About the presenter: Rob Grieve PhD, MCSP is a senior lecturer in Physiotherapy at the University of West of England, Bristol, UK. As a person who has stuttered since childhood, his experience of teaching has been hugely beneficial in the successful self management of his speech dysfluency. Apart from research interests in myofascial trigger points (MTrPs) and musculoskeletal dysfunction, he is involved in sharing ideas and strategies in relation to speech dysfluency, education and self management. This ISAD 2012 paper is based on a workshop at the 15th British Stammering Association (BSA) National Conference, September 2012.

You can post Questions/comments about the following paper to the author before October 22, 2012.


Stand Up and Be Heard

by Rob Grieve
from England, UK

*This paper is partly based on a workshop held at the 15th British Stammering Association (BSA) National Conference, Lincoln University, September 2012.

Introduction

As a person with a mild/covert stutter since childhood, who has successfully managed his speech dysfluency, many difficulties and challenges associated with my speech have been encountered. People who stutter believe that stuttering has a negative impact on their employability and job performance (Klein and Hood, 2004). In relation to higher education, a person who stutters (PWS) may decide not to attend university because of the fear of negative evaluation from their peers and academic staff, including the fear that they may not be able to fulfill the oral assignments often required in most courses (Meredith, Packman and Marks, 2012). Previous decades of research have indicated that fluent speakers do hold negative attitudes towards stuttering and the PWS (Hughes, Irani and Daniels 2012).

As a senior lecturer, excellent communication (job description) and fluency are taken for granted, however as a PWS how one teaches (presentation) can be more of a challenge to what (content) is taught. This paper is based on the personal experience of a person with a mild/covert stutter who lectures for a living. Relevant evidence from the literature is included to substantiate this subjective account.

The underlying positive take home message of this paper is that good communicators need not be fluent at all times. Throwing yourself into the verbal deep end and talking/presenting to a group of people can be a strong motivator for change and a valuable tool for stuttering self management and speech fluency.

The emphasis of this paper will be on the following:

Issues with standing up and talking/presenting to a group of people

Regardless of whether one is a PWS or not, many people feel anxious and try to avoid speaking in public. One of the more common social phobias is a phobia of public speaking, known as glossophobia (glossa meaning tongue and phobos meaning fear). Overall, stuttering appears to be associated with a dramatically heightened risk of social phobia in adults (Iverach et al, 2009).

Social phobia leads to avoidance of social situations such as speaking in public, and using the telephone which may result in stuttering becoming more severe in these anxiety provoking situations (Craig and Tran, 2006). The frequency of stuttering is generally reduced when talking to a familiar person, or someone not in authority (Craig and Tran 2006). Linked to the fear and anxiety that a PWS may have for public speaking, evidence suggests that fluent listeners of a stutterer are physiologically aroused by stuttering and appear to maintain feelings of unpleasantness to stuttered speech (Guntupalli et al, 2006). The PWS often report that the reactions and attitudes of their listeners influence the severity of their stuttering (Klassen, 2001). This negative response may in turn lead to increased self anxiety about the prospect of public speaking and may in turn increase the rate and severity of stuttering. In a more humorous light, a well known Jerry Seinfeld quote is that "most people would prefer to be lying in the casket rather than giving the eulogy."

Some of the personal issues I faced in standing up and speaking to colleagues and students are:

Strategies that worked for me!
The above personal issues in relation to public speaking were barriers that I initially faced, but over time most of these were overcome. The end result was increased confidence and improved speech fluency (more in the next section). The following strategies for public speaking I found very beneficial, some of these could also be applied to the PWS and to fluent speakers alike:

i) Self disclosure

A primary concern for me in public speaking was the overriding fear and over emphasis on fluency in the presentation (fear of blocking, hesitations) and not the content in relation to my knowledge and expertise. The end result was the fear of the next word or sentence and trying as hard as possible to be fluent. Attempts at covert strategies were not always successful when trying to replace words or devise avoidance strategies, when anatomical or technical terms could not be replaced.

