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Impact of Stuttering. Speaking fears are normal, not exceptional . Studies show that public speaking is the number one fear of FLUENT speakers (death was ranked as number 6). Related to Perceptions . Stutterers, parents, teachers, peers, etc. Stereotype.

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speaking fears are normal not exceptional

Speaking fears are normal, not exceptional

Studies show that public speaking is the number one fear of FLUENT speakers (death was ranked as number 6)

related to perceptions

Related to Perceptions

Stutterers, parents, teachers, peers, etc.

stereotype
Stereotype
  • Personality characteristics and attitudes of person who stutters
      • self-consciousness
      • reticence
      • shyness
      • fearfulness
      • unpleasantness
stereotype5
Stereotype
  • Personality characteristics and attitudes of person who stutters
      • unfriendliness
      • nervousness
      • introversion
      • tension
      • anxiety
adults often judged negatively in areas of
Adults often judged negatively in areas of:
  • Intelligence
  • Sensitivity
  • Aggression
slide7

Women who stutter considered more negatively than other women relative to their male stuttering counterparts and other men.

Stuttering women considered to be:

Naïve insecure boring

Unsociable lacking influence

masculine

impact of those attitudes on stutterer
Impact of those attitudes on stutterer
  • Feelings of inadequacy
  • guilt
  • powerlessness
  • shame
  • helplessness
impact of those attitudes on stutterer9
Impact of those attitudes on stutterer
  • hopelessness
  • failure
  • altered body image
  • negative self-concept
research results
Research Results
  • Non-stutterers prefer to interact with severe stutterers who acknowledge their stuttering
slide11
Mild and severe

stutterers who

acknowledged their stuttering received more favorable ratings on intelligence, personality, appearance than those who did not acknowledge their stuttering

slide12
Pediatricians:
    • strong tendency to

delay intervention

    • preference for

parent-oriented

treatment

    • indicated strong

interest in learning

more about the

subject

impact on children
Impact on Children
  • Stuttering is an “expectancy disorder”
  • For child who stutters, fearful expectation regarding speaking can lead to justification of the belief that talking is hard.
  • The correlation between fear & avoidance is strong
attitude scales tests
Attitude Scales/Tests
  • Children’s Attitude Test (Dr. Gene Brutten)
  • A-19 Scale for Children
attitude scales tests16
Attitude Scales/Tests
  • Children’s Attitude Test (Dr. Gene Brutten)
  • A-19 Scale for Children
  • Modified Erickson

Scale of Communication Attitudes

attitude scales tests17
Attitude Scales/Tests
  • Stutterers’ Self Rating of Reactions to Speech

Situations

  • Perceptions of

Stuttering Interview

(PSI)

keep parent s role in perspective
Keep parent’s role in perspective
  • They did not cause this problem…but
  • Conversational behaviors can exacerbate or alleviate symptoms, as many chronic disease states (i.e. asthma)
keep parent s role in perspective20
Keep parent’s role in perspective:
  • They did not cause this problem….but
  • Conversational behaviors can exacerbate or alleviate symptoms, as in many chronic disease states (i.e. asthma)
current recommendations to parents of young children who stutter
Current recommendations to parents of young children who stutter
  • Slow down
  • avoid interruptions &

”simultalk”

current recommendations to parents of young children who stutter22
Current recommendations to parents of young children who stutter
  • Slow down
  • avoid interruptions &

”simultalk”

  • use simpler language
  • reduce communicative pressures

on child

multicultural considerations in intervention
Multicultural Considerations in Intervention
  • Need to understand

precipitating

and perpetuating

factors

slide24
Need to understand
    • linguistic demands of culture
    • patterns of family interaction
    • behavioral expectations
    • gender behaviors
    • education
    • religion… spiritual beliefs
    • fears, attitudes, values
examples
EXAMPLES
  • Event: Family arrived late for their scheduled appointment and was admonished by the clinician
clinician s interpretation
Clinician’s Interpretation
  • Family is irresponsible and unmotivated

Cultural Interpretation

  • Families culture is not time oriented
recommendation
Recommendation
  • Clinician might schedule this family earlier to allow for late arrival

1:30

2:00

event
Event
  • Clinician who is feeling time pressure began an interview by asking parents questions about the child’s development.
clinician s interpretation30
Clinician’s Interpretation
  • Clinician used clinical time efficiently

Cultural Interpretation

  • Clinician rudely discussed

business before social

interaction

recommendation31
Recommendation
  • Value people and build interpersonal rapport first.
event32
Event
  • Clinician directed questions to the

mother who did not respond and

who deferred to the father

who was present.

