Announcing 'Stammering Research' - Stammering Research - UCL

Stammering Research. Vol. 1.
The participant interviews were set up in a structured way to allow comparisons between subjects
and allow real life experiences to illuminate the quantitative data gathered from a questionnaire survey
and pre and post intervention measures. Because of problems with ethics committees, regarding the
interviews and data protection, these had to take place after the main cohort survey and pre and post
intervention course measures. This was not ideal as the interviews would have been useful pointers to
survey questions. Responses of interview participants are constrained by the nature of the questions
which are narrow, arbitrary and selective, although the structure was guided by the concerns of clients
and the views that were commonly aired in a focus group discussion on stammering. Although there are
weaknesses in the introspective comments from the researchers they do pose a set of questions
regarding intervention and further research that is client-led and reflects their specific concerns.
In summarising this evidence, one is aware from such qualitative data of the awful misery that
people with stammers have to endure, just because the people they mix with do not understand how to
cope with this difficulty in everyday transactions. In schools, teachers often do not include students
who stammer, in oral activities, so making their situation worse by not giving them the chance to
develop thinking and communication skills. Speaking aloud, in a large class, can be a fearful
experience, but there are ways around this with pair or group speaking/reading activities, which give
practice without making the problem of dysfluency so obvious. This is an important issue as the
questionnaire data, from 200 course respondents, indicated that formal speaking produced the most
problem and received less attention than informal aspects of communication in therapeutic and
education programmes (Sage, 1998).
These case studies demonstrate, that in spite of negative learning experiences and an initial lack of
success in reducing the stammer, it is possible to progress academically and achieve good jobs in life. It
is evident that a stammer may prohibit one from pursuing a career that depends on constant speaking,
such as lecturing or television presenting. However, most people have to adjust their aims because of
circumstances and the group exhibits an ability to do this effectively.
Paul and Robert were participants in the early stages of the Apple House courses. Their
development and attitudes are not remarkably different from that of John and Helen, who have been
attendees in the last ten years. Stammering is a miserable affliction for everybody, but can be coped
with successfully if there is personal motivation and effective professional support.
Case histories are commonly taken by therapists as background information to make decisions on
intervention. Using a structured format, demonstrated in this example, it is possible to compare data
across populations to provide not only guidance for treatment but pointers to possible research
directions.
So what is revealed from client accounts that might influence the direction of practice and research?
5. Implications of the data for research and practice
Cognitive and communication management
The statements of respondents confirm they are a category with as yet no clear medical diagnosis of
their problems and consequently suffer from being pushed from pillar to post throughout their lives in
the hope of finding something that will alleviate symptoms. They have been over-investigated and overtreated.
Active management is indicated to deal with a range of difficulties, apart from speech, using a
fresh approach and different attitude. The method that worked for this group demonstrates cognitive
therapy in three clear steps. The first is acknowledging the client’s problem. The second is identifying
the factors that perpetuate the symptoms, which include disordered physiology (such as breathing),
misinterpretations of bodily sensations, abnormalities of mood/attitude, unhelpful coping behaviours
and social stresses. The third step is to make a management plan that targets the most important of these
factors for the particular client.
For example, the respondents benefited from help to combat fears (hypnotherapy and NLP),
coaching to tackle speaking activities, help with social relationships and employment difficulties,
arising from dysfluency. Clients need to think of their problems in different ways and where necessary
live with them. Medical science cannot always guarantee to explain symptoms, which may not always
be treated successfully in conventional ways. Comments from case participants suggest a strategy that
assesses how much symptoms affect life and how they can be coped with to enjoy living. The move to
more holistic approaches targets the person and their varying and changing needs, suggesting cognitive
approaches which span several different specialties, including psychiatry, psychology, general
medicine, education and career advice, as well as speech and language therapy. They require people to
cross professional boundaries, which present training and practice procedures do not facilitate. These
are high-level policy and practice issues that if tackled will save money for the health, social and
educational services, preventing persistent misery for clients. We need to research professional skills to
assess whether they match client needs. For example, the most common need identified as not met by
the course was guidance and practice in communicating in formal settings, as in giving a speech or
284