Over the last few years a great weight has been lifted from my shoulders regarding public speaking and the fear of stuttering. The answer has been the use of self disclosure when first teaching a cohort of students, presenting at a workshop or any form of public speaking. This is achieved by doing some "verbal housekeeping" as opposed to the usual "housekeeping" (location of toilets and fire exits) that often precedes a workshop or lecture. Initially the audience are a bit bemused and then often respond warmly when I begin my talk by informing them I have stuttered since childhood and that "if I pause, hesitate, deviate or say the same word a few times it is just my speech and that I do know what I am talking about".

In a study on males with a severe stutter, it was found that for PWS there is more benefit to self-disclosure at the beginning of a communicative interaction than at the end (Healey et al 2007). The main outcome was that self- disclosure did not prevent negative listener reactions to stuttering; however the benefits of disclosing stuttering appeared to be greater for the speaker than for the listener.

ii) Other strategies

Know your subject is a key way to overcome the anxiety and understandable self preoccupation on fluency and presentation. Important to ensure you take the time to do the preparation and have an in depth knowledge on your chosen topic. The audience may be initially blinded by a slick presenter with verbal fluency but this will soon wear off when they realise that there is more style over substance. I always ensure that I know the topic really well and ensure that it is presented in a way that the audience understand. In presenting academic lectures, simplifying some of the key concepts meets the learning needs of many students and shows a depth of understanding. In the words of Albert Einstein, "everything should be made as simple as possible, but not one bit simpler". A presentation with substantial content and easily understood key concepts, will often have the audience absorbed, motivated and less focussed on the speaker`s speech fluency.

Be enthusiastic and passionate about your topic, focus less on the fluency. The one common theme that emerges when students positively evaluate teaching is the praise for enthusiasm shown by the lecturer or presenter. I find that grabbing the topic by the scruff of the neck and making it come alive by my enthusiasm and passion, ignites audience interest. The downside of this enthusiasm is that it can be very tiring, although it will most likely keep the audience awake.

Be creative in your presentation and do not rely solely on the spoken or written word. Over the years I have moved away from relying only on didactic teaching methods and moved onto more creative strategies/techniques, for example; anatomical crosswords, quizzes and visual presentations. Avoid reading from a script all the time (apart from the difficulty in fluency this may pose) this shows mediocrity and will not inspire and stimulate your audience. This is even more relevant for the PWS, when standing up in front of an audience. Given the above mentioned difficulty on reading text out loud, I have always aimed for limiting the text in a PowerPoint presentation. The use of diagrams, pictures, cartoons and video is more interesting and removes the constant verbal pressure.

Encourage audience participation and verbal or written interaction as much as possible. Although I am standing up and doing the presentation, by including the audience takes the focus of attention off me and makes the audience feel involved. When teaching anatomy, I have asked students to work in pairs and draw the specific muscle outline and attachments on each other. The use of stick-on notes, later displayed on a board is useful for the listeners to share ideas in a large lecture hall.

Use humour in your presentation and also as a tool when using self-disclosure at the beginning. I have been known to joke at the beginning of a presentation that; "there will be a far amount of repetition and hopefully you should have enough time to write your notes." Important to be serious in imparting your message but do not take yourself too seriously!

Further strategies that are helpful, specifically related to stuttering that may be used as described by Souter (2011) are
Slowing the flow or rate of speech- I have often speeded up when feeling myself unable to get a word out in my desire (panic) to finish the sentence. Consciously slowing down can reduce that feeling of panic, increase fluency, put you in control and add an air of authority to your presentation.
Don`t worry about hesitations or pauses - consciously introduce pauses into your speech, and therefore reduce the pressure to get the words out as quickly as possible. One of my own strategies is to write the key words or relevant phrases on a board or use a digital tool if I am about to block.
Maintain eye contact - try to look at the audience when you feel you are about to stutter. Looking away may reinforce this behaviour.
Shift the focus away from yourself and your related speech anxiety to the message that you're aiming to impart in your presentation. People are there to hear what you have to say, not necessarily how you say it. Souter (2011) further advises to see yourself as the messenger, not word perfect just part of the process and not actually the process itself.

