2003 IFA Congress: Montreal, Canada

Research Summary On Stutterers’ And Nonstutterers’ Belief Systems

Dale Gronhovd1 and Phillip L. Rice2
1Department of Speech/Language/Hearing Sciences, Minnesota State University Moorhead, Moorhead, Minnesota, 56563, USA
2Department of Psychology, Minnesota State University Moorhead, , Moorhead, Minnesota, 56563, USA

SUMMARY

A series of projects and research studies has yielded an experimental version of a 130 item belief checklist, based on responses from 107 stutterers and 228 nonstutterers. The checklist has been used to study and compare the belief systems of stutterers and nonstutterers regarding fluent speech, fluent Speakers, stutterers, and stuttering. It has also suggested a potentially significant relationship between certain beliefs of stutterers and their levels of speech-related anxiety. Finally, a clinical study has suggested that the checklist may be able to track cognitive change during therapy.

  1. Introduction
The following studies assume that people who stutter may be different from normal speakers in the way they behave, think and/or feel about fluent and disfluent speech and speakers. In short, we assume that in any given person who stutters, there may be behavioral, cognitive and/or emotional components that are clinically significant and may need to be assessed and managed (Gronhovd & Zenner, 1982).

In addition to these behavioral, cognitive and emotional components, another term that is often associated with the problem of stuttering is “attitude.” However, an attitude is generally considered to be comprised of the previously mentioned emotional (feeling) and cognitive (belief/thought) components. In addition to the emotional and cognitive components, the behavioral component may be included as an additional aspect of an attitude because of a person’s tendency to behave in certain ways based on their thoughts and feelings.

There is no shortage of literature on the topics of behavioral, emotional and attitudinal components of stuttering. Although beliefs are considered to be an essential element of an attitude, most of the research on attitudes in stutterers have involved the use of affect-based instruments. For Example, Erickson (1969) says of his S-scale that “many of the S-scale items appear to be related with some specificity to experiences of difficulty or to feelings of fear, discomfort, and inadequacy in relatively unfamiliar or unsympathetic situations” (p. 721). This also appears to be the case when the individual items of most “attitude” scales are scrutinized.

In summary, little has been published on the specific nature and role of beliefs (as opposed to affect-loaded attitudes) in stuttering. Fishbein’s (1967) assertion that attitudes are best studied through belief statements rather than affective statements, along with the relative dearth of research regarding stutterers’ beliefs, motivated our attempts to study and define some of the beliefs and belief systems of normal speakers and those who stutter.

  1. Development of belief statements
Peschong (1982) developed 132 belief statements based on a review of the “attitude” checklists of Ammons and Johnson (1944), Erickson (1969), Gronhovd and Zenner (1979), and Crowe and Cooper (1977) and her own interviews with stutterers. The belief statements met criteria suggested by Fishbein and Ajzen (1975). These criteria state that the belief statements must:
  1. Show an understanding between the individual and his environment.
  2. Be able to be proven or disproven.
  3. Stress the probability (factual) rather than the evaluative (affective/emotional) aspect of a concept.
Examples:
  1. Stutterers are most disfluent when talking to an authority figure.
  2. A stutterer tends to stutter on the same words.
  3. Stutterers are more intelligent than nonstutterers.
  1. Study 1 - N onstutterers’ belief systems: stutterers’ and nonstutterers’ reactions

Fitzgerald (1983) cast 130 of Peschong’s 132 belief statements into a bipolar six point scale ranging from “strongly agree” to “strongly disagree.” She administered this scale to 107 stutterers and 228 nonstutterers recruited from 20 clinics associated with academic programs throughout the United States and Canada. The responses of the 228 nonstutterers were subjected to a factor and item analysis to determine the scale structure and identify the belief systems of the 228 nonstutterers. A main scale (consisting of 93 belief statements/items) and six subscales emerged (see below). (Note: The wording of some of the subscales’ titles and concepts has been refined since the original 1983 study.)

Once these subscales for nonstutterers were identified, a multivariate analysis of variance indicated the degree to which the stuttering group and the nonstuttering group agreed with each subscale and the degree to which the stuttering group and the nonstuttering group agreed with each other on each of the six subscales. I

Anxiety in Stutterers Subscale
- Stutterers feel nervous when asking members of the opposite sex for a date.
- People who stutter are nervous when talking.
- Stutterers are most disfluent when talking to an authority figure.
- Nonstutterers find it easier than stutterers to talk to new people they meet.
- Stutterers are embarrassed by their speech.
- Stutterers would be much happier if they could get over their stuttering.


