surveys

IS
if you want to
test your instincts
work from a
cl ient's bel iefs
turn black and
white into shades
of grey
How do people who stammer think others
perceive them, and are they right?
Do people who don't stammer -Find everyday
speaking situations as easy as people who
stammer seem to think? Guet Lee set out to
find answers - and discovered that
comparing perception and reality can be a
useful therapeutic tool.
here seems to be an abundance of Against such a backdrop of studies, it is hardly
literature indicating that people surprising that the adults I have worked with
who don't stammer hold negative often tell me that they perceive people who don't
perceptions of those who do. For stammer to regard them as less confident, social
example, Ham (1990), who ran ly disabled, laughable, unprofessional, having
dom Iy contacted telephone incomprehensible speech and ignorant, amongst
respondents ranging from 11 to 85 years of age, other things. These negative perceptions are fur
found a general trend among his respondents, ther extended to perceptions that, unlike them
regardless of whether or not they stammered selves, people who don't stammer have no prob
themselves, to hold stereotypical views of peo lem whatsoever handling speaking situations like
ple who stammer - that is, they were often per telephoning, ordering meals, going for inter
ceived as less adequate and less well adjusted. views, speaking whilst in a queue, and interacting
In another 1990 study, Silverman & Paynter with the opposite sex.
found that their subjects who stammer were This led me to wonder whether people who
often regarded as less competent in their occu don't stammer do indeed perceive those who do
pations than those who don't. In Kalinowski & to have negative personality traits? My personal
Armson's study (1993), there was a tendency for feelings and those of various colleagues and cer
both speech clinicians and the general public, tain personal friends seem to indicate the con
for differing reasons, to perceive people who trary. Also, do people who don't stammer really
stammer as being "guarded, withdrawn, tense, have no problems coping with everyday speaking
shy, anxious, afraid, reticent and introverted". situations, as those who do stammer seem to
Such negative views were further reinforced by think? I have encountered many people who
Lass et al (1994), who reported perceptions held report problems being interviewed, talking on
by school administrators of negative personali the telephone or communicating with someone
ty traits in people who stammer. These percep in authority.
tions were similar to those held by teachers, To try to answer these two questions I carried
special educators and speech and language out a very small-scale survey in two parts: the first
pathologists. dealt with personality traits typically associated
SPEECH & LANGUAGE THERAPY IN PRAalCE AUTUMN 2003 21
ISSN (online) 2045-6174 www.speechmag.com
surveys
confi dence In handling
speaking situations
became something of a
motivating {actor - they
looked upon It as
something to aspire to.
~ with people who stammer and the second with
how easily people who don't stammer deal with
common speaking situations.
I asked a client, Alan, to list the typical negative
traits that he perceives people who don't stam
mer to have of people who do. He came up with
eight which I developed into the polarities of :
unconfident
easily embarrassed
socially disabled
have incomprehensible
speech
fearful
ignorant
confident
not easily
embarrassed
not socially disabled
have comprehensible
speech
not fearful
not ignorant
have restricted social lives do not have
restricted social lives
I then put these polarities on a rating scale of 1
(extreme negative) to 5 (extreme positive).
Alan also listed the speaking situations with
which he thought people who don't stammer
would have no problems:
making phone calls socially
making phone calls at work
answering phone calls socially
answering phone calls at work
ordering food/drinks
speaking in shops
speaking in queues
speaking in group situations
speaking to people in authority
talking to strangers.
Each of these situations was also given a rating scale
of 1to 5of various degrees of difficulty (1 - totally dif
ficult; 2 - significantly difficult; 3 - average difficulty; 4
- slightly difficult; and 5 - not at all difficult.)
Representative
The next step involved taking both sections of the
survey and discussing them with a self-support
group for people who stammer. Although Alan
provided me with the survey items, I wanted to
know if the same items were representative of
the way most people who stammer would view
other people's perceptions of them, and if the
speaking situations listed were typically the ones
that they thought people who don't stammer
would have no problems with. Almost all the
members of the self-support group agreed with
the items in the survey.
I then went back to Alan and asked him to pre
dict what number on the rating scales a person
who doesn't stammer would circle in both sections
Table 1 . Perceptions versus actual views (traill)
4.7o 1
2.60 I
3.90 1
2.301
4. ,5 I
2.901
3.381
2.20 I
3.80 1
2.10 1
3.50 I
2.20 I
2 7 0 ~
1.60
3 0 0 ~
1.70
5 4 3 2
extreme
extreme RATINGS
negative
positive
end
end
of the survey. He made his predictions by circling
the appropriate numbers. This was repeated with
nine other dysfluent clients, male and female. I
kept all the predictions / perceptions. The 10
clients then kindly took four copies of the survey
each to distribute among their colleagues, friends
and family members who don't stammer. In all, 10
clients made their predictions and 40 other people
- who had no idea what these predictions were
circled the appropriate number on the rating scales
according to how they actually felt.
The results for the first section of the survey
dealing with personality traits of the people who
stammer are in table 1 (the scores on the horizon
ta I axis of the table are averages). They show that
perceptions did not match the reality. They clearly
suggest that the person who stammers had a ten
dency to think that other people's view of them
was much more negative than it actually was.
The results for the second section of the survey
are in table 2 (again the scores on the horizontal
axis are averages). They indicate that, in this case,
perceptions appeared to match the reality. There
did not appear to be a significant difference
between the way in which a person who stam
mers thought someone who doesn't stammer
would cope with various speaking situations, and
the way they actually do.