clinician s interpretation33
Clinician’s Interpretation
  • Mother was conversationally passive

and uninvolved versus in this

patriarchal family, the father

speaks for he family and the

wife does not speak when

the husband is present

cultural interpretation
Cultural Interpretation
  • In this patriarchal family, the father

speaks for the family and the wife

does not speak when the

husband is present

recommendation35
Recommendation
  • Address both parents and allow them

to decide who will respond;

  • Address each parent in

separate settings

event36
Event
  • Clinician determined that the father

speaks for the family and directed

questions to him. The father seemed

awkward and responded

tentatively.

clinician s interpretation37
Clinician’s Interpretation
  • Father became upset at questions

Cultural Interpretation

  • Father was not accustomed

to a female (i.e. clinician) being

in authority and questioning his responses.

recommendation38
Recommendation
  • Share purposes and accept tentative responses
event39
Event
  • Clinician interviewed the parents about communication-related family matters
clinician s interpretation40
Clinician’s Interpretation
  • Parent’s became silent and agitated

Cultural Interpretation

  • Family matters are private

and not to be shared with

strangers

recommendation41
Recommendation
  • Plan treatment based on general information
event42
Event
  • Clinician repeatedly praised child

and child’s behavior

to the parent.

clinician s interpretation43
Clinician’s Interpretation
  • Mother was uncomfortable hearing clients

Cultural Interpretation

  • Mother believed clinician

would abduct the child or

cast the evil eye (a powerful

spell) on the child

recommendation44
Recommendation
  • Be positive, but not to excess
event45
Event
  • Family refused to allow a male

clinician to escort a female child

away from her parents to the clinical

room

clinician s interpretation46
Clinician’s Interpretation
  • Family has trouble with separation

Cultural Interpretation

  • Culture does not allow a female

child to be alone with a male

stranger (not related to her

family)

recommendation47
Recommendation
  • Allow parent to accompany child
  • Assign a female

clinician

event48
Event
  • Clinician patted child on the head
clinician s interpretation49
Clinician’s Interpretation
  • Clinician was offering nonverbal form of reward
clinician s interpretation50
Clinician’s Interpretation

Cultural Interpretation

  • Clinician broke religious rule that hair is sacred and not to be touched by a stranger and thereby insulted the family
  • Clinician was offering nonverbal form of reward
recommendation51
Recommendation
  • Know the family before using touch

as a nonverbal form of reward

or affection

event52
Event
  • Client did not stutter openly as directed by the treatment program and clinician
clinician s interpretation53
Clinician’s Interpretation
  • Client was not committed to treatment process

Cultural Interpretation

  • Culture highly regard speech, thus dysfluency invites ridicule by others within that culture
recommendation54
Recommendation
  • Us a more fluency oriented program
event55
Event
  • Client refused to maintain eye contact with the clinician as prompted by clinician
clinician s interpretation56
Clinician’s Interpretation
  • Client did not follow instructions

Cultural Interpretation

  • Culture views direct eye contact as a sign of hostile or sexually aggressive behavior and lowering the eyes is a sign of respect
recommendation57
Recommendation
  • Interpret apparent resistance from multiple perspectives
event58
Event
  • Clinician offered a gesture (forming a

circle with tip of thumb touching index

finger) after which the client

fell silent

clinician s interpretation59
Clinician’s Interpretation
  • Clinician’s gesture was a form of

nonverbal praise

Cultural Interpretation

  • The gesture is interpreted as an obscenity in the client’s culture
recommendation60
Recommendation
  • Use verbal forms of feedback

Very

good

event61
Event
  • Clinician did not observe or perform deliberate repetition of a disfluency on a word containing “th”.
clinician s interpretation62
Clinician’s Interpretation
  • Client was noncompliant

Cultural Interpretation

  • Client was reluctant to expose the tongue, which is considered impolite
recommendation63
Recommendation
  • Modify behavior so that tongue is barely visible between the teeth

Th

event64
Event
  • Client did not perform transfer activities at home
clinician s interpretation65
Clinician’s Interpretation
  • Client was noncompliant

Cultural Interpretation

  • Client’s home is not child-oriented, thus speech initiation by child is penalized
recommendation66
Recommendation
  • Interpret apparent resistance from multiple perspectives
event67
Event
  • Client refused to dialogue with clinician
recommendation68
Recommendation
  • Invite and understand client’s and

family’s causal assumptions about

stuttering and expectations for

treatment

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