Speech-Language Pathologists' Perceptions Toward Normal Speakers and People with Communication Disorders Before and After Completion of Therapy Lin Sun, M.A. 1 Daniel Hudock, Ph.D. 2 Graham Schenck, M.S. 1 Joe Kalinowski, Ph.D Department of Communication Sciences & Disorders East Carolina University 2 – Department of Communication Sciences & Disorders Idaho State University

Introduction – Development of the Scale Yairi & Williams (1970) asked 174 school speech pathologists (127 responded, 32 males and 95 females) to describe the “designation of stutterer”. Specifically, they were asked to list all words, adjectives, or traits that they felt were needed to adequately describe elementary school boys who stutter. The 26 most frequently mentioned items tended to describe personality rather than their intellectual, cognitive, and/or physical traits. Those most often cited were nervous, shy, tense, guarded, anxious, withdrawn, afraid, and quiet.

Development of the Scale Woods & Williams (1971) asked 45 school speech pathologists to write adjectives they felt best described the adult male stutterer. Most of the same adjectives were judged to be undesirable personality characteristics for males. 75% of the clinicians listed adjectives that fell into the category of “nervous or fearful,” and 64% listed those that were included in the category of “shy and insecure”, Only 31% of the clinicians listed adjectives that reflected “abnormalities in speech.”

Semantic Differential Scale Woods and Williams (1976) used the aforementioned adjectives to establish a 25-item semantic differential scale to examine four hypothetical groups of people (e.g. typical eight-year-old male, typical adult male, typical eight-year-old male who stutters, typical adult male who stutters). Results demonstrated a negative stereotype of PWS as: tense, shy, guarded, afraid, introverted, reticent, also suggested that the stuttering stereotype doesn’t differ between hypothetical adults and elementary-age boys. Follow-up researchers examining the perceptions of PWS by parents (Crowe & Cooper, 1977; Fowlie & Cooper, 1978), teachers (Crowe & Cooper, 1977; Crowe & Walton, 1981; Lass, et al., 1992), employers (Hurst & Cooper, 1983a), and vocational rehabilitation counselors (Hurst & Cooper, 1983b) confirmed that a pervasive negative stereotype existed.

Speech-Language Pathologists Perceptions of PWS With respect to Speech-Language Pathologists’ (SLPs) perceptions of PWS, numerous studies (Cooper,1975; Cooper & Cooper, 1982, 1985; Cooper & Cooper,1996; Cooper & Rustin, 1985, Lass & Ruscello et al.,1989; Kalinowski, Stuart & Lerman,1993; Woods & Williams,1971) have confirmed similar attitudes and perceptions. Findings indicate that stereotypes of PWS are robust and resistant to alteration even after years of training and working in the field of Speech- Language Pathology.

Stereotypes of Other Deficits Gilmore (1974) compared normal speakers to esophageal speakers and esophageal were rated as less socially and vocationally acceptable. McKinnon, Hess, and Landry (1986) had college students listen to audiotaped speech samples then completed a figure placement instrument and a 30-item bipolar scale. Disorders were all rated in a similar negative manner.

Rationale To the best of our knowledge, this is the first study to investigate SLPs’ perceptions of PWS compared to their perception of people with other speech and language disorders and normal speakers. This is also the first study to examine clinicians’ stereotypes of hypothetical clients before and after attending therapy. The purpose of this study was to examine changes in SLPs’ perceptions toward people with communication disorders before and upon completion of therapy, differences of their attitudes toward normal speakers and people with communication disorders.

