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University students’ perceptions of the life effects of stuttering
Stephanie Hughes
a,
*, Rodney Gabel
b
, Farzan Irani
b
, Adam Schlagheck
b
a
Department of Communication Disorders, Governors State University, University Park, IL 60484, United States
b
Department of Communication Disorders, Bowling Green State University, Bowling Green, OH 43403, United States
Received 11 February 2009; received in revised form 11 September 2009; accepted 14 September 2009
Abstract
An open-ended, written survey was administered to 146 university students who did not stutter to obtain their impressions of the
effects of stuttering on the lives of people who stutter (PWS). Participants first wrote about the general effects of stuttering and then
considered how their lives would be different if they stuttered. Both types of responses, while not qualitatively different, indicated
that participants were more likely to focus on negative listener reactions and barriers to social, academic, and occupational success
when they imagined themselves as PWS. Fewer participants indicated that PWS may positively cope with their stuttering through
acceptance of stuttering, motivation and determination, and support systems. Quantitative differences based on gender and
familiarity with PWS were not observed. The findings suggest that while university students are generally sensitive to the issues
which can affect PWS, they may also tend to exaggerate the limitations placed on PWS by their stuttering.
Learner outcomes: The reader will be able to (1) understand the various ways in which fluent speakers perceive the life effects of
stuttering; (2) discuss how fluent speakers, while apparently sensitive to the negative effects of stuttering, can also overemphasize
the degree to which PWS are unable to participate effectively and autonomously in society; and (3) recognize the need for additional
research in this area and for continued education of the general public and others by advocacy groups.
#2009 Elsevier Inc. All rights reserved.
People who stutter (PWS) may experience negative consequences in terms of their academic experiences (Daniels,
2007; Dorsey & Guenther, 2000), intimate and social relationships (Boberg & Boberg, 1990; Linn & Caruso, 1998),
and employment opportunities (Gabel, Blood, Tellis, & Althouse, 2004; Hurst & Cooper, 1983). Often the disruptions
in speech fluency that PWS experience are accompanied by 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, to
paraphrase Van Riper (1982), the fluent listener is just as important as the person who stutters during conversations
between PWS and people who do not stutter (PWDS).
A number of studies have indicated that a wide variety of fluent speakers are likely to stereotype PWS negatively.
These fluent speakers have included educators (Crowe & Walton, 1981; Dorsey & Guenther, 2000; Lass et al., 1992,
1994), speech-language pathologists (Turnbaugh, Guitar, & Hoffman, 1979; Woods & Williams, 1971; Yairi &
Williams, 1970), family members of PWS (Fowlie & Cooper, 1978), and members of the general public (Ham, 1990;
Hulit & Wirtz, 1994). In these studies, PWS appear to be stereotyped as quiet, shy, guarded, anxious, and nervous
A
vailable online at www.sciencedirect.com
Journal of Communication Disorders 43 (2010) 45–60
* Corresponding author. Tel.: +1 708 534 4594; fax: +1 708 235 2195.
E-mail addresses: s-hughes@govst.edu,stephanie.a.hughes@gmail.com (S. Hughes).
0021-9924/$ – see front matter #2009 Elsevier Inc. All rights reserved.
doi:10.1016/j.jcomdis.2009.09.002
individuals who are nevertheless friendly, intelligent, and cooperative. The predominant methodology used to assess
the attitudes of PWDS toward stuttering and PWS has been to administer semantic differential scales to research
participants. These instruments ask respondents to identify the degree to which a set of paired adjectives (e.g., open/
guarded, anxious/calm) represents PWS. Semantic differential scales are advantageous because they have proven
extremely reliable in the identification of group trends related to perceptions of PWS, but they also force participants to
describe PWS according to traits that the researcher has selected (Schneider, 2005).
Only a few studies have been able to use semantic differential scales to propose new theories about how and why
stuttering stereotypes develop and persist. White and Collins (1984) administered semantic differential scales to fluent
university students and hypothesized that the stuttering stereotype originates from typically fluent speakers’
perceptions of their own negative emotions when they are placed in stressful speaking situations. Thus, according to
the stereotype formation by inference hypothesis, fluent speakers use their own disfluent experiences to infer the
personality traits of PWS. MacKinnon, Hall, and MacIntyre (2007) also administered semantic differential scales to
fluent university students in order to further expand upon the work of White and Collins. MacKinnon et al.’s (2007)
anchor-adjustment hypothesis suggests that PWDS use their own experiences of temporary disfluency as a starting
point (or anchor) for their judgments about PWS. Often these first impressions are not adjusted to account for all of the
reasons why someone might stutter, or how PWS may otherwise be very similar to PWDS. These studies indicate that
typically fluent speakers make judgments about the personality traits of PWS based on a quick and possibly
subconscious examination of their own experiences with disfluency.
The nature of the research to date has provided much information about the personality traits that PWDS associate
with stuttering, but complementary information about fluent speakers’ perceptions of stuttering in general are lacking.
In particular, there is little evidence to suggest that fluent speakers are aware of the effects of stuttering on the lives of
PWS. When considered from the World Health Organization’s International Classification of Functioning,Disability,
and Health (ICF), stuttering is more than the speech disfluencies associated with the disorder (Yaruss & Quesal, 2004).
In this context, stuttering is also associated with negative attitudes toward communication, the degree to which PWS
are able to participate in society, negative responses from listeners, and individual factors which may facilitate positive
coping with stuttering, including an accepting environment. It is unclear at this time whether PWDS are aware of these
potential consequences of stuttering, and to what extent these considerations influence their perceptions of the overall
capability of PWS to fully participate in all aspects of life.
