About the presenter: Louise B. Heite (Iceland) is from Seydisfjord, Iceland. She holds a doctorate in history and an Icelandic teaching certificate. She is presently enrolled as a graduate student in the Communication Sciences department at Temple University. She has presented papers on stuttering at the NSA conference in New York, the ELSA conference in Ireland, and the ASHA convention in San Francisco.

Questions/comments

Icelandic Teachers' Attitudes towards Stuttering and Classroom Decision Making

by Louise B. Heite
from Iceland

Introduction:

Not long ago, someone asked the following question on one of the Internet lists about stuttering: "If there is 1 [stutterer] per 100 people, where do they hide in the schools?" The person went on to say that in all his years in school he had never met a pupil who stuttered. Indeed, stuttering is a rare enough disorder that many school speech pathologists spend entire careers without ever treating a child who stutters. Random chance alone dictates that in an elementary school of about 400 kids, there should be four who stutter. So, it's a good question. Where are they?

I'll tell you where they are. They're hiding. They hide inside the mouthy kid who *always* comments out of turn, usually on topic, and sometimes with a pun or with sarcasm. They hide inside the class clown who always answers, "Whooo meee??" or "Eeeenh, what's up, Doc?" when the teacher asks a question. They hide inside the jerk who throws spitballs or otherwise causes disruptions - almost exclusively during oral classwork. They hide inside the angry child who seems to have no friends and has frequent violent outbursts of temper in the classroom. They hide inside the college freshman who passes the prof a note asking her not to call on him in class discussions. The hide inside the kid who drops out of college in the third week of his freshman year, and who brings his big sister along to tell his professors that he's leaving while he stands there and examines his shoelaces. They hide inside the wallflower who never seems to know the answers to anything, whose teachers don't even remember his name, who is dying of loneliness that nobody sees.

The first one was me - by the time I was in the sixth grade I had realized that I could talk out when it suited me, that is, when I felt fluent and confident. As long as I stayed on topic, the only grade that got zapped was "conduct," but I didn't much care about that grade. As a wannabee baby beatnik, I thought it was cool to be considered kind of bad.

The second is the son of a friend, whose teachers often told her that they had never heard him stutter. Of course not - those smart-alec laugh lines were the only two set-phrases he could get out of his mouth without stuttering. His exasperated teachers would roll their eyes, and move on to the next kid.

The next four were students of mine, or nearly so in the case of the college kid who dropped out.

The last one nearly committed suicide before he found someone he could talk to who understood what he was going through.

A few years ago, I conducted a study of teachers' attitudes towards stuttering. As part of that study, I asked my sample of teachers to tell me the number of stutterers they thought they had taught during their careers. Using some pretty simple calculator math, I figured that my teachers probably did not recognize half of the kids who stutter with whom they came into contact. That really hit home when I met with my colleagues regarding the spitball thrower. Most of them had taught this boy since he started school, but not one had ever even considered that his behavior might be related to his carefully disguised speech problem. When I addressed the stuttering directly in conference with him, his behavior improved by an exponent. That year - he was in the 9th grade - he passed all his classes for the first time in his life.

What became of the other kids? Well, some will say that I grew from an obnoxious, mouthy teenager into an obnoxious, mouthy adult who occasionally uses language like a fire hose. But there is more to the story than that. When I began teaching, I found that my own experience gave me a special insight into the behaviors of children with communication problems. That is how I spotted the underlying cause of the spitball-thrower's disruptive behavior, when so many well-meaning adults had missed it altogether. I am now training in speech-language pathology so that I can hone my instincts into a useful and reliable tool.

The angry child became a friend, and I spent a lot of time showing rather than telling her that stuttering is nothing to be afraid or ashamed of. Again, her school behavior improved a lot, and she finally developed the ability to handle social situations that have complex communication demands with something like equanimity. She'll be OK.

The son of the friend has dropped in and out of high school for a number of years, never quite receiving the help he needs because he is so good at hiding his stuttering. He's had run-ins with the law and with drugs. One day he will either crash and burn, or he will get tired of drifting and learn to deal with the problem. But I wonder what would have happened if he had had just one teacher who understood what was going on.

The lonely wallflower found some confidence but had a hard time in college. He has a girlfriend now, and the last contact I had with him, he sounded pretty content, though he was rethinking his career plans.