Methods Participants  Speech-Language Pathologists who were members of North Carolina Speech Hearing & Language Association (NCSHLA) were targeted participants. A link to a Qualtrics® online survey was sent to professionals. Test Instrument  The instrument employed in this study was the 25-item semantic differential test developed by Woods and Williams (1976) to examine stereotypes of PWS. It has been validated and proven reliable with its use in many stereotypes assessments of PWS (Turnbaugh, Guitar, & Hoffman, 1981; White & Collins, 1984).  Each bipolar adjective pair was presented on a 7-piont Likert scale. Procedures  Three web links for three stuttering, voice disorder, aphasia questionnaires concerning hypothetical people with communication disorders were sent to three unique groups of members of NCSHLA asking them to rate their perceptions of success and personality attributes. Additionally, a questionnaire asking SLPs to rate their perceptions of normal speakers were sent to these three groups of SLPs. Outcomes for SLPs in each of three groups were compared to their perceptions of normal speakers.

Results Stuttering

Stuttering group

Results Aphasia

Aphasia group

Results Voice Disorders

Voice disorder Group

Results Preliminary results show that there are changes in speech-language pathologists’ perception toward people with communication disorders surveyed in this study (stuttering, aphasia and voice disorder) before and after therapy as compared to normal speakers. Tables 1, 2 and 3 report the significant effects for questions within each group and between levels on pairwise comparisons. Questions 5, 10, 13, 22, and 23 were nonsignificant for any group.

Discussion - Stuttering SLPs exhibit stereotypes of PWS prior to therapy that trend to normalization following therapy that assimilate to a hypothetical fluent speaker.  This indicates that SLPs have a preconceived notion of their therapy positively influencing clients’ personality attributes close to normal when completed with therapy.

Discussion - Aphasia SLPs personality attribute judgments of clients with Aphasia are similar before therapy as to an unaffected individual, however their judgments become more negative and polar of an individual after therapy.  SLPs perceive people with Aphasia before therapy close to identical to how they perceive normally fluent speakers. This may be due to the fact that the SLPs believed that the before therapy condition was prior to the cerebral vascular attack (CVA) and not after the event but before therapy, as was intended.  SLPs perspectives of personality attributes after therapy remain different from both normally fluent speakers and clients prior to therapy. This altered outcome perspective demonstrates that clinicians exhibit different expectations for people with Aphasia than PWS.

Discussion – Voice Disorders Before therapy – SLPs judged people with voice disorders before therapy to be more; open, calm, cooperative, friendly, self-assured, relaxed, composed, pleasant, outgoing, approaching, secure and flexible, as compared to their perceptions of fluent speakers. After therapy – SLPs judged individuals to be more; nervous, self-conscious, tense, anxious, fearful, afraid and insecure than their fluent counterparts or individual with voice disorders before attending therapy. These results suggest that SLPs perceive people with voice disorders as being less impacted by their disorder as compared to people with Aphasia and PWS. Additionally, they rate the clients with voice disorders as becoming more insecure and negative affected after therapy.

General Discussion SLPs perceive:  Therapy normalizing personality attributes of PWS, even though many therapies do not directly target these factors  After people with aphasia attend therapy, they may not regain complete normality of personality characteristics  People with voice disorders before therapy are perceived as being more outgoing and confident as compared to normally fluent speakers; however, after therapy they are perceived as becoming more anxious, insecure and negative.

References Betz, I. R., Blood, G. W., & Blood, I. M. (2008). University students’ perceptions of pre- school and kindergarten children who stutter. Journal of Communication Disorders, 41(3), 259–273. doi: /j.jcomdis Cooper, E. B., & Cooper, C. S. (1985). Clinician attitudes toward stuttering: A decade of change (1973–1983). Journal of Fluency Disorders, 10(1), 19–33. doi: / X(85) Cooper, E. B., & Cooper, C. S. (1996). Clinician attitudes towards stuttering: Two decades of change. Journal of Fluency Disorders, 21(2), 119–135. doi: / X(96) Cooper, E. B., & Rustin, L. (1985). Clinician attitudes toward stuttering in the United States and Great Britain: A cross-cultural study. Journal of Fluency Disorders, 10(1), 1– 17. doi: / X(85) Crowe, T A, & Cooper, E. B. (1977). Parental attitudes toward and knowledge of stuttering. Journal of communication disorders, 10(4), 343–357.

