About the presenter: Rob Grieve MSc, PG Cert (HE), MCSP is a senior lecturer in Physiotherapy at the University of West of England, Bristol, UK. Prior to lecturing, previous physiotherapy experience has included part time physiotherapy at Bath Rugby Academy, NHS and private work. His special interest is Myofascial Trigger Points in musculoskeletal dysfunction and is presently doing a PhD on the subject. He has experience in teaching on postgraduate courses throughout the UK. Rob has been a person who stutters (PWS) since childhood..

You can post Questions/comments about the following paper to the author before October 22, 2007.

The challenges associated with dysfluency and university life: personal perspective of a mild/covert stutterer*

by Rob Grieve
from England

* This title is partly based on a poster presentation at the 5th World Congress of IFA July 2006 at Trinity College Dublin, Ireland. The ultimate main aim of this paper is to give encouragement to people who stutter (PWS) involved in higher education.


As a person with a stutter (PWS) since childhood, who has successfully managed his dysfluency, many difficulties and challenges associated with my speech have been encountered. Although some studies found that people who stutter believe that stuttering has a negative impact on their employability and job performance (Klein and Hood, 2004) this presentation has an overall positive outcome. As a senior lecturer, excellent communication (job description) and fluency are taken for granted. However, as an academic with a dysfluency (mild stutter), how one teaches (presentation) can be more of a challenge to what (content) is taught.

This presentation is not based on the author's own quantitative or qualitative research findings. The main aim of this presentation is to present a personal perspective on the difficulties and challenges associated with dysfluency and academic life. Relevant literature may be included to substantiate this subjective account. The conclusions taken from this personal perspective may extend to adults with a mild or covert stutter.

Early Days

The first indications that I stuttered were apparent at nursery/preschool. Official recognition began when my parents received a note from my nursery school teacher to the effect that I was having difficulty saying words clearly. My early attempts of sentence formation were hampered by the unhelpful intervention of my father who would often tell me to "spit it out", which added more pressure and had a very negative effect! As both of my parents were very articulate and fluent, this seemed to re-inforce the dysfluency I was struggling with. On the advice of a speech therapist we ignored the early stuttering of one of our children, who is now a very fluent speaker. The drawing of attention and pressure to "spit it out" made me very self conscious and lowered my self esteem when young.

Primary school was a struggle in class, especially when it came to saying my name or reading out loud. One of my teachers kindly gave me "extra instruction" to help with my speech but it was not very effective. Throughout my schooling I had no formal speech therapy, as I seemed to manage on the whole, due to a number of covert strategies and avoidance of certain situations that would exacerbate my stuttering. Speaking on the telephone was avoided most of the time, although purchasing things from the local corner shop was sometimes quite daunting. When asking for something over the counter, occasionally I would leave with an item easier to pronounce even though it was not exactly what I wanted.

Fortunately, sport was my saviour which gave me recognition and acceptance with my peers. Therefore when I struggled with the odd word or sentence I was not teased or ridiculed as I was respected for my sporting abilities, which seemed to override any speech irregularities.

University life

The difficulties and challenges/positive outcomes associated with dysfluency and the role of a university lecturer will be identified below and discussed later. Each of these points below is directly related to a personal experience of being an academic with a mild or covert stutter. Some of these could also apply to a student with a speech dysfluency.

Problems and difficulties

Challenges and positive outcomes Discussion

Some of the recent literature 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). This could have a direct impact on the academic in his dialogue and communication with fluent speakers. This was clearly illustrated when at my first physiotherapy management committee meeting I had to read out loud a module report from a set (already prepared) script. Due to the difficulty many covert stutterers have on reading aloud to a set script, I was unable to supplement words or devise avoidance strategies and therefore the end result was a painful and slow performance. This seemed to surprise a few of my colleagues and students who had always seen me as a "fluent" person! As a physiotherapy student in social dialogue with friends I was reasonably fluent, however this fluency quickly disappeared when I had to do a presentation or be examined in a live or practical session.

Apart from the effect that stuttering could have on fluent colleagues and students, the effect on the individual stutter can be very negative. Stuttering could have significant limitations in the speaker's ability to participate in daily activities and a negative impact on the speaker's overall quality of life (Yaruss and Quesal, 2004). As lecturing is an overtly verbal occupation, the effect on quality of life is self evident. In the early days of my lecturing, I used to really struggle with exam boards in front of my faculty colleagues and the reading out loud out of student's names. All manner of techniques did not really prevent the blocking, long hesitations and general fear. On one occasion while we were introducing ourselves by name I struggled to get my name out much to the amusement of a colleague -- who thought I was choking on a biscuit! The overall feeling was one of frustration at struggling with such a simple process as saying a name or reading out loud, while knowing fully my ability and proven experience.

Standing up and talking to groups of people 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. As a teaching academic, verbal communication is essential. 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 for speech perfection and increased my self confidence.

Plexico et al, (2005) in a phenomenological approach on a group of individuals, 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. Most of the participants in this study shared a similar occupation (health care professional) and participated in demanding speaking tasks as does the author of this reflective account.

Apart from teaching at a university I am involved in teaching on a national/international level to groups of qualified physiotherapists on one day postgraduate courses. In the early days, although mainly fluent, I used to struggle with varying covert techniques (foot tapping, long pauses, replacement terms, etc). This was very stressful as my main concerns were on fluency (presentation) and not always content. Within the last year, before every course I let the participants know that I have stuttered since childhood and if I pause (block) before a word it is not because I do not know what I am talking about, just having a "bit of a speech dysfluency". This self disclosure has given me an incredible sense of freedom and optimism and broken down the dysfluency barrier.

Klompas and Ross (2004), in a study on personal accounts of life experiences of people who stutter found the following related to the identified difficulties in this presentation, namely:

Interestingly, Klompas and Ross (2004) found reading aloud emerged in the responses of some of the participants as an aspect of school life which stresses fluency. Of all the difficulties highlighted in this paper, reading aloud from a set script at an exam board or programme committee meeting, introducing oneself by name and speaking on the phone to strangers are identified as the most problematic.

Apart from self disclosure to my colleagues and students, (this paper is a very public self disclosure), creativity and preparation are the other very important tools in overcoming some of the challenges of speech dysfluencey. 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. The emphasis has also been to involve student's more (enquiry based learning and problem solving) thus taking the emphasis and responsibility for learning away from the lecturer.

Overview /Conclusion:

Increased understanding of the covert stutterer's personal/subjective experience of dysfluency will inform both the clinician and academic researcher. It has been suggested to incorporate subjective feelings about stuttering into the clinical practice of speech-language therapy (Klompas and Ross, 2004).

The identification and realisation of the problems and challenges associated with dysfluency and academic life have ultimately, over a period of years, reduced the severity of my stuttering experience. The overall outcome has been positive for both the lecturer and the student. This paper identifies an important outcome, which is by fully understanding my vulnerability as a communicator I am more empathetic with the student learning experience. This may result in my role being seen as less authoritarian and threatening and therefore more able to facilitate student learning.


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, Article in Press

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

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

Klompas M and Ross E (2004) Life experiences of people who stutter, and the perceived impact of stuttering on quality of life: personal accounts of South African individuals. Journal of Fluency Disorders, 29(4), 275-305

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

Yaruss JS and Quesal RW (2004) Stuttering and the international classification of functioning, disability, and health (ICF): An update, Journal of Communication Disorders, 37 (2004), 35-52

You can post Questions/comments about the above paper to the author before October 22, 2007.

August 14, 2007
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