An Investigation of Stuttering; Challenges Faced by Rawalpindi Cantonment s Students of Public and Private Secondary Schools Samia B 1, Ayesha K B 2

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1 An Investigation of Stuttering; Challenges Faced by Rawalpindi Cantonment s Students of Public and Private Secondary Schools Samia B 1, Ayesha K B 2 Abstract: Background: Secondary schools provide the basis for the learning of a young student. Negative social experiences of children suffering with stammering at this level leave lasting impressions in their minds which may impact their future lives. Objectives: To analyze the social environments being faced by stammerers in public and private secondary schools of Rawalpindi Cantt. To identify the communication pressures faced by stuttering students of secondary schools of Rawalpindi Cantt. To provide evidences for the need for a healthy school environment that may assist these children in their social development by reducing negative pressures. Methods: A comparative cross sectional survey was conducted. Study was conducted in Armed Forces Institute of Rehabilitation Sciences (AFIRM). There were 40 male subjects with age between years included in the study. 20 students were selected from public school and 20 from private schools of Rawalpindi those rated moderate to severe on Urdu and English conversation and reading percentage syllable stammered by three different speech pathologists were surveyed. Primary and secondary behaviors of these children belonged to the stage four of Van Riper. A self formulated survey of 24 items was conducted. Results: The results of the present study indicate a majority of the private school going stammering students are facing more difficulties in their social environments. The research also showed that majority of the secondary school stammering students are being imposed with communication pressures in the form of peer and teacher criticism. Conclusions: The present study indicates that children who stammer are extensively at higher risk of being rejected or neglected in school/class social environments. Key words: Stuttering/ Stammering, Dysfluency, Negative pressures/ Communication Pressures, Peer Awareness Introduction: According to a survey done by US Census Bureau, International Data Base, (1), 1,591,963 people may be suffering from stammering in Pakistan alone most of which are children. Stammering is due to the in coordination of the speech processes and is characterized by repetitions, prolongations and blocking of words. (2) Young children often stammer as they learn to commute what they want to say into words. (3) Positive or negative experiences with in the school or class room environments can impact the fluency of the child. (4) Students play, assist, consult and take turns speaking with each other with in schools. According to (5) Mooney.S s research learners may even be expected to participate in assembly discussion on beliefs, play activities etc, share things, emotions and stories with others. Conveying opinions and perspectives require fluent speech which is well comprehendable and favorable by listeners. These tasks may not be performed as well to the expectations of stutters and as a consequence they may be ridiculed by thier peers. (5) Being familiarized with negative pressures in the company of other class 1. Speech Language Therapist, AFIRM 2. Assistant Professor, RCRS, RIU Correspondence to: Ms Samia Bibi Department of Speech Therapy, Armed Forces Institute of Rehabilitation, Rawalpindi burqi_khat@yahoo.com mates by peers creates a sense of shame and embarassment for the students who suffer with stammering. This ebarassment say Mooney.S, Brumfitt.S (5) in their work leaves the child to shun away from social activity in future and impacts his social development. An investigation by Langevin, M.et al done in 1998 (6) descovered that 81% of the children who stutter reported that they were bullied at school at some point in time, with 56% of them are those children who are being bullied about their stuttering once a week or more often. Young people who stutter are likely to experience both indirect and direct types of 13

2 bullying. It was documented that a child's response to being bullied actually reiterates his continued victimization. Where as the responces of the stammers are likely to generate bullying reactions as they may not be able to speak or fight for their causes or even when they attempt to do so they face yet even more sevre social subjugation or rejection or even may not be listened to at all and be ignored by their teachers. (7) Many pupils in a large school, who stutter, simply live in anxiety of being put on the spot by adults and peers who are ignorant of their stutter and retort to impatience or worse when a question may not be or be inaptly answered. This apprehension of a child about his dysfluent verbal expression being exposed in the company of his peer group leads to the likelihood of living in a