The college students -- I have no idea what happened to them. I wish I did.

Just because a naive listener doesn't recognize stuttering, it doesn't mean that stuttering isn't there leaving deep footprints all over the life of the stutterer. Most teachers are naive listeners, unprepared by either their training or their backgrounds to deal with stuttering, or with many communication problems. Most mean well and want to help their students, but they lack the tools to do the work they want to do. The following paper discusses in some detail how this lack of awareness serves to form and color the classroom environment of most children who stutter.

This paper was presented originally as a poster session at the American Speech-language and Hearing Association's annual convention in San Francisco, in November of 1999.

Icelandic educational policy mandates that children receive education appropriate to their abilities, and tailored to individual circumstances. However, a shortage of speech-language professionals in Iceland and a lack of familiarity among teachers with the problems that stuttering can present in the classroom prevent stutterers from receiving an education that appropriately takes their speech disability into account.

Most teachers know little or nothing about stuttering. Prevailing prejudice forces na•ve listeners to assess stutterers negatively. Listeners tend to make judgments about the stutterer's abilities on the basis of the pervading cultural mythology regarding the disability, as well as inappropriate analogy to their own stress reactions. Pragmatic effects of this prejudice on classroom interaction puts the child who stutters at a real disadvantage.

This study was intended to outline Icelandic teachers' beliefs about stuttering and to see how these beliefs influence teachers' reactions to stuttering in the classroom. A sample of 116 teachers from all over Iceland were polled as to their attitudes towards and knowledge about stuttering; their assumptions about "typical" stutterers; and their own anticipated reactions to stuttering in a number of classroom situations.

The Survey

There were four groups of questions in the survey. The first concerned background information, including whether a eacher had a close relative who stuttered and whether the teacher had ever had any instruction in stuttering as a classroom problem. The second was a seantic difference scale which has been used in several English-speaking countries to define prejudices towards stutterers and stuttering. The third was a Lickert scale designed to measure the strength of agreement or disagreement with a set of assertions and beliefs about the etiology, nature, and effects of stuttering. The fourth was a binary choice (accept / not accept) from a list of teacher behaviors which are known to have been applied to children who stutter.

attitudes towards stuttering by country

Comparison of Icelandic teachers' responses on the semantic difference scale with previously reported results from English-speaking countries shows that Icelandic teachers have the same pattern of prejudices regarding stuttering and stutterers that are common elsewhere, but their opinions are weaker. This suggests that one may fairly make inferences across the cultural and language differences between Icelanders and English-speakers regarding stuttering.

Nearest-neighbor cluster analysis was used on this section of the questionnaire to divide the sample into teachers who view children who stutter in a fairly positive light, and those who view them more negatively. The responses to the assertions regarding the etiology, nature, and effects of stuttering were also subjected to nearest-neighbor cluster analysis to divide the teachers into a protective group and a demanding group. These results were then crosstabulated to produce four groups of teachers: positive-protective , positive-demanding , negative-protective, and negative-demanding.

group N's

Group Characteristics

The responses of the four groups were plotted against one another on the sematic difference scale. For the most part, the teachers in both positive groups evaluated stutterers just to the positive side of the neutral middle, while those in the negative groups evaluated them just to the negative side. The only two points on which all four groups were in fairly strong agreement were that children who stutter are emotional and intelligent.

teacher groups' attitudes toward stuttering

The differences among the groups described as "protective" and "demanding" are less clear. The circled areas show the main associations which permitted the establishment of the clusters. The points on which there was clear disagreement between the "protective" and the "demanding" groups were: assertion 2, that the teacher should protect the student who stutters from circumstances in which he or she is likely to do so; assertion 3, that stuttering troubles a child's progress in school; assertion 4, that it is difficult to know how to manage stuttering in the classroom; and assertion 23, that teachers know how to react to stuttering. There are two points of strong concurrence as well. The sample rejects assertion 7, that stutterers are generally quiet, shy, and untalkative; andthey reject assertion 21, that parents cause their children's stuttering.

assertions about stuttering by teacher group

Estimated Number of Stutterers

Teachers must recognize stuttering if they are going to deal with it effectively. Icelandic classroom teachers do not recognize stutterers very well. Using a recent estimate of the prevalence of stuttering among the school-age population in Iceland, it is possible to estimate the number of times the total sample should have had children who stutter in their classes. The teachers reported teaching only half that number of children who stutter.

