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surveys

ISif you want to test your instincts work from a

cl ient's bel iefs turn black and

white into shadesof grey

How do people who stammer think othersperceive them, and are they right?Do people who don't stammer -Find everydayspeaking situations as easy as people whostammer seem to think? Guet Lee set out tofind answers - and discovered thatcomparing perception and reality can be auseful therapeutic tool.

here seems to be an abundance of Against such a backdrop of studies, it is hardlyliterature indicating that people surprising that the adults I have worked withwho don't stammer hold negative often tell me that they perceive people who don'tperceptions of those who do. For stammer to regard them as less confident, socialexample, Ham (1990), who ran ly disabled, laughable, unprofessional, havingdom Iy contacted telephone incomprehensible speech and ignorant, amongst

respondents ranging from 11 to 85 years of age, other things. These negative perceptions are furfound a general trend among his respondents, ther extended to perceptions that, unlike themregardless of whether or not they stammered selves, people who don't stammer have no probthemselves, to hold stereotypical views of peo lem whatsoever handling speaking situations likeple who stammer - that is, they were often per telephoning, ordering meals, going for interceived as less adequate and less well adjusted. views, speaking whilst in a queue, and interactingIn another 1990 study, Silverman & Paynter with the opposite sex.found that their subjects who stammer were This led me to wonder whether people whooften regarded as less competent in their occu don't stammer do indeed perceive those who dopations than those who don't. In Kalinowski & to have negative personality traits? My personalArmson's study (1993), there was a tendency fo r feelings and those of various colleagues and cerboth speech clinicians and the general public, tain personal friends seem to indicate the confor differing reasons, to perceive people who trary. Also, do people who don't stammer reallystammer as being "guarded, withdrawn, tense, have no problems coping with everyday speakingshy, anxious, afraid, reticent and introverted". situations, as those who do stammer seem toSuch negative views were further reinforced by think? I have encountered many people whoLass et al (1994), who reported perceptions held report problems being interviewed, talking onby school administrators of negative personali the telephone or communicating with someonety traits in people who stammer. These percep in authority.tions were similar to those held by teachers, To try to answer these tw o questions I carriedspecial educators and speech and language out a very small-scale survey in two parts: the firstpathologists. dealt with personality traits typical ly associated

SPEECH & LANGUAGE THERAPY IN PRAalCE AUTUMN 2003 21

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surveys

confidence In handlingspeaking situationsbecame something of amotivating {actor - theylooked upon It assomething to aspire to .people who stammer and the second witheasily people who don't stammer deal with

I asked a client, Alan, to list the typical negativehe perceives people who don't stam

to have of people who do. He came up withof :

confidentnot easilyembarrassednot socially disabledhave comprehensiblespeechnot fearfulnot ignorant

restricted social lives do not haverestricted social lives

I then put these polarities on a rating scale of 1to 5 (extreme positive).

lan also listed the speaking situations withhe thought people who don't stammerhave no problems:

making phone calls sociallymaking phone calls at workanswering phone calls sociallyanswering phone calls at workordering food/drinks

in shopsin queues

speaking in group situationsto people in authority

to strangers.Each of these situations was also given a rating scale1 to 5of various degrees of difficulty (1 - totally dif

significantly difficult; 3 - average difficulty; 4and 5 - not at all difficult.)

next step involved taking both sections of thewith a self-support

for people who stammer. Although Alanme with the survey items, I wanted to

if the same items were representative ofwho stammer would view

people's perceptions of them, and if thethey thought people who don't stammer

have no problems with. Almost all theof the self-support group agreed within the survey.I then went back to Alan and asked him to pre

what number on the rating scales a persondoesn't stammer would circle in both sections

Table 1 Perceptions versus actual views (traill)

4.7o 12.60 I

3.90 12.301

4. ,5 I2.901

3.3812.20 I

3.80 12.10 1

3.50 I2.20 I2 7 0 ~.60

3 0 0 ~1.70

5 4 3 2 extremeextreme RATINGS negativepositive endendof the survey. He made his predictions by circlingthe appropriate numbers. This was repeated withnine other dysfluent clients, male and female. Ikept all the predictions / perceptions. The 10clients then kindly took four copies of the surveyeach to distribute among their colleagues, friendsand family members who don't stammer. In all, 10clients made their predictions and 40 other people- who had no idea what these predictions were circled the appropriate number on the rating scalesaccording to how they actually felt.