constant state of anticipation; stress and anxiety with all its negative connotations for achievement and behaviour all contribute to his poor social development. (8) The Audit Commission (9) regards the lack of awareness about the speech disorder, among peers and teachers as one of the major problems that the stuttering learners are facing today in their schools. This lack of adequate knowledge of stuttering creates hinderences in school and classroom activities and performances of stuttering pupils. The inability to be responsive to stuttering learners by their peers and teachers leads to the classroom segregation and isoloation of stutterers, the pre existing aviodent behaviors that prevail in these students are further reinforced by such situations as bullying and teasing. (9,10) As a consequence many stutterers report broken peer and teacher relationships or unpursued as a result of stuttering. (10) Problems with speech can lead to difficulties learning to listen, speak, read, or write. As a result, adolescents with stuttering may perform at a poor or insufficient academic level, they at times may struggle with reading fluently, face difficulty in making others understand what they attempt to express in a fluent utterance. Therefore they misunderstand social cues, avoid attending school, show poor judgment, or have difficulty with oral tests. (11) The need for the current study is underscored by the fact that there is modest research available that investigates the school and class room experiences of stuttering students chiefly with reference to the secondary schools of Pakistan. The present investigation seeks to highlight the problems of stammers in the context of Secondary schools of Rawalpindi Cant. It would also investigate the impacts of stammering student on their school lives. Methods: The study was comparative cross sectional survey conducted in a clinical setting (AFIRM). Sample size of the study was 40 male students, selected through convenient non probability sampling technique. 20 stammering students each from private and public secondary schools were surveyed years old male students who s stammering rated moderate to severe on Urdu and English conversation and reading percentage syllable stammered by three different speech pathologists were selected for the study. Primary and secondary behaviors of these children belonged to the criteria of stage four of Van Riper. (12) A self formulated survey of 24 close ended items was used. The questionnaire (attached) was formed on the basis of literature review (7,8,9) and consultations with the supervisors of the research. Data was analyzed through SPSS. To address the objectives the designed items of the survey were selected according to previous studies and were divided into two categories most prevailing within the school/class room environment of the stammering students. (8,9) The categories included items that were related to the social environment faced by stammering students in their school; and items related to communication pressures dealt by stammering students exerted by their non-stammering peers and teachers upon them which expose the awareness about stammering that peers and teacher have. (10) For the purpose of drawing comparison between the public and private school stammering student s responses, each item was discussed individually as given as IT#P representing item number concerning private school whereas IT#G signifying item number related to government schools. Result: Table I: Shows T test values of items related to Social Environment. The items IT4P-IT4G, IT6P- 14

3 IT6G, IT7P-IT7G, IT9P-IT9G and IT10P-IT10G are ranked amongst the highly significant items when it comes to denoting the social environment that stammering students of the public and private secondary schools are faced with. Table II: Highlights the T test values of items related to negative communication pressures exerted by peers of the stammering students. The highlighted items i.e. IT12P - IT12G, IT13P - IT13G and IT13P - IT13G are ranked amongst the highly significant items when it comes to designating the negative communication pressures exerted by the peers of stammering students of the public and private secondary schools. Table III: Illustrates the T test values of items related to negative communication pressures applied by the teachers that educate the stammering students. The highlighted items i.e IT17P - IT17G, IT18P - IT18G, IT21P - IT21G and IT23P - IT23G denote the highly significant items when it comes to designating the negative communication pressures exerted by the teaching staffs in the public and private secondary schools that teach the stammering students. Discussion: Results of the study provide evidences to believe that more of the private sector students consider their school social environments unsuitable for their social development. While a majority of the students interviewed for the study believe they are not facing suitable social environments due to the negative pressures imposed on them by teachers and peers which impact their social development. (IT3, IT5). The findings of the study may be suggestive of the risks that these students may face in their future academic and professional careers. Studies done by Davis et al (13) prove that stuttering students who are more rejected and disliked than their non stuttering coarse mates, in the group activities, ignored in the play grounds and are not allowed to participate with their peers are at risk of hampering their social development. These students may face a hard time socializing with peers and elders in future. (12,13) Negative pressures that these students face at the secondary school levels may compromise them of their potentials to be successful in future with regards to their academic and occupational careers. (9,13) The currents study revealed that 80% of the private school students face peer aggression and 95% of the stammering students in our private secondary schools are facing aggression from their teachers as they stammer. (IT3, IT7) in this regard the researches of Hodges and Perry (14) state that young students who are perceived as different, due to the absence of or lack of appropriate verbal skills that are socially endorsed can be at high risk for victimization or bullying by peers. The Hodges and Perry (14) discovered that children who are bullied are more disliked by their peers and have lesser friends than those who are not bullied. The students who stutter 15

4 were three times likely to be victims of peer aggression than their fluent peers since these students demonstrate a poor social standing in their peers. (14) Some researches provide evidences to believe that the stammering students are behaved aggressively towards and face negative pressures within their school social environments as their persists a lack of awareness amongst students and teachers in the school environment. (12,13,14) Stammering students of the both populations say that their peers don t cooperate with them in school/class participaition (IT11) because they stammer (IT12). These students also claim that their peers don t help them in speaking fluently (IT13) and finish off words for them (IT14). Evidences given by the present study in the form of responcses of the stammering students also show that their peers mimic them (IT15). A t test analysis of the responses of the public and private sector primary school going stuttering children shown through Tables I-III indicates that large numbers of students in the private sector believe that they suffer negative experiences with their peers and teachers as they suffer from stuttering Communicating in front of a class room full of other students is dependent on the attitudes of the listeners for a stammering student. (15) If his peers are non cooperative in helping him speak fluently, he may indulge in avoidance behaviors. Communication pressures imposed on the dysfluent students while they are speaking such as finishing off words for them, not allowing them time to speak their minds or ridiculing them whilst they speak lead stammering students feeling prominent fear and anxiety, particularly when they are required to speak under such pressures. (15) Present desrtation has also acknowledged that majority of the students in the both sectors are emposed with communication pressures by their peers in their schools generally and class rooms particulaly (Table II). Various studies reveal teachers behavior and expectations can affect children s behavior. (7,12) These expectations may establish the child s level of accomplishment by appropriation of his learning opportunities to those available in a particular class (16). Teachers' expectations of pupils can impact on whether they are placed in a high or low ability set, and thus pupils will achieve to the expectations of the classroom. (16) Results of the study indicate that primary school teachers may not be aware of the communication needs of the stammering students. According to the stammering student s oppinions their teachers behave aggressively towards them, (IT7) may exclude them in class (IT8) and may not give them enough time to finish want to say (IT20). The students think that their teachers attitude towards them is due to their stammering (IT18) as the students feel embarassed in taking part in class activities due to the their teachers attitude (IT10). Studies have proven that teachers have a vital role in the educational process of children who stutter and the perceptions that the teachers' have of a stuttering student significantly impacts on their academic progress. (17) Conclusion: The research study aimed to investigate the impacts of stammering on a student s school life. Results designate that majority of the secondary school students were of the opinion that they are disclosed in class room social activities in the play grounds as they are facing communication pressures which may be effecting their social environments. The