Interpretation of items - “Stutterers feel anxious when speaking.”

Stutterers’/nonstutterers’ agreement with items - Stutterers and nonstutterers moderately agreed that stutterers feel anxiety when they talk. However, stutterers (mean = 4.80) agreed significantly more strongly than nonstutterers (mean = 4.32) (p<.OO0l).

Anxiety in Nonstutterers Subscale
- Nonstutterers do not mind speaking before a group.
- Nonstutterers do not feel self conscious when speaking.
- Nonstutterers face speaking situations with confidence.
- A stutterer tends to stutter on the same words.
- Stutterers can predict the words on which they will stutter - Nonstutterers do not fear saying certain words.
- Stutterers can predict the sounds on which they will stutter.
- Nonstutterers do not avoid saying certain sounds.


Interpretation of items - “Nonstutterers do not feel anxious when speaking.”

Stutterers’/nonstutterers’ agreement with items - "The nonstutterers disagreed (mean = 3.04 with the idea that they feel no anxiety when they speak but agreed with two of the three statements that suggest stutterers anticipate their stuttering. This seems to suggest the general idea that nonstutterers fear speaking just as they assume stutterers do.Where the nonstutterers disagreed with this Subscale (mean = 3.04), the stutterers agreed (mean = 3.96 (p<.000l).The stutterers are assuming that nonstutterers feel no speech-related anxiety, while the nonstutterers are saying they do” (Fitzgerald, 1983, p. 35).

Stutterers’ Expectations Subscale
- Stutterers should avoid giving speeches.
- Stutterers should plan on jobs that require little or no talking.
- When in a group, stutterers should let other members of the group do most of the talking.
- A person who stutters should not babysit small children.
- Stutterers should not plan on becoming teachers.
- Stutterers should not expect to lead normal lives.
- Stutterers should have other people order for them in a restaurant so no one will be embarrassed.
- A lower level of performance should be expected from people who stutter.
- If a person stutters he should avoid talking to his spouses associates.
- If possible, a stutterer should have someone else answer the telephone.
- Stutterers do not talk well enough to do the kind of work they really like to do.

Interpretation of items -"Stutterers are handicapped and shouldn’t expect to lead normal lives.”

Stutterers’/nonstutterers’ agreement with items - Stutterers (mean = 2.12) and nonstutterers (mean = 1.99) moderately disagreed with this subscale, but did not disagree with each other (p = .2854).

Social/Emotional Influences Subscale
- Stuttering is basically an emotional problem.
- Parents often cause their child ‘s stuttering problem
- Psychological problems cause a person to stutter.
- Poor parental attitudes contribute to a child ‘s stuttering problem.
- A father’s behavior has an efiect on his child ‘s stuttering problem.
- A mother’s behavior has an efiect on her child ‘s stuttering problem.

Interpretation of items - " Parents contribute to the psycho-emotional problem of stuttering.”

Stutterers’/nonstutterers’ agreement with items - Stutterers (mean = 3.83) and nonstutterers (mean = 3.88) slightly agreed with this Subscale, and did not disagree with each other (p = .6646).

Intrinsic Flaw Subscale
- Stuttering is caused by a germ.
- The cause of stuttering is hereditary in nature.
- Stuttering is caused by some kind of mental disorder.
- Stuttering is “catching” and others might start stuttering if they are around stutterers too much.
- If a stutterer discusses his/her feelings about stuttering it will get worse.
- When a stutterer is having dijfficulty with a word, he prefers having the listener say it for him.
- If a person starts to stutter, you should change the topic of conversation.
- Spanking a child for stuttering will help decrease the stuttering behavior:
- Stutterers should speak rapidly so people will not notice their stuttering.
- An authoritative interruption and command not to stutter is useful in increasing fluency.
- Speech therapy is not beneficial to a stutterer.
- Stuttering can be viewed as a sign of inherent character weakness

 

Interpretation of items - “Stuttering is an intrinsic flaw that the stutterer can’t do much about”
StutterersYnonstutterers’ agreement with items - Stutterers (mean = 1.74) and nonstutterers (mean = 1.84) strongly disagreed with this subscale, but did not disagree with each other (p = .0702).

