DISABILITY AND REHABILITATION,
2003;
VOL.
25,
NO.
9, 491–496
CLINICAL COMMENTARY
Self-Perceptions of speech language
pathologists-in-training before and after
pseudostuttering experiences on the telephone
MANISH K. RAMI{*, JOSEPH KALINOWSKI{, ANDREW STUART{
and MICHAEL P. RASTATTER{
{ Stuttering Research Laboratory, Department of Communication Sciences and Disorders,
University of North Dakota, USA
{ Stuttering Research Laboratory, Department of Communication Sciences and Disorders,
East Carolina University, USA
Accepted for publication: January 2003
Abstract
Purpose: This survey investigated the effect of ‘pseudostuttering’ experiences on self-perceptions of 29 female, graduate
students enrolled in a graduate seminar in stuttering while in a
programme of study to become professional speech language
pathologists.
Method: Perceptions of self prior to, and immediately after,
participation in five scripted telephone calls that contained
pseudostuttering were measured via a 25-item semantic
differential scale.
Results: Participants perceived themselves as significantly more
(p 5 0.002) withdrawn, tense, avoiding, afraid, introverted,
nervous, self-conscious, anxious, quiet, inflexible, fearful, shy,
careless, hesitant, uncooperative, dull, passive, unpleasant,
insecure, unfriendly, guarded, and reticent after their pseudostuttering telephone call experiences.
Conclusions: Findings suggests that the pseudostuttering
experiences have an impact on self-perceptions and that the
experience of ‘adopting the disability of a person who stutters’
may provide insight as to the social and emotional impact of
communicative failure. It is suggested that pseudostuttering
exercises may be a valuable teaching tool for the graduate
students, especially for those who do not stutter.
Introduction
‘Pseudostuttering’ is defined as ‘the deliberate
production, by any speaker, of overt dysfluencies that
resembles stuttering . . .’ (p. 98).1 The pseudostuttering
experience is often used by those that treat the disor-
* Author for correspondence; e-mail: manish.rami@und.edu
der of stuttering.1 – 4 Pseudostuttering in the treatment
of stuttering has three purposes: to help the person
who stutters identify the overt core and ancillary
behaviours that are constituents of the stuttering
phenomena (e.g., repetitions, prolongations, facial
contortions, and head-jerking), to provide a series
of desensitization experiences which puts the oftreported ‘phobic’ stuttering experience into a different
perspective, and to demonstrate that stuttering is
comprised of both volitional and non-volitional
components.5
In addition to the aforementioned purposes, the practice of pseudostuttering also has a long history as a
teaching tool for speech language pathologists-in-training.1 – 4, 6 A multidimensional rationale for its use in
training includes: an efficient and effective way to illustrate the nature and difficulty of stuttering in environments where communicative failure bears some social
responsibility with its attendant costs (e.g., being
laughed at, uncomfortable stares, and deriving negative
social attention for aberrant behaviour). In other words,
some training institutions feel the best way to understand stuttering is to ‘embrace the disorder’ for short
periods of time and to use the ruse of ‘pretending’ to
be a person who stutters. Stuttering, unlike many other
disorders, is relatively easy to emulate and the disorder
bears no other signature behaviours other than stuttering itself, that would reveal the fallacious nature of the
pseudostuttering act. The use of pseudostuttering has
been recommended for speech language pathologists
and people who stutter to understand, empathize and
to test the reasonable and unreasonable expectations
Disability and Rehabilitation ISSN 0963–8288 print/ISSN 1464–5165 online # 2003 Taylor & Francis Ltd