The benefits of standing up and being heard

Standing up and talking has greatly improved my speech fluency and self-confidence. The concept of "feel the fear and do it anyway" (Jeffers, 1987) has been very liberating and given me a strong sense of achievement and satisfaction. Being fully engaged as a communicator, without limitations, has been suggested as instrumental in recovery from stuttering (Finn et al, 2005). Throwing myself "into the deep end" and believing that good communication does not always mean 100% fluency has been a strong motivator for change. Allowing the odd period of dysfluency to occur and not seeking perfection in speech has reduced the pressure and let me be myself.

Plexico et al, (2005) have identified the following five themes for successful management of their stuttering, namely; continued management, self- acceptance and fear reduction, unrestricted interactions, sense of freedom (self disclosure about their stuttering) and optimism. Apart from formal management (speech therapy), these identified themes give meaning to the experiences of the stutterer and method of managing the dysfluency.

Overview/Conclusion:

Key to the above is that a PWS can very be very effective in public speaking and be a good communicator. Initially this may be a challenge and take courage but the rewards can be personal growth, increased self esteem and self management in relation to their stutter. Apart from the often quoted accounts of famous PWS, less famous and as powerful examples in relation to public speaking can be found. In 2008 Grant Meredith a stutterer, won the lecturer of the year award at his University in Australia and placed 14th overall nationally. A member of the British Stammering Association (BSA) David Jones won the UK and Ireland `Topics` contest at the Conference of Toastmasters International in Dublin (2010). According to David Jones, "the more I speak in public the easier it gets and the more I enjoy it. There are still words I sometimes stammer on but my fluency has increased dramatically." Need I say more!

References

British Stammering Association (2010) The case of the stuttering lecturer. Available from http://www.stammering.org/stutteringlecturer.html (Accessed 7 July 2012)

British Stammering Association (2010) Toastmasters winner. Available from http://www.stammering.org/news_toastmasters.html (Accessed 05 August 2012)

Finn P, Howard R, Kubala R (2005) Unassisted recovery from stuttering: Self-perceptions of current speech behaviour, attitudes, and feelings. Journal of Fluency Disorders, 30(4), 281-305

Guntupalli VK, Kalinowski J, Nanjundeswaran C, Saltuklaroglu T, Everhart DE (2006) Psycho physiological responses of adults who do not stutter while listening to stuttering, International Journal of Psychophysiology, 62, (1), 1-8

Healey EC, Gabel RM, Daniels DE, Kawai N (2007) The effects of self-disclosure and non self-disclosure of stuttering on listeners` perceptions of a person who stutters. Journal of Fluency Disorders, 32(1), 51-69

Hughes S, Irani F, Daniels DE (2012) Fluent speakers' management of prospective communication breakdowns: The case of stuttering. English Linguistics Research, 1, 35-41

Iverach L, O'Brian S, Jones M, Block S, Lincoln M, Harrison E, Hewat S, Menzies R G, Packman A, Onslow M (2009) Prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Journal of Anxiety Disorders, 23, 928 -934

Jeffers S (1987) Feel the fear and do it anyway. Arrow Books, London

Klassen T R (2001). Social distance and the negative stereotype of people who stutter. Journal of Speech-Language Pathology and Audiology, 26(2), 90-99

Klein JF and Hood SB (2004) The impact of stuttering on employment opportunities and job performance. Journal of Fluency Disorders, 29(4), 255-273

Meredith G, Packman A and Marks G (2012) Stuttering, disability and the higher education sector in Australia. International Journal of Speech-Language Pathology, 14, (4), 370-376

Plexico L, Manning WH, DiLollo A (2005) A phenomenological understanding of successful stuttering management. Journal of Fluency Disorders, 30 (1), 1-22

Souter K (2011) Teach Yourself How You Can Talk To Anyone. Teach Yourself Books, Hodder Education, London


You can post Questions/comments about the above paper to the author before October 22, 2012.


SUBMITTED: August, 2012
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