Given that the disorder of stuttering encompasses listeners’ reactions to stuttering as well as the highly
individualized circumstances, attitudes, and coping mechanisms of PWS, the purpose of this study was to explore how
fluent speakers perceive PWS to be affected by their stuttering. The study investigated fluent speakers’ thoughts and
attitudes toward stuttering from two perspectives: a generalized account of fluent speakers’ beliefs about the life
effects of stuttering (e.g., responses to the question, ‘‘How do you think people who stutter are affected by their
stuttering?’’) and a more personal context (e.g., ‘‘How would your life be different if you were a person who
stutters?’’). The personal version of the question was included on the basis that fluent speakers make judgments about
PWS based upon their own disfluencies, (e.g., MacKinnon et al., 2007; White & Collins, 1984), and that the ability to
compare responses from fluent speakers’ general as well as personal perspectives was crucial in order to add to the
limited body of knowledge related to stuttering stereotypes.
An equally important component of the study was to ensure that the methodology would allow for exploration of
the fluent speakers’ subjective emotions and thoughts related to PWS while at the same time observing trends in these
attitudes by recruiting a large number of research participants. The data gathered from this study are meant to provide
initial impressions of fluent speakers’ thoughts and attitudes about the life effects of stuttering that may ultimately
serve to identify how fluent speakers may behave toward PWS. The research questions that guided the study are as
follows:
1. What responses do fluent speakers provide when asked to consider the life effects of stuttering for PWS and for
themselves if they stuttered?
2. Is there a qualitative or thematic difference in the responses of the participants as they describe the life effects of
stuttering in general and personal contexts?
3. Is there a quantitative difference in the responses of the participants as they describe the life effects of stuttering in
general and personal contexts?
4. Are there differences in responses based on gender and level of familiarity with PWS?
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6046
1. Methods
1.1. Design
This study used a mixed methods approach to consider the research questions from both a qualitative and
quantitative perspective. Tashakkori and Teddlie (2003) have provided three reasons why mixed designs are useful, all
of which are applicable to the present study. First, mixed designs can answer research questions that a solely
qualitative or quantitative approach cannot. Second, they allow researchers to obtain and make sense of participants’
views, which may be quite diverse and are, in and of themselves, subjective and not based on an absolute truth. Finally,
stronger and better inferences can be made when methodologies are combined. For example, while it is understood that
the results of qualitative research studies cannot be generalized to the larger population, certain types of mixed
methods designs may allow for cautious generalization of the results, as quantitative methods are also employed. Thus,
mixed methods designs present advantages to researchers who wish to gain a deep understanding of the subjective
opinions of large numbers of research participants.
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, p. 190). In this study, the
theoretical drive was qualitative in nature (e.g., to gain a better understanding of how fluent speakers perceive the effects
of stuttering); however, a purely qualitative approach could not answer such questions as whether participants’ responses
differed on the basis of gender or familiarity with stuttering. Recruiting a relatively large number of participants,
therefore, made it possible to incorporate quantitative approaches into several phases of the research process including
development of the research questions, analysis of data, and formation of inferences and conclusions.
The specific design used in this study is a multistrand conversion mixed model design (Tashakkori & Teddlie, 2003).
Essentially, this design has a mixed qualitative and quantitative purpose that is served by a set of qualitative research
questions and a set of quantitative research questions. Data collection involved a strictly qualitative approach (written,
open-ended surveys), but these data were analyzed using both qualitative and quantitative techniques. Finally, the
qualitative and quantitative inferences derived from both sets of data analyses were combined to form general conclusions
about both sets of research questions as a whole. Thus, the design allowed the researchers to draw conclusions about the
participants’ understanding of the life effects of stuttering while simultaneously gaining information about how these
perceptions varied according to gender, familiarity with PWS, and the general versus personal context. Fig. 1 provides a
visual representation of the multistrand conversion mixed model design as applied to this study.
1.2. Participants
A total of 146 graduate and undergraduate non-communication disorders students from a Midwestern university
participated in the study. The 99 women (67.8%) and 47 men (32.2%) ranged in age from 18 to 58 years (M= 22.5,
SD = 6.18) and were recruited from a variety of academic majors. The majority of participants (52.7%, n= 77) were
from the College of Education and Human Development which included such diverse majors as interior design,
tourism, and human movement/leisure studies in addition to education. Other participants were from the College of
Arts and Sciences (22.6%, n= 33), the College of Business Administration (10.3%, n= 15), the College of Health and
Human Services (7.5%, n= 11), and the College of Technology (4.8%, n= 7). Three participants (2.1%) reported that
they were undecided as to their major. Participants were generally representative of the university in terms of gender
and ethnicity. Students who reported a history of stuttering were excluded from the data set; however, students were
not screened for other speech, language, or hearing disorders.
Participants varied in terms of their familiarity with PWS and ranged from knowing no one who stutters to knowing
seven PWS (M= 1.42, SD = 1.39). One participant who reported knowing a combined total of 36 PWS was removed
as an outlier from subsequent data analyses involving familiarity with PWS, and one participant neglected to report the
number of PWS known. Thirty-four participants (23.6%) reported not knowing anyone who stutters. The remaining
110 participants (75.3%) reported knowing a combined total of 204 PWS. Participants also indicated how well they
knew their acquaintances who stutter (e.g., not very well, well, very well). Table 1 provides frequency counts and
percentage data of participants’ familiarity with PWS. In addition to familiarity with PWS, 35 participants (24%)
reported taking some type of class that discussed communication disorders in general. While four participants
indicated that they had taken a formal course such as Introduction to Communication Disorders, the vast majority of
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 47
the students reported that they had discussed communication disorders in their Introduction to Personal
Communication (IPC) course. Consultation with IPC instructors indicated that communication disorders were not
formally discussed as part of the course.
1.3. Instrumentation
A written survey consisting of two open-ended questions and a demographic questionnaire was developed. On the
first page of the survey, participants were asked, ‘‘How do you think people who stutter are affected by their stuttering?
Please explain.’’ The second page of the survey asked, ‘‘If you were a person who stutters, how would your life be
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6048
Fig. 1. Visual representation of the multistrand conversion mixed model design.
different, and why?’’ These questions were developed in conjunction with two ASHA Board-Recognized Fluency
Specialists and were piloted with a subset of university students who provided critical feedback on several versions of
the questions. Data analysis indicated that there were no substantial thematic differences associated with versions of
the personal and general questions that were more similar (i.e., ‘‘How do you think PWS are affected by their
stuttering?’’ versus ‘‘If you were a person who stutters, how would you be affected by your stuttering?’’).
The written instructions that preceded the survey questions asked participants to be as honest as possible with their
answers and assured participants that their responses were neither right nor wrong. The third and final page of the
survey requested demographic information and asked participants to provide such information as age, gender, and
academic major. Participants were also asked to indicate whether they considered themselves to be a person who
stutters (either currently or in the past), and if they ever had a class (whether formal or otherwise) that discussed
communication disorders. In addition, participants were asked if they know/knew any PWS, and if so, how well they
know/knew that person or persons.
1.4. Procedure
The university students were personally invited to participate in the study during a visit to their classroom by the
first author. The author emphasized that one could complete the survey even if one did not know a person who stutters,
and that students’ responses would remain confidential. Students who decided to participate completed the survey
outside of class and mailed the survey to the researchers at their convenience. Follow-up procedures, including
reminder notices, were conducted as described by Dillman (2007) and a response rate of 35% was obtained.
Interviews were also conducted with 18 participants who volunteered to meet with the first author to elaborate on
their written survey responses. The interviews lasted between 10 and 20 min and allowed the researchers to ensure that
they had correctly interpreted the responses of participants in the written data set. Interviewees were first asked to
define or imitate stuttering. Most interviewees indicated that they associated stuttering with part-word repetitions and
occasional sound prolongations. Open-ended questions and probes were asked as needed based on the interviewees’
written survey responses. The data obtained from these interviews were transcribed verbatim and were merged with
the written data set after quantitative analysis of the responses was performed. Thus, the interviews served as a means
of ensuring that the researchers’ interpretation of the written data set was credible.
1.5. Data analysis
The general procedure for analysis of qualitative research as proposed by Maxwell (2005) was used to analyze all
data. In the first step of the analysis process, the survey data were read as they became available and notes were taken
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 49
Table 1
Frequency counts and percentages of participants’ familiarity with PWS (n= 144
a
).
Familiarity level Number of PWS known NPercentage of participants
Know 0 PWS 0 34 23.6%
Know PWS not very well 0 88 60.3%
1 37 25.3%
2 8 5.5%
3 8 5.5%
4–7 4 2.8%
Know PWS well 0 96 65.8%
1 36 24.7%
2 8 5.5%
3 3 2.1%
4–7 1 .7%
Know PWS very well 0 114 78.6%
1 22 15.1%
2 9 6.2%
a
One of the 146 participants was removed as an outlier; another participant did not provide a response to the familiarity question.
regarding initial impressions. Preliminary ideas about the nature of participants’ responses and how these 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. The coded data were then arranged into
themes which allowed the researchers to present the broader issues that were representative of participants’ individual
responses.
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 the participants’ responses. In addition,
the ratio of responses was calculated for individual themes as compared to the total number of participants’ responses.
The ratio data provided information about the relative frequency of themes that was not confounded by differences in
the total number of responses made by participants, i.e., participants who made many statements versus those who
made fewer statements. Participants’ general responses as compared to their personal responses were compared using
t-tests to determine if group differences existed. Advanced statistical analyses were subsequently conducted and
included Multivariate Analysis of Variance (MANOVA) for gender, level of familiarity with PWS, and the interaction
of these factors.
1.6. Credibility and reliability
The primary design used in this study was qualitative in nature, and so the assumptions for credible and reliable
qualitative research were met as set forth by Creswell (1998). First, triangulation of the qualitative and quantitative
data helped to validate the researchers’ analyses. The term triangulation has come to represent the concept of
combining multiple data sets, or multiple forms of data interpretation, in order to ensure that researchers’ conclusions
related to a particular phenomenon are credible (Denzin, 1978). In the present study, a number of methods were used to
achieve triangulation. The most obvious of these methods was the use of both qualitative and quantitative approaches
to investigate students’ beliefs about the life effects of stuttering. In addition, data collection was also triangulated,
because although the primary source of data was the open-ended survey, a small subset of participants were also
interviewed to determine if the researchers’ conclusions about the survey responses did indeed correspond to
participants’ actual views. This process, called member checking, also ensures credibility of results in qualitative
research (Glesne, 2006).
In addition to triangulation, the validity of the qualitative data analysis was enhanced by the use of two peer
reviewers who ensured that the themes as established by the first author were credible. The peer reviewers had
backgrounds in fluency disorders and qualitative research methods, but had no personal interest in the outcome of the
study. These individuals also provided measures of inter-rater reliability, in which a subset of the data (approximately
25% of responses) was randomly selected for analysis by the peer reviewers and the first author. For the general
question, inter-rater percent agreement was 94.5%, and Cohen’s Kappa, a more stringent measure of agreement, was
calculated to be .92. Measures of intra-rater reliability were obtained as the first author re-coded the data subset
approximately two weeks after the inter-rater reliability measures were obtained. Intra-rater percent agreement was
100% and Cohen’s Kappa was 1.0. For the personal question, inter-rater percent agreement was 96.9%, and Cohen’s
Kappa was .96. Intra-rater percent agreement was 99.2 and Cohen’s Kappa was .99. These findings indicate that inter-
and intra-rater agreement were high for both questions.
