About the presenter: Louise Heite is a speech-language pathologist who has recently entered a private practice in Kenai, Alaska after serving a number of years as a school-based SLP. She has a MA in speech-language pathology from Temple University, and has been interested in stuttering for many years. Her master's thesis was on the connection between stuttering and the psychological phenomenon of dissociation. She is a co-owner and member of the advisory board of the Stutt-L discussion list.

You can post Questions/comments about the following paper to the author before October 22, 2006.

Are people who stutter truly oppressed?

by Louise Heite
from Alaska, USA

On Thursday, 9 Feb 2006 19:57:25 the following email appeared on "Stutt-L", a large, international email discussion list for people who stutter:

Hello all,

Being a PWS [Person Who Stutters], I am going through one of the worst periods of life. I am trying to find a JOB! I am a Master's graduate in Mechanical Engineering. All employers get impressed by my resume, invite me for an interview. When the time comes for a personal or a telephonic interview, I try to be upfront about my speech disorder. They don't express a concern at that time. But their perceptions change... ultimately I get a "Thank You and Best of Luck" note 2 weeks after. My worst fears of so many years have now come ALIVE! And I am not able to face them with enough courage. As every day is passing by, my confidence is being shattered, I am losing hope...Thoughts of committing a suicide are no longer a strange phenomenon to my mind. I did not want to appear like a cry-baby here, but that is what I finally come out to be- hence my apology on that. Here are my questions- How should I go about approaching the employers for searching the jobs? Sometimes I think I should include this information directly in my resume or a cover letter, but my SLP [speech-language pathologist] and other advisors told to do it at the time of the interview. I learnt on web that stuttering is in fact considered as a disability in the disability act. Would it help to ask an employer to consider my application under the ADA act? Are there any particularly identifiable employers in US, who would be taking the affirmative action to hire a PWS? My appreciation in advance for reading through this mail, and all your valuable inputs!

Clearly, the writer was deeply distressed by his inability to land a job, and clearly he was certain that his stuttering was the reason. He is not alone: the presence of an international discussion list about stuttering on the internet is testimony to the perception of people who stutter that they are a special and distinct group with special and distinct needs. Employment discrimination, social isolation, school bully victimization, and workplace teasing are common topics of discussion.

Who are these people, and what is the condition that sets them apart? Are people who stutter truly an oppressed group with a legitimate claim to some remediation of discrimination?

What is stuttering?

Stuttering is one of the most studied speech-language disabilities, and yet it is one of the least understood. "Ordinary" stuttering is increasingly referred to in the field of speech-language therapy as "persistent developmental stuttering" to distinguish it from dysfluency caused by brain damage, Most people recognize stuttering when they hear it, but even experts who have studied the disorder for decades are at something of a loss when they try to define it. In a nutshell, stuttering can be described as involuntary and uncontrolled disfluency of speech. But this is inadequate, as not only does stuttering take many different forms in different individuals, it also can be induced in almost any individual in certain circumstances.

There is no consensus on what kind of disfunction lies at the root of stuttering. Stuttering sometimes responds to drug treatment such as risperidone (Ranjan , 2006; Wattum, 2006). A corresponding ability of other drugs, for example, theophylline, (Movsessian, 2005) to induce stuttering suggests that there is a strong neurological component to the disorder. Current studies are exploring what kind of stuttering responds best to what drug and what dosages are appropriate. Although there is considerable evidence from brain imaging studies that people who stutter and people who do not stutter process speech differently, there is no consensus at all as to whether these differences are causal or are the result of stuttering.

There seems to be a genetic component to vulnerability to stuttering, but data are as yet inconclusive (Viswanath, 2004). Currently there is a NIH study of a number of families in which stuttering occurs, to determine the validity and strength of this genetic interpretation.

Stuttering also has a strong psychological component. It can be made worse in some people under conditions of stress; however, the stressful conditions that produce stuttering or that exacerbate it vary widely from person to person. Situations that may induce stuttering in one person may obliterate it in another. Sometimes stutterers excell in situations that leave many nonstutterers tongue-tied, such as acting or presenting arguments in court.

The general incidence of stuttering in the population is about 5%, meaning that one of every twenty adults either stutters or stuttered as a child but overcame or outgrew the disorder before puberty. Prevalence at any point in time is usually closer to 1%. About four of five of these people are male. However, there is no difference in the prevalence of stuttering worldwide, and aside from the gender bias, no one population seems to be more likely to stutter than any other population. Stuttering cuts across racial, ethnic, and economic boundaries with admirable evenhandedness. (Bloodstein, 1995).