formula for estimating unrecognized stutterers

Classroom Choices

The questionnaire presented 22 possible choices of teachers' behaviors towards stuttering in the classroom. All teachers chose "Give the student enough time to answer" so it was dropped from further analysis. A second item, "Other (what?)" received only three very disparate responses and was also dropped.

choices of classroom behaviors, by group

The frequency with which the four groups chose the remaining 20 responses were converted into indexed scores. When the four groups' indices are examined separately, there appears to be a connection between the way teachers view stuttering and stutterers and the classroom responses they choose. The index of each group's response to each question was separately compared with the index of the sample as a whole using the t-test. The small size of two of the groups probably affected these statisics, so they are offered with caution. However, in several instances there were statistically significant differences between a group's score and the whole sample's.

Response 3: Pass over the student in class discussions and oral classwork. Although all the groups on average reject this response, only teachers in the "negative" groups do believe that they should pass over the stutterers. Negative-demanding teachers, who are a third of the sample, are the most likely to do that.

Response 5: Use no particular methods. This is not a popular response. There is reason to believe that the choice of this response by some positive-protective teachers may represent their own shyness about stuttering. This is discussed further below.

Response 6: Talk with the student about stuttering. Both negative-protective and negative- demanding teachers chose this response, while both positive groups reject it. Positive-protective teachers chose it at only half the rate of negative-demanding teachers. That is not disheartening by itself, but if a teacher has a negative prejudice towards stutterers, he or she may cause harm if that negative prejudice colors the conversation.

Response 9: Protect the student from those circumstances in which he stutters most. Although the sample as a whole gives this response a weak index score of only 0.4, the positive-protective teachers are in complete opposition to their positive-demanding colleagues. Almost three-quarters of the positive-protective group choose this response while less than a third of positive-demanding teachers chose it. One might expect that demanding teachers would be less likely to protect students from difficult situations. The fact that this response is favored by protective teachers may also suggest a certain amount of overprotectiveness.

Response 12: Tell the student to take a deep breath before he speaks. It is encouraging that most teachers reject this response. Positive teachers reject it almost unanimously, but both groups of negative teachers scored this response right around 0.2. Those who have a negative prejudice towards stuttering are slightly more likely than their more positive colleagues to tell stutterers to take a deep breath.

Response 13: Allow the student to be among the first to present oral classwork. Most teachers reject this response, and positive-protective teachers reject it unanimously. The positive-protective teachers' complete rejection of this response could be another indication of overprotectiveness.

Response 14: Allow the student read aloud often to build up his courage. Although most of the sample rejected this response, and the scores the various groups gave this response are not significantly different in the statistical sense, it is notable that the scores of the demanding teachers are somewhat higher than those of the protective teachers. It is also interesting that approximately a quarter of the negative-demanding teachers chose this response.

Response 16: Praise the student when he speaks well. Positive-protective teachers give this response a score of 0.80, which clearly differentiates them from the sample as a whole. The other groups' scores are close to the overall score, in the neighborhood of a random 0.50. In fact, this response is not recommended despite the fact that it seems to be a recognition of desirable behavior. It draws attention to the child's speech in such a way that the child is likely to emphasize on not stuttering at the expense of speaking freely and with enthusiasm. The result of this response is all too often the opposite of what was intended. This response could represent another expression of overprotection.

Response 21: Tell the child to slow down and take his time. Negative-demanding teachers gave the highest scores on this response, 0.53. All the other groups reject it, but the response of the negative-protective teachers is the lowest, 0.29. This could represent some impatience with the child who stutters on the teacher's part.

These clusters of attitude and behavior suggest two kinds of unfavorable responses to stutterers. In the larger group are the teachers who are either impatient with the effect of stuttering on a child's progress in school, or who are insensitive to it. They either push the young stutterer to the side and ignore him, or they try to encourage him to do things that he simply is unable to do. The other undesirable response is overprotectiveness, which can be equally harmful to a young stutterer as lack of consideration. Refusal to acknowledge the child's stuttering or to make demands which might challenge him is truly no better than pushing the child aside or setting goals that he cannot meet. In the best light, overprotection is perhaps more desirable than lack of understanding, but it might actually represent teacher's own shyness about stuttering as much as too much kindness.