2. Results
The general themes extrapolated from the qualitative analysis are presented first and are followed by descriptive
statistics derived from the quantitative analysis of these themes. Advanced analyses of the qualitative and quantitative
data are then presented.
2.1. Descriptive findings
2.1.1. Qualitative themes
Four themes emerged from participants’ responses for both the general and personalized versions of the survey
question. These themes were the same for both questions. A brief discussion of each theme is considered below, with
more advanced analysis of the qualitative responses considered in Section 2.2.1.
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6050
Theme 1: Difficulty communicating can have emotional and behavioral consequences for PWS. Participants’
statements related to this theme referred to the speaking difficulties that PWS experience. These difficulties were
associated with emotions and coping mechanisms that were often negative in nature. For brevity, additional references
to this theme will be shortened to Communication Difficulties.
Theme 2: PWS can be negatively affected by the actual or anticipated reactions of their listeners. Participants
indicated that fluent speakers are not always kind to PWS. In addition, anticipation of negative listener reactions was
also reported as being a source of stress for PWS. Thus, the actual or perceived reactions of fluent listeners toward
stuttering and PWS were considered to have important consequences upon the lives of PWS. This theme is shortened
to Listener Reactions in future references.
Theme 3: The life effects of stuttering are broad and encompass social, academic, and occupational opportunities.
Participants indicated that stuttering generally limits one’s ability to participate as fully in life events as one might
desire. Finding a good job, succeeding in school, and forming social relationships were perceived as difficult for PWS.
This theme is shortened to Life Effects in future references.
Theme 4: Individual differences among PWS result in variations in the life effects of stuttering. Some participants
recognized that PWS are not a homogeneous group of people who experience stuttering in the same ways. Instead, the
unique life experiences of individuals who stutter, when combined with their personality traits, motivation to
overcome stuttering, and sources of support, result in different effects of stuttering upon individuals. Future references
to this theme use the shortened form of Individual Variations.
2.1.2. Descriptive statistics
The 146 participants provided a total of 813 statements (M= 2.78, SD = 1.40). Of these statements, 419 (M= 2.87,
SD = 1.35) were responses to the general question and 394 statements (M= 2.70, SD = 1.44) were related to the
personal question. When participants’ responses to the general question were rank ordered from most statements to
least statements by theme, Communication Difficulties accounted for 43.7% of the statements, followed by Listener
Reactions (31.5%), Life Effects (18.1%), and Individual Variations (6.7%). Differences in the rank order were
observed for the personalized question, in which Listener Reactions statements accounted for 38.6% of responses,
followed by Life Effects (37.9%), Communication Difficulties (15.2%), and Individual Variations (7.9%). Table 2
provides the means and standard deviations for both the general and personal 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 nine statements. Ratio data for both questions are also provided in
Table 2.
2.2. Advanced analysis
2.2.1. Qualitative themes
2.2.1.1. Communication Difficulties. In response to both the general and personal question about the life effects of
stuttering, participants indicated that PWS have difficulty communicating effectively. These difficulties were reported
in such statements as ‘‘Stuttering affects [PWS] because they can’t say a thought without stuttering,’’ and ‘‘I would
likely have trouble communicating effectively with others.’’ The effects of not being able to communicate easily were
reflected in statements that reported the emotional consequences of stuttering. A participant responding to the general
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 51
Table 2
Descriptive and ratio data for participants’ statements by theme (n= 146).
Themes Descriptive statistics Ratio data
General question Personal question General question Personal question
NMSD NMSD NMSD NMSD
Communication Difficulties 183
*
1.25 1.19 60
*
.41 .65 65.38
*
.45 .38 23.39
*
.16 .28
Listener Reactions 132 .90 1.00 152 1.04 .95 48.35
*
.33 .35 62.86
*
.43 .39
Life Effects 76
*
.52 .84 149
*
1.02 1.25 22.32
*
.15 .25 44.65
*
.61 .33
Individual Variations 28 .19 .69 31 .42 .51 9.58 .07 .21 13.44 .13 .24
*
Significant difference at p<.05.
question wrote, ‘‘I imagine stutterers can become frustrated because they know what they want to say but just can’t get
it out.’’ Similarly, another participant wrote, ‘‘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.’’ Deeper psychological problems were also mentioned:
‘‘They probably get discouraged and depressed trying to say words that just won’t come out right,’’ wrote one
participant. ‘‘I might feel inadequate due to my relative deficiency, and would, possibly, suffer from deep-seated
psychological problems such as clinical depression,’’ wrote another.
Difficulty speaking and its accompanying emotional effects were also related to the use of negative coping
mechanisms and avoidance behaviors by PWS. Participants reported that PWS were likely to talk less and withdraw
from communication with others, especially in public speaking situations and 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.’’ When considering stuttering from a more personal standpoint, another participant
wrote, ‘‘It would take so long to say something that I wouldn’t say as much when I talked.’’ Participants also reported
that PWS use coping mechanisms to help them be more easily understood. For example, PWS were thought to use
‘‘body language, writing, or sign language’’ instead of speaking, as well as ‘‘shorter sentences and more basic words.’’
Thus, some participants appeared to believe that PWS employ negative coping mechanisms, such as withdrawing from
verbal communication with others, as a result of the speaking difficulties that occur because of stuttering.
When the qualitative responses to the general and personal version of the question were compared, there were some
notable differences in participants’ responses. Participants’ personal responses indicated 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 the general question as ways in which PWS cope with their stuttering. In
addition, only one participant wrote of relatively 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.’’ This sentiment was not reported by participants in their general considerations of the life effects of PWS.
It would appear that the participants, when considering stuttering in both generalized and personal contexts,
appeared to acknowledge that it is difficult for PWS to express their thoughts easily. The emotional effects of such
speaking and communication difficulties were a focal point for participants’ responses, to the point where the inability
to fluently and easily communicate was, perhaps, overshadowed by the emotional repercussions, such as frustration,
impatience, and even anger, that stuttering might engender in PWS. When asked to consider what their lives would be
like if they stuttered, participants tended to provide more personally meaningful responses, including specific
situations that they would find difficult to manage as a person who stutters.
