% of the total statements (n = 36, M = .24, SD = .53). “Supportive” statements accounted for

18.2% of the total statements (n = 28, M = 19, SD = .42). “Negative feelings” statements

accounted for 10.4% of the total statements (n = 16, M = .11, SD = .37). “Message/comments”

statements accounted for 30.5% of the total statements (n = 47, M = .31, SD = .61), and


miscellaneous statements accounted for 17.5% of the total statements (n = 27, M = .18, SD =

.48).

Qualitative Results

Reflection/Information statements. Approximately one quarter of the participants who

provided an answer to the survey question made statements that were coded as

“Reflection/Information.” These types of statements generally indicated that taking the survey

required the participant to reflect upon stuttering in general, or to consider specific aspects of

stuttering. Also included in this theme were responses that indicated that the participant would

like to gain more information about stuttering. Participants who said that the survey caused them

to reflect upon stuttering provided such statements as, “I think these questions really made me

think about people I know who stutter and how I initially reacted to them,” and “The questions

were good and really made me sit back and think about what it would be like to be someone who

had this condition. I can now understand a bit what they are going through.” Another participant

wrote, “This survey actually made me realize that there’s a lot of things I could do better as a

person to help others.”

Four participants wrote that they had never really thought about stuttering until taking the

survey. Other participants indicated that taking the survey caused them to want to know more

about stuttering and PWS. As one participant wrote, “This questionnaire has sparked my

curiosity about what causes stuttering and what you can do to treat it.” In addition to learning

more about the causes and treatments for stuttering, participants also indicated that they wanted

to know more about how to help and interact with PWS, e.g.: “I would be really interested to see

the findings of this research so that I would be in a better position to handle people who stutter

without offending or irritating anyone.” In general these participants wished for more


information about the cause of stuttering and its “cure.” Survey respondents also expressed

interest about reading the results of the study, as well as learning of others’ responses to the

questions, e.g., “I wondered what other people said in response to these questions. I wondered if

anyone thinks badly of people who stutter.”

Supportive statements. Another theme consisted of participants’ supportive statements.

These statements tended to normalize stuttering or view stuttering in a positive light. For

example, “I think [stuttering] isn’t a big deal unless the person who doesn’t understand them

takes it that way,” and “People who stutter, are, for the most part, just like anyone else and

should be treated with the same courtesy as anyone else.” Similarly, participants who expressed

positive statements generally advocated for acceptance of PWS by society, e.g., “Stuttering is

something one can’t change or has to change. We should accept them just like others and not

ridicule them or segregate them,” and “I think people should be aware that people who stutter are

just like anyone else, they just have a speech impediment. It makes them unique, not bad.” The

involuntary nature of stuttering was also expressed by participants: “People should understand

that things happen to people that they can do nothing about at all.” Similarly, “People should just

learn to not make fun of people who stutter and deal with it because most of the time, the person

who stutters cannot help it at all.” The overall tone of these statements suggests that PWS are

perceived as being mocked or treated negatively by listeners in general and should not be.

Negative feelings statements. Approximately 10% of responses consisted of participants’

negative feelings, and included feeling “bad” or “sorry” for PWS. These and other negative

feelings were not directly opposed to supportive statements. Instead they generally related to the

discomfort expressed by participants as they examined their attitudes toward PWS. For example,

one participant wrote, “I feel helpless. I’ve always wanted to help others, but some people do not


want you to help them, it humiliates them. Others do not mind, if you are not trying to intimidate

them or embarrass them.” The preceding statement illustrates this participant’s discomfort and

uncertainty about how to act around PWS.

Other participants expressed negative feelings about their attitudes, e.g., “I am ashamed

to say that when I hear someone stutter I think they are handicapped. I think maybe I’m better

than they are because I can speak well.” Likewise, one participant wrote, “I am guilty of losing

my patience, or losing interest in a conversation with someone who stutters. I try to be as tolerant

as possible, however, I do not always give the stutterer a fair chance.” It is interesting that, like

PWS feel guilt and shame about their stuttering (Murphy, 1999), some fluent speakers feel guilt

and shame about their attitudes toward PWS. Along these lines, another participant wrote, “I feel

bad for those who stutter, but find myself in a situation where it’s easier to avoid those who

stutter. I feel like a bad person for this, but I don’t want to work hard to understand their points.”

Similarly, “I wish I were more patient toward people who stutter. I usually don’t show it overtly,

but sometimes I do judge people on the way they speak. And I hate that I do that.” Thus, the

participants in this study seemed to have reflected on their thoughts, emotions, and behaviors

toward PWS and feel badly as a result.

Message/Comments statements. Many of the statements (30.5%) consisted of

participants’ messages to the researcher or comments on the survey questions. Messages to the

researcher were generally encouraging or in support of the research, e.g., “I wish you the best of

luck on you research and your doctoral degree,” and “On a side note, when I was working

towards my sociology degree I did my fare share of surveys, so I appreciate the time and effort

that has gone into this. Good luck!” Participants probably felt that it was appropriate to include

these types of comments as they had met the researcher when she visited classrooms on campus


to recruit participants for the study. Approximately 14 respondents who provided comments on

the survey questions gave positive statements about the survey as a whole, e.g., “I thought these

were good questions,” or “I thought these questions were very thorough and informative.”

Fewer participants (n = 4) provided comments that indicated that they had perceived the

questions or the purpose of the survey negatively. For example, one participant wrote,

“I thought question #2 [describe people who stutter] was interesting because it struck me

as almost demeaning to people who stutter. I think people who stutter are as different

from each other as any random people would be, and there’s no way to [describe them]. I

look as stuttering as a disability you do not choose.”

Similarly, one participant wrote, “I don’t like question 2, but I understand your purpose of asking

it. Hopefully no one answers it judgmentally or with the stereotype.” Along these lines, another

participant wrote, “I don’t really think someone who stutters would find this survey appealing.”

The fourth participant stated, “Some of these questions were ridiculous because people who

stutter aren’t freaks—they’re people, and the questions kind of made them out to be completely

different than [other] people, which they aren’t.” These statements suggest that that sometimes

the researcher’s rationale for asking such questions was somewhat suspect and was also

perceived by participants as perpetuating stuttering stereotypes.

Other participants stated that they had a difficult time answering the questions because

they did not know PWS. For example, “[I] wish I knew more about it because I felt like I

couldn’t answer the questions,” and “I really had to think about these questions because I’ve

never actually thought about it. Some of them were hard to answer.”

Similarly, “I think the questions were pretty standard, but they were kind of biased because if

you didn’t know somebody who stuttered it would be kind of hard to answer the questions,” and


“I felt uncomfortable answering some of the questions because I don’t know much about

stuttering and have not interacted much with people who stutter.” These assertions are

noteworthy because they may explain why fewer individuals who did not know PWS chose to

complete and return the survey; however, it is also interesting that participants’ responses

generally did not differ significantly based on level of familiarity with stuttering. Thus, it appears

that even though some participants with limited exposure to PWS were uncomfortable with

answering the survey questions, their responses were similar to the responses of participants who

were more familiar with PWS.

Finally, comments consisted of statements about the length of the survey and that the

questions seemed somewhat repetitive. For example, “At times I felt that this survey was a bit

lengthy, but I understand the need for research.” Similarly, “The questions were fine, [but] some

seemed redundant.” Another participant elaborated: “Some of them seemed repetitive, like #1,

what is it like talking to someone who stutters, #8 share your experiences with people who

stutter, [and # 4] why my life would be different if I stuttered. I think they kind of cross over.”

These responses indicate that future versions of the survey may be modified to make the survey

seem less lengthy and repetitive.

Miscellaneous statements. Statements that did not fit into any of the established themes

accounted for 17.5% of the total responses to the question. Examples of these types of statements

included such comments as “Stuttering is a relatively unknown problem,” “I didn’t think

stuttering would be such a large issue,” and “I guess I just don’t know that much about

stuttering.” One participant wrote about the actor James Earl Jones:

“I read that James Earl Jones, the actor, stuttered. In high school, one of his teachers

helped him to control his stuttering by speaking slower. This same teacher encouraged


James Earl Jones to get involved in theater. Now we see the results of one person’s

involvement in the life of a person who stuttered.”

Another participant wrote about her brother who stutters: “I have seen the pain it can cause and

would give anything to be able to fix the problem and stop the stutter, and I believe he would as

well.” Miscellaneous responses in general were quite varied but seemed to emphasized

participants lack of knowledge about stuttering or their perceptions of stuttering based on

personal and other experiences.

No response. A total of 57 participants did not respond to the question. Somewhat

surprisingly, the majority of participants (62%) chose to answer the question even though it

could easily have been skipped due to having somewhat of an optional overtone. This finding

suggests that participants wished to clarify or expand on their answers, or to provide the

researcher with comments or feedback regarding the survey itself.


First, even though “Negative feelings” statements and “Supportive” statements were not

diametrically opposed, a paired samples t-test was conducted to determine if participants

reported significantly more statements coded “Negative feelings” than statements that were

coded as “Supportive” of PWS. The results of this analysis indicated that there was no difference

in these types of statements (t = 1.71, p = .09), suggesting that participants were as likely to

express support of PWS as they were to report negative feelings toward PWS or toward their

attitudes about PWS. Second, a Multivariate Analysis of Variance (MANOVA) was conducted

to determine if responses differed according to gender, familiarity, or interactions between

gender and familiarity for all of the themes. The means and standard deviations for this analysis

are presented in Table 18. There was no significant difference for any of the themes according to


gender (F[6, 137] = 1.62, p = .15, 2η = .07, observed power = .61), level of familiarity (F[18,

388] = 1.35, p = .16, 2η = .06, observed power = .84), or gender/familiarity interaction (F[18,

388] = 1.51, p = .08, 2η = .06, observed power = .89). These findings suggest that men and

women did not vary in terms of the responses they provided to the survey question; nor did

responses differ on the basis of how well participants knew PWS.