http://www.tandf.co.uk/journals
DOI: 10.1080/0963828031000090425
M. K. Rami et al.
for fluency,3 and modelling stuttering for the sake of
analysis by the client.7 It has been suggested that pseudostuttering be used to help improve the speech
language pathologist’s understanding of the attitudes
toward stuttering population and their attendant skills
in dealing with the disorder.1 Several researchers have
indicated its use for desensitization in the stuttering
population, transfer and maintenance; 4 – 6, 8 – 10 and in
the training of prospective speech language pathologists.1, 3, 4 The practice of having speech language pathologists-in-training
experience
stuttering
via
pseudostuttering exercises has been in existence since
the mid 1930’s and it continues to be in use.1 – 10
Several authors have reported that reluctance, anxiety, and resistance to pseudostuttering among normal
speakers is common.1, 5, 8, 11, 12 Ratings of self-perception
of ‘inner’ and ‘outer’ ‘beauty’ before and after pseudostuttering assignments of 55 students were examined
by Klinger.12 A significant lowering of perceptions of
inner and outer ‘beauty’ after pseudostuttering experiences was reported. Students were instructed in the act
of pseudostuttering and asked to initiate a series of pseudostuttering interactions off-campus. This assignment
was completed without supervision or monitoring.
From changes noted in inner and outer beauty, the
author inferred that the pseudostuttering experience
was capable of lowering self-image and producing empathy for people who stutter. However, Klinger failed to
identify the possible origin of this effect and to specify
how changes in beauty translated into possible changes
in perceptions of character traits or perceptions of self.
Given the above findings,12 the oft-stated student
apprehensions about the pseudostuttering assignments,1, 4, 5, 8 and on the basis of anecdotal evidence,11
one may expect some change in self-perceptions of
normal speakers and people who stutter due to pseudostuttering experiences. If these pseudostuttering exercises
are to be employed with any knowledge of benefit, it
seems essential to empirically demonstrate if any change
occurs as a result of these exercises. If changes do occur,
then we need to determine the pattern of that change in
self-perceptions as a result of pseudostuttering exercises.
However, no empirical evidence of the effects of these
exercises on the short- and long-term self-perceptions
and perceptions towards people who stutter is currently
available. This study examined the immediate effect of
pseudostuttering experience during scripted telephone
calls on the self-perception of speech language pathologists-in-training. Telephone calls were used to make the
experience somewhat distant as compared to a face-toface experience, which participants have shown resistance to enter into.1, 4, 5, 8, 12
492
If the pseudostuttering experience is as powerful as
anecdotally, and otherwise reported, one would expect
a substantial shift in self-perceptions, which would indicate the cognitive/affective power of stuttering (be it of
the artificial kind or be it real.) However, if the act of
stuttering itself is not a genesis of these percepts, then
no shift should occur.
Methods
PARTICIPANTS
Twenty-nine graduate female students, enrolled in a
graduate course in Stuttering and other Fluency Disorders and in training to become professional speech
language pathologists at East Carolina University,
served as participants in this study. Their mean age
was 23.5 years (SD = 1.5). All participants were volunteers and reported normal speech, language, and hearing. An all female sample is considered appropriate
since over 95.2% of practicing speech language pathologists are females.13 In addition, rater gender has not been
found to be a significant factor.14
MATERIALS
A scale of 25 traits consisted of adjectives which
speech language pathologists most frequently used to
describe people who stutter.14 These words were paired
with antonyms to form a bipolar dimension with a 7point Likert scale. Numerous researchers15 – 21 have
employed this scale and it has been used to survey
self-perceptions and stereotypes towards people who
stutter and others as well as to quantify the effect of a
specific experience22 (watching a video tape) in normally
speaking people on their perceptions towards selves and
people who stutter. This 25 item semantic differential
survey was administered to examine the self-perceptions
of the participants in this experiment.
Forty telephone call scripts were used in this experiment. Twenty-one scripts for telephone calls were developed and used along with nineteen available scripts.23
See Appendix A for the telephone scripts.
PROCEDURE
University and Medical Center’s Institutional Review
Board at East Carolina University, Greenville, NC,
approved this experimental study. The first author
conducted all testing. Participants individually met with
the experimenter, in a quiet laboratory setting to participate in this experiment. All participants were volunteers,
and written informed consents were obtained from the
Effect of pseudostuttering on self-perceptions
participants before beginning the experiment. The 25item scale was administered prior to and following the
pseudostuttering telephone calls. All participants were
instructed to evaluate how they felt about themselves
at the present time. See Appendix B for instruction.
Participants were instructed that they would be making
five scripted telephone calls to local businesses while
voluntarily stuttering during their conversation.
Stuttering was operationally defined for all participants as ‘Part-word or whole word, repetitions and/or
prolongations and/or postural fixations or blocks’.