The results for the first section of the surveydealing with personality traits of the people whostammer are in table 1 (the scores on the horizonta I axis of the table are averages). They show thatperceptions did not match the reality. They clearlysuggest that the person who stammers had a tendency to think that other people's view of themwas much more negative than it actually was.

The results for the second section of the surveyare in table 2 (again the scores on the horizontalaxis are averages). They indicate that, in this case,perceptions appeared to match the reality. Theredid not appear to be a significant differencebetween the way in which a person who stammers thought someone who doesn't stammerwould cope with various speaking situations, andthe way they actually do.

The results in table 1 conflict with the literatureand allude to the possibility that, if anything, peo

laughable - not laughable

restricted lives - unrestricted lives

ignorant - not ignorantV1r

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Table 2 - Perceptions versus reality (speaking situations)

2.70 I speaking to strangers3.001speaking to peoplein authority2.70 I3.00 I

2.571 speaking in groups3.50 I

3.30 I speaking in queues3.70 I

3.50 I speaking in shops3.7013.871 ordering food/drink3.801

3.651 answering phone3.50 I calls at work3.501 answering phone

3.90 I calls socially3.50 1 making phone calls3.50 I at work

3.95 1 making phone calls socially3.70 I

2 Mann-Whitney UTest Of Significancei g n o f < . n t notat aldofftQjh diffic.ult =0.818 {Not Significant}RATII\lGS CLI ENTS' PREDICTIONS D REALITY

hold the same degree of negative opinions ofpeople who do stammer as he had once thought- helped to build more positive attitudes. It alsoappeared to aid in reducing Alan's once hard-heldimage of the world as a place that was constantlyagainst him.

However, the general pattern from the secondhalf of the survey was a tendency for perceptionsto match reality. Did this have a negative effect onmy clients? On the contrary, for most, this seemedto reaffirm their perceptions that generally people who don't stammer cope better with typicaleveryday speaking situations. This confidence inhandling speaking situations became somethingof a motivating factor for some of my dysfluentclients - they looked upon it as something toaspire to. For the rest, the general trend was tofeel pleased that their predictions were proven

part were generally

The results .. . clearly suggest thatthe person who stammers hada tendency to think that otherpeop le's view of them wasmuch more negative than itactually was.correct in most cases.Michael (19) could notresist saying, "There, I'vetold you so!" when wediscussed the results ofthe second half of thesurvey. One of his principal difficulties was intelephone situations. Hecame to therapy wantingto reduce his fear of thetelephone as one of hisgoals. The second part ofthe survey did not actually help him in achievingthis goal but merely reaffirmed his conviction thathe wanted to handle thetelephone without anyqualms, just like themajority of people whodon't stammer.

The survey was a usefulexercise in this respectbut I can see there wereflaws _ or example, someof the people who tookknown to my clients and

would perhaps be inclined to be more positivethan people who did not know them. The otherlimitation is the possibility that, when faced withfilling in a survey form, someone who does notstammer might give more positive answers thanthey truly feel, to appear more sympathetic. Inthis way, the question remains - can any sort ofsurveyor research truly assess actual feelings?

I am sure that the work I have done can beextended further or developed into another formof study. In the meantime I would welcome anycomments.Guet C. Lee is a speech and language therapistwith City Hospitals Sunderland NHS Trust.Although she specialises in adult neurology shealso carries an adult dysfluency caseload. At the

time of completing the survey in this article, Guetwas working for Hull and East Riding CommunityNHS Trust.AcknowledgementsI wish to say thank you to the Hull and EastYorkshire Self-Support Stammerers' Group for theirassistance with this survey, to former colleagues LizBuckles and Ruth Edwards for their helpful suggestions, and to Dr. Trudy Stewart for her commentson the first draft of this article. Most of alii wouldlike to say thank you to all my clients withoutwhom this article would not have been possible.ReferencesHam, R.E. (1990) What is Stuttering: Variationsand Stereotypes. Journal of Fluency Disorders 15,259-273.Kalinowski, J. & Armson, J. (1993) Clinicians' andthe General Public's Perceptions of Self andStutterers. Journal of Speech and LanguagePathology 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 WhoStutter. Language, Speech and Hearing Services inSchools 25, 90-93.Silverman, F.H. & Paynter, K.K. (1990) Impact ofStuttering on Perceptions of OccupationalCompetence. Journal of Fluency Disorders 15,87-91. Re ections

Do I recognise thatperceptions are crucial toprogress? Do I use surveys as a

therapeutic tool? Do I access the expertise in

self-support groups?

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