Group Behaviors

Negative-protective teachers formed the largest category. Similar to their positive-demanding colleagues, they were not terribly far from the general averages in the scores they assigned to any of the responses. It is interesting that this group was the only one to unanimously reject the response "take no special measures." They are unlikely to encourage the child to concentrate and to tell him to slow down. They are somewhat predisposed to pass over the stuttering child and to shield him from the situations in which he stutters most. They are rather unlikely to maintain eye contact with the child when he stutters, and nearly a quarter of them believe that it is appropriate to interrupt and finish sentences for the stutterer.

Negative-demanding teachers are the most likely to talk to the student about stuttering; to keep eye contact with him; to tell him to take a deep breath before he speaks; to have him read aloud often in order to build his courage; to ignore the stuttering; and to tell the child to take his time. They are the least likely to refrain from interrupting or finishing sentences for the child. However, these teachers do indicate that they are willing to read books about stuttering to find out more about it, and they are willing to consult with specialists.

Positive-protective teachers are the most likely to shield the child from the circumstances in which he is most likely to stutter. They are also more likely to talk about the child's stuttering with the class than with the student who stutters. Theresult is that the child who stutters can find himself in a situation in which everyone talks about him and his stuttering, but nobody talks with him about it.

Positive-demanding teachers are very near the overall group average in all responses, but their strongest responses are telling. They are the least likely to ignore the child's stuttering and also the least likely to tell the child to slow down. Like the positive-protective teachers, they are very unlikely to tell the child to take a deep breath before he speaks. They are the least likely to shield the child from the circumstances in which he stutters, and also the least likely to praise the child when he speaks well. On the other hand, several teachers in this group would choose to have the child read aloud often to build up his courage, and they are much more likely to talk with the class about stuttering rather than with the child himself.

Analysis of the teachers' backgrounds suggests that the two factors most closely associated with teachers' choice of positive classroom behaviors were first, how often a teacher had actually taught a student who stutters; and second, whether the teacher had ever received any directed instruction, no matter how superficial, about stuttering as a classroom problem. Whether or not the teacher had a close relative who stuttered was not associated with choices of classroom behavior, indicating that it is specifically the teacher's familiarity with stuttering in the classroom, and not a more diffuse kind of familiarity with stuttering, that produces teachers who handle it better in the classroom.

Bibliography

Ambrose, Nicoline Grinager and Ehud Yairi: "The Development of Awareness of Stuttering in Preschool Children." Journal of Fluency Disorders (1994) vol. 19 pp. 229-245.

Association des b*gues du Canada: "For the Teacher: How to Help Students who Stutter." Paper presented at the Canadian Association of People who Stutter, Ottawa 1993;

Audet, Lisa R and Danielle Ripich: "Psychiatric Disorders and Discourse Problems." School Discourse Problems (second edition). Danielle Newberry Ripich and Nancy Creaghead, eds. Singular Publishing Group, San Diego Calif: 1994.

Bergljot Gudmundsdottir, Johann Thoroddsen, Jonina Konnrādsdottir: "Report of the Committee on Support for Children, Their Increased Need for Special Support, and Conditions for Provision of That Support." Dagvist barna, Reykjavik, 1997.

Bernstein-Ratner, Nan: "Language Complexity and Stuttering in Children" . Topics in Language Disorders (1995): vol. 15 nr 3 pp. 32-47

Birna Bragadottir: "Stutteing while Suffocating, Suffocating in Stuttering, Suffocating while Stuttering" Malpipan nr. 13. Malbjörg, Reykjavik, November 1997: pp. 3-4)

Bloodstein, Oliver: A Handbook on Stuttering (5. ed, 1995)

Borg, Christer: Stamning i teorins och skolans vSrld. (Stuttering in Theory and in the World of School) (1996) Unpublished thesis, Gsteborgs Univrsitet, Psychologiska Institutionen.

Byrd, Kathryn and Eugene B. Cooper: " Expressive and Receptive Language Skills in Stutering Children." Journal of Fluency Disorders (1989) vol. 14, pp. 121-126

Conture, Edward G. and Ellen M. Kelly: "Young Stutterers' Nonspeech Behaviors During Stuttering." Journal of Speech and Hearing Research (Oct 1991) vol. 34, pp. 1041-1056

Cooper, Eugene B and Crystal S. Cooper: "Clinician Attitudes Towards Stuttering: Two Decades of Change." Journal of Fluency Disorders (1996) vol. 21 pp. 119 - 135.