These defined behaviours were demonstrated for each
participant individually by the first author, an experienced speech language pathologist, and all participants
were given an opportunity to rehearse each of the
defined stuttering behaviours for several minutes before
making the telephone calls. Participants were provided
with an opportunity to ask questions and clarify if they
had any doubts. The individual participant’s ability to
produce stuttering like behaviour was not a concern
since it is shown that listeners do not differentiate
between real stuttering and pseudostuttering.24
However, all telephone conversations were audio
recorded, and 30 telephone calls (20%) were randomly
selected and analysed for number of syllables stuttered
by the participants. The mean number of syllables stuttered were found to be 23.3% (range 12 – 46%.) It has
been shown that speech language pathologists rate all
levels of stuttering severity negatively as compared to
normals.16 Participants were instructed not to deviate
from the script but they were allowed to ad lib briefly
to keep the conversation as natural as possible. Specific
instructions as to where exactly to pseudostutter in the
given script were not given to participants. Telephone
scripts were randomly selected from the list of scripts
and telephone numbers of target businesses were
randomly chosen from the Yellow Pages in the local
telephone book. Five scripted telephone calls were made
successively in presence of the experimenter and upon
completion of the calls, the participants were asked to
rate their self-perceptions during and immediately after
these telephone calls.
telephone call ratings of self perceptions. Comparison
of the pre- and post-telephone call ratings of self-perceptions were of specific interest. Table 1 shows the results
of the Wilcoxon matched pairs sign rank tests for the 25
items revealing that significant difference existed for 22
items (p 5 0.05).
RESULTS
Discussion
Figure 1 illustrates the mean and standard error
values for the 25 items on semantic differential14 for
the pre- and post- pseudostuttering telephone calls of
all the participants. Wilcoxon matched pairs sign ranks
tests were conducted to explore differences between
Likert scores of all the 25 attributes in the semantic
differential scale for the pre- and post-pseudostuttering
The principal finding of this study is that a negative
self-perception emerged following the experimental
condition of a series of pseudostuttering telephone
calls in speech language pathologists-in-training. Specifically, the results showed a significant shift in 22 of
the 25 scales (p 5 0.05). After the telephone calls,
speech language pathologists-in-training were signifi-
Figure 1 Pre- and post-pseudostuttering telephone calls
mean Likert scale scores for all 25 attributes. Open circles
represent pre-pseudostuttering telephone call ratings and
closed circles represent post-pseudostuttering telephone call
ratings. Error bars represent plus minus one standard error.
Asterisks on the ordinate scale item pairs represent statistical
significance.
493
M. K. Rami et al.
Table 1 Summary table for Wilcoxon matched pairs sign rank tests
between pre- and post-pseudostuttering telephone calls for each scale
item.
Statistics
Pairs
*Withdrawn – Outgoing
*Tense – Relaxed
*Avoiding – Approaching
*Afraid – Confident
*Introverted – Extroverted
*Nervous – Calm
*Self-conscious – Self-assured
*Anxious – Composed
*Quiet – Loud
*Inflexible – Flexible
*Fearful – Fearless
*Shy – Bold
Sincere – Insincere
Bragging – Self-derogatory
Emotional – Bland
*Perfectionistic – Careless
*Daring – Hesitant
*Cooperative – Uncooperative
*Intelligent – Dull
*Aggressive – Passive
*Pleasant – Unpleasant
*Secure – Insecure
*Friendly – Unfriendly
*Open – Guarded
*Talkative – Reticent
z
p
7 4.12
7 3.79b
7 3.54b
7 3.18b
7 3.64b
7 3.34b
7 3.30b
7 3.18b
7 3.93b
7 3.44b
7 2.66b
7 2.70b
7 0.35b
7 0.16b
7 0.11a
7 2.33a
7 2.94a
7 2.95a
7 3.82a
7 3.80a
7 3.49a
7 3.45a
7 4.05a
7 4.27a
7 4.12a
b
0.001
5 0.00
5 0.00
0.001
5 0.00
0.001
0.001
0.001
5 0.00
0.001
0.008
0.007
0.726
0.869
0.906
0.02
0.003
0.003
5 0.00
5 0.00
5 0.00
0.001
5 0.00
5 0.0
5 0.00
(Note: *considered significant at p 5 0.05, a = based on negative
ranks, b = based on positive ranks.)
cantly more withdrawn, tense, avoiding, afraid, introverted, nervous, self-conscious, anxious, quiet, inflexible, hesitant, dull, passive, unpleasant, insecure,
unfriendly, guarded, and reticent. This shift, towards
more negative percepts, suggests that perception of
self can be altered via the voluntary pseudostuttering
experience.