The ninth and final survey question gave participants the opportunity to write any last

thoughts about stuttering and PWS. It also provided participants with the option of informing the

researcher about their thoughts regarding the survey in general. Although many participants

indicated that the survey was interesting, good, or ultimately helpful in promoting reflection

about stuttering and how the disorder affects individuals, some participants also reported

negative feelings toward the survey and specific questions that were perceived as requiring

stereotypical answers, e.g., “Describe someone who stutters.” Participants also reported that

sometimes their feelings about PWS caused them to feel bad about themselves; these negative

feelings included such emotions as guilt or shame due to avoiding PWS and not being patient

enough with them. On the whole, participants made comments about PWS that were supportive

and suggested that society should not mock or tease PWS. It is interesting to note that while none

of the survey respondents reported engaging in such mockery or teasing, it was perceived that

others in society do engage in such behaviors. This finding may lead one to wonder if the

responses of individuals who do engage in such overtly negative reactions to stuttering would

have provided different survey responses, or if some participants in this study do engage in such

behaviors but did not write about them in order to provide socially desirable responses.


Table 18



No Response Male None 0.17 0.41 6


Well 0.38 0.51 13

Very well 0.36 0.50 14

Total 0.29 0.46 48



Well 0.44 0.51 25

Very well 0.55 0.51 20

Total 0.42 0.50 102

Reflection/Information Male None 0.17 0.41 6


Well 0.46 0.66 13

Very well 0.29 0.61 14

Total 0.29 0.54 48



Well 0.16 0.37 25

Very well 0.10 0.31 20

Total 0.22 0.52 102




Supportive Male None 0.00 0.00 6


Well 0.08 0.28 13

Very well 0.50 0.52 14

Total 0.25 0.44 48



Well 0.20 0.50 25

Very well 0.05 0.22 20

Total 0.16 0.42 102

Negative Feelings Male None 0.17 0.41 6


Well 0.38 0.77 13

Very well 0.07 0.27 14

Total 0.21 0.54 48



Well 0.04 0.20 25

Very well 0.00 0.00 20

Total 0.06 0.24 102




Message/Comments Male None 1.00 0.63 6


Well 0.31 0.48 13

Very well 0.07 0.27 14

Total 0.35 0.56 48



Well 0.44 0.87 25

Very well 0.15 0.37 20

Total 0.29 0.64 102

Miscellaneous Male None 0.17 0.41 6


Well 0.00 0.00 13

Very well 0.14 0.36 14

Total 0.13 0.33 48



Well 0.12 0.33 25

Very well 0.30 0.66 20

Total 0.21 0.53 102


Findings Related to the Research Questions

Question 1: What descriptions do participants provide when asked to describe a person who

stutters, and what rationale do they provide for these descriptions?

Numerous studies have asked participants to describe PWS via the use of semantic

differential scales (e.g., Ragsdale & Ashby, 1982; Turnbaugh et al., 1979; Woods & Williams,

1976). These studies have indicated that many groups of fluent speakers perceive PWS in a

negatively stereotypical manner. In these studies, PWS are often described as being more

anxious, nervous, shy, and frustrated than typical speakers. Positive stereotypes were also

reported in these studies, and indicated that PWS are perceived as being more friendly,

intelligent, and cooperative than typical speakers. Semantic differential or other forced choice

questionnaire techniques do not generally allow participants to elaborate on their responses; thus,

we have only a very limited understanding of how participants’ rationales or motivations for

their survey responses correspond with the numerical, objective data that are generated from

quantitative studies.

The descriptions of PWS by the participants in this study were similar to the descriptions

reported in the literature on this topic. Unlike most quantitative studies, however, the participants

were asked to provide an explanation for their descriptions of PWS. These explanations indicate

that the participants did not believe that PWS are inherently shy, nervous, or frustrated. Rather,

PWS were perceived as developing these characteristics over time as a result of exposure to

negative societal reactions to stuttering, such as teasing, laughing, or discrimination. The

inability of listeners to comprehend their speech was also perceived as being a considerable

source of frustration for PWS.


In this study, the positive descriptions of PWS were often associated with the perceived

normality of PWS, e.g., “People who stutter are just like you and me.” Participants also reported

that PWS are more patient, kind, and accepting of others because they have experienced

hardships and suffering due to their stuttering. In addition, descriptions of PWS as smart were

associated with somewhat circular reasoning, so that PWS were described as smart because they

were not perceived as being less intelligent than fluent speakers.

These findings indicate that the participants in this study were able to report their

attitudes toward PWS and that the attitudes reported toward PWS were similar to findings of

other studies (Lass et al., 1989; 1992, 1994; Ruscello et al., 1994; Woods & Williams 1971;

Yairi & Williams, 1970). More significantly, however, the participants elaborated on their

descriptions of PWS and could explain why they felt such descriptions were apt. Also of

importance was the small number of participants who rather pointedly indicated that being asked

to describe a person solely on the basis of his or her stuttering was unfair to PWS and could only

lead to stereotyping. These types of responses were reported when participants were asked to

describe someone who stutters (Question 2) as well as when participants were given the

opportunity to discuss their opinions regarding the survey in general (Question 9). Such

responses may confirm that a growing number of research participants are uncomfortable with

providing negative or stereotypical opinions about PWS. This discomfort may be one reason why

participants have tended to report neutral to positive ratings of PWS in quantitative studies (e.g.,

Gabel, 2006; Healey et al., 2007).

Question 2: What do participants know about stuttering in terms of its cause?

One’s attitude toward people or objects is shaped by many factors, including one’s

thoughts and beliefs (Breckler, 1984; Triandis, 1971). Aside from a few exceptions, (e.g., Crowe


& Cooper, 1977; Hurst & Cooper, 1983a), little research has attempted to measure fluent

speakers’ knowledge of stuttering. The existing studies have tended to use such quantitative

formats as true/false questions and statements to which participants indicate agreement on a

Likert scale. In this manner, participants’ true knowledge of stuttering may be masked or biased

by forced-choice responses and guesses on survey items. The present study attempted to identify

participants’ knowledge regarding several aspects of stuttering, including life effects of stuttering

(Questions 3 and 4), and how fluent speakers and PWS can help each other during conversations

(Questions 5 and 6). Participants’ knowledge regarding the cause of stuttering (Question 7) was

considered especially important. Smart (2001) has indicated that people’s perceptions about the

causes of disability are likely to manifest themselves behaviorally as people interact with

individuals who are disabled. Like all of the survey questions, participants were asked to simply

describe what they thought causes stuttering. This method was free from bias, as participants

were free to list any causes they wished without the inherent restriction of quantitative methods.

In general, participants believed that stuttering has a physiological or neurophysiological

cause that may be genetic in nature. Psychological or emotional causes such as nervousness or

anxiety were also reported; however, in many cases such emotional causes were viewed as

exacerbating or worsening stuttering rather than being a primary cause of the disorder. To a

lesser extent, participants reported that stuttering was developmental in nature and could result

from one’s childhood environment or from difficulties learning to speak when growing up. Many

participants were unable to answer the question, or, if they did provide an answer, commented

that it was “only a guess” or that they were “not sure” as to the actual cause of stuttering.

As a group, participants’ beliefs about stuttering corresponded to the major theories about

stuttering causation that have been proposed in the literature (e.g., Bloodstein & Bernstein


Ratner, 2008), and most especially with more recent theories of stuttering as a multi-factorial or

multi-dimensional disorder (e.g., Smith & Kelly, 1997). Thus, individual participants tended to

provide multiple causes of stuttering, which is very much the belief held by the field of speech-

language pathology. In addition, a large number of participants indicated that they were unsure

of the cause of stuttering. It is difficult, therefore, to relate participants’ knowledge about the

cause of stuttering to their attitudes or behaviors toward PWS. Perhaps, however, participants’

uncertainty regarding the cause of stuttering would manifest itself as uncertainty, hesitancy, or

avoidance as these participants interact with individuals who stutter.

Question 3: What difficulties do participants associate with being a person who stutters?

Participants uniformly reported that stuttering has unpleasant life consequences for PWS.

In addition, PWS were perceived as experiencing barriers and limitations to participation in

social activities as well as academic and career opportunities. Participants tended to report the

same negative effects when asked to consider how stuttering would effect their own lives

(Question 4) as well as the lives of PWS (Question 3).

Participants’ explanations for the decreased social, academic, and vocational

opportunities for PWS seemed to stem primarily from participants’ beliefs that society in general

is intolerant of stuttering. Thus, participants indicated that potential friends may avoid

individuals who stutter, teachers and classmates may treat PWS poorly, and employers may

decline to hire PWS. In addition, some participants reported that PWS are so discouraged by

their stuttering and suffer from such low self-esteem that they withdraw from society and decide

not to pursue higher education or certain types of careers.

These findings demonstrate that participants are aware of and sensitive to the potentially

negative life consequences of stuttering as described by Yaruss and Quesal (2004) in their


adaptation of the World Health Organizations’ International Classification of Functioning,

Disability, and Health (ICF). It is not clear, however, to what extent participants believed that

PWS can adapt to, accept, or otherwise overcome their stuttering and lead fulfilling lives that are

not restricted by negative self-opinions or the prejudicial and discriminatory views of society.

Only a small number of participants reported that the effects of stuttering on the lives of PWS

would depend on such factors as the severity of stuttering, the age of the person who stutters, and

support from family members and friends.

Question 4: What do participants report as being important considerations or facilitative

techniques when interacting with PWS?