 Crowe, Thomas A., & Walton, J. H. (1981). Teacher attitudes toward stuttering. Journal of Fluency Disorders, 6(2), 163–174. doi: / X(81) Doody, I., Kalinowski, J., Armson, J., & Stuart, A. (1993). Stereotypes of stutterers and nonstutterers in three rural communities in Newfoundland. Journal of Fluency Disorders, 18(4), 363–373. doi: / X(93)90015-V Fowlie, G. M., & Cooper, E. B. (1978). Traits attributed to stuttering and nonstuttering children by their mothers. Journal of Fluency Disorders, 3(4), 233–246. doi: / X(78) Gilmore, S. I. (1974). Social and vocational acceptability of esophageal speakers compared to normal speakers. Journal of Speech and Hearing Research, 17(4), 599– 607. Horsley, I. A., & Fitzgibbon, C. T. (1987). Stuttering children: Investigation of a stereotype. International Journal of Language & Communication Disorders, 22(1), 19– 35. doi: /

Hurst, M. A., & Cooper, E. B. (1983). Vocational rehabilitation counselors’ attitudes toward stuttering. Journal of Fluency Disorders, 8(1), 13–27. doi: / X(83) Hurst, M. I., & Cooper, E. B. (1983). Employer attitudes toward stuttering. Journal of Fluency Disorders, 8(1), 1–12. doi: / X(83) Joseph Kalinowski, J. A. (1993). Speech clinicians’ and the general public’s perceptions of self and stutterers. Journal of Speech-Language Pathology and Audiology, 79–85. Kalinowski, J. S., Lerman, J. W., & Watt, J. (1987). A preliminary examination of the perceptions of self and others in stutterers and nonstutterers. Journal of Fluency Disorders, 12(5), 317–331. doi: / X(87) Kalinowski, J., Stuart, A., & Armson, J. (1996). Perceptions of stutterers and nonstutterers during speaking and nonspeaking situations. American Journal of Speech-Language Pathology, 5(2), 61–67.

Lass, N. J., Ruscello, D. M., Pannbacker, M. D., Schmitt, J. F., & Everly-Myers, D. S. (1989). Speech-language pathologists’ perceptions of child and adult female and male stutterers. Journal of Fluency Disorders, 14(2), 127–134. doi: / X(89) Lass, N. J., Ruscello, D. M., Schmitt, J. F., Pannbacker, M. D., Orlando, M. B., Dean, K. A., Ruziska, J.C., Bradshaw, K. H. (1992). Teachers’ perceptions of stutterers. Language, Speech, and Hearing Services in Schools, 23(1), 78–81. MacKinnon, S. P., Hall, S., & MacIntyre, P. D. (2007). Origins of the stuttering stereotype: Stereotype formation through anchoring–adjustment. Journal of Fluency Disorders, 32(4), 297–309. doi: /j.jfludis McKinnon, S. L., Hess, C. W., & Landry, R. G. (1986). Reactions of college students to speech disorders. Journal of Communication Disorders, 19(1), 75– 82. doi: / (86) Turnbaugh, K. R., Guitar, B. E., & Hoffman, P. R. (1979). Speech clinicians’ attribution of personality traits as a function of stuttering severity. Journal of Speech and Hearing Research, 22(1), 37–45.

White, P. A., & Collins, S. R. C. (1984). Stereotype formation by inference: A possible explanation for the “stutterer” stereotype. Journal of Speech and Hearing Research, 27(4), 567–570. Woods, C. L., & Williams, D. E. (1971). Speech clinicians’ conceptions of boys and men who stutter. Journal of Speech and Hearing Disorders, 36(2), 225–234. Woods, C. L., & Williams, D. E. (1976). Traits attributed to stuttering and normally fluent males. Journal of Speech and Hearing Research, 19(2), 267–278. Yairi, E., & Williams, D. E. (1970). Speech clinician’s stereotypes of elementary-school boys who stutter. Journal of Communication Disorders, 3(3), 161–170. doi: / (70)