To the best of our knowledge, this is the first experiment to show that normal speaking graduate speech
language pathologists-in-training can, at least for a time,
‘stand in the shoes’ of the person who stutters. That is,
after the pseudostuttering experience and the communicative disruption during a series of telephone calls to
various businesses, normal speakers evoked a statistically significant negative shift in perception indicating
a strong emotional response.
Nothing exemplified the power of this act more
than the emotional responses of some of the participants, although most stated they were grateful for
the insight and knowledge they gained from the stuttering experience, they often responded with affective
distress. At times, participants would show a flushed
face and neck before calling, breathe heavily, post494
pone, avoid calling the telephone number, and some
would even well-up in tears—but when asked if they
would like to stop, they would ask to continue. There
were also comments such as ‘this was one of the most
difficult things I did in my life’, ‘I would hate to do
this all the time’ and so on. Thus, it is evident that
the teaching tool of pseudostuttering does succeed in
furnishing the students with a powerful experience.
Further, the results also suggest that stuttering is so
salient and vivid that one seemingly reacts to
controlled, voluntary, and short-lived stuttering in
the same manner as those who demonstrate a chronic
pathology.
The question as to the value of this commonly
employed exercise remains. One can speculate that there
can be a positive and a negative outcome. On the positive side, this exercise can provide the students in training with an experience to develop empathy towards
people who stutter. They viewed life on life’s terms as
a person who stutters does for a short period of time,
and it was disconcerting, uncomfortable, and eye opening. This experiential face with stuttering is one that
cannot be taught in a didactic fashion, but must be felt
viscerally and emotionally and will change how the
speech pathologist views the disorder and the person
who stutters. On the negative side, a caveat must be
expressed that such an experience could confirm the
negative stereotype held by the normal speaking population towards people who stutter,22, 25 which is not
substantiated by the personality literature.26 However,
the incongruence between the stereotype and reality of
personality changes may finally be just a simple manifestation of the saliency and vividness of the powerful,
aberrant, atypical nature of the stuttering moment.
Thus, one may have the first empirical inkling into the
lack of congruency between what people who stutter feel
and what others feel about them. Stuttering, even
pretend stuttering, is very powerful.
References
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Jersey: Prentice Hall, 1986.
2 Bryngelson B. Sidedness as an etiological factor is stuttering.
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3 Mulder RL. The student of stuttering as a stutterer. Journal of
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6 Shapiro DA. Stuttering Intervention: A collaborative journey to
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Effect of pseudostuttering on self-perceptions
7 Maxwell DL. Cognitive and behavioral self-control strategies:
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8 Van Riper C. Experiments in stuttering therapy. In: J Eisenson
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9 Adler S. A Clinician’s Guide to Stuttering. Springfield, Illinois:
Charles C. Thomas, 1966.
10 Gregory H. Controversies About Stuttering Therapy. Baltimore,
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11 Woods CL. Stigma of a disorder. Australian Journal of Human
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12 Klinger H. Effects of pseudostuttering on normal speakers’ selfratings of beauty. Journal of Communication Disorders 1987; 20:
353 – 358.
13 American Speech–Language–Hearing Association. Asha count for
mid-year 2002. Rockville, MD: Author, 2002.
14 Woods CL, Williams DE. Traits attributed to stuttering and
normally fluent males. Journal of Speech and Hearing Research
1976; 19: 267 – 278.
15 Yairi E, Williams DE. Speech clinicians’ stereotypes of elementaryschool boys who stutter. Journal of Communication Disorders 1970;
3: 161 – 170.