Participants tended to report that PWS should engage in behaviors or conduct themselves

so that their speech becomes more intelligible to listeners. Increased intelligibility was often

associated with stuttering less. Consequently, participants stated that they would find it helpful if

PWS were to relax, slow down, and think before they speak. Avoidance behaviors were also

suggested and included such things as speaking less, avoiding problematic sounds and words,

writing instead of speaking, and using gestures to distract the listener from stuttering. These

types of facilitative techniques were suggested by participants who knew individuals who stutter

as well as participants who did not. Thus, even participants who regularly interacted with PWS

appeared to believe that these techniques would help to facilitate conversation with individuals

who stutter by promoting increased fluency. There is little empirical research that has

investigated the benefits, if any, of this kind of advice from fluent speakers to PWS. Anecdotal

evidence would suggest that PWS are annoyed by such advice and do not find it helpful in the

management of their stuttering, particularly when the advice comes from familiar listeners such

as family members (Hughes, 2007). As a whole, these findings indicate that fluent speakers do


not understand the mechanics of stuttering and why telling someone who stutters to slow down

or to relax is unlikely to promote long-term fluency. Listeners who are familiar with PWS appear

to be just as likely as unfamiliar listeners to make suggestions that would be unhelpful to PWS.

Furthermore, the statements of a number of participants who had younger siblings or friends who

stutter seemed to indicate that these participants recognized that their advice was emotionally

upsetting but perceived that increased fluency outweighed the emotional concerns of the

individual who stutters. Thus, listeners with varying degrees of familiarity with PWS may be

equally intolerant of stuttering and may offer help or advice as a means of attempting to reduce

or ameliorate the stuttering of the speakers with whom they interact.

Other types of facilitative techniques that participants felt PWS should employ included

advocacy behaviors, such as acknowledging that one stutters and educating others about

stuttering. Letting the listener know one’s personal communication preferences was also

perceived as helpful. Participants reported appreciating a “warning” that their conversational

partner stutters at the beginning of the interaction. This preference of participants for disclosure

of stuttering is consistent with previous studies on this topic (e.g., Collins & Blood, 1990; Healey

et al., 2007).

The participants also reported that listeners could interact more effectively with PWS by

engaging in a number of observable behaviors, such as making eye contact or not laughing at

PWS. Some uncertainty among participants was reported for these observable behaviors, such as

whether it is acceptable to ask PWS to repeat themselves, or whether one should finish words or

thoughts for PWS when they seem to be “stuck.” The majority of participants indicated that one

should try to maintain positive thoughts and try to avoid negative emotions, such as impatience

and frustration, when speaking with someone who stutters. Most participants reported relatively


positive thoughts and attitudes regarding how one should interact with PWS, but there was some

confusion over how these thoughts and attitudes should manifest themselves behaviorally.

Acting normally, being patient, and having respect for PWS were encouraged by participants.

These behaviors are largely intangible and may manifest themselves differently among fluent

speakers. Furthermore, these behaviors may or may not be recognized or perceived similarly

among PWS. The direct measurement of these intangible behaviors would also be difficult for

researchers, and consequently there is little if any research that has investigated the effects of

such thoughts and feelings among fluent speakers’ behaviors toward PWS. Regardless of

whether or not these intangible behaviors have been empirically justified, organizations such as

the National Stuttering Association and the Stuttering Foundation of America have indicated that

these behaviors help to facilitate interactions between PWS and their fluent listeners.

In general, participants reported that listeners’ reactions exert a great deal of influence

over the emotions of PWS. Fluent speakers were often placed in the role of emotional caretakers

for PWS during conversational interactions. For example, listeners who treat PWS with respect

and as normal human beings were perceived as helping PWS to feel good about themselves and

even to help them overcome their stuttering. If, however, listeners react negatively in the form of

impatience, laughing, or disinterest, individuals who stutter may experience loss of self-esteem,

withdraw from society, and experience generally negative life effects. Thus, some participants’

responses appeared to be paternalistic and virtually ignored the emotional resiliency of PWS or

the ability of individuals who stutter to not internalize negative reactions from listeners and

society.


Question 5: To what extent do participants hold similar or different attitudes toward stuttering

and PWS based on frequency counts and percentages of statements related to specific themes for

each question positive, neutral, and negative statements?

The total number of statements and percentages of statements associated with the themes

were reported for each of the nine survey questions. Where appropriate, participants’ responses

for specific themes or positive, neutral, and negative statements were compared to determine if

these responses were significantly different. In only a few instances were significant differences

found. For example, participants tended to report that if they were a person who stutters

(Question 4), they would have significantly fewer speaking difficulties but more negative life

effects as compared to PWS (Question 3). In addition, participants did not provide significantly

different numbers of positive and negative descriptions of PWS as a whole, (Question 2), but

they did report significantly more positive descriptions of their interactions with specific

individuals who stutter (Question 8). Thus, participants’ responses to the survey questions

occasionally varied across themes or the numbers of positive, neutral, or negative statements.

Question 6: To what extent do participants’ survey responses vary in terms of demographic

characteristics such as gender and level of familiarity with PWS?

The total number of statements for all of the themes generated by the nine survey

questions was not significantly different on the basis of gender, level of familiarity with PWS, or

the interaction between gender and level of familiarity. In addition, no significant difference for

gender or level of familiarity was found when the ratio of participants’ statements to the total

number of statements for each theme was calculated to account for variations in the numbers of

statements made by participants.


Participants’ responses differed only when the type of relationship participants reported

with PWS were considered (Question 8). The statements of participants who had a family

member who stutters were correlated with negative descriptions of interactions with this family

member. Conversely, participants who had a classmate who stutters or were friends with

someone who stutters were more likely to make statements that were correlated with positive

descriptions of these interactions. Such findings support the work of Hughes (2007) and only

partially support the work of Klassen (2001, 2002).


CHAPTER 5

Discussion

This chapter seeks to summarize the issues that were of importance to the fluent speakers

in this study as they considered their interactions with PWS. The ways in which these findings

provide new insights into our understanding of fluent speakers’ attitudes toward PWS are

examined from the context of the limitations which have long been problematic in the existing

literature. The implications of these findings for fluent speakers, PWS, and SLPs are presented in

order to identify the many ways in which fluent speakers’ attitudes toward PWS may have both

clinical and public policy applications. Finally, limitations of the study as well as suggestions for

future research are discussed.

Describing Fluent Speakers’ Experiences with PWS

One of the purposes of qualitative research is to better understand the experiences of a

group of people who have encountered some phenomenon, such as a conversation with someone

who stutters. In this study, the participants were fluent speakers, many of whom had experienced

a conversation or repeated interactions with at least one person who stutters. To better

understand the thoughts, emotions, and behaviors of these participants, a survey was

administered which allowed the participants to freely express their opinions about stuttering and

PWS. The participants appeared to provide thoughtful, honest responses to these questions.

These responses are presented below in terms of summative or over-arching themes which

represent the experiences of many of the fluent speakers who completed the survey. It is

important to note that group differences were not observed, so that men and women provided

similar survey responses regardless of their level of familiarity with PWS.


Theme 1: Listeners are unsure of how to act around PWS.

The participants indicated that they were not entirely sure about how fluent speakers can

facilitate positive interactions and effective communication with PWS. The most striking finding

was that many of the participants reported that they believed that doing or saying the wrong thing

could have a direct impact on the emotional state of individuals who stutter. Participants worried

that their reactions to stuttering could cause the person who stutters to suffer from poor self-

esteem, depression, and other negative emotions. Consequently, the fluent speakers in this study

expressed a desire to help PWS, as supportive listener responses were perceived as promoting

increased self-esteem and the ability of PWS to overcome their stuttering.

Some fluent speakers experience strong emotions when interacting with PWS, and report

that there are unspoken rules or guidelines for how to interact with PWS. Because these

presumed rules remain unacknowledged by the person who stutters, fluent speakers tend to make

assumptions about the thoughts and feelings of PWS in response to the behaviors of their

listeners. These assumptions may result in what the author proposes is a cognitive-emotional

loop, in which the thoughts and emotions that are attributed to PWS tend to induce similar

feelings in the fluent speaker. The following statements are examples of the types of thoughts

and emotions that can contribute to this looping effect:

• Look at how much he’s stuttering. He must be really anxious and nervous and now it’s

making me feel anxious and nervous too.

• Is he judging me because he thinks that I’m judging him?

• Does he think I think I’m better than him because I don’t stutter?

• He probably expects me to act a certain way but I’m not sure how to act, so it will be

awkward for both of us.


• I’d better not ask him to repeat himself because that will make him stutter more and then

we’ll both feel bad.

As these examples illustrate, some fluent speakers’ thoughts and emotions run in circles or

loops in which beliefs about the negative thoughts and emotions of PWS “boomerang” and come

back to have direct effects on the thoughts and emotions of fluent speakers. It is possible that the

negative thoughts and feelings attributed to PWS will ultimately have a greater or stronger

impact as they complete the loop, causing the fluent speaker to experience more negative

thoughts and emotions than those that are attributed to PWS. This pattern may be one reason

why fluent speakers perceive PWS to be “worse off” or more highly affected by their stuttering

than is perhaps warranted.

The cognitive-emotional loop appears to stem not so much from the overt reactions or

responses of PWS as from the beliefs that fluent speakers hold regarding the negative effects of

stuttering for PWS. Consequently, fluent speakers may assume that PWS expect negative listener

reactions and feel badly about their stuttering. The cognitive-emotional loop may be perpetuated

and maintained because these assumptions are rarely, if ever, discussed between PWS and their

listeners. In addition, cognitive-emotional looping tends to require very little input from the

individual who stutters, although presumably PWS may experience their own types of loops,

e.g., “My listener feels uncomfortable and it makes me feel uncomfortable,” or “She looks like

the kind of person who might be impatient with someone who stutters, so I’d better hurry up and

be as fluent as possible.” What the author has termed cognitive-emotional looping may be an

example of applied “theory of mind,” in which human beings who are mentally and emotionally

healthy possess the neurological ability to engage in thinking about the mental states of the

people with whom they interact (Saxe & Kanwisher, 2003). Within this context, it makes sense


that fluent speakers who have not received definitive instructions for interacting with PWS may

project their own discomfort or awkwardness onto PWS.