Stuttering Control Subscale
- Telling a person to “slow down” when he stutters will help him to be more fluent.
- Telling a person who stutters to think about what he is going to say will help him be more fluent.
- Stutterers are more fluent when they whisper.
- Thinking before speaking will help to eliminate the stuttering behavior.
- Taking a deep breath before speaking will help to eliminate stuttering.
- If told to relax, a stutterer will relax and become more fluent.
- It is helpful for a stutterer to repeat stuttered words until he speaks them fluently.
- Stuttering usually disappears when the individual gets older.
- Stutterers could be fluent if they would only try.
- Telling a person to “stop and start over again” when he stutters is helpful.
- If a stutterer would stop worrying about his speech the stuttering would decrease.
- If a person starts to stutter he should talk more loudly and act more confidently.
- On the average, a stutterer will stutter on approximately one-half of the words spoken. - Most normal speakers are never disfluent.
- The only types of disfluencies normal speakers experience are interjections of unnecessary words and pauses.

Interpretation of items – “Stuttering can be influenced by both the stutterer’s and listener’s behavior.”

Stutterers/nonstutterers’ agreement with item - Stutterers (mean = 3.24) and nonstutterers (mean = 3.13) slightly disagreed with this Subscale, but did not disagree with each other (p = .6646).

  1. Study 2 - Stutterers’ belief systems: stutterers and nonstutterers’ reactions

Gronhovd, Rice and Fitzgerald (1986) subjected the data from 99 of the stuttering subjects used in Fitzgerald’s (1983) original study to a factor and item analysis to determine the scale structure and identify the belief systems of Stutterers. A main scale consisting of 70 belief statements/items and seven subscales emerged (See below). (Note: The wording of the subscales’ titles and concepts has been refined since the original 1986 study.)

After the main scale and the seven subscales for stutterer’s belief systems were established using 99 of the original 107 stutterers, a t-test was used to determine if the original 107 Stutterers and 228 nonstutterers significantly disagreed on the seven subscales.

Speech Difficulty and Anxiety Subscale

- Stutterers can predict the words on which they will stutter.
- Nonstutterers find it easier than Stutterers to talk to new people they meet
- Nonstutterers do not mind speaking before a group.
- Stutterers feel nervous when asking members of the opposite sex for a date.
- People who stutter are nervous when talking.
- Nonstutterers face speaking situations with confidence.
- Psychological problems cause a person to stutter:
- Stuttering is basically an emotional problem.
- Stutterers are most disfluent when talking to an authority figure.
- Nonstutterers do not avoid saying certain sounds.
- People are uncomfortable when they hear someone stutter
- Stutterers are embarrassed by their speech.
- People make more fun of stutterers than they do of people with other kinds of speech problems.
- Stutterers write better than they talk.
- Stutterers have a harder time in school.
- Stutterers talk less than nonstutterers.
- Stuttering is often used as an excuse to avoid saying certain words.

Interpretation of items - "Stutterers have more difficulty and anxiety when speaking than nonstutterers.”

Stutterers’/nonstutterers’ agreement with item - Stutterers and nonstutterers slightly agreed that stutterers have more difficulty and feel more anxiety when they talk. However, stutterers (mean = 3.98) agreed significantly more strongly than nonstutterers (mean = 3.63) (p<.0Ol).

Normal Capability Subscale
- If a person stutters he should avoid talking to his spouse ‘s friends.
- Stutterers should not plan to become teachers.
- Stutterers should have other people order for them in a restaurant.
- A person who stutters should not babysit small children.
- If you hear someone stutter you should feel sorry for them.
- Stuttering is just an attention getting device.
- Stutterers should not expect to lead normal lives.
- Teachers should excuse children who stutter from giving oral reports.
- Stutterers do not talk well enough to do the kind of work they want.
- Stutterers do not perform as well in most tasks as nonstutterers.
- When a stutterer is having difficulty with a word, he prefers that someone else say it for him.

Interpretation of items – “Stutterers are relatively incapable people and cannot live normal lives.”

Stutterers’/nonstutterers’ agreement with items - Stutterers and nonstutterers moderately disagreed with the idea that stutterers are incapable people. However, nonstutterers (mean = 2.11) disagreed significantly more strongly than stutterers (mean = 2.39) (p<.0Ol).