16 Turnbaugh KR, Guitar BE, Hoffman PR. Speech clinicians’
attribution of personality traits as a function of stuttering severity.
Journal of Speech and Hearing Research 1979; 22: 37 – 45.
17 Turnbaugh KR, Guitar BE, Hoffman PR. The attribution of
personality traits: the stutterer and nonstutterer. Journal of Speech
and Hearing Research 1981; 24: 288 – 291.
18 White PA, Collins SRC. Stereotype formation by inference: A
possible explanation for the ‘stutterer’ stereotype. Journal of Speech
and Hearing Research 1984; 27: 567 – 570.
19 Kalinowski JS, Lerman JW, Watt J. A preliminary examination of
the perceptions of self and others in stutterers and nonstutterers.
Journal of Fluency Disorders 1987; 12: 317 – 331.
20 Kalinowski J, Armson J, Stuart A, Lerman J. Speech clinicians’
and the general public’s perception of self and stutterers. Journal of
Speech–Language–Pathology and Audiology 1993; 17: 79 – 85.
21 Kalinowski J, Stuart A, Armson J. Perception of stutterers and
nonstutterers during speaking and nonspeaking situations. American Journal of Speech-Language Pathology 1996; 5: 61 – 69.
22 McGee L, Kalinowski J, Stuart A. Effect of a videotape
documentary on high school students’ perceptions of a high school
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23 Zimmerman S, Kalinowski J, Stuart A, Rastatter MP. Effect of
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Research 1997; 40: 1130 – 1134.
24 Fucci D, Leach E, Mckenzie J, Gonzales MD. Comparison of
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25 Leahy MM. Attempting to ameliorate student therapists’ negative
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26 Bloodstein O. A Handbook of Stuttering. San Diego, California:
Singular Publishing, 1995.
Appendix A
LIST OF TELEPHONE CALL SCRIPTS
1 Restaurant: Hello, I am calling to see if you have a
Sunday brunch. What does it include? Do you have children’s menu? Thank You.
2 Department Store: Hello, Could I have the jewelry
department please? Do you have any Timex watches?
What time do you close today? Thank You.
3 Office Supply: Hello, Do you sell mouse pads for a
computer? Where are you located? What time do you
close? Thank You.
4 Sporting Goods: Hello, Do you carry rollerblades?
And do you also carry snowboards? Are you open on
Friday night? Thank You.
5 Hotel: Hello, Do you have a conference room to
accommodate a party of 10? Do you cater? Do you have
a lounge in your facility? Thank You.
6 Bakery: Hello, Do you make birthday cakes? How
many days’ notice would you require? Do you take Visa
or Mastercard? Thank You.
7 Hotel: Hello, What is your rate for a double room?
Do you have a fitness centre? Do you have a swimming
pool? Thank You.
8 Copy Centre: Hello, Do you make colored overheads? What is your charge per overhead? What time
do you open weekday mornings? Thank You.
9 Dry Cleaner: Hello, How much do you charge to dry
clean a man’s sport jacket? If I drop it off in the morning, may I pick it up the same day? Are you open on
Sundays? Thank You.
10 Video Store: Hello, Can you tell me if you have the
movie ‘‘Chasing Amy’’? What are your membership
requirements? Thank You.
11 Bookstore: Hello, I was wondering if you have the
new book by John Grisham in stock? Is that hard or soft
cover? How much is it? Thank You.
12 Florist: Hello, Can you tell me how much your
long-stem roses are per dozen? How much are a dozen
carnations? Do you take Mastercard? Thank You.
13 Hair Salon: Hello, How much do you charge for a
man’s shampoo, cut, and blow dry? Do I have to make
an appointment? Thank You.
14 Pet Store: Hello, I am interested to know if you
carry rabbit food? What brands do you carry? Do you
sell chew toys? Thank You.
15 Toy Store: Hello, Do you carry the ‘Tickle me
Elmo’ doll? Do you have them in stock? Can you tell
me where your store is located? Thank You.
16 Music Store: Hello, Do you carry CD’s by the
band ‘Ben Folds Five’? Do you know if you have all
three of their albums in stock? Can you tell me when
you close tonight? Thank You.