The fluent speakers in this study indicated that they would like to know how one should

best interact with someone who stutters, particularly in regards to directly observable behaviors

such as making eye contact, asking PWS to repeat or clarify when they are not understood, and

finishing words or sentences for PWS. The author and two peer reviewers found that the

participants seemed to be genuinely (if not overly) concerned with the emotional health of PWS

and wanted to be supportive of them. The numerous comments that advised listeners to “act

normally” around PWS and to “be respectful” of them indicate that if these fluent speakers do

hold negative attitudes toward PWS, these attitudes are not malicious in nature and instead stem

in part from confusion about how best to interact with PWS.

Theme 2: Ultimately, listeners want PWS to be more like fluent speakers.

Talking with someone who stutters was reported to be a difficult experience in a number

of ways. According to the participants, talking with PWS is often confusing and requires extra

cognitive effort. Some fluent speakers may be so conditioned to humorous depictions of

stuttering in the media and by other people in society that they at first assume that the person

who stutters is merely joking instead of demonstrating a true speech disorder. The fluent speaker

may experience confusion and eventual embarrassment as he or she realizes that they have

expressed amusement at a condition that is not under the voluntary control of the person who

stutters. The participants also reported that PWS are sometimes very difficult to understand.

Fluent speakers may need to expand more cognitive effort to comprehend or understand the

message of PWS as compared to other fluent speakers. Fluent speakers may also feel that it is not

as easy to hold a simple conversation with someone who stutters, as they believe that they must


devote all of their attention to conversing with PWS rather than “only paying half attention” to

the speaker while multitasking, as is commonly the case during conversations between two fluent

speakers. In addition, talking with someone who stutters may take more time, as the repetitions,

prolongations, and hesitations or blocks that comprise the core behaviors of stuttering may

prevent the person who stutters from speaking as rapidly as other individuals. Thus, talking with

someone who stutters has the potential to be an embarrassing, frustrating and/or confusing

experience, particularly if the listener is required to expend more time, cognitive effort, and

emotional energy during the conversation.

Given that some participants perceived conversations with PWS as being fundamentally

different than conversations with other fluent speakers, it is not surprising that they indicated that

PWS should attempt to speak more quickly and fluently, or that PWS should essentially become

more like fluent speakers. Fluent speakers may wish that PWS would engage in practices that

minimize or eliminate the degree to which their listeners are distracted from the conversation by

stuttering. The primary manifestation of this desire for more fluent speech was participants’

reports of providing advice or suggestions to PWS, such as “slow down,” “relax,” “stop, take a

deep breath, and start over,” etc. From a fluent speaker’s perspective, this advice is probably

meant to have beneficial effects for both the speaker who stutters and the listener; e.g., decreased

negative emotions for the person who stutters and less confusion, frustration, and mental effort

for the listener.

Should we then fault fluent speakers for making these suggestions and identify such

advice as being representative of negative attitudes toward PWS? Perhaps not. Hughes (2007)

suggests that some of this “unhelpful” advice is generated by well-intentioned speech therapists

who direct family members and significant others to help PWS by reminding them to use their


therapy techniques. And indeed, slow rate of speech and more relaxed ways of speaking and

thinking about stuttering underlie the theoretical underpinnings of the two most commonly used

forms of fluency therapy (Guitar, 2006). It may be most helpful, therefore, to examine how

fluent speakers’ suggestions for improved fluency impact the lives of PWS. For example, are

PWS likely to be annoyed or frustrated by such advice, as anecdotal evidence would suggest?

Will they avoid, whenever possible, listeners who make these suggestions? Do PWS experience

tension and stress when it is not possible to avoid these individuals? Finally, how might fluent

speakers’ suggestions impact the fluency of PWS, regardless of whether or not PWS choose to

implement these suggestions? These questions have not been answered in the literature to date

and may provide valuable information about the ways in which PWS are affected by the

responses of fluent speakers toward their stuttering.

Theme 3: Listeners believe that PWS experience adverse life consequences because of their

stuttering.

Prior to this study, there was little if any evidence to suggest that fluent speakers were

aware of the potential consequences of stuttering on the lives of PWS. The participants in this

study seemed to be very sensitive to the many ways in which PWS could be adversely affected

by their stuttering. They believed that it is difficult for PWS to form intimate relationships, to

pursue higher education, or to obtain a job that requires public speaking. These considerations

may have been especially important to the participants in this study as they were primarily

younger university students who were probably establishing intimate relationships and career

plans for themselves.

Participants believed that PWS are affected, directly or indirectly, by society’s reactions

to stuttering. In particular, negative listener reactions were presumed to play a large role in the


ability of PWS to participate in social, academic, and vocational activities. Sometimes the fear or

anticipation of negative responses from listeners was cited as a reason why PWS may choose to

withdraw from life activities. When they considered the effects of stuttering on their own lives,

many participants stated that they might choose not to pursue higher education or certain types of

careers. They also indicated that they might have fewer or different friends. These types of

suppositions about the life effects of stuttering are unlikely to be true of all PWS, and could lead

to the formation of harmful stereotypes if they are over-generalized by fluent speakers. These

assumptions about what it is like to be a person who stutters are especially important, as they

indicate the degree to which PWS are viewed as being unable or unlikely to participate in society

to the same extent as fluent speakers.

The responses of participants in this study were closely aligned with those of researchers

who have proposed that the life effects of stuttering are greater than the simple inability to speak

fluently. For example, participants indicated, much like Sheehan’s (1970) iceberg analogy which

suggests that the stuttering experience consists of the unseen thoughts and emotions of PWS.

Participants also reported that stuttering can have a negative effect on the ability of PWS to

engage in life activities, as was noted by Yaruss & Quesal (2004). The ability of participants to

put themselves in the place of someone who stutters indicates that some fluent speakers are

readily able to recognize that the effects of stuttering go beyond speech disfluencies. This finding

suggests that fluent speakers, even if they have never before interacted with someone who

stutters, have the ability to empathize with PWS.

What is somewhat concerning about participants’ responses is that so few of them

indicated that PWS are able to accept their stuttering, to overcome it, or to succeed at whatever

they choose despite negative reactions from listeners. That so few participants suggested speech


or other forms of therapy to help PWS manage their stuttering may be indicative of participants’

strongly held beliefs about stuttering as a pervasively negative aspect of life for PWS. Smart

(2001) suggests that “the view from the outside versus life on the inside” is often very different

when people without disabilities consider what it is like to be a person with a disability. She also

suggests that some people with disabilities would not necessarily choose to be “cured” but can

instead appreciate the insights that their disability allows them. Thus, like many people without

disabilities, fluent speakers may believe that it is worse to be a person who stutters than it

actually is. They may also believe that PWS internalize the negative reactions of listeners and

may place an inordinate amount of importance on the effects of both negative and positive

listener reactions on PWS.

What do these findings mean in terms of fluent speakers’ attitudes toward PWS and the

ways in which these attitudes may affect PWS? More research is certainly needed in this area,

but it would seem logical that well-meaning fluent speakers may feel sorry for PWS and

demonstrate various expressions of pity and sympathy. Fluent speakers may assign themselves

the role of “emotional caretaker,” in which PWS are viewed as needing to be protected from the

negative reactions of others in society. Smart (2001) notes that such paternalistic views may have

a direct impact on the lives of people with disabilities. Thus, parents of children who stutter may

not encourage their child to pursue careers like teaching or law, which tend to require large

amounts of public speaking. Friends may choose to exclude the individual who stutters from

group social activities on the basis that the person who stutters would probably feel

uncomfortable. Teachers may tell students who stutter that they do not have to give class

presentations because of the assumption that it will be embarrassing for the student to stutter in

front of his or her classmates. Employers and co-workers may exclude PWS from presentations


due to similar assumptions. In addition, PWS may be prevented from engaging in situations

where they could encounter negative reactions from listeners because the fluent speaker would

then be unable to carry out his or her role as an emotional caretaker. Thus, PWS may experience

prejudice and discrimination more from those with whom they have close relationships versus

unfamiliar listeners. Research that addresses how PWS are affected by the reactions of familiar

and unfamiliar listeners to their stuttering may help to address these issues.

Summary of Themes

The survey respondents in this study seemed to be well-meaning but sometimes confused

individuals who placed a lot of importance on the role of the listener during interactions with

PWS. They often cited that stuttering was frustrating, confusing, or otherwise tiring, but such

comments often seemed to be directed toward the stuttering behaviors rather than individuals

who stutter. Fluent speakers may provide advice and suggestions to PWS that are meant produce

increased fluency and are perceived as being helpful for both the person who stutters and the

fluent speaker. Behaviors that promoted fluency were viewed as the remedy for the affective and

cognitive stresses that occur when fluent speakers and PWS interact. Accepting one’s stuttering

or striving to succeed in life in spite of one’s stuttering were not reported as factors that make it

easier for fluent speakers and PWS to converse more easily with each other.

In addition, stuttering was be perceived by some participants as a disorder that is more

terrible or awful than perhaps it really is for PWS, particularly as participants indicated that

stuttering has far-reaching life effects that can prevent PWS from achieving their goals or

succeeding in life. Stuttering also seemed to be regarded as a very difficult disorder to overcome

by many participants, even those participants who reported that PWS were “normal” or “no

different than anyone else.” Few participants reported that PWS could or should seek treatment


to manage their stuttering, a finding which may suggest that fluent speakers believe that there is

little that PWS can do to overcome or adapt to their stuttering. Furthermore, this finding

indicates that speech therapists are not recognized as agents of positive affective, behavioral, or

cognitive change for PWS.