Fluency Enhancement Subscale
- Telling a person to “stop and start over again” when he stutters is helpful.
- Telling a person who stutters to think about what he is going to say will help him be more fluent.
- Stutterers could be fluent they would only try.
- Stuttering usually occurs when a person talks faster than he is thinking.
- If told to relax, a stutterer will relax and become more fluent.
- Thinking before speaking will help to eliminate the stuttering behavior.
- Stuttering is the most devastating of all speech disorders.
- Most stutterers are rarely fluent.
- Stutterers have about the same amount of difiiculty with all the speech sounds. Section 8. Attitudes, Personality and Emotional Factors in Stuttering 471
- The only type of disfluency normal speakers experience are interjections of unnecessary words and pauses.

Interpretation of items - "The stutterer and listener can "enhance fluency with tips and suggestions.”

Stutterers’/nonstutterers’ agreement with item - Stutterers (mean = 2.90) and nonstutterers (mean = 3.04) slightly disagreed with the these common conceptions, but did not disagree with each other (p = .109).

Psycho-Social Cause/Effect Subscale
- Stutterers possess certain personality traits.
- Parents often cause their child ‘s stuttering problem.
- Poor parental attitudes contribute to a child ‘s stuttering problem.
- Stutterers should date members of the opposite sex who also stutter.
- Stutterers are more intelligent than nonstutterers.
- The cause of stuttering can be traced to a specific event in a person ‘s life.
- Labeling a child ‘s speech as stuttering makes it become worse.
- Stutterers have fewer friends than nonstutterers.
- Discussing feelings about stuttering often helps the stutterer.
- Most stutterers are fluent in a few situations.
- Stutterers would have fewer problems if they did not stutter

Integration of items -- “Stutterers are emotionally and socially abnormal.” Stutterers’/nonstutterers’ agreement with items - Stutterers and nonstutterers slightly disagreed with the idea that stutterers are emotionally and socially abnormal. However, nonstutterers (mean: 3.10) disagreed significantly more strongly than stutterers (mean = 3.42) (p<.00l).

Stuttering Avoidance Subscale
- If a person thinks he is going to stutter; he should substitute another word.
- Making excuses for a stutterer is good practice.
- Spanking a child for stuttering will help decrease the stuttering.
- There are definite speaking situations a stutterer should avoid.
- A stutterer should avoid all situations where he knows he will stutter:
- Most normal speakers are never disfluent.
- Stutterers should speak rapidly so people will not notice their stuttering.

Interpretation of items - "Stutterers should try to hide their stuttering.” Stutterers’/nonstutterers’ agreement with items - Stutterers strongly disagreed and nonstutterers moderately disagreed with the idea that stutterers should try to hide ;heir stuttering. However, stutterers (mean = 1.76) disagreed significantly more strongly than nonstutterers (mean = 2.04) (p<.00l).

Listener Acknowledgement Subscale
- Parents should not talk with their child about his/her stuttering.
- Stuttering is “catching” and others might start stuttering if they are around stutterers too much.
- If a person starts to stutter, you should change the topic of conversation.
- When a person stutters you should look away until they complete the word.
- Stutterers should not discuss their stuttering with their friends.
- Ignoring a person’s stuttering will help to eliminate the problem.
- It is helpful to educate stutterers about the facts of stuttering.
- Parents are potentially important factors in the overall process of helping their child deal with stuttering.

Interpretation of items - "Listeners should not acknowledge the stutterer’s speech difficulty. “

Stutterers’/nonstutterers’ agreement with items - Stutterers strongly disagreed and nonstutterers moderately disagreed with the idea that listeners should not acknowledge the stutterer’s stuttering. However, stutterers (mean = 1.71) disagreed significantly more strongly than nonstutterers (mean = 1.91) (p<.0l).

Recovery Subscale - Stutterers may recover from stuttering at any time.
- If stutterers do not concentrate on their speech they will not stutter:
- Stuttering usually disappears when the individual gets older
- Four of five stutterers recover from stuttering without receiving any help.
- An authoritative interruption and command not to stutter is useful in increasing fluency.

Interpretation of items - "Stutterers may unexpectedly recover from stuttering.” Stutterers’/nonstutterers’ agreement with items - Stutterers moderately disagreed and nonstutterers slightly disagreed with the idea that stutterers may unexpectedly stop stuttering. However, stutterers (mean = 2.52) disagreed significantly more strongly than nonstutterers (mean = 2.74) (p<.O2).