495
M. K. Rami et al.
17 Audio Store: Hello, Does your store sell tube
amplifiers? Can you tell me if you sell Polk Audio? What
time will you be closing tonight? Thank You.
18 Restaurant: Hello, Do you serve Chicken Parmesan? Can you tell me where you are located? Does your
restaurant deliver? Thank You.
19 Shoe Store: Hello, Do you have a big selection of
work boots? I wear a size 15; do you have work boots
in my size? Do you carry children’s shoes as well? Thank
You.
20 Garden Supply: Hello, What is your price for a 10lb. bag of potting soil? Do you have any geraniums?
How late are you open today? Thank You.
21 Bank: Hello, Do you have safety deposit boxes?
What sizes do you have? What is the rent for your smallest safety deposit box? Thank You.
22 Library: Hello, What kind of ID do I need to get a
library card? Is there a charge for that? What are your
hours on the weekend? Thank You.
23 Carpet Cleaner: Hello, What is your charge to
steam clean a 12 6 14 room? When could I make an
appointment to have that done? Do you take American
Express? Thank You.
24 Bowling Alley: Hello, How late are you open
tonight? What is your charge per game? How much
are your shoe rentals? Thank You.
25 Car Wash: Hello, How much do you charge to
wash and wax a compact car? Do I need to make an
appointment to have that done? Are you open on Saturdays? Thank You.
26 Golf Store: Hello, Do you carry Titleist DCI irons?
Do you have any in stock right now? How late are you
open on the weekends? Thank You.
27 Camera: Hello, Do you have one hour photo
processing? How much do you charge to develop a roll
with 24 exposures? What time do you close today?
Thank You.
28 Computer Games: Hello, Do you carry the game
‘‘Myst’’? Do you have it in stock? Where are you
located? Thank You.
29 Pharmacy: Hello, What are your pharmacy hours
on the weekend? Can I call in prescriptions ahead of
time? Will you be able to file my prescriptions on my
insurance for me? Thank You.
30 Vet: Hello, How much do you charge to groom a
Standard Poodle? How long will I need to leave my
dog to have that done? Are you open on the weekends?
Thank You.
31 Church: Hello, What time are your Sunday
services? Do you also have Sunday school classes? Is
there a nursery available on Sundays? Thank You.
496
32 Coffee Shop: Hello, How much do you charge for a
dozen-glazed doughnuts? Do you also sell sandwiches or
bagels? What time do you open in the morning? Thank
You.
33 Motel: Hello, I was wondering if you had any
vacancies for next Thursday through Sunday? Do I need
a credit card to reserve a room? Does your hotel offer
free movie channels? Thank You.
34 Camera Store: Hello, I was wondering if you sold
lenses for the Canon Eos? Do you also carry lithium
batteries that fit this camera? How late are you open
tonight? Thank You.
35 Bicycle Store: Hello, I was wondering if you sold
Schwinn Bicycles? Does your store carry a large selection of rims? Are you open on Sundays? Thank You.
36 Car Rentals: Hello, What kind of cars does your
store rent? How much is the insurance that your store
offers if I rent a car? Do your cars come with unlimited
mileage? Thank You.
37 Moving Van Rental: Hello, What are the sizes of
the moving vans that you carry? How much does your
company charge per-mile? Can you tell me how much
it costs to rent a hand-truck? Thank You.
38 Pizza Joint: Hello, How many people will a large pizza
serve? I was wondering if your restaurant made Chicago
Style pizzas? Does your store deliver? Thank You.
39 Grocery Store: Hello, Is your store hiring employees? What qualifications do I need to work at your store?
How much money do new employees make? Thank
You.
40 Electronic repair store: Hello, I think my VCR has
a tape stuck in it, how much would it cost for you to
take a look at it? How long will it take to fix it? Can
you tell me when you close tonight? Thank You.
Appendix B
INSTRUCTIONS
The following were the instructions for completing the
25-item scale (Woods & Williams, 1976):
Below you will see some rating scales each with seven
points. We would like you to evaluate how you feel
about YOURSELF AT THE PRESENT TIME on each
of these scales. Please circle the number on the scale that
best describes your current feelings about YOURSELF,
on each scale.