Table 19 provides a description of the three major themes that emerged from participants’

responses and gives examples of the cognitive, affective, and behavioral correlates that fluent

speakers may experience as they interact with PWS. The implications that fluent speakers’

thoughts, emotions, and behaviors about stuttering and PWS have for PWS are also discussed

within the table.


Table 19

Components of Fluent Speakers’ Attitudes and their Implications for PWS

Issue: Fluent speakers are unsure of how to act around PWS

Listeners’ Thoughts:

• “How can I tell if this person is really stuttering or just joking around?”

• “This person seems to be stuttering—what should I do?”

• “Do I finish his thoughts if he gets stuck? Can I ask for clarification or repeats?”

• “How can I help this person?”

• “How do I indicate patience, tolerance, and acceptance for this person who stutters?”

Associated Emotions:

• Confusion or uncertainty

• Discomfort

• Frustration

• Fear of acting inappropriately

• Amusement if stuttering is first perceived as a joke

Behavioral Correlates:

• Give advice such as “slow down” or “relax” to help PWS stutter less

• Interrupt or finish words or thoughts

• Ask simple, close-ended questions which require minimal verbal responses

• Be overly solicitous, or attempt to speak for the person who stutters

• End the conversation as soon as possible or avoid future conversations with PWS

Implications for People who Stutter:

• Recognize that listeners do not always know how they should behave around PWS

• Acknowledge stuttering to help decrease participants’ uncertainty or confusion

• Be assertive and educate listeners if they are acting inappropriately—be prepared to give

an explanation for why some listeners’ behaviors are unhelpful.



Issue: Ultimately, listeners want PWS to be more like fluent speakers


• “This conversation is taking longer than usual, and I can’t take the time to listen.”

• “I wish he would spit it out already.”

• “I don’t understand what this person is saying.”

• “If only she would slow down, she wouldn’t stutter so much.”


• Impatience

• Frustration

• Annoyance

• Confusion

• Anxiety


• Interrupt PWS or finish their words or thoughts

• Provide nonverbal cues to hurry, such as looking at a watch or seeming uninterested in

prolonging the conversation

• Ask PWS to repeat themselves often or seek to ensure they understood what was said

• Avoid conversations with PWS altogether

Implications for People who Stutter:

• PWS may feel under pressure to speak as quickly and as fluently as possible

• They could experience anxiety, pressure, or stress because of listeners’ expectations

• PWS could attempt to comply with listeners’ wishes and speak more quickly

• They may use avoidance or secondary behaviors to minimize stuttering or to avoid

interactions with people who are viewed as impatient or unpleasant during conversational

interactions



Issue: Listeners believe that PWS experience adverse life consequences because of their

stuttering.


• “Stutterers withdraw from social situations because they are afraid that other people

won’t like them, or because they have been treated badly in the past.”

• “People who stutter are not as likely to do well in school because they do badly during

class presentations.”

• “People who stutter will not be hired for prestigious jobs which require a lot of talking.”


• Pity or sympathy

• Feelings of protectiveness

• Righteous anger on behalf of PWS


• Encourage PWS to refrain from social or other situations in which they might experience

unpleasant listener reactions

• Exclude PWS from situations which require verbal communication under the assumption

that PWS would prefer not to stutter in front of others

• Recommend that PWS not pursue careers which would require large amounts of

speaking, such as teaching, law, or medicine

Implications for people who stutter:

• PWS may feel resentful of the limitations placed on them by fluent speakers

• PWS may experience prejudice and discrimination as fluent speakers make assumptions

about their ability to be effective communicators or their willingness to participate in life

events

• PWS may be sheltered or protected by fluent speakers who assume a “caretaker” role


Benefits of this Study as Compared to the Existing Literature

The numerous studies that have investigated listeners’ attitudes toward stuttering over the

course of the last half century have been interesting if not particularly illuminating. If the

purpose of understanding attitudes toward any one group of people is to identify the ways in

which these attitudes may predict behavior, then the existing research has not made much

progress beyond identifying a restricted range of stereotypes that are commonly reported toward

PWS. The most often used method of assessing fluent speakers’ attitudes toward PWS, the

semantic differential technique, has provided only a narrow window of insight into the thoughts

of fluent speakers. Certainly semantic differential scales do not address the affective or

behavioral components that also form the basis of people’s attitudes. As a case in point,

researchers have reported that negative attitudes toward PWS are very difficult to ameliorate

(e.g., McGee et al., 1996; Snyder, 2001). McGee et al. (1996) administered a semantic

differential instrument to students before and after they watched a video about stuttering. The

students’ attitudes reportedly did not change as a result of watching the video, as students

continued to report that PWS are shy, quiet, anxious individuals. For this study and others which

have used semantic differential or other types of quantitative scales, it may be accurate to state

that if there was a change in participants’ attitudes, the quantitative methods used by these

researchers were not sensitive enough to detect them. Furthermore, the existing attitude measures

seem ill-prepared to address the larger issues associated with attitudes toward PWS, such as

whether fluent speakers believe that PWS can and should participate in all of the social,

academic, and vocational opportunities that are afforded to fluent speakers. We need to better

understand the implications of these stereotypes and attitudes if we are to work toward changing

fluent speakers’ attitudes toward PWS.


In addition, the literature has also been unable to address with any degree of certainty the

emotions that fluent speakers experience as they interact with PWS or the ways in which fluent

speakers’ thoughts and emotions may influence their behaviors toward PWS. The purpose of this

study was to examine the attitudes of fluent speakers toward stuttering and PWS from as broad a

context as possible. Thus, participants were asked to go beyond merely rating or listing the

personality traits of PWS and were asked instead to discuss their thoughts and feelings about

stuttering. They were also asked to identify the behaviors that both fluent speakers and PWS

should engage in as they interact. The benefit of this method was that participants could write

about whatever they wished, and were not constrained by close-ended questions or forced-choice

scales that collapse the subjective experiences of participants into a numerical score. The

university students who served as participants in this study did not provide one or two word

answers; indeed, some respondents wrote one or two paragraphs for each survey question. These

responses indicate that participants in attitudinal research studies may have more to say than can

be captured in a quantitative questionnaire. Thus, the use of open-ended surveys, interviews,

focus groups, or other qualitative methods may be the most appropriate way to gain meaningful

information about fluent speakers’ attitudes toward PWS.

Ultimately, this study may be useful in that it raises an awareness of the issues that are of

concern to fluent speakers when they interact with PWS. There is very little research that

addresses this topic, an oversight which seems to be a gross omission of one very important part

of fluency therapy. PWS do not exist in a vacuum. Whether the goal of fluency therapy is to help

the client to become as fluent as possible, to stutter as easily as possible, or some combination of

the two approaches, SLPs must always keep in mind that PWS will be communicating with

fluent speakers. Thus, the thoughts, feelings, and behaviors of fluent speakers are vitally


important from a therapeutic standpoint. Helping one’s client to recognize and react

appropriately to the attitudes of fluent listeners should be a part of fluency therapy. SLPs also

should work closely with the significant others of PWS to provide counseling and education

about the most appropriate ways in which to interact with the individual who stutters. Even if

significant others of PWS are unwilling or unable to attend therapy sessions, SLPs should

provide their clients who stutter with information regarding some of the thoughts that fluent

speakers have about stuttering and their emotions as they interact with PWS. The behaviors of

fluent speakers may then be viewed by PWS as rational or logical, even if they are ultimately

unhelpful.

New Directions in Attitude Research

It seems that the vast majority of research in our field has not identified the affective,

behavioral, and cognitive components that comprise fluent speakers’ attitudes toward PWS. As

such, we have no basis from which to assess how fluent speakers’ attitudes may influence their

behaviors toward PWS. Furthermore, there is limited data about what fluent speakers’ attitudes

toward PWS should be, and there is no specific criterion or gold standard by which to assess

fluent speakers’ attitudes toward PWS as positive/negative or acceptable/unacceptable. Perhaps

our discipline may benefit from less rigid and constrained views of attitudes, and break away

from quantitative paradigms which consider attitudes and stereotypes as all-or-nothing, black or

white concepts. For example, stereotypes are not inherently good or bad. The psychological

literature suggests that stereotypes serve important purposes, and help us to make sense of the

world around us. It is important, therefore, for researchers to refrain from identifying fluent

speakers’ stereotypes of PWS as negative in a pejorative sense, and to focus instead on the

purpose these stereotypes serve for fluent speakers and their ultimate effects on PWS. Certainly


we would not want to be overly-critical of the opinions of fluent speakers, especially because

some stereotypes of any particular group of people may be true (Schneider, 2005). It is very

difficult to reliably measure whether PWS are actually more shy, nervous, employable, quiet,

frustrated, etc. than fluent speakers. Individuals who stutter may report different personality traits

depending on contextual factors (e.g., speaking situations versus general life situations, type of

conversational partner, etc.), or on the degree to which they have internalized the stereotypes of

their listeners. Thus, at the present time we cannot be certain if fluent speakers are reporting

factual information about PWS or unfounded beliefs that have no basis in reality.

Another consideration is that researchers who investigate stereotypes and attitudes toward

PWS have not formed a consensus regarding which types of fluent speakers’ thoughts, emotions,

and behaviors might best facilitate positive interactions between fluent speakers and PWS. Thus,

the results of both quantitative and qualitative research studies in this area should explore

researchers’ own beliefs about the appropriate thoughts, behaviors, and emotions of fluent

speakers as they interact with PWS. To begin to address this issue, researchers and clinicians

may consider how they would answer the nine survey questions that were posed to participants

in this study. Are there “right” and “wrong” answers to the questions, as many of the participants

wanted to know? What do we as a discipline want fluent speakers to know about stuttering and

how they should interact with PWS? Is it realistic to expect that fluent speakers will be able to

recognize that stuttering may have wide-ranging and sometimes negative life effects (e.g.,

Yaruss & Quesal, 2004) while at the same time expecting them to report that the experience of

stuttering does not shape the thoughts, emotions, and behaviors of PWS in similar (and perhaps

stereotypical) ways? In other words, fluent speakers may sometimes be caught in a Catch-22: If

they take note of the possible differences between fluent speakers and PWS on the basis of their


stuttering, they may be reported as possessing negative stereotypes about PWS. On the other

hand, if they disregard the impact of stuttering on the lives of PWS, they may be judged as being

insensitive to the difficulties associated with stuttering, and could be identified as possessing

negative attitudes toward PWS. Perhaps the most effective way for researchers and clinicians to

gain a better understanding of how fluent speakers should interact with PWS is to conduct

qualitative or mixed methods studies that investigate the preferences of PWS in this regard.