Prerequisites of oppression

Life, the platitude states, is not fair. For unfairness to constitute oppression, however, certain identifying factors must be present in one form or another. In the literature on social and psychological effects of stuttering, several of these appear in recurring forms. Stereotypical classification of the stutterer as an "other" is well documented, and can be found among people in positions of power such as employment counselors, school principals, teachers, and even speech-language pathologists. Stigmatization appears in the forms of infantilization of the stutterer; and a tendency for people who are in a position to judge the competency of stutterers to "blame the victim." Pathologization appears in the tendency of people unfamiliar with the disorder to ascribe several very undesireable traits to those who stutter. Victimization on the individual level can be severe. There are real-world consequences that are at least systemic, if not systematic, in their application. And people who stutter engage in many of the coping device common to oppressed groups when they have not yet found their voice.

Stereotypical classification

People who do not stutter generally carry in their minds a stereotype of the "typical" stutterer. In a study of stereotype formation among New Zealand college students, White and Collins describes the stereotype of the stutterer as "a number of primarily negative personality trait attributions, including self-consciousness, shyness, nervousness, tension, anxiety, guardedness, reticence, fearfulness, and introversion." They concluded (agreeing with many other studies) that this stereotype is based on an inaccurate confusion of what they assume to be trait rather than state anxiety in the person who stutters. That is, because most nonstutterers can become disfluent in situations of high negative emotional arrousal (state), they assume that chronic negative arousal is the typical condition of the person who stutters (trait). (White and Collins, pp 567-570).

Stigmatization

Stuttering generally carries a stigma. In an article explaining the social consequences of stuttering to social workers, Suzanne Altholz and Martha Golensky say: "Any verbal situaltion can expose the stutterer to negative reactions and rejection. Simple, taken-for-granted activities such as being asked to introduce oneself, talking on the telehone, or seeking directions become major tasks. The tension and feelings of shame can be overwhelming." (Altholz and Golensky, 2004). The anecdotal record of stuttering is rife with tales of people being singled out as defective for their stuttered speech. Perhaps the most famous of these tales is the novel I, Claudius and it sequel by Robert Graves, but there are many others. A good source of these anecdotes is a little book entitled Knotted Tongue be Benson Bobrick. This collection of both sad and funny true stories of dealing with stuttering gives a clear picture of the stigma associated with the disorder.

Pathologization

In a paper presented to the annual meeting of the International Fluency Association in 1995, Jürgen Benecken of the University of Applied Sciences, Merseberg, Germany, analysed the portrayals of stutterers in a wide range of popular entertainment media. He surveyed 19 movies, 36 books, and an assortment of jokes, headlines, and other incidental expressions, and found that stutterers in popular media are almost always "neurotic or even psychopathic." In the media, people who stutter are "almost exclusively" men, although one must point out that that actually reflects the 4:1 male to female ratio of stuttering in the general population. These men are "mostly in subordinate roles...[and] unattractive or at least not masculine in their appearance and behaviour." He goes on to elaborate, "The stutterer appears as rather soft, unattractive, frail, pinched, and subordinating. He might be a sexually deprived, possibly perverted man with pimples or nibbled fingernails who could be thinking about murdering somebody...These popular attributions to stuttering contradict the traits and qualities considered distinctive of manhood." (Benecken, 1995)

Infantilization of stutterers is also common. Freud and his followers tended (or tend) to view stuttering as a fixation in the oral or the anal stage of mental development. This view has given rise to a number of unfounded psychological theories as to the origin of the disorder and especially to its explanation as a difficulty in detaching from the mother and inadequate toilet training. Benecken (op cit) points out that the social consequences of stuttering for children may indeed drive them to unusual dependency on their mother or another primary care giver.

Blaming the victim is not uncommon. Stuttering seems to the nonspecialist and the nonstutterer to be merely a matter of pulling up one's socks and getting one's speech under control. The inability to speak, and the distortions of stuttered speech, are both reminiscent of small children's communication patterns. However, infantilization is imposed on the adult stutterer with a certain blissful unconsciousness. A former client of this writer's, a very severe stutterer who worked in a factory, felt that his co-workers looked on him as a "small boy" because he was not able to take part in the aggressively playful banter that is the lingua franca of factory-floor socialization.

Victimization

Studies of bullying in both Britain (Hugh-Jones and Smith, 1999) and Germany(Benecken, 1995) have shown that about 75%-85% of children who stutter in those countries are regularly victimized by school bullies. Similar studies have not been conducted in the US, but two of this writer's present clients report having been bullied for their speech in their elementary school years.

