About the authors
|Shannon Fischer is a recent master’s graduate of University of Wisconsin-Stevens Point. She currently works as a speech-language pathologist at the Cooperative Educational Service Agency #5 (CESA-5) in Wisconsin, where she provides speech and language services for children in early childhood up through twelfth grade. She has presented research at the ASHA convention, and her areas of interest within the field include fluency, language, and augmentative and alternative communication.|
|Charlie Osborne is a clinical associate professor at the University of Wisconsin – Stevens Point. He teaches the fluency disorders class and mentors graduate students working with people who stutter and their families. Charlie has worked with people who stutter for over 30 years. He is a NSA Adult Chapter Leader.|
|John A. Tetnowski, Ph.D., CCC-SLP, is the Blanco Endowed Professor in Communicative Disorders at the University of Louisiana-Lafayette. He is a Fluency Specialist and an ASHA fellow. He has authored over 70 manuscripts on stuttering, assessment procedures, and research methodologies. He has worked clinically with PWS for over 25 years. He has been the DiCarlo nominee from the state of Louisiana, past Speech-Language Pathologist of the Year from the National Stuttering Association and is the 2016 Distinguished Professor at the University of Louisiana-Lafayette. He currently serves on the Steering Committee for ASHA’s SIG-4 on Fluency Disorders.|
*This was presented as a poster at the 2016 annual ASHA conference in Philadelphia, PA
One hundred twenty-seven graduate students engaged in three separate public pseudostuttering interactions. Students worked in pairs; one pseudostuttered while the other observed. Both reflected on the experience. Over 380 student reflections were analyzed using thematic analysis to identify major themes and subthemes. Speaker and observer reflections were compared and contrasted.
Over the past two decades there have been numerous studies that have focused on the academic and clinical training in fluency disorders (Brisk, Healey, & Hux, 1997; Cooper & Cooper, 1996; Kelly, Martin, Baker, Rivera, Bishop,1997; Murphy & Quesal, 2004; Tellis, Bressler, & Emerick, 2008; Yaruss & Quesal, 2002). A common discussion point with each of these studies is the many challenges involved in teaching a fluency disorders course within the university curriculum. The instructional challenge on this topic for pre-service clinicians is daunting. The American Speech-Language-Hearing Association’s changes to training requirements in 1993 and in 2005 have had a significant impact on the university training curriculum. Yaruss and Quesal (2002) reported that over one-quarter of the academic programs they surveyed had reduced the course requirements for fluency in response to the ASHA’s 1993 standards with an average of 40.2% of class time spent on theoretical issues and 58.6% of class time spent on clinical issues. Over 71% had a laboratory or practical application activities incorporated into their course. The need for clinical relevance in coursework is a valid one and has been echoed in other studies (Kelly, et. al., 1997). Murphy and Quesal (2005) stated the need for skill acquisition activities that included reading stories of stutterers, learning how to stutter, and stuttering in public as means of developing students’ knowledge/awareness of the behavioral, affective, and cognitive aspects of stuttering. They later reiterated their concerns regarding developing students’ “basic clinical skills” and suggested varied activities including pseudostuttering.
There have been several recent studies that have espoused the benefits of pseudostuttering (Reitzes, 2007; Klein, Cervini, & Clemenzi, 2006), as well as examined student reactions (Hughes, S., 2010; Mayo, Mayo, & Williams, 2006; Lohman-Hawk, 2008) and listener reactions to pseudostuttering (Irani & Richmond, 2012). These studies have found that as a result of pseudostuttering, students experience anxiety when pseudostuttering, perceive negative listener reactions, and have an increased sense of empathy for people who stutter. Listeners are perceived as being confused or uncertain, frustrated, patient, and/or overly helpful in response to student pseudostuttering. All studies have concluded that the experience of pseudostuttering is a valuable one. It was suggested by Irani and Richmond (2012)that future exploration of pseudostuttering have students do so in pairs, with one pseudostuttering while the other observes the interaction, so reflections can include the speakers’ and listeners’ responses. Another strength of students working in pairs would be to compare the speakers’ perceptions of listeners’ responses to the observers’ perceptions of listener reactions.