In summary, our discipline must advance beyond simply identifying stereotypes of PWS.

It will be especially helpful for researchers to develop an increased appreciation for the

complexity of attitudes and the limitations of the semantic differential technique as a

measurement tool. In addition, future investigators should keep in mind that the most significant

reason for attempting to measure attitudes is to understand the ways in which both fluent

speakers and PWS may be affected by these attitudes as they interact with each other. Qualitative

data will be helpful in furthering our understanding of fluent speakers’ attitudes. We must be

prepared to examine these data not from the perspective of wanting to chastise or blame fluent

speakers for their thoughts, emotions, and behaviors, but from the standpoint of trying to better

understand the purposes that these attitudes serve for fluent speakers and how they may affect

our clients who stutter.

Implications In addition to the suggestions proposed for the future of attitude research as proposed in

the previous section, a number of findings in this study may be of importance to fluent speakers,

PWS, and SLPs. These implications are discussed in the following section.


Implications for fluent speakers

The participants in this study indicated that it takes a great deal of cognitive and

emotional energy to speak with someone who stutters. This finding confirms that fluent speakers

are typically under a great deal of emotional and physiological stress when interacting with PWS

(Guntupalli et al., 2007). Participants indicated that it is very difficult to understand the speech

of PWS, and that talking with someone who stutters can be disconcerting on a number of

emotional parameters. Thus, fluent speakers may feel the need to pay more attention and listen

more closely in order to comprehend PWS. They may also experience such emotions as surprise,

confusion, impatience, and frustration. The need to hide such negative emotions from PWS was

reported by some participants and indicates that fluent speakers must pay close attention not only

to the speech of PWS, but to the regulation of their own emotions as well. Despite reports of

confusion regarding proper etiquette when speaking with PWS, participants felt that their

reactions to stuttering could have negative emotional implications for PWS. Thus, listeners may

want to help the person who stutters, or to prevent him or her from experiencing emotional

distress, but not know how to do so. This confusion and uncertainty may lead fluent speakers to

experience feelings of frustration and helplessness, and to avoid interactions with PWS

altogether.

Implications for PWS

The fluent speakers in this study tended to report stereotypical descriptions of PWS as is

consistent with past research (e.g., Dorsey & Guenther, 2000; Gabel, et al., 2004; Hulit & Wirtz,

1994; White and Collins, 1984; Woods & Williams, 1971; Yairi & Williams, 1970). If fluent

listeners believe that all PWS are shy, anxious, and frustrated, it may have negative

consequences for those individuals who stutter but who are no more shy, anxious, or frustrated


than the average fluent speaker. Participants were generally sensitive to the possible prejudice

and discrimination that PWS may experience due to negative societal reactions toward stuttering.

The tone of some participants’ statements, however, indicated that PWS were destined to lead

unfulfilling lives or to not succeed in life because of these negative societal reactions. Thus,

PWS may experience prejudice or discrimination by fluent speakers who believe that individuals

who stutter cannot or should not attempt to engage in certain social activities or careers because

society in general will react negatively toward them. It is also conceivable that fluent listeners

could attempt to prevent PWS from trying to engage in social, academic, or occupational

opportunities because they wish to protect individuals who stutter from experiencing negative

reactions to their stuttering.

Participants also reported that PWS should engage in facilitative behaviors that would

result in increased fluency and intelligibility from individuals who stutter. Accordingly, PWS

may find themselves being pressured to be more fluent, whether covertly via listeners’ nonverbal

responses, or overtly in the form of unhelpful advice, such as “think before you speak,” or

“relax.” Similarly, participants felt that they needed to take more time and be more patient with

PWS during conversations. Thus, despite participants’ advice for PWS to slow down their rate of

speech in order to be more intelligible, participants may also state, verbally or nonverbally, that

they desire the individual who stutters to hurry up and speak. Individuals who stutter, therefore,

may experience mixed signals from their listeners and may feel the need to be more fluent even

while they attempt to speak more quickly.

Another important consideration is that participants who reported knowing PWS “very

well” or “well” generally responded no differently to the survey questions than did participants

who did not know anyone who stutters or knew PWS “not very well.” Thus, level of familiarity


had little impact on the reports of fluent speakers regarding their attitudes toward PWS. In

addition, unlike Klassen’s (2001, 2002) findings, the participants in this study did not report

more positive attitudes toward family members who stutter or PWS in general. Instead, the

responses of participants who had a family member who stutters were correlated with negative

descriptions of their interactions with that individual. Interestingly, family members of PWS

were the only group of participants whose statements were correlated with negative interactions

with specific individuals who stutter. For PWS, this finding may indicate that relationships with

family members are more complex than perhaps any other type of relationship, including

friendships and work relationships. The attitudes of some family members toward PWS may be

more negative than the attitudes of co-workers, friends, or classmates. Additional research

certainly is needed to investigate how familial relationships and degree of social closeness

impact PWS; however, the results of this study indicate that if PWS experience adverse effects

from fluent speakers’ negative attitudes toward their stuttering, family members are as likely as

anyone else to be the cause.

Implications for SLPs

The large percentage of participants who expressed uncertainty regarding the “right

answers” to the survey questions or reported a desire to learn more about stuttering suggests that

fluent speakers may welcome information and education from SLPs and PWS about stuttering.

Educating and counseling the friends, family members, and classmates of PWS may be

especially important, as many of the survey respondents who reported these types of

relationships with PWS also expressed a desire to know more how to facilitate positive

interactions with PWS. Some participants in this study also reported that they would commonly

tell PWS to slow down, relax, or think before speaking. Speech-language pathologists could


discuss the limitations of such advice with fluent listeners and could instead promote other

behaviors, such as maintaining eye contact with the individual who stutters, giving him or her

extra time, and not finishing words or sentences.

Speech-language pathologists should also be aware that some fluent speakers appear to

believe that the self-esteem and autonomy of individuals who stutter are directly related to

responses of listeners. Thus, fluent speakers may feel that PWS are at the emotional mercy of

their listeners, and that PWS routinely internalize both negative and positive reactions from

listeners. As a result, SLPs should encourage PWS to take an active role in facilitating

conversations with listeners about the rights and responsibilities of both fluent speakers and PWS

as they interact in various contexts.

In addition, SLPs should realize that individuals who stutter may be caught in the

crossfire between their therapists’ advice and the wishes of the fluent speakers with whom they

interact. Commonly utilized fluency techniques, such as speaking more slowly, stuttering easily,

and not using avoidance techniques, may be directly opposed to the suggestions of fluent

speakers, who want PWS to talk as quickly and as fluently as everyone else. Speech-language

pathologists and their clients can address these conflicting pressures and develop strategies to

resist or minimize these pressures. For example, research has shown that individuals who stutter

are rated negatively by fluent speakers when employing therapy techniques (Manning et al.,

1999). Conversely, PWS are perceived more positively when fluent speakers are informed that

they are attending speech therapy (Gabel, 2006). Thus, some PWS may find it beneficial to

inform their listeners that they stutter and that they will be using some techniques that they

learned in therapy. This approach may be especially helpful when combined with other assertive

instructions to listeners, e.g., “I’m not particularly nervous or excited right now. I just stutter


sometimes. You can help by not finishing my thoughts when I stutter.” Thus, participants may be

reassured that PWS are capable of managing their stuttering as well as their emotions.

Finally, SLPs and speech-language pathology students have reported stereotypical

attitudes toward PWS (e.g., Cooper & Cooper, 1985, 1986; Horsley & FitzGibbon, 1987; St.

Louis & Lass, 1981). Clinicians and SLPs-in-training have also indicated that they experience

anxiety and discomfort at the prospect of treating PWS (Brisk, Healey, & Hux, 1997; Kelly,

Martin, Baker, Rivera, Bishop, et al., 1997; St. Louis & Durrenberger, 1992). In this regard,

SLPs and speech-language pathology students appear similar to the university students in this

study, who reported feelings of discomfort and uncertainty when interacting with PWS. Perhaps,

like university students, SLPs and speech-language pathology students report negative attitudes

because they are unsure of how to help PWS. For SLPs, some of this uncertainty may stem from

the lack of training or exposure to PWS that students receive during the course of their

communication disorders program (Yaruss & Quesal, 2002). In addition, SLPs and pre-

professional students may, for personal or temperamental reasons, find it awkward,

uncomfortable, or distasteful to discuss thoughts and emotions with clients (Kelly, et al., 1997;

Manning, 2001). It is conceivable that these SLPs will, therefore, acknowledge increased fluency

as the only benchmark for treatment success. Accordingly, if a client’s speech does not rapidly

become more fluent as a result of therapy, it is possible that SLPs may begin to feel they have

failed at helping their clients and begin to report negative attitudes toward stuttering and PWS.

More research that addresses the attitudes of SLPs toward PWS, the client-clinician relationship,

and the effect of perceived clinician competence when treating PWS is certainly warranted.


