Is 'Pseudostuttering' in SLT training appropriate?

Image

Findings from a piece of research exploring whether it's right or wrong for speech & language therapy students to simulate stammering on training courses.

In 2021, here at STAMMA we shared an invitation with our supporters to take part in a study being carried out by researchers at St. John's University in New York. With their findings now published in a peer reviewed research article, one of the researchers Mellissa A. Bortz tells us all about it.

Background & purpose

The profession of speech-language pathology, or speech & language therapy (SLT) as it's called in the UK, is currently in flux, with many therapists moving away from the 'medical model' approach. This is the traditional approach which considers stammering as a disorder, something to be 'fixed', and something which has been increasingly criticised for stigmatising people who stammer. 

There has also been pushback on exercises used in SLT training courses here in the USA to simulate stammering. 'Pseudostuttering', as it's known, has been a common assignment on courses, with students being required to go out into the public and put on a fake stammer, eg when asking people for directions or making an order in a restaurant. The aim of the exercise is to help SLT students develop empathy for stammering clients.

In the last few years, some SLT students have been reluctant to do these assignments, feeling that they are stigmatising people who stammer. Therefore, the purpose of our study was to explore what people who stammer, as well as SLT students and course lecturers, thought, and what they wanted for future assignments.

Survey

For our study, we invited people from each of these groups to complete an online survey asking them what they thought of using pseudostuttering assignments in SLT training. We also wanted to find out their opinions on whether or not these assignments developed empathy towards people who stammer. We approached STAMMA to invite people to take part, which they did via its website and on social media.

Involving people who stammer (which has never happened before) was essential, as they are the experts in stammering and their opinions about SLT training directly impacts on them.

Results

134 people from all over the world took part in our survey, including 68 people who stammer, 48 SLT students and 18 course lecturers. 

The results indicated that 83% of lecturers supported pseudostuttering assignments. 52% of people who stammer, just over half, had positive or neutral attitudes to these assignments. For example, one person said, "The more that a speech-language therapy student understands and has empathy, the better their treatment". 48% of people who stammer were negative about it, with one participant saying "Stammering has ruined my life, seeing someone pretending to stammer is offensive to me". 

68% of SLT students did not support these assignments as they believed them to be stigmatising and not useful for developing empathy. One student said, "I am empathetic enough to be understanding of stammerers' struggles. Also, this very much seems like making fun of someone who is disabled". Comparable results were found with a similar study involving SLT students who carried out stroke disability simulations. The results of that study therefore recommended that students need to be taught empathy in class instead, just like they are taught other subjects.

Recommendations & conclusion

In our study, we asked people to suggest alternatives to pseudostuttering assignments. The responses included: "Talk to people who stammer. Go with someone who stammers and witness what happens when they stammer". One lecturer recommended scheduling a class visit by someone who stammers.

One of the conclusions that came out of our findings is that it is important to partner with all constituent groups when planning student education. Additionally, a 'neurodiversity paradigm' should be adopted by the SLT profession whereby stammering isn't pathologised (ie, seen as 'abnormal'). Also, it would be helpful if speech & language therapists ally with people who stammer, regard them as the experts in their treatment and collaborate to advocate for the acceptance of stammering.

Thank you to all STAMMA supporters who took part in the survey.

Mellissa A. Bortz is Assistant Professor at the Department of Communication Sciences and Disorders, St. John’s University in New York. 

The article 'Is There a Place for Pseudostuttering Assignments in Speech-Language Pathology Training Within the Neurodiverse Paradigm? was published in Perspectives of the ASHA Special Interest Groups, Volume 9, Issue 3, June 2024, p518-532.

See our Take Part In Stammering Research page to see what current projects you can get involved with.