Developmental stuttering has been defined as a condition that is extremely common in young children and affects the process of their healthy growth and development (Yairi & Seery, 2015). Stuttering forms a type of speech disorder that is characterized by the repetition of words, syllables or sound. The phenomenon of frequent interruptions in the flow of speech is known as a speech block. According to Yairi and Ambrose (2013), it has been mentioned that speech disruptions in young children is accompanied with struggle behaviours and uncomfortable body gestures, that include, rapid blinking of the eye and tremors of the lips (NIDCD, 2018). Stuttering makes it extremely difficult to communicate with ease and this has been tightly linked to be one of the primary reasons that affects the quality of life of the people (Menzies et al., 2009). Studies reveal that stuttering elicits a negative impact on the quality of interpersonal and professional relationship that leads to diminished level of self-confidence and self-esteem (Logan & Willis, 2011); (NIDCD,2018). Stuttering is also referred to as stammering or a condition of dis-fluent speech. As stated by Link et al. (2011), individuals who are affected with stuttering often are deprived of better job and career opportunities. This paper aims to propose a project to successfully evaluate the impact on the quality of life of individuals who suffer from speech block. It further intends to investigate the impact of stuttering and associated self-stigma behaviour that affects the process of development in individuals.
According to Iverach and Rapee (2014), it has mentioned that almost 3 million people in the United States of America suffer with the problem of Stuttering. As mentioned by Guitar (2013), stuttering can impact individuals across all age-groups. It should be mentioned in this regard, that the problem is commonly prevalent in children who are between the age groups of 2 to 6 years old. Studies indicate that, on an average basis almost 5 to 10 percent of children stutter for a period of time that might last for a minimum tenure of few weeks to almost several years. As mentioned by Gerlach et al. (2018), during childhood it is common for girls as boys to stutter prior to proper language development. However, with the advancement of age, the probability of continued stuttering in boys is three times more than that in girls. As mentioned by Boyle (2015), advancing age generally solves the problem of stuttering and almost 75% of the children recover from the problem of stuttering. However, studies reveal that 25% of the children who do not recover from stuttering with the advancing age, continue to stutter and it leads to pertinent speech and communication disorder (Boyle, 2013). According to Boyle (2015), a significant relationship exists between self-stigma and developmental stuttering. This can be explained using the model of self-stigma devised by Boyle that suggests individuals who are affected with the problem of stuttering often become aware about the fault in their style of communication and end up being stigmatized by other individuals. This disheartens then and they end up developing a negative attitude towards themselves and consequently it hampers the psychological wellbeing of the concerned individuals. At the same time, it also leads to demotivation, reduced social participation and poor quality of life. As stated by Abdalla and St Louis (2012), attitude and behaviour of others play an integral role in the evolution of self-stigma. It can thus be mentioned here that, the attitude of others elicit negative experiences in association with stuttering. Studies reveal that the western culture presents a major proportion of evidence-based studies that focus on the behaviour of others towards stuttering (NIDCD,2018).
As stated by Yairi and Ambrose (2013), Speech sounds are produced through a series of coordinated muscle movements. The movements involve the process of breathing, phonation or the production of voice and clear articulation or the coordinated movement of the throat, palate, tongue and lips. The muscle movements are stringently controlled by the brain and are constantly evaluated through our auditory and tactile sensory perceptions (Menzies et al., