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Peer attitudes toward children who stutter

Article reviewed: "The Peer Attitudes Toward Children who Stutter scale: Reliability, known groups validity, and negativity of elementary school-age children’s attitudes", by Marilyn Langevin, from the Journal of Fluency Disorders, 34 (2009) 72-86.

Background for the study

Research indicates that children who stutter are less well accepted socially, less likely to be seen as leaders, and more likely to be teased and bullied.  In order to address this situation, clinicians have developed programs to educate children about stuttering. Some are designed for classes that include children who stutter. Others are meant for all students.

Marilyn Langevin of the University of Alberta has developed a teasing and bullying prevention program that includes a unit about stuttering. The program, Teasing and Bullying: Unacceptable Behaviour (TAB), is designed to help all children deal with bullying, not just those who stutter.

TAB features classroom activity sheets, parent handouts, and a video. It defines bullying and teaches strategies for dealing with it. In the unit on stuttering, children learn about the muscles involved in speech and how stuttering interrupts their coordination. They learn about common myths related to stuttering. Video clips show the vocal folds during normal speech, and when a person simulates a laryngeal block. The video also features classroom scenes, and children working together to generate classroom rules aimed at reducing teasing and bullying.

Preliminary research has indicated that TAB is effective in changing attitudes toward children who stutter. Marilyn Langevin and Paul Hagler have developed a tool – the Peer Attitudes Toward Children Who Stutter (PATCS) scale – that can be used to evaluate such programs by measuring attitudes toward children who stutter. The tool features a 5-point Likert response scale (1 = strongly disagree; 5 = strongly agree) to measure attitudes.

The PATCS scale has three subscales, which seek to measure:

  • Social pressure (SP), which reflects concern with what others think about children who stutter, e.g. “I’d be ashamed to be seen with a kid who stutters.”
  • Positive social distance (PSD), which reflects comfort with being with a child who stutters, e.g. “I would let a kid who stutters hang out with us.”
  • Verbal interaction (VI), a construct characterized by frustration, e.g. “I would feel uptight talking with a kid who stutters.”

Langevin and colleagues originally developed a series of scale items to represent aspects of a person’s attitude, and to assess a range of peer interactions. Field testing reduced the original 116 items to 40. Further study reduced them to 36. Before children fill out the scales, they watch a video of a boy, and of a girl, who stutters. Langevin has tested construct validity of the scale, which refers to how well it does what it claims to do. Langevin had expected, based on research about other disabilities, that children filling out to the PATCS scale would see kids who stutter in a more positive light if (a) they’d had contact with kids who stutter, (b) were in higher grades, or (c) were female. Research with this scale, and other research, has suggested, however, that grade level and gender are largely irrelevant. What is relevant is contact. If nonstuttering kids have contact with an individual who stutters, they will view children who stutter more positively than ones who’ve never had such contact.

The current study

The study’s purpose was to further investigate the scale’s validity and reliability, and the proportion of students with negative attitudes about kids who stutter. The study included 97 children in Grades 4 to 6 from three urban schools in Western Canada. A 40-item scale was used.

Before completing the scale, students viewed a video of a 9-year-old boy with moderate stuttering, and an 8-year-old girl with severe stuttering. They were also asked to indicate if they knew someone who stuttered, and if so, to record the stutterer’s first name and/or to indicate who the person was (e.g. a relative, friend, neighbour, or other). For purposes of test-retest reliability, a second PATCS was administered a week later to 29 participants.

The TAB program was taught to the participants after they had completed the scale. This minimized the potential for inadvertently fostering a negative bias toward kids who stutter by the inclusion of negative items in the scale.

Results and discussion

Students who had contact with someone who stutters showed a significantly more positive attitude toward children who stutter than those who did not have such contact. No such significant effects were found for grade or gender. The study also reported evidence for the internal consistency and test-retest reliability of the data. The study found considerable consistency between the results of this study and earlier findings. The differences included a finding that gender and grade may not be as relevant as earlier findings suggested.

Results of this and two previous PATCS studies have consistently shown that contact with children who stutter leads to more positive attitudes toward them. This finding is also consistent with research indicating that adults who know someone who stutters tend to have a more positive attitude toward people who stutter than adults in the general population.

Contact with someone who stutters may thus be an important part of educational programs seeking to change attitudes toward children who stutter. The video included in the TAB resource may go some way toward achieving the desired effect of having contact with someone who stutters. The latter video shows children who are open about their stuttering, and who effectively, confidently, and assertively contribute their ideas.

Close to one-fifth of the students had mean scores that were somewhat to very negative with regard to attitudes about kids who stuttered. A large proportion of the student body has the potential to have a negative influence on the feelings and behaviours of their nonstuttering peers toward children who stutter.

Langevin concludes that future research into characteristics or experiences of peers with such negative attitudes may assist in further development of educational materials and strategies to positively influence the attitudes of such students.

As well, here’s another key interpretation of the findings. If you as an individual who stutters want to make a difference with regard to public attitudes, your best route is to become involved in public education activities about stuttering.

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