2.2.1.2. Listener Reactions. Another theme consisted of participants’ beliefs about the reactions of fluent listeners to
stuttering and, similarly, the reactions of PWS to fluent listeners’ reactions to their stuttering. In the general context,
participants suggested that listeners react negatively toward stuttering and will tease PWS, not take them seriously, and
be impatient during conversations. For example, one participant wrote, ‘‘They get looked at as different and people
choose not to be around them because they do not want to deal with the stuttering.’’ Such considerations were also
reflected in the personal context: ‘‘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.’’ 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.)’’
The anticipation of negative listeners’ reactions was also reported as influencing the thoughts, emotions, and
behaviors of PWS. Examples of these perceptions from participants responding to the general question included such
statements as, ‘‘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 provided similar responses
in the personal context: ‘‘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. In totality, the
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6052
responses to both survey questions indicate that the participants believed that PWS encounter mostly negative
reactions from listeners. These negative reactions were presumed to have an adverse emotional and behavioral effect
on PWS.
2.2.1.3. Life Effects. Participants indicated that PWS experience general life difficulties because of their stuttering.
For example, one participant wrote, ‘‘I can imagine situations where their speech would have negative effects, almost
every day.’’ Another participant wrote that ‘‘stuttering can be detrimental to a person’s mental and emotional health,
and maybe even physical health.’’ 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.’’ Participants wrote similar statements
when they considered what their lives would be like if they stuttered, e.g., ‘‘I feel I would have a completely different
life,’’ and ‘‘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
the effects of stuttering are perceived as being broad and having far-reaching consequences.
Participants also indicated that social opportunities for PWS are limited, and that PWS experience difficulties
making friends and forming intimate relationships. For example, one participant wrote, ‘‘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.’’
Another participant wrote, ‘‘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 felt that if they stuttered they would have an equally hard time forming social and intimate relationships,
and both male and female participants described how they would not be perceived as attractive by potential romantic
partners if they stuttered.
There was some divergence in terms of the focus of participants’ responses for the general and personal versions of
the question. In the general context, participants mentioned the effects of stuttering on childhood friendships and
socialization: ‘‘Sometimes when they are younger it seems like it is 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.’’ In the personal context,
participants cited that their main issues would be lack of friends and the inability to participate in hobbies such as
singing, debate, and acting.
In addition to social difficulties, participants indicated that stuttering can have an impact on academic performance.
In the general context, difficulties with oral communication were 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,’’ wrote one participant. Likewise, another participant remarked that
stuttering ‘‘may affect how they do in school regarding speeches and reading.’’ Similar responses were described by
participants as they considered stuttering from a personal standpoint: ‘‘[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 would question their ability to participate in
extracurricular activities if they stuttered, particularly in ‘‘positions of leadership.’’ One’s ability to attend college was
also questioned: ‘‘I don’t think I would be in school and I probably would still be living with my parents.’’ This
statement and others like it suggest that stuttering was perceived as having a negative impact on participants’ ability to
achieve higher educational goals and to live independently. It should be noted, however, that although the vast majority
of responses indicated poor academic experiences due to stuttering, 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, participants indicated that stuttering has occupational effects. When the
employability of PWS in general were considered, participants reported that they felt stuttering would limit job
opportunities, particularly those jobs that involve oral communication. ‘‘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,’’ wrote one participant. When participants reported on the possible occupational effects of stuttering on
their own lives, similar statements emerged, and with considerably more detail. Future teachers, in particular, seemed
to anticipate the necessity of choosing a different career path if they stuttered. One participant wrote, ‘‘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.’’ Another participant, writing from a more personal viewpoint, suggested that, ‘‘I would also have to change
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 53
my major because I wouldn’t be able to be an early childhood teacher with a stutter.’’ These participants 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.’’ 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 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.’’
Difficulties during the interview process and mostly negative attitudes of employers and customers toward
stuttering were also reported. One participant wrote, ‘‘I would assume [PWS] are limited in occupations and
discriminated as unintelligent when attending interviews.’’ The interview process was also be a point of concern for a
physical therapy major who imagined that if she stuttered she could be discriminated against during her graduate
school interviews. Similarly, participants also indicated that the reactions of employers to PWS would prevent them
from obtaining jobs that require high levels of verbal communication. A participant who had a history of working in
sales wrote, ‘‘I believe [PWS] 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.’’ One
participant imagined that if she stuttered she ‘‘would not be able to be a waitress because I would have trouble talking.’’
Thus, it appears that PWS are perceived as being a potential liability to companies in which communication is
essential, such as sales, teaching, or a variety of other professions. The overall life effects of not being able to obtain a
high-paying job in a communications-related field were perceived as impacting 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 the prejudices of employers,
and as a result they may not obtain financial security or maintain their autonomy. In one notable exception, a
participant wrote ‘‘[If I stuttered,] 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.’’
2.2.1.4. Individual Variations. Participants indicated that the effects of stuttering for PWS (or for the participants, if
they stuttered) could vary depending on a number of factors. These factors were exemplified in the quite detailed
response of one participant who responded to the general version of the question:
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 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.
Thus, factors such as the duration of stuttering, its severity, listeners’ responses to the individual’s stuttering, and the
personal coping responses of PWS were suggested as ways in which the life effects of stuttering may vary from person
to person. In their more personalized responses, participants reported similar sentiments. Stuttering severity and
listeners’ reactions were reported as factors that influence life effects of stuttering, as was the fortitude of the
participants themselves and their ability to cope with stuttering. 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, e.g., ‘‘I think that I would be able to work through the problem and not let it affect my life.’’ In general, these
responses were positive and reflected participants’ beliefs that they could move past their stuttering. As one participant
wrote, ‘‘I would not let this challenge define me as a person!’’