The results in table 1 conflict with the literature
and allude to the possibility that, if anything, peo
laughable - not laughable
restricted lives - unrestricted lives
ignorant - not ignorant
V1
r
<t:
fearful- not fearful
cr:::
I-
incomprehensible speech - comprehensible speech
socially disabled - not socially disabled
easily embarrassed - not easily embarrassed
unconfident - confident
Mann-Whitney UTest Of Significance
=0.000 (Highly Significant)
CliENT,' PREDICTIONS 0 RfAllTY
pie who don't stammer have a much more posi
tive view of people who do stammer than these
people who stammer would think. However, a
direct comparison with the literature is not possi
ble as this is a small-scale survey and not a
research project. I did not eliminate variables nor
did I set up control groups. In addition, the sam
ple size is quite small and results may be vastly
different with a much larger sample size.
Positive and self-confident
Despite these drawbacks, I found that contrast
ing perceptions with the reality became a useful
therapeutic tool. On hearing the results of the
first half of the survey, the dysfluent clients were
very surprised, and even pleased, that their origi
nal negative perceptions were mostly not proven
right. The realisation, when I compared their
original predictions with the results, encouraged
them to change their perceptions and helped
them to develop a much more positive and self
confident attitude. Alan (26), who gave me the
idea for the survey in the first place, began ther
apy with many negative perceptions. The percep
tion that people who don't stammer think of him
as ignorant and foolish figured quite predomi
nantly. This did not help his then lack of self-con
fidence and sense of isolation. By carrying out the
survey and discovering the more positive trend
that people who don't stammer generally do not
22 SPEECH & LANGUAGE THERAPY IN PRACTICE AUTUMN 2003
ISSN (online) 2045-6174 www.speechmag.com
Table 2 - Perceptions versus reality (speaking situations)
2.70 I
speaking to strangers
3.001
speaking to people
in authority
2.70 I
3.00 I
2.571
speaking in groups
3.50 I
3.30 I
speaking in queues
3.70 I
3.50 I
speaking in shops
3.701
3.871
ordering food/drink
3.801
3.651
answering phone
3.50 I calls at work
3.501
answering phone
3.90 I
calls socially
3.50 1
making phone calls
3.50 I
at work
3.95 1
making phone calls socially
3.70 I
I I I I
5 2
Mann-Whitney UTest Of Significance
notat all
offk1J1t dofftQjh diffic.ult =0.818 {Not Significant}
RATII\lGS CLI ENTS' PREDICTIONS D REALITY
hold the same degree of negative opinions of
people who do stammer as he had once thought
- helped to build more positive attitudes. It also
appeared to aid in reducing Alan's once hard-held
image of the world as a place that was constantly
against him.
However, the general pattern from the second
half of the survey was a tendency for perceptions
to match reality. Did this have a negative effect on
my clients? On the contrary, for most, this seemed
to reaffirm their perceptions that generally peo
ple who don't stammer cope better with typical
everyday speaking situations. This confidence in
handling speaking situations became something
of a motivating factor for some of my dysfluent
clients - they looked upon it as something to
aspire to. For the rest, the general trend was to
feel pleased that their predictions were proven
part were generally
The results.. . clearly suggest that
the person who stammers had
a tendency to think that other
people's view of them was
much more negative than it
actually was.
correct in most cases.
Michael (19) could not
resist saying, "There, I've
told you so!" when we
discussed the results of
the second half of the
survey. One of his princi
pal difficulties was in
telephone situations. He
came to therapy wanting
to reduce his fear of the
telephone as one of his
goals. The second part of
the survey did not actual
ly help him in achieving
this goal but merely reaf
firmed his conviction that
he wanted to handle the
telephone without any
qualms, just like the
majority of people who
don't stammer.
The survey was a useful
exercise in this respect
but I can see there were
flaws _ for example, some
---------------------------... of the people who took
known to my clients and
would perhaps be inclined to be more positive
than people who did not know them. The other
limitation is the possibility that, when faced with
filling in a survey form, someone who does not
stammer might give more positive answers than
they truly feel, to appear more sympathetic. In
this way, the question remains - can any sort of
surveyor research truly assess actual feelings?
I am sure that the work I have done can be
extended further or developed into another form
of study. In the meantime I would welcome any
comments.
Guet C. Lee is a speech and language therapist
with City Hospitals Sunderland NHS Trust.
Although she specialises in adult neurology she
also carries an adult dysfluency caseload. At the
time of completing the survey in this article, Guet
was working for Hull and East Riding Community
NHS Trust.
Acknowledgements
I wish to say thank you to the Hull and East
Yorkshire Self-Support Stammerers' Group for their
assistance with this survey, to former colleagues Liz
Buckles and Ruth Edwards for their helpful sugges
tions, and to Dr. Trudy Stewart for her comments
on the first draft of this article. Most of alii would
like to say thank you to all my clients without
whom this article would not have been possible.
References
Ham, R.E. (1990) What is Stuttering: Variations
and Stereotypes. Journal of Fluency Disorders 15,
259-273.
Kalinowski, J. & Armson, J. (1993) Clinicians' and
the General Public's Perceptions of Self and
Stutterers. Journal of Speech and Language
Pathology and Audiology, 17 (2): 61-67.
Lass, N.J., Ruscello, D.M., Pannbacker, M., Schmitt,
H., Kiser, A.M., Mussa, A.F. & Lockhart, P. (1994)
School Administrators' Perceptions of People Who
Stutter. Language, Speech and Hearing Services in
Schools 25, 90-93.
Silverman, F.H. & Paynter, K.K. (1990) Impact of
Stuttering on Perceptions of Occupational
Competence. Journal of Fluency Disorders 15,
87-91.
Re ections
Do I recognise that
perceptions are crucial to
progress?
Do I use surveys as a
therapeutic tool?
Do I access the expertise in
self-support groups?
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SPEECH & LANGUAGE THERAPY IN PRACTICE AUTUMN 2003 23
ISSN (online) 2045-6174 www.speechmag.com