Limitations of the Study and Ideas for Future Research

Perhaps one of the dangers of conducting qualitative research is that the participants’

responses are coded into themes, and these themes are said to be representative of the total

sample. It is important to realize that these assertions about participants could, in and of

themselves, be considered stereotypes. Even if the majority of fluent speakers believed that PWS

are shy, frustrated, and/or fearful of listeners’ reactions, there were some participants who did

not believe this to be true. One of the benefits of this study’s mixed model approach is that it

allowed participants’ responses to the survey questions to be sorted into general categories while

still maintaining a sense of how many participants provided statements that were associated with

these categories. Thus, an important consideration for future research is to address why some

fluent speakers have negative attitudes and engage in behaviors that are hurtful or unhelpful for

PWS, while other fluent speakers have positive attitudes and engage in supportive or helpful

behaviors. There are many questions to consider: Does the personality or temperament of

listeners influence how they will respond to PWS? Are some individuals simply more

predisposed in general to act negatively toward people with disabilities and differences, or is

there something about stuttering in and of itself that some listeners find difficult to tolerate?

What makes some listeners report that PWS are very unintelligible, while others do not seem to

have difficulty understanding stuttered speech? Are perceptions of intelligibility related to

increased exposure to PWS, or do some listeners simply have better speech perceptions skills

which allow them to focus less on stuttering and more on content? These answers to these

questions will allow researchers and clinicians to better address the needs of listeners as they

counsel and educate others about stuttering.


Researchers are prevented from generalizing the results of qualitative studies due to small

numbers of research participants and the decreased likelihood that such participants are

representative of the larger population. The present study, while using primarily qualitative

methods, utilized a larger number of research participants than most qualitative studies and

adopted quantitative measures for data analysis; however, attempts to generalize these results to

university students in general should be undertaken cautiously. It is important to note that the

participants were not representative of the larger population in terms of gender. More women

than men volunteered to take the survey and actually returned it. Thus, the opinions of male

university students may be underrepresented in this study.

Furthermore, information about the average university student’s relationships with PWS

was not readily available. Statistics such as the average number of PWS known by university

students, the average number of students who report friendships or familial relationships with

PWS versus professional, school, or other types of relationships, and the degree of personal

intimacy the average university student has with PWS would be helpful as future researchers

attempt to compare their sample population of university students with university students in

general. One area of future research may involve conducting a cross-university study that gathers

information about students’ relationships with PWS. A study of this kind would be most helpful

if its participants were representative of university students on a national level, and if university

students were recruited from a variety of geographic locations.

In addition, it may be advantageous for researchers to conduct studies that aim to collect

very detailed information about the quantity, quality, and type of relationships individuals have

with PWS. The university students who participated in the present study tended to provide

general responses to questions about their relationships with PWS, possibly due to the rather


long length of the survey. When participants did elaborate on their relationships with PWS, it

became apparent that some statements, though qualitatively different, would be virtually

indistinguishable when analyzed quantitatively. For example, the participant who wrote about

meeting a cousin who stutters only once in early childhood provided a very different response, in

a qualitative sense, from that of the participant who reported a close and ongoing relationship

with a cousin who stutters. Future studies would do well to ask participants to elaborate, as much

as possible, on their relationships with PWS. For example, if a participant reports knowing a

person who stutters in school, is the participant referring to a contemporary at college, or

someone he or she knew years ago in elementary school? Similarly, if a participant reports

having a friend who stutters, is this friend a close one or simply a casual acquaintance?

Participants may vary in the extent to which they consider acquaintances to be friends;

furthermore, research participants, in an attempt to provide more socially desirable responses,

may tend to inflate or exaggerate their closeness to PWS. Asking participants specific yet open-

ended questions about their relationships with individuals who stutter may help to provide a

better understanding of how these relationships influence fluent speakers’ attitudes toward PWS

as a group and as individuals.

It is also important to note that this study explored only the attitudes of university

students toward PWS. The mixed qualitative and quantitative approach used in this study may be

also be used to examine the attitudes of speech-language pathologists, educators, members of the

general public, family members and friends of PWS, and PWS themselves. Furthermore, this

method would be equally applicable to examining listeners’ attitudes toward people who have

other types of communication disorders. Investigating listeners’ reactions to various types of

speech and voice disorders, as well as language and hearing disorders, would be advantageous


for SLPs who treat and counsel these clients and their significant others. It is likely that members

of the general public and others, such as teachers and employers, would appreciate “coaching”

from SLPs in order to better facilitate communication with people who have various types of

disorders. In addition, it would be interesting to compare listeners’ qualitative perceptions of

stuttering with their perceptions about people with other types of communication disorders and

even types of physical disabilities. In this way, researchers could identify whether the attitudes

reported by listeners toward PWS are specific to stuttering or are equally applicable to other

disorders.

The results of this study indicated that participants themselves rarely reported engaging in

negative behaviors toward PWS. Instead, other people, and indeed, society as a whole, were

perceived as doing so. This finding is a potential limitation of the study, as it may indicate that

participants were more likely to complete a survey if they had generally positive attitudes toward

PWS. It is difficult to make survey research of this type compulsory, and impossible to prevent

participants from being untruthful in their responses. If, however, all of the students recruited to

take the survey had actually done so, more participants may have reported acting negatively

toward PWS. Nevertheless, the concept of group versus individual stereotypes (e.g., Schneider,

2005) arises from participants’ reports that others in society hold more negative views about

PWS than they do. Researchers may wish to compare how fluent speakers’ perceptions about

their own attitudes toward PWS differ from their perceptions about how the rest of the world

views PWS.

Another line of future research may stem from participants’ beliefs that PWS are more

unintelligible than fluent speakers and are more difficult to comprehend. Fluent listeners in this

study only rarely reported that the speech of PWS is as intelligible as that of fluent speakers.


Participants did not tend to differentiate between listeners’ perceptions about the intelligibility of

the speech of PWS versus listeners’ ability to comprehend this speech. Thus, it would be

interesting to examine the ability of fluent listeners to discern the individual words spoken by

PWS and the subsequent ability of listeners to comprehend the meaning of these words in

connected speech. Bar (1969) found that both speech therapists and naïve listeners paid

significantly more attention to the stuttering of PWS than the content of their speech. Similarly,

Susca and Healey (2002) reported that fluent speakers’ perceptions of PWS were influenced, in

part, by their ability to comprehend the message of the person who stutters. Thus, fluent listeners

may become distracted by stuttering and simply not concentrate on the message of the speaker

who stutters. Future research could examine the individual factors that contribute to listeners’

comprehension of the speech of PWS. For example, do listeners become more easily able to

comprehend the speech of PWS over time as a result of repeated interactions with PWS? Are

some listeners more susceptible or more bothered than others by the atypical disfluencies of

conversational partners? Is there anything PWS or listeners can do to help listeners focus more

on the content of the conversation rather than the stuttering? The answers to these questions may

ultimately result in more effective communication for PWS and their fluent listeners.

The findings from this study also raise two other considerations for future research. First,

it was interesting that very few participants reported that PWS might find speech therapy

beneficial. When speech therapy was mentioned, it was only in the context of reducing or

eliminating stuttering, not learning to cope with one’s stuttering or the negative reactions of

listeners. Thus, it may be helpful to explore which types of educational programs and/or

marketing campaigns would help fluent speakers perceive speech therapy as a viable treatment

option for stuttering. In addition to not mentioning speech therapy, few participants reported that


the media influenced their perceptions of PWS. Does this omission mean that fluent speakers’

attitudes are more likely to be influenced by real or imagined interactions with PWS rather than

the stereotypical depictions of stuttering in the media? This question is an important one, in that

the answer may suggest that even positive examples of PWS in the media may be ignored by

fluent listeners (McGee et al., 1996, Snyder, 2001).

Finally, when asked to consider the effects of stuttering on their own lives, as well as the

lives of PWS, participants generally reported decreased social interaction and participation in life

activities due to negative societal responses to PWS. It would be interesting to learn how fluent

speakers would perceive an individual who does not conform to these stereotypical behaviors.

Would fluent speakers be more likely or less likely to report positive attitudes toward an

individual who has a prominent position that requires public speaking, or a person who stutters

who has an active social life with many friends? Would fluent speakers be capable of

recognizing that this individual does not conform to stereotypes of PWS as shy, quiet,

embarrassed, or fearful of others’ reactions, or would they continue to assign these stereotypes to

this individual? Future investigations on this subject may provide helpful information about

whether fluent speakers who interact with PWS are capable of changing their stereotypical

perceptions of individuals who stutter.

Conclusions

The participants in this study demonstrated that fluent speakers are capable of providing

detailed information about their beliefs, thoughts, and emotions related to stuttering and people

who stutter. When analyzed both qualitatively and quantitatively, the data from this study

indicate that PWS believe that listeners’ reactions to stuttering are important. Participants felt

that PWS should be treated with respect and with sensitivity, particularly because society in


general was perceived as treating PWS very negatively. Participants often expressed a desire to

help PWS, but did not know how to do so without giving offense or causing emotional harm.

Other participants reported providing advice that was judged to be unhelpful to PWS and placed

increased pressure on PWS to be fluent or to speak more rapidly. Thus, participants perhaps

inflated their own contributions to the emotional stability and fluency of PWS and did not

acknowledge that many people who stutter are able to manage their own stuttering and to cope

effectively with listeners’ reactions, even if they are negative.

Participants’ attitudes toward PWS can also be examined in regard to attitude theory as

discussed in Chapter 1. Katz (1960) and Rosenberg (1956) suggested that attitudes can serve a

variety of functions for individuals. Some of these functions seem to apply to the attitudes of

participants in this study. For example, the ego-defensiveness function suggests that some fluent

listeners may take on important roles, such as offering advice to PWS or acting as emotional

caretakers, in order to maintain their own self esteem and sense of importance. The value-

expressive function, which helps individuals to express their values and beliefs, may stem from

listeners’ desire to help PWS in order to be viewed as different from others in a society that is

intolerant of stuttering. Feeling sympathetic toward PWS was reported by some participants and

may be one manifestation of the value-expressive function. Finally, the adjustment or utilitarian

function of attitudes allows individuals, based on learned experiences, to develop positive

attitudes toward things that are perceived as rewarding and negative attitudes toward things that

may result in negative consequences. Accordingly, participants reported that they disliked

speaking in public, despite being fluent speakers. Participants also reported embarrassment over

their own instances of disfluencies. As a result, fluent listeners may extrapolate from their own

negative speaking experiences and transfer them to the everyday experiences of people who


stutter. Thus, the functions that attitudes serve for fluent speakers who interact with individuals

who stutter appear to be one of many considerations for future research which investigates the

attitudes toward PWS.