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6054
2.2.2. Quantitative results
Quantitative comparisons were made between participants’ responses to the general and personal survey questions.
Paired samples t-tests were conducted to determine if the participants provided quantitatively different responses to
these questions, even though the responses for both questions were qualitatively similar. The results indicated that the
total number of statements made by participants did not differ between the two questions (t= 1.22, p= .22). The total
number of Communication Difficulties statements decreased significantly from the general question to the personal
question (t= 7.57, p<.001), and the same was true of Life Effects statements (t=4.17, p<.001). There was not a
significant difference between the total number of Listener Reactions statements (t=1.20, p= .29) or Individual
Variations statements for each question (t=2.81, p= .78). Analysis of the ratio data indicated largely similar results
as compared to the total number of responses. Specifically, the ratio data followed the same trends as compared to total
numbers of responses for all of the themes except Listener Reactions. Unlike the total number of Listener Reactions
statements, which did not significantly differ in the personal versus general contexts, the ratio of Listener Reactions
statements to the total number of statements was significantly greater for the personal question than for the general
question (t=2.23, p= .03). The means and standard deviations for this analysis are displayed in Table 2.
Separate Multivariate Analysis of Variance (MANOVA) statistics were calculated for the general question and the
personal question to determine if responses differed according to gender, familiarity with PWS, or interactions
between gender and familiarity for the total statements per theme and the ratio data per theme. Box’s Test to determine
homogeneity of covariance indicated unequal variances among participants’ responses due to dissimilar numbers of
male and female participants. Therefore, Pillai’s Trace statistics were used to interpret the multivariate tests because
these statistics are robust enough to withstand unequal variances (Meyers, Gamst, & Guarino, 2006). For the general
question, there was no significant difference for any of the themes according to gender (F[8,129] = 1.77, p= .09,
h
2
= .10, observed power = .74), or interaction between gender and familiarity (F[32,528] = 1.2, p= .21, h
2
= .07,
observed power = .95). There was a significant difference according to level of familiarity with PWS
(F[32,528] = 1.67, p= .013, h
2
= .09, observed power = .10). Post hoc tests indicated that the ratio of Life Effects
statements to the total number of statements accounted for this difference. The ratio of reported Life Effects statements
was greater for participants who knew PWS very well (M= .23, SD= .27) and who knew no PWS at all (M= .14,
SD = .223) and somewhat lower for participants who knew PWS well (M= .13, SD = .23) or not very well (M= .10,
SD = .22).
For the personal question, there was no significant difference for any of the themes according to gender
(F[9,128] = .88, p= .55, h
2
= .06, observed power = .42), level of familiarity (F[36,524] = 1.23, p=.17, h
2
= .08,
observed power = .97), or gender/familiarity interaction (F[36,524] = .86, p= .70, h
2
= .06, observed power = .86).
The means and standard deviations for these analyses are presented in Table 3. While ratio data were included in the
MANOVA calculations for each question, they have not been included in the table for the sake of brevity. These
findings suggest that men and women did not vary in terms of the responses they provided to the survey questions, and
that familiarity with PWS appeared to be salient only when participants described the life effects of stuttering in a
general versus personal context. Cautious interpretation of these results is warranted given the unequal variances
among groups of participants.
3. Discussion
The purpose of this study was to add to the body of knowledge related to fluent speakers’ attitudes toward stuttering
and PWS. Unlike other studies, the current study did not ask fluent speakers to rate the personality traits of PWS versus
PWDS. Instead, fluent speakers’ open-ended responses were analyzed both qualitatively and quantitatively to gain a
broader and deeper understanding of the ways in which PWS are perceived to be affected by their stuttering. This
approach is unique in several ways, and the discussion that follows is meant to provide a springboard for other
researchers who may wish to conduct mixed methods research on a variety of topics related to the attitudes of fluent
speakers toward PWS. Many considerations for future research are presented.
The results indicate that stuttering was perceived as having general as well as specific negative effects for PWS.
Difficulty expressing oneself was cited as a cause of frustration and other negative emotions for PWS. In addition,
PWS were perceived as coping with these speaking difficulties by withdrawing from society and using less verbal
communication. The reactions of listeners were perceived as being negative and consisted of avoidance, teasing, and
discrimination of PWS. The fluent speakers who served as participants suggested that PWS become shy, quiet,
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 55
frustrated, or withdrawn as a reaction to these negative listener responses. These negative adjectives are similar to the
results of nearly all studies which have investigated fluent speakers’ perceptions of the personality traits of PWS. It
would seem that fluent speakers believe that certain negative personality traits emerge over time as a result of negative
experiences with listeners. It appears unlikely that fluent speakers believe that PWS stutter because they are inherently
shy, nervous, anxious, or frustrated, but more research is needed on this topic.
In addition to experiencing negative listener reactions, the participants indicated that stuttering would have other
effects on the lives of PWS. Making friends and dating were perceived to be difficult, as was finding and maintaining
employment. Careers that required high levels of oral communication, such as teaching, telemarketing, and sales were
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6056
Table 3
Means and standard deviations for themes by gender and familiarity with PWS (n= 146).