Dell, Carl: Treating the School Age Stutterer: a Guide for Clinicians.. Memphis, Tennessee: Stuttering Foundation of America: 7. ed (1996)

DeNil, Luc and Gene J. Brutten,: "Speech-Associated Attitudes of Stuttering and Nonstuttering Children." Journal of Speech and Hearing Research (February 1991) vol. 34, pp.. 60-66.

Donahue, Mavis L: "Differences in Classroom Discourse Styles of Students with Learning Disabilities." School Discourse Problems (second edition). Danielle Newberry Ripich and Nancy Creaghead, eds. Singular Publishing Group, San Diego Calif., USA: 1994.

Doody, Irene; Joseph Kalinowski, Joy Armson, and Andrew Stuart: "Stereotypes of Stutterers and Nonstutterers in Thre Rural Communities in Newfoundland." Journal of Fluency Disorders (1993), vol. 18 pp.. 363-373.

Elmar Ūordarson: Stam: upplˆsingar um stam and thā sem stama. Reykjavik: 1990.

Farmer, Thomas W and Elizabth M Z Farmer: "Social Relationships of Students with Exceptionalities in Mainstream Classrooms: Social Networks and Homophily." Exceptional Children (Mars-April 1996) vol. 62, pp.. 431 - 450.

Guitar, Barry, Helen Kopff Schaefer, Gail Donahue-Kilburg, and Lynne Bond: "Parent Verbal Interactions and Speech Rate: A Case Study in Stuttering." Journal of Speech and Hearing Research vol. 35, pp.. 742-754 August 1992

Heite, Louise: "What's a Teacher to Do?" Fyrirlestur ā rādstefnu European League of Stuttering Associations, Dublinni, Irlandi, 1. mars 1998.

Horsley, Irmgarde and Carol T FitzGibbon: "Stuttering Children: Investigation of a Stereotype." British Journal of Disorders of Communication (1987) vol. 22 pp. 16 - 35.

Ingvar Sigurgeirsson: Listin ad spyrja: handbok fyrir kennara. Rannsoknarstofnun Kennarahāskola Islands, Reykjavik: 1996.

Jezer, Marty: Stuttering: a Life Bound up in Words. New York: Basic Books, 1997.

Kaplan, Paul S: Educational Psychology for Tomorrow's Teacher. West Publishing Company, St. Paul, Minnesota, USA: 1990.

Kristjana Bjarnthorsdottir and Margr*t Ūorleifsdottir:Stam Skolabarna. Lokaritgerd, Kennarahāskoli Islands, April 1997.

Langlois, Aim*e and Steven H. Long: "A Model for Teaching Parents to Facilitate Fluent Speech." Journal of Fluency Disorders (1988) v 13 pp 163 - 172.

Larsen, Lennart and Karin Svanholm: Um Stam Skolabarna (1987). Reykjavik: Nāmsgagnastofnun.

Lass, Norman J; Dennis M. Ruscello; John F. Schmitt; Mary D. Pannbacker; Mary Banyas Orlando; Kathy A. Dean; Julie C. Ruzisk 198 :eachers' Perceptions of Stutterers." Language, Speech, and Hearing Services in Schools (janĪar 1992) vol. 23 pp.. 78 - 81.

Lass, Norman J; Dennis M. Ruscello; John F. Schmitt; Mary D. Pannbacker; Angela Marsh Kiser; Ashraf Mussa; and Patricia Lockhart: "School Administrators' Perceptions of People Who Stutter." Language, Speech, and Hearing Services in Schools (april 1994) vol. 25 pp.. 90 - 93.

Laulund, Egil; Tine Egberg; and Per Fab*ch Knudsen: Stammen and skole. Dansk Videnscenter for Stammen and Foreningen for Stammere i Danmark: 1996

Mālbjsrg, f*lag um stam: "Stam skolabarna: leidbeiningar til kennara." ˜pprunulega "The Child who Stutters at School", Stuttering Foundation of America. Reykjavik: odagsett.

