|About the presenter: Ken St. Louis, Ph.D., is a professor at West Virginia University, a speech-language pathologist and mostly recovered stutterer. His research in person-first terminology has lead naturally to research on public attitudes toward stuttering in general. In that area, he coordinates an international initiative to develop an instrument for measuring public opinion toward stuttering.|
Beginning of a Discussion
Early this year, on STUTT-L, the well-known stuttering listserv, someone posted the following sincere question:
Because I have been rankled by the person-first movement since its inception, I could not resist making a detailed reply. Most of the arguments given pro and con for this sort of thing come from one's own personal feeling of labeling someone else or being labeled. Personal preferences are important, but I believe that actual research data should be brought to bear on this issue. With that in mind, I carried out a series of studies and published an article entitled "Person-First Labeling and Stuttering," published in 1999 in the Journal of Fluency Disorders. First, let me summarize that study again.
In the mid to late 1990s, I arranged for four groups of respondents to evaluate on rating scales various terms or labels. The groups included: (a) actual speech or language clients in our speech clinic (more than 50% of whom in this study were stutterers), (b) parents of young clients, (c) students in speech-language pathology, and (d) members of the general public. Half of the questionnaires asked about respondents' impressions of--and personal experiences with--various labels or names given to people; the other half asked about appropriate use of the labels. The labels were as follows:
PERSON-FIRST VS. DIRECT LABELS
"Person who Composes" / "Composer"
"Person who Gambles" / "Gambler"
"Person with Leprosy" / "Leper"
"Person who Murders" / "Murderer"
"Person who Smokes" / "Smoker"
"Person who Wets the Bed" / "Bed Wetter"
"Person with Psychosis" / "Psychotic"
"Person with Aphasia" / "Aphasic"
"Person who Lisps" / "Lisper"
"Person who Clutters" / "Clutterer"
"Person who Stammers" / "Stammerer"
"Person who Stutters" / "Stutterer"
"Person with Cancer"
The labels obviously range from negative to positive. The ones between the dotted lines are speech-language-hearing related terms. Also, first 12 terms were either person-first or direct labels, and these were carefully counterbalanced in the questionnaires. Half of the questionnaires contained one version; the other half contained the other version. But all of the questionnaires contained the remaining 16 "anchor" terms, in order to compare each of the two groups on the same labels and to serve as a control for similarities or differences between the two groups of respondents. It is important to realize that the person-first or direct label terms were mixed with the anchor labels so that there was no predictable pattern or clue that the study was about the labels for "stutterer" or "person who stutters."
The average responses among the different groups of respondents were remarkably similar, even though there were large differences in age, education, and occupation. All the groups basically agreed on the degree to which labels were negative (or stigmatizing), neutral, or positive. Virtually all (98%) of 480 comparisons for person-first versus direct labels terminology did not result in a significant difference. The rare significant differences favored "person with leprosy" over "leper" and "person with psychosis" over "psychotic." Not one of the 640 group comparisons for the anchor terms was significant.
There were essentially no systematic differences in ratings among "stuttering," "person who stutters," "stammerer," "person who stammers," and "disfluency." This is somewhat surprising since clinicians often prefer the term "disfluency" to "stuttering" because it is felt to be less negative.
This and two other studies have supported the inescapable conclusion from group studies that person-first terminology has little effect on lessening negative ratings for stuttering and most other terms. One such study by Dietrich, Jensen, and Williams (2001) found that college students in a general education class were no more likely to agree that a hypothetical student should enter a college degree program in speech and language if he were described as "stutterer" versus a "person who stutters." Another in the UK compared "stammerer" versus "person who stammers" (Brocklehurst, 2005). ("Stammering" in the UK is synonymous with "stuttering" in the USA.) Brocklehurst, using the same words as in my studies, asked questions of respondents representing the general public that involved a hypothetical person who was a "stammerer," "person who stammers," or a number of descriptors (taken from the list above). Respondents rated their willingness to socialize, trust, talk to, or employ the hypothetical person as well as to rate their perceptions of what the labels implied about a person's sincerity, mental stability, and intelligence. Brocklehurst found that none of the person-first versus direct label comparison was statistically significant. Accordingly, he suggested that the adoption of the person-first label is unlikely to change or improve the public's perceptions of stammerers (stutterers).
To provide a sampling of the discussion on this issue, following are a few views expressed on the list. (It should be noted that the quotes are not always exactly as written. I did some slight editing to correct a few typographical errors and provide a level of consistency.)
Paul Brocklehurst shared with me the paper cited above. In the course of our correspondence, he wrote:
In two follow-up messages, I posted the following perspectives, which are not summarized here as "the last word" but as my opinions only.
Two contributors to the discussion (Paul Brocklehurst and I) presented objective data on whether or not person-first labeling makes a difference or not. In spite of this, aside from some agreements here and there with our positions, all the discussion has been on "what I feel" or "what I think someone else might feel." That, in my opinion, is precisely what is wrong with political correctness as it relates to any but the most obvious and well-known pejorative or stigmatizing labels, e.g., "idiot." For terms such as "stutterer," the validity of the sensitivity shown--or lack thereof--is almost never based on verifiable fact. Instead, it is based on someone's well-intentioned--but according to the data, inaccurate--ideas about what might be construed as negative. Once we start down that road, there seems to be no stopping.
For example, the American Speech-Language-Hearing Association (ASHA) insists on person-first terminology in its publications. The citations for support do not include any data. I find this sad in light of the fact that our profession advocates the use of "evidence-based practice." Apparently, "evidence" in this case is only what we feel or have been told that others feel.
No doubt, stutterers sometimes encounter negative, derogatory, or stigmatizing comments, attitudes, and reactions from others. However, unless there is a wholesale change in the attitudes surrounding that (such as has occurred to a large extent for people in wheelchairs), modifying the name of an unfortunate condition typically neither eliminates nor reverses the hard realities faced by those suffering from it. I would also argue that changing the name of an undesirable condition may have the undesired effect of euphemistically promoting the conclusion that something is not what it really is. In my years as a clinical speech-language pathologist, I have observed numerous instances when stutterers or clinicians used the term "disfluency" instead of "stuttering" in order to lessen the negativity of the diagnosis. As a result, I have witnessed several cases where a person has insisted that he or she did not "stutter" but was only "disfluent".
Perhaps one of the most bizarre results of person-first terminology in stuttering is that many now use "PWS" (i.e., "person who stutters") or "CWS" (i.e., "child who stutters"). These acronyms, at first appeared only in writing, but now have entered the verbal lexicon as well. As a (mostly recovered) stutterer myself, I would react much more negatively to someone calling me a "PWS" than a "stutterer." Finally, I find it strange that some believe we can use abbreviations like "PWS," "CWS," and "PWDS". in writing (apparently believing that we are being sensitive, or why else would we write them?) but simultaneously believe that calling someone a "PWS" is insensitive.
I would like to conclude with an extended quote from my 1999 article:
Brocklehurst, P. (2005). "Stammerer" or "person who stammers"? A comparison of the impact of two labels on the general public. Unpublished sociolinguistics project. De Montfort University, Leicester, UK.
Dietrich, S., Jensen, K. H., & Williams, D. E. (2001). Effects of the label "stuttering" on student perceptions. Journal of Fluency Disorders, 26, 55-66.
St. Louis, K. O. (1999). Person-first labeling and stuttering. Journal of Fluency Disorders, 24, 1-24.
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