Bullying of stutterers does not disappear when the stutterer leaves elementary school. The National Stuttering Association maintains an advocacy arm to assist its members with employment discrimination and other examples of adult bullying. William Parry, Esq., a Philadelphia attorney who served for a number of years as the head of NSA's advocacy committee, wrote in a pamphlet on self-advocacy, "I have heard from stutterers who try to hide their stuttering on the job for fear of being fired, who suffer harassment or unfavorable evaluations by intolerant supervisors, and who have been denied promotions to supervisory positions or jobs that involve speaking or dealing with the public." (Parry [a], 1998)

Real world consequences

One of the groups usually included in legislation that attempts to limit discrimination is people with disabilities. Discrimination against, and oppression of, the disabled has happened throughout history, and only recently have policies of "inclusion" begun to make a dent in that long and sorry career. One is tempted to classify the prejudices against stuttering as a subset of prejudice against disability. Indeed, stuttering is a disability, but it is often overlooked in discussions of discrimination against the disabled. It is, in that context, not a very compelling disability. People who stutter are normal-enough looking when they refrain from speaking, so people who are concerned with more obvious and salient disabilities tend to disregard the real difficulties that a noticeable speech impediment may pose to the person who has to bear it.

As part of his advocacy work for the National Stuttering Association, Parry has done a detailed analysis of case law regarding stuttering under the Americans with Disability Act. Some contend that stuttering does not qualify as a disability as defined in the Americans with Disabilities Act. However, he points out that the ADA, "Does not list specific conditions by name as 'disabilities'...Therefore there is no significance to the fact that stuttering is not specifically listed." He also points out that one qualification for disability is "being regarded as having such an impairment" that limits a major life function. (Parry [b], undated)

Unfortunately, no precedent-setting ADA case regarding stuttering has yet come to trial. An international scholarly study, begun in 1998, of the perceptions of stuttering and their consequences for employment and social inclusion has yet to be completed, but preliminary results suggest that this prejudice is pervasive (Dr. Kenneth St. Louis, personal communication). But even without case law or scholarship, the fear and desperation which characterize the letter that opened this paper give evidence that the prejudice which at least some stutterers feel has a real-world effect on their lives.

Oblieration of the stigma

While many people who stutter perceive that they are the victims of discriminatory and oppressive behaviors and stereotyping, others prefer to concentrate on proving the "disability" label wrong. Much is made of the success of individuals who stutter in popular literature about the . Advocacy groups use the success of individuals such as James Earl Jones, the founder of the NAPA auto parts chain, author John Updike, or senator Joe Biden of Delaware, as evidence that stuttering is not necessarily a barrier to success. The life of Annie Glenn, wife of former astronaut and senator John Glenn is often held up as an example of how one can overcome stuttering to become a respected leader in one's corner of the world. A respected Internet installation, The Stuttering Homepage (www.stutteringhomepage.com), housed at the University of Minnesota- Mankato, contains a back page entitled "Famous People who Stutter" that offers brief biographies of dozens of successful, somewhat well known people who have either overcome their stuttering or succeeded despite of it.

In the late 1990's, several stuttering self-help organizations organized "International Stuttering Awareness Day." On this day, which occurs in late October, people who stutter are asked to turn to whoever is to their right at noon and say, "I stutter." The hope is that this simple act will point out to a large number of uninvolved pesons just how common stuttering is, and open up opportunities to discuss stuttering with the general populace. This day is accompanied by the annual online publication of a body of both scholarly and lay papers examining various aspects of stuttering. These papers are archived at The Stuttering Homepage.(http://www.stutteringhomepage.com).

Distancing oneself from the prejudice

The Internet-based discussion list which provided the letter at the beginning of this paper is only one of a number of "safe" places in cyberspace that people who stutter have made for themselves. In the real world, The National Stuttering Association, founded in the early 1980's as the National Stuttering Project, is a nationwide self-help and advocacy group for people who stutter in the US. It is divided into state and local chapters. Europe has a similar organization, the European League of Stuttering Associations, which is an umbrella group for a number of national associations. The Stuttering Foundation of America sponsors therapist training, education, and research into the disorder, while a relative newcomer, "Friends," has as its mission providing socially encouraging assistance to children who stutter and their parents.

All of these organizations have in common the fact that they are places where a person who stutters can go to be heard, sometimes literally, and to find assistance in dealing with the difficulties that their impediment imposes on their daily lives. In these safe places, the stabs of the popular media are roundly reviled, and one can count on finding a sympathetic ear for one's complaints.

Identifying with the oppressor

One is tempted to wonder how a person who stutters can "identify with the oppressor." In an interesting interaction among points of view, there is a lively debate every few months on the Stutt-L list as to whether the correct designation for those who have this disorder is "stutterer" or "person who stutters" abbreviated PWS. This writer is one of the list managers, and monitors most postings. It seems, and would bear some genuine research, that most of those who are content with the older designation of "stutterer" are people who are otherwise relatively successful in their work and social lives, while those who prefer the supposedly less derogatory "person who..." designation are not. Here again is an area where research is yet to be done, though. The above problem would make an interesting semester paper for an enterprising student. List archives are readily available.