Theme Gender Familiarity level General question Personal question
NMSD NM SD
Communication Difficulties Male Know 0 PWS 5 .60 .89 5 .80 1.10
Know PWS not very well 15 1.20 1.08 15 .40 .63
Know PWS well 12 1.67 1.37 13 .46 .88
Know PWS very well 12 1.17 1.53 14 .43 .65
Total 44 1.25 1.28 47 .47 .75
Female Know 0 PWS 31 1.10 .83 30 .40 .56
Know PWS not very well 26 1.88 1.45 25 .36 .64
Know PWS well 25 .96 .98 25 .28 .46
Know PWS very well 20 1.05 1.10 19 .53 .77
Total 102 1.25 1.15 99 .38 .60
Listener Reactions Male Know 0 PWS 5 1.60 1.14 5 1.20 1.10
Know PWS not very well 15 .60 .74 15 .87 .74
Know PWS well 12 .42 .67 13 1.31 1.03
Know PWS very well 12 .92 .90 14 .57 .85
Total 44 .75 .87 47 .94 .92
Female Know 0 PWS 31 1.23 1.12 30 1.23 1.07
Know PWS not very well 26 .54 .76 25 .96 .79
Know PWS well 25 .96 1.10 25 1.12 1.09
Know PWS very well 20 1.15 1.09 19 1.00 .88
Total 102 .97 1.05 99 1.09 .97
Life Effects Male Know 0 PWS 5 .20 .45 5 1.00 1.00
Know PWS not very well 15 .53 .74 15 1.00 1.25
Know PWS well 12 .92 1.24 13 .69 .95
Know PWS very well 12 .75 .87 14 1.14 .95
Total 44 .66 .91 47 .96 1.04
Female Know 0 PWS 31 .45 .77 30 .90 1.12
Know PWS not very well 26 .38 .70 25 .92 1.04
Know PWS well 25 .48 1.00 25 1.52 2.04
Know PWS very well 20 .55 .76 19 .84 .96
Total 102 .46 .80 99 1.05 1.38
Individual Variations Male Know 0 PWS 5 .00 .00 5 .00 .00
Know PWS not very well 15 .07 .26 15 .33 .62
Know PWS well 12 .08 .29 13 .00 .00
Know PWS very well 12 .33 1.15 14 .36 .63
Total 44 .14 .63 47 .21 .51
Female Know 0 PWS 31 .16 .37 30 .20 .55
Know PWS not very well 26 .12 .33 25 .28 .61
Know PWS well 25 .52 1.29 25 .32 .56
Know PWS very well 20 .05 .22 19 .00 .00
Total 102 .22 .71 99 .21 .52
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 significant amounts of oral communication. Negative academic consequences were
associated with stuttering, including teasing and bullying by peers, lower grades, and poor performance during
presentations and while reading aloud. Some participants questioned the ability of PWS to attend institutions of higher
education. These types of responses indicate that fluent speakers may believe PWS to be at a social, occupational, and
academic disadvantage as compared to PWDS.
How might fluent speakers come to acquire these perceptions of the effects of stuttering? The responses to the
survey questions in this study seem to confirm White and Collins’ (1984) stuttering stereotype formation by inference
hypothesis. It seems that the fluent university students answered the written open-ended survey questions by
considering their own experiences of state (temporary) disfluency in speaking situations. For example, most
participants reported that PWS have difficulty saying what they want to say when they want to say it, and that
frustration, embarrassment, shyness, and anxiety result in these situations. Certainly normally fluent speakers have
experienced situations in which their lack of fluency prevents them from communicating as effectively as they would
like and in which negative emotions are felt. Thus, to the extent that no one can maintain perfect fluency, and that
disfluency can cause frustration and embarrassment, PWS and PWDS have in common a basic understanding of the
ways in which a lack of fluency can result in unpleasant consequences for the speaker. The ability of fluent speakers to
readily imagine themselves as PWS may indicate that the participants in this study had experienced the effects of
disfluency and recalled them as they responded to the survey questions.
Further support for the stuttering stereotype formation by inference hypothesis and also MacKinnon et al.’s (2007)
anchoring-adjustment hypothesis was provided by analysis of thematic differences in the responses of fluent speakers
who considered the effects of stuttering from a general versus personal context. Participants reported similar themes
for both questions, but most 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 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 considered equally important for actual PWS and participants who
imagined themselves to be PWS. Participants seemed to have adjusted their responses from the general question to the
personal question based on their experiences as relatively young university students. That many of the participants
reported on how stuttering would affect them negatively in terms of forming relationships, finding jobs, and
succeeding in college seems indicative of the challenging life stage that is young adulthood, when one focuses on
forming relationships and attempts to make major life decisions. Likewise, the participants’ beliefs that they would
experience or be afraid of unpleasant listener reactions to their stuttering may be related to a self-consciousness that
could lessen as the participants aged. This explanation may account for why more statements about listener reactions
and life effects of stuttering were made for the personal version of the question versus the general version, though the
content of the responses were very similar thematically. It is conceivable that some aspects of fluent speakers’
perceptions of the effects of stuttering may change over time as new life experiences are gained.
Also of note is that fewer participants reported that the effects of stuttering would depend on the individual who
stutters. One such aspect as reported in this study 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 received speech therapy. Thus, small numbers of participants appeared to report less stereotypical answers to
the survey questions by recognizing that PWS will experience their stuttering in diverse ways based on individual
differences. More research is needed to determine how PWDS come to develop this perspective, as the present study is
unable to account for those factors which may influence participants’ responses in this way.
Another consideration of the study was whether participants’ responses differed on the basis of gender and level of
familiarity with PWS. There did not appear to be a gender bias, as men and women reported the same types of beliefs
about the effects of stuttering. In addition, even though participants varied in the number of PWS they knew and the
closeness of their relationships with these individuals, participants who knew PWS were not significantly more likely
to provide thematically different responses from people who did not know any PWS at all. While multivariate testing
revealed that familiarity did influence participants’ responses for only the general question, closer examination
indicated that the basis for this influence was based solely on the calculated ratio for Life Effects statements, and no
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–60 57
dependent variables. The lack of a straightforward rationale for this result and the fact that equal variances could not be
assumed during statistical analysis suggest that any conclusions about the effects of gender and familiarity must be
tentative at best. Still, the results of this study cautiously support the findings of various researchers who have not
found a gender or familiarity bias toward PWS (e.g., Doody, Kalinowski, Armson, & Stuart, 1993; Patterson & Pring,
1991).