  1. Study 3 - Relationship between beliefs and speech-related anxiety in stutterers
Templeton (l992) had 37 high anxiety and 35 low anxiety stutterers complete the 130 item belief checklist. A discriminant analysis identified the Speech Difficulty and Anxiety Subscale and the Normal Capability Subscale as being capao .e of classifying high and low anxiety stutterers at a level beyond chance.

Also, the following four individual belief statements were found to have equal or greater power than the two subscales which contained a total of 28 belief statements.

- Nonstutterers find it easier than stutterers to talk to new people they meet.
- Nonstutterers do not mind speaking beforea group.
- Nonstutterers face speaking situations with confidence.
- The only type of disfluencies normal speakers experience are interjections of unnecessary words and pauses.

These results suggest that these four beliefs may be especially closely related to anxiety level in stutterers.

  1. Study 4 - Belief statements’ ability to reflect change as a result of therapy Harvey (1999) attempted to determine if any of the belief items were sensitive to cognitive change in stutterers enrolled in a therapy program known to be effective with a majority of stutterers. Her larger purpose was to identify items that should be retained in a clinical version of the belief checklist.
She had 21 stuttering subjects complete the 130 item belief checklist before and after participating in a three week intensive stuttering program at the Institute for Stuttering Treatment and Research (ISTAR) at the University of Alberta. A t-test (with Bonferroni adjusted probability) indicated that pre-post differences of 24 of the 130 items were statistically significant. In short, the 24 items seemed to be capable of reflecting cognitive change as a result of therapy. In addition, the specific beliefs that changed were consistent with the stated goals and targets of the ISTAR program.

  1. Summary and conclusions
The foregoing research has identified some beliefs and belief systems of stutterers and nonstutterers. that may help to 1) identify stutterers with high levels of speech-related anxiety, 2) suggest cognitive strategies for anxiety reduction, 3) track cognitive change during the therapy process, and 4) identify beliefs in stutterers and the general public that are not consistent with current knowledge.

Further research is necessary to determine the potential clinical usefulness of the belief items and subscales, and to trim the number of belief statements to only the most powerful and useful items.

References
Ammons, R., & Johnson, W. (1944). Studies in the psychology of stuttering: XVIII. The construction and application of a test of attitude toward stuttering. Journal of Speech Disorders, 9, 39-49.

Crowe, T. A., & Cooper, E. B. (1977). Parental attitudes toward and knowledge of stuttering. Journal of Communication Disorders, 10, 342-357.

Erickson, R. (1969). Assessing communication attitudes among stutterers. Journal of Speech and Hearing Research, 12, 711-724.

Fishbein, M. (1967). A consideration of beliefs and their role in attitude measurement. In M. Fishbein (Ed.), Readings in attitude theory and measurement. New York: John Wiley and Sons, Inc.

Fishbein, M., & Ajzen, I. (1975). Beliefi attitude, intention and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

Fitzgerald, M. C. (1983). A comparison of the belief systems of stutterers and nonstutterers. Master’s thesis, Moorhead State University, Moorhead, MN.

Gronhovd, K. D., Rice, P.L., & Fitzgerald, M. C. (1986) A comparison of stutterers ‘and nonstutterers’

belief systems. Paper presented to the Canadian Association of Speech-Language Pathologists and Audiologists, Winnipeg, Manitoba, CA.

Gronhovd, K. D., & Zenner, A. A. (1979). G-Z Attitudes and beliefs about stuttering inventory. Unpublished clinical form, Department of Speech/Language/Hearing Sciences, Moorhead state University, Moorhead, MN.

Gronhovd, K. D., & Zenner, A. A. (1982). Anxiety in stutterers: rationale and procedures for management. In N. J. Lass (ed.), Speech and language: Advances in basic research and practice: Volume 8. New York: Academic Press.

Harvey, D. L. (1999). Beliefs of stutterers pre and post treatment. Master’s thesis, Moorhead State University, Moorhead, MN.

Peschong, E. J. (1982). Assessing attitudes of stutterers through belief statements. Unpublished research paper, Moorhead State University, Moorhead, MN.

Templeton, M. W. (1992). Beliefs as predictors of anxiety for individuals who stutter Unpublished research paper, Moorhead State University, Moorhead, MN. 474 Theory, research and therapy in fluency disorders

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