As a whole, these results suggest that many fluent speakers have good intentions when

interacting with people who stutter. Because interacting with PWS can exact a cognitive or

emotional toll on listeners, some fluent speakers may demonstrate behaviors that are not

particularly helpful for PWS. Thus, individuals who stutter, as well as speech-language

pathologists, should work to educate fluent speakers about the behaviors that would allow for the

most effective interactions between fluent speakers and people who stutter.


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Purpose: To gain a breadth and depth of understanding of college students’ attitudes toward stuttering and PWS.

Research Questions: • What descriptions do participants

provide when asked to describe a person who stutters, and what rationale do they provide for these descriptions?

• What do participants know about stuttering in terms of its cause?

• What difficulties do participants associate with being a person who stutters?

• What do participants report as being important considerations or facilitative techniques when interacting with PWS?

Research Questions: • To what extent do participants hold

similar or different attitudes toward stuttering and PWS?

• To what extent do participants vary in terms of demographic characteristics such as gender and level of familiarity with PWS?

Data Collection: Written survey administered to 150 students. Interviews with a small subsection of the participants conducted to help clarify written information.

Data Analysis: Review all participant data and then code individual statements to reduce information. Identify commonalities among participants’ responses for the development of themes.

Data Analysis: Obtain frequency counts and/or percentages of participants’ demographic characteristics and responses by theme. Analyze responses for positive/neutral statements and gender/familiarity.

Meta-Inference

Inference

Inference

Appendix A: Visual Representation of the Multistrand Conversion Mixed Model Design


Appendix B: Written Survey

Stuttering Survey Thank you for participating in this survey! The first part of the survey asks for your personal opinions about stuttering and people who stutter, and the second part asks you to provide some information about yourself. The third part of the survey asks for some follow-up information and is optional. There are no right or wrong answers. You are encouraged to reply openly and honestly to these questions. It will be very helpful if you can provide as much of an explanation as possible for your responses. Your responses will remain confidential. Please note that there are questions on both the front and back of each page.

Part 1—Questions about Stuttering and People Who Stutter:

1) If you have had a one-on-one conversation with someone who stutters, what was it like? If you have not had a conversation with someone who stutters, what do you think it would be like?

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2) How would you describe someone who stutters? Why did you choose these words? ______________________________________________________________________________

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3) How do you think people who stutter are affected by their stuttering? Please explain.

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4) If you were a person who stutters, how would your life be different, and why?

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5) What is a good way to act around someone who stutters? Please explain. ______________________________________________________________________________

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6) What can people who stutter do to help their listeners? Please explain. ______________________________________________________________________________

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7) What do you think causes stuttering? ______________________________________________________________________________

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8) What kinds of experiences have you had with people who stutter? Please be as specific as possible.

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9) Please share any comments you have about stuttering or your reactions to these questions. ______________________________________________________________________________

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Part 2—Information about You:

1. Your academic standing:

___ Freshman ___ Sophomore ___ Junior ___ Senior ___ Graduate Student ___ Other

2. Your academic major: _______________________________

3. Your age:____________

4. Your gender:________________

5. Your ethnicity:_______________________________

6. Do you now or have you ever considered yourself to be a person who stutters? ___yes ___no

7. a. Do you know/have you known people who stutter? ____yes ____no

b. If yes for question 7a, please indicate the number of people and how well you know/knew

them (e.g., __2__ people very well)

____ people very well ____ people well ____ people not very well

8. Have you had any classes that discussed types of communication problems that people have?

____yes ____no If yes, please explain: _________________________________________

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Part 3—Follow-up Information:

Please provide the following information only if you would be willing to consider participating in a face-to-face follow-up interview:

Your name:_______________________________________

E-mail address:____________________________________

Course in which you were invited to participate in this study:_______________________

**End of Survey**

Thank you for your help

Page 11 of 11


Appendix C: Informed Consent Document - Written Survey

Informed Consent My name is Stephanie Hughes. I am a graduate student in the Department of Communication Disorders at Bowling Green State University. I would like you to consider participating in a research study that I am conducting. This study is about people’s attitudes toward stuttering and people who stutter. The information that currently exists is limited, and I would like to gain a deeper understanding of people’s attitudes toward stuttering and people who stutter. You must be 18 years of age or older to participate in this study. You are welcome to participate even if you do not know anyone who stutters. If you decide to participate, you will be asked to complete a written survey that asks for your opinion on stuttering and people who stutter. This survey consists of nine open-ended questions and also asks for some information about you, such as your age, your major, and whether you or anyone you know stutters. This survey takes between 15 minutes to 45 minutes to complete. There are no anticipated risks to you. By participating in this study, you will help us to better understand how people who stutter and people who do not stutter can interact more smoothly with each other. Participants who complete the written survey will have the opportunity to enter a drawing to win an iPod Shuffle. The information you provide will remain confidential and your identity will not be revealed, either while you are participating in the study or while I attempt to publish the results. Your consent form, surveys, and any other paperwork with your identifying information will remain in a locked cabinet in a locked office and on a password-protected computer. Only my advisor (Dr. Rodney Gabel) and I will have access to the information you provide. Your participation in this study is completely voluntary, and you can refrain from answering any or all questions without penalty or explanation. You are free to withdraw consent and to discontinue participation in the project at any time. Deciding to participate or not participate in this study will not impact your grades or class standing, or your relationship to the University. If you decide to participate and change your mind later, you may withdraw your consent and stop your participation at any time without penalty or explanation. You have the right to have all questions concerning the study answered by the researcher, and may request a summary or copy of the results of the study.

Department of Communication Disorders Speech & Hearing Clinic


If you have any questions or comments about this study, you can contact me, Stephanie Hughes, at (419) 372-4320, [email protected], or my project advisor, Rodney Gabel, at (419) 372-7168, [email protected]. For additional questions or concerns about your rights as a research participant, you may contact the Chair of the Human Subjects Review Board (HSRB) on the Bowling Green campus at 201 South Hall, (419) 372-7716, [email protected]. By signing this form I acknowledge that I have been informed about the risks, benefits, and activities associated with participating in this study. I agree that my questions relating to the study have been answered. I also certify that I am at least 18 years of age. I agree to participate in this study. __________________________ ___________________________ ________ Participant’s Printed Name Participant’s Signature Date


Appendix D: Informed Consent Document - Interview

Informed Consent My name is Stephanie Hughes. I am a graduate student in the Department of Communication Disorders at Bowling Green State University. I would like you to consider participating in a research study that I am conducting. This study is about people’s attitudes toward stuttering and people who stutter. The information that currently exists is limited, and I would like to gain a deeper understanding of people’s attitudes toward stuttering and people who stutter. You must be 18 years of age or older to participate in this study. You are welcome to participate even if you do not know anyone who stutters, but you may not participate if you yourself are a person who stutters. If you decide to participate, you will be asked to complete an oral interview with the researcher. This interview will take up to one hour and will take place on campus. You will be asked to describe your thoughts about stuttering and people who stutter during the interview. The interview will be audiotaped and/or videotaped so that I can analyze the data after the interview is complete. Once the interview is complete and I have had time to type and analyze your interview, I may ask you if you would like to read over your transcript to make sure that I accurately transcribed what you said. I may also ask if you would like to read over the conclusions I made about your statements. This will help to ensure that I did not misinterpret any of your remarks. Reading your interview and my conclusions is completely voluntary, and you may choose not to participate beyond the initial interview if you so desire. There are no anticipated risks to you. By participating in this study, you will help us to better understand how people who stutter and people who do not stutter can interact more smoothly with each other. The information you provide will remain confidential and your identity will not be revealed, either while you are participating in the study or while I attempt to publish the results. Your consent form, any audio- or videotapes, and any other paperwork with your identifying information will remain in a locked cabinet in a locked office and on a password-protected computer. Only my advisor (Dr. Rodney Gabel) and I will have access to the information you

Department of Communication Disorders Speech & Hearing Clinic


provide. You will also be given the opportunity to choose a pseudonym. This is a fake name that I will use in place of your real name when I write up the results. This is to protect your confidentiality. Your participation in this study is completely voluntary, and you can refrain from answering any or all questions without penalty or explanation. You are free to withdraw consent and to discontinue participation in the project at any time. Deciding to participate or not participate in this study will not impact your grades or class standing, or your relationship to the University. If you decide to participate and change your mind later, you may withdraw your consent and stop your participation at any time without penalty or explanation. You have the right to have all questions concerning the study answered by the researcher, and may request a summary or copy of the results of the study. If you have any questions or comments about this study, you can contact me, Stephanie Hughes, at (419) 372-4320, [email protected], or my project advisor, Rodney Gabel, at (419) 372-7168, [email protected]. For additional questions or concerns about your rights as a research participant, you may contact the Chair of the Human Subjects Review Board (HSRB) on the Bowling Green campus at 201 South Hall, (419) 372-7716, [email protected]. By signing this form I acknowledge that I have been informed about the risks, benefits, and activities associated with participating in this study. I agree that my questions relating to the study have been answered. I also certify that I am at least 18 years of age. I agree to participate in this study. __________________________ ___________________________ ________ Participant’s Printed Name Participant’s Signature Date

Exploring Attitudes toward People Who Stutter

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Transcript of Exploring Attitudes toward People Who Stutter