Maguire, Gerald, MD: "Medical Treatment of Stuttering." Fyrirlestur ā ārsfundi National Stuttering Project, Buffalo, New York, June, 1998.

Menntamālarāduneytid Islands: Enn Betri Skoli.. Reykjavik: febrĪar, 1998.

Mooney, Siobhan and Peter K. Smith: "Bullying and the Child Who Stammers." British Journal of Special Education. (March 1995) vol. 22 nr. 1 pp. 24 - 27

Nippold, Marilyn and Ilsa E Schwarz: "Reading Disorders in Stuttering Children ." Journal of Fluency Disorders . (1990) vol. 15 pp.. 175-189

Nippold, Marilyn A., Ilsa E. Schwarz, and Jörg-Dieter Jescheniak: "Narrative Ability in School-age Stuttering Boys: a Preliminary Investigation." Journal of Fluency Disorders (1991) v. 16 pp 298 - 308 P 291.

Ramig, Peter: "To the Teacher of the Nonfluent Child." Stuttering Home Page:Odagsett. http://www.mnsu.edu/comdis/kuster/InfoPWDS/Ramig2.html

Riley G D & J Riley: Treatment of Stuttering In Early Childhood- Methods & Issues, David Prins & Roger J Ingham (eds). kfl.3, pp.. 43. College Hill Press: 1983.

Rind, Ellen and Patricia Rind: "The Stutterer in the Classroom." Stuttering Resource Foundation: New Rochelle NY, Odagsett.

http://www.mnsu.edu/comdis/kuster/InfoPWDS/Classroom.html

Ruscello, Dennis M.; Norman J Lass; John F. Schmitt; and Mary D. Pannbacker: "Special Educators' Perceptions of Stutterers." Journal of Fluency Disorders (1994) vol. 19 pp.. 125 - 132.

Silverman, Franklin H : Stuttering and Other Fluency Disorders. Prentice-Hall, Inc.; Englewood Cliffs, NJ, USA: 1992

Starkweather, C Woodruff:Fluency and Stuttering. Prentice-Hall, Englewood Cliffs, NJ., USA: 1987

Starkweather, C Woodruff, and Janet Ackerman: Stuttering. Pro-Ed Inc.; Austin, Texas, USA: 1997

Starkweather, C Woodruff, Sheryl R Gottwald, and Murray M Halfond. Stuttering Prevention: A Clinical Method. Prentice-Hall, Englewood Cliffs, NJ., USA: 1990

Van Riper, Charles:The Nature of Stuttering (annar ed.) Prentice-Hall, Inc: Englewood Cliffs, NJ, 1982

Van Riper, Charles: undated article in Letting Go, newsletter of the National Stuttering Project http://www.mnsu.edu/comdis/kuster/vanriper/vrmessage.html

Van Riper, Charles and Emerick, Lon L : Speech Correction: An Introduction to Speech Pathology and Audiology. (Sjsundi ed) Prentice-Hall, Inc.; Englewood Cliffs, NJ, USA: 1984

Weiss, Amy: "The Pragmatic Context of Children's Disfluency" Seminars in Speech and Language, (August 1993) vol. 14 nr. 3.

Weiss,Amy: "Conversational Demands and their Effects of Fluency and Stuttering" Topics in Language Disorders 1995; v 13 nr 3, pp. 18-31)

White, Peter A and Sara R C Collins: "Stereotype Formation by Inference: a Possible Explanation for the 'Stutterer' Stereotype." Journal of Speech and Hearing Research (des. 1984) vol. 27 pp. 567 - 570.

Williams, Dean E.: "What Do I Tell People about My Child" Your Child: Questions and Answers. Kfl. 4, pp.. 33 - 43. Stuttering Foundation of America, Memphis Tenn., 5th edition: 1996.

Yeakle, Mary Kaye and Eugene B. Cooper: "Teacher Perceptions of Stuttering." Journal of Fluency Disorders (1986) vol. 11 pp. 345 - 359.

Yoder, Paul J, Betty Davies, Kerri Bishop, and Leslie Munson: "Effect of Adult Continuing Wh-Questions on Conversatinal Participation in Children with Developmental Disabilites" Journal of Speech and Hearing Research (Feb 1994), vol. 37, pp. 193 - 204.

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August 10, 2000