Subjects were 127 first-year speech-language pathology students, from the previous four years, enrolled in the graduate level Fluency Disorders class. The students had read information related to the clinician and the therapeutic process and aspects of stuttered and nonstuttered speech (Manning, 2010); an article representative of the therapeutic process (Pensinger, Osborne, and Tetnowski, 2015); participated in a discussion of common factors in the change process; and had had several weeks to practice pseudostuttering amongst themselves and in class.
Students were required to pseudostutter in three different venues. As a part of the pseudostuttering experience, each student was required to learn how to pseudostutter convincingly and read three to five personal stories by people who stutter from the Stuttertalk book (Reitzes & Reitzes, 2012). Each student then paired with a classmate and pseudostuttered in three different venues/situations. One student pseudostuttered, while the other observed the interaction. Both students wrote reflections of their perceptions of each interaction. Each student also wrote a summative reflection regarding the assignment as a whole.
Data consisted of four years of student reaction papers regarding their experience of pseudostuttering. Analysis of these reflections was ethnographic in nature. Student reaction papers were analyzed for common themes using coding and thematic analysis (Maxwell, 2013). Student reactions were grouped into speaker and observer categories. Each author read student reactions and coded them into categories that emerged from cyclic analysis, then compared and discussed results with co-authors to reach an agreement regarding major themes and accompanying subthemes insuring reliability and validity of results.
The following themes and subthemes were discovered:
Major Theme I: Student feelings and emotions prior to pseudostuttering.
Subtheme A: Anticipation and apprehension regarding pseudostuttering.
Students expressed concern regarding the authenticity of their stuttering and feared possible listener responses to their pseudostuttering.
“As a communicator, it was difficult to let go of my normal level of fluency to be purposefully disfluent. Part of me felt like I was mocking disfluency. That feeling really took me by surprise.” (Subject 68)
Subtheme B: Avoidance of pseudostuttering
Students often postponed planned interactions, “chickened out,” deciding to not pseudostutter during an interaction, or chose to interact with a preferred listener (by age or gender).
“I tried to pick a person who looked the ‘least threatening,’ I chose the number of people around, and I had the ability to stutter as much as I felt comfortable within my conversation… no one seemed to be the ‘right’ person and no time was the ‘right’ time so we walked around the store for quite a while.” (Subject 33)
Major Theme II: Experienced feelings and emotions during pseudostuttering.
Subtheme A: Autonomic physiologic responses while pseudostuttering.
Students reported rapid pulse, sweaty hands, shakiness, and unplanned increased tension of pseudostutters.
Subtheme B: A change in communicative style; less interactive and reduced eye contact.
Students limited verbal output and avoided looking at the listener.
“I had a difficult time maintaining eye contact and then almost seemed to whisper ‘thank you’ instead of using a normal conversational tone.” (Subject 78)
Subtheme C: A lack of confidence in perceived listener reaction(s).
Major Theme III: Experienced feelings and emotions after pseudostuttering.
Subtheme A: Increased negative self-concept as a communicator.
“I felt incompetent since I couldn’t order my own lunch and I felt like a nuisance to the person taking my order… While I ended up getting what I wanted, I felt horrible about myself.” (Subject 32)
Subtheme B: Increased empathy for people who stutter.
“After having my pseudostuttering experiences, I think I can empathize with the authors [of the course text] but I will never fully understand what they have experienced and can’t pretend to understand either and I believe that will help me the most in therapy.” (Subject 10)
Subtheme C: An increased awareness of the need to educate the public about stuttering.
“… as an SLP, it is my responsibility to help transform the views of people around me when they think about people who stutter.” (Subject 58)
Major Theme I: Viewed others’ responses.
Subtheme A: A broadened perception of listeners’ responses to pseudostuttering.