4. Conclusions
This study suggests that fluent speakers perceive PWS as being disadvantaged by discrimination and prejudice
against PWS, but that PWS may choose not to participate in the opportunities and activities that are available to them.
The limited research on this topic suggests that PWS do feel that they are disadvantaged by their stuttering in a variety
of contexts, including academically, occupationally, and emotionally (Corcoran & Stewart, 1998; Klompas & Ross,
2004). Smart (2001) suggests that people with disabilities in general may internalize society’s negative stereotypes and
consequently have lowered self esteem and self worth. It is conceivable that the fluent speakers in this study recognized
and reported this possibility as they assumed that PWS would not be able to or would not want to participate in many
life events. Certainly the issues raised by participants in this regard correspond very well with the work of Yaruss and
Quesal (2004) related to the World Health Organization’s International Classification of Functioning,Disability,and
Health (ICF). When asked to consider how PWS are affected by their stuttering, the fluent speakers 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, a smaller number of participants were able to
recognize that the kinds of individual differences and facilitating factors suggested in the ICF model would result in a
more positive quality of life for PWS. It is important to note, however, that participants also made comments that
seemed to exaggerate the life effects of stuttering. Fluent speakers imagined that PWS live in poverty because they are
unable to obtain high-paying jobs or any job at all, are sent to group homes because they are unable to live
independently, and use sign language, gestures, or writing to communicate because they cannot speak effectively. Such
sentiments were made by a relatively small number of participants, but they indicate that stuttering foundations and
support groups would do well to continue their efforts to educate members of the general public about stuttering and
the ability of PWS to be fully-functioning members of society.
It is also apparent that many fluent speakers believe that much of one’s success in life is based on the ability to speak
fluently. While it is not surprising that the participants indicated that stuttering can have negative consequences on the
lives of PWS in general, these fluent speakers also tended to report that if they stuttered their accomplishments and
achievements to date would not have occurred. Only a few participants indicated that their personal characteristics,
such as motivation, hard work, and perseverance, would not change if they stuttered, and that they could achieve
personal, occupational, and academic success regardless of their fluency. For the vast majority of participants, the
thought of living life as a person who stutters seemed to invoke a sense of loss that seemed related to a vital part of their
identities as fluent speakers. Thus, it would appear that asking research participants to consider the effects of stuttering
on their own lives, in addition to the lives of PWS in general, results in a more holistic and detailed account of the
attitudes of fluent speakers toward stuttering.
There are numerous directions that future research on this topic can take, particularly as little is known about the
self-perceived and actual behavior of fluent speakers toward PWS. For example, it is unclear at this time if recognition
of the potentially negative consequences of stuttering results in less negative attitudes toward PWS. It is also unclear as
to whether less negative attitudes are correlated with less prejudicial or discriminatory behaviors toward PWS. Along
these lines, more direct surveying techniques may address the degree to which PWDS believe that PWS can positively
cope with and manage their stuttering. The characteristics of PWDS who report less stereotypical views in this regard
should be identified in order to promote those factors which may ameliorate negative attitudes toward PWS and toward
people with communication disorders in general. Future research on this topic may benefit from surveying a wider and
more diverse range of fluent speakers, as well as PWS, in order to gain a more complete understanding of the perceived
effects of stuttering. Finally, participants in this study were not asked to state whether they had a history of a
communication disorder other than stuttering. It is possible that participants who had experienced or continued to
experience a communication disorder would respond differently to the survey questions as compared to the larger
sample of participants. Similarly, the few participants who had taken a formal communication disorders course may
have responded in ways that were subtly different or biased as compared to the other participants. Future researchers
S. Hughes et al. / Journal of Communication Disorders 43 (2010) 45–6058
may wish to investigate these limitations as separate variables that may influence fluent speakers’ attitudes toward
people who stutter.
Appendix A. Continuing education questions
1. Which of the following statements best summarizes the majority of fluent university students’ perceptions of the life
effects of stuttering?
a. Stuttering can be overcome with therapy and other forms of environmental support.
b. PWS are likely to experience adverse consequences in terms of their academic, social, and occupational
experiences.
c. Motivation and a personal determination to succeed are necessary for PWS to be fully functioning members of
society.
d. PWS will require extra economic and social support if they wish to lead financially stable and independent lives.
2. What changes in participants’ responses were note d as participants considered how stuttering affects PWS generally
versus how stuttering would affect them personally if they were PWS?
a. The responses to the questions were quantitatively different.
b. The responses to the questions were qualitatively different.
c. There were no differences among participants’ responses to both questions.
d. The responses were both qualitatively and quantitatively different.
3. What were some participants’ concerns for PWS when trying to obtain and maintain employment?
a. Employers and customers will not tolerate people who cannot communicate effectively.
b. Employers may discriminate against PWS during job interviews.
c. PWS may decide not to pursue jobs which require large amounts of verbal communication.
d. All of the above.
4. Which of the following statements is true regarding the extent to which gender was related to participants’
responses?
a. Women considered the effects of stuttering to be more dependent upon the personal characteristics of PWS than
men.
b. The qualitative responses indicated that men felt stuttering had fewer life effects than women.
c. No gender differences were observed.
d. Both A and B.
5. Which of the following statements is true regarding the extent to which level of familiarity was related to
participants’ responses?
a. Level of familiarity with PWS influenced participants’ quantitative but not qualitative responses.
b. Level of familiarity with PWS influenced participants’ qualitative but not quantitative responses.
c. Participants who did not know any PWS provided less responses in general than did participants who knew at
least one person who stutters.
d. The level of familiarity with PWS was not a significant factor in participants’ responses.
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