A different kind of identification with the oppressor occurs in some people who have extraordinary linguistic skills. By constantly scanning their speech and perennial vigilance against the expression of stuttering blocks, a few people are able to "pass" as totally fluent. These people, called "covert stutterers," probably pay the greatest price for their identification with the nonstuttering world. In an International Stuttering Awareness Day paper, Terry Griffith of Australia described suffering intense stress regarding his covert stuttering, which eventually led him to seek psychiatric help. Admitting that he did indeed stutter, the author says,

"The fact remains, however, that many coverts don't want to declare their status.  And there are good reasons for this as well.  If we can pass as fluent, at least most of the time, why shouldn't we do so?  Nobody likes to stammer, so if we can avoid stammering--if we can avoid publicly stammering, regardless of the turmoil within--why shouldn't we do so? Conclusion

This paper has provided a look at several social aspects of stuttering that appear to qualify persons who stutter as an oppressed group. Their condition is involuntary, and not likely to be easily remediated. The condition is stigmatized by society, through negative portrayals in popular media. People who stutter are assumed to possess a number of negative personality traits that exclude them from membership in the dominant group. They are often victimized and infantilized, and also often blamed for their own condition. They suffer negative consequences including bullying, harassment, and exclusion from desirable jobs because of this condition.

Stutterers in the Western world have adopted a number of coping mechanisms that closely resemble those used by members of other, recognized, oppressed groups. These include destigmatizing, by means of holding up successful stutterers for admiration; distancing oneself from the oppressor group through Internet associations with other stutterers, and the establishment of stuttering support and advocacy groups; and identifying with the oppressor by trying to "pass as fluent" or by denigrating the belief that stutterers are in fact deserving of some remediation from oppression.

Taken as a whole, it becomes evident that people who stutter do genuinely constitute an oppressed group. Associations such as NSA in the US and ELSA in Europe have begun to try to remedy this oppression, but until this group of people is recognized as subject to unconscious oppression by a more powerful majority, there is not a lot that can be done to remedy the oppression.

Bibliography

Altholz, Suzanne, and Martha Golensky, "Counseling, support, and advocacy for clients who stutter." Health and Social Work, v. 29 no. 3, August, 2004

Benecken, Jürgen, "The stutterer, or what happens when grace fails: on the nature and psychological relevance of a stigma." Proceedings of the First World Congress on Fluency Disorders, vol. 2, 1995.

Bloodstein, Oliver, A handbook on stuttering, Singular Publishing Group, San Diego, 1995.

Bobrick, Benson, Knotted tongues: Stuttering in history and the quest for a cure. Kodansha America, New York, 1995.

Dartnall, Terry, "Passing as fluent", International Stuttering Awareness Day Online Conference, http://www.mnsu.edu/comdis/isad6/papers/dartnall6.html, 2003

Hugh-Jones, S, and Smith PK, "Self-reports of short- and long-term effects of bullying on children who stammer." British Journal of Educational Psychology, vol. 69 no. 2, pp. 141 -- 158, June 1999. (Abstract)

Movsessian P, "Neuropharmacology of theophylline induced stuttering: the role of dopamine, adenosine and GABA." Medical Hypotheses, Vol. 64 (2), pp. 290-7, 2005. (Abstract)

Parry, William, [a] "Stuttering and employment ciscrimination." International Stuttering Awareness Day Online Conference, http://www.mnsu.edu/comdis/isad2/papers/parry.html, 1998,
[b] "Stuttering as a disability under the Americans with Disabilities Act of 1990." National Stuttering Project Advocacy Committee, http://members.aol.com/wdparry/ada.htm, 2004.

Ranjan S, "Persistent developmental stuttering: treatment with risperidone.

The Australian And New Zealand Journal Of Psychiatry Vol. 40 (2), pp. 193, Feb. 2006. (Abstract)

St. Louis, Kenneth, personal communication regarding "International Project on Attitudes Toward Human Attributes" (IPATHA; also and previously known as the "International Project on Attitudes Toward Stuttering," 25 February, 2006.

Viswanath N, "Evidence for a maHuman Biology; An International Record Of Research, Vol. 76 (3), pp. 401-12, June, 2004. (Abstract)

Wattum, PJ, " Stuttering improved with risperidone." Journal Of The American Academy Of Child And Adolescent Psychiatr, Vol. 45 (2), pp. 133Feb. 2006. (Abstract)

You can post Questions/comments about the above paper to the author before October 22, 2006.
Return to the opening page of the conference