“When I did it myself, I was really clammed up and nervous, so it was fun to watch someone else do it so that I could really soak in everything that happened during those moments.” (Subject 53)
Subtheme B: A sense of protectiveness for the person pseudostuttering.
“One thing I noticed with me though was how protective I was getting with [my partner]. I tried to help her when I could and almost felt like her guard since I kept scanning the room watching for anyone to react negatively to her.” (Subject 78)
Students chose to pseudostutter when interacting with retail sales people, when ordering at a restaurant or drive through, when asking for directions on campus, and asking for information.
The majority of students used repetitions and/or prolongations when pseudostuttering. Other types of pseudostutters used included prolongations, blocks, and attempted secondary behaviors (e.g., eye blinking and tension).
There was a high level of agreement between the speaker and observer regarding listener responses. Out of 142 recorded observer reactions, there was agreement 70% of the time between speakers and observers and partial agreement 23% of the time.
Results of this study were highly similar to previous studies conducted.
Use of pseudostuttering experience heightened student empathy when reading personal stories of PWS.
Students overwhelmingly disliked this assignment, while at the same time valued it as a learning experience.
Having a partner when pseudostuttering;
- Helped students “go through” with planned pseudostutter.
- Was reassuring to speaker during and following the pseudostutter experience.
- Allowed for a much richer experience. Partners could confirm the accuracy of the speaker’s perception and often noticed additional information the speaker missed.
“It is different knowing and learning about something through texts and lectures than to actually experience it firsthand. This project put things into perspective for me… I know that what I have gone through in this project is nowhere near what people who stutter go through but I do feel like I can empathize better than I was able to before.” (Subject 36)
Brisk, D., Healey, E.C., and Hux, K. (1997). Clinicians’ training and confidence associated with treating school-age children who stutter: A national survey. Language, Speech, and Hearing Services in the Schools, 28, 164-176.
Cooper, E. and Cooper, C. (1996). Clinician attitudes towards stuttering: Two decades of change. Journal of Fluency Disorders, 21, 119-135.
Hughes, S. (2010). Ethical and clinical implications of pseudostuttering. ASHA SIG 4 Perspectives on Fluency and Fluency Disorders, 20, 84-96.
Irani, F. and Richmond, A. (2012). Listener reactions to pseudostuttering experiences. Canadian Journal of Speech-Language Pathology and Audiology, 36, 2, 106-115.
Kelly, E., Martin, J., Baker, K., Rivera, N., Bishop, J., Krizizke, C., Stettler, D., and Stealy, J. (1997). Academic and clinical preparation and practices of school speech-language pathologists with people who stutter. Language, Speech, and Hearing Services in the Schools, 28, 195-212.
Klein, J., Cervini, M., and Clemenzi, K. (2006). When do I get to shut the door? Journal of Stuttering, Advocacy & Research, 1, 36-41.
Maxwell, J. A. (2013). Qualitative research design: An interactive approach. Thousand Oaks, CA: Sage.
Murphy, W. and Quesal, R. (2004). Best practices for preparing students to work with people who stutter. Contemporary issues in communication science and disorders, 31, 25-39.
Quesal, R. and Murphy, W. (2008). The fluency curriculum in the new millennium: Building “skills” into “knowledge” classes. ASHA SIG 4 Perspectives on Fluency and Fluency Disorders,18, 33-36.
Reitzes, P. (2007). Teaching graduate and undergraduate students to model stuttering behaviors. Journal of Stuttering, Advocacy & Research, 2, 26-31.
Reitzes, P. and Reitzs, D. (2012). Stuttering: Inspiring stories and professional wisdom (StutterTalk Publication #1), Chapel Hill, NC: StutterTalk, Inc.
Tellis, G. M., Bressler, L., and Emerick, K. (2008). An exploration of clinicians views about assessment and treatment of stuttering, 18, 16-23.
Yaruss, J.S. and Quesal, R. (2002). Academic and clinical education in fluency disorders: An update. Journal of Fluency Disorders, 27, 43-63.
1,158 total views, 6 views today