present study revealed a majority of the private school stammering students are faced with more negative pressures in their school social environments then public school students are facing. Moreover the research illustrated that the majority of the secondary school stammering students are being inflicted upon with negative pressures in the forms of peer and teacher criticisms and inappropriate reactions. The results are suggestive of further probations of both the environments with regards to Pakistan in order to discern the actual picture. In the light of above opinions of the stammering students following suggestions may be considered to ease the plight of the students. Teacher and staff training could be conducted thorough workshops by speech and language pathologist and therapists could be enforced in this regard. Professional development courses for the entire faculty should include separate sections for stammering in order to equip the faculty with better training to deal with the students who stammer. Teachers may educate peers about stammering thus creating awareness in them and meeting their need of peer cooperation could be met. 16

5 References: 1. US Census Bureau, International Data Base and Population Estimates. Statistics by Country for Stuttering. (accessed July 2012). 2. ICD-10 Version: F98.5 Stuttering [stammering] /en#/F90-F98 (accessed July 2012). 3. Anxiety Zone-Anxiety Forum. Stuttering. ns/stuttering.html (accessed July/August 2012). 4. Ward, David. Stuttering and Cluttering: Frameworks for understanding treatment. 1st Ed. New York City. Hove and New York City:Psychology Press; Mooney.S, Brumfitt.S. Stammering in Schools. 1st ed. University of London department of Psychology. University of London department of Psychology; Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. Teasing/Bullying Experienced by Children who stutter: Toward Development of a Questionnaire. Contemporary Issues in Communication Science and Disorders.2005;25: Jessica Link and Glen Tellis, PhD. Bullying Intervention for Students Who Stutter. audiology.advanceweb.com/article/bullying- Intervention-for-Students-Who-Stutter.aspx (accessed July 2012). 8. Julie Mazzuca-Peter. The child who stutters - parents' guide. dwhostutters.html (accessed July/August 2012). 9. Audit Commission. Special Education Needs: A Mainstream Issue. 1st ed. London. The Audit Commission; Pollack, Andrew. To Fight Stuttering, Doctors Look at the Brain. New York Times,.September Crystal, D. Teaching vocabulary: The case for a semantic curriculum.. Child Language Teaching and Therapy.1987;8: Van Riper, C. The Nature of Stuttering. 1st Ed. New Jersey. Prentice- Hall, Inc.; Davis. S, Howell. P, Cooke.F. Sociodynamic Relationships between Children Who Stutter and Their Non-Stuttering Classmates. J Child Psychology and Psychiatry.2002;43(7): Hodges, E.V.E., & Perry, D.G. Personal and interpersonal antecedents and consequences of victimization by peers.. Journal of Personality and Social Psychology,.1999;76: Rinaldi, W. Pragmatic Comprehension in secondary school aged students with. International Journal of Language & Communication Disorders.2000;35(1): Cohen, L. and Manion, L. A guide to teaching practice. 3rd ed. London. Routledge; The British Stammering Association.. Stammering Information (accessed July 2012). 17

6 APPENDIX I Demographic Information: Age: School: Class: Questionaire: Please answer each question with a Yes/No. Items related to social environment A. Do you have few friends in school/class? Yes/No B. Do you think you don t have more friends in school/class because you stammer? Yes/No C. Are your peers ever aggressive towards you? Yes/No D. Your peers don t include you in school/ class activities? Yes/No E. You don t get played with because you stammer? Yes/No F. Do your peers ever tease you? Yes/No G. Are your teachers ever aggressive towards you? Yes/No H. You get excluded in class activities by your teachers? Yes/No I. Your teachers treat you equally like every student? Yes/No J. You feel embarrassed in school environment because you stammer? Yes/No Items related to peer awareness A. Are your class peers non cooperatives with you in class? Yes/No B. Lack of cooperation by peers is because you stutter? Yes/No C. Your peers don t help you speak more fluently? Yes/No D. Do your peers finish off words for you? Yes/No E. Do your peers mimic you? Yes/No F. Do your peers interrupt you when you are saying something? Yes/No Items related to teacher awareness A. Are your teachers non cooperatives with you in class? Yes/No B. Lack of cooperation by your teachers is because you stutter? Yes/No C. Your teachers don t help you speak more fluently? Yes/No D. Do your teachers finish off words for you? Yes/No E. Do your teachers mimic you? Yes/No F. Do your teachers interrupt you when you are saying something? Yes/No G. Your teacher s attitude towards you is due to your stuttering? Yes/No H. Your teacher s attitude towards you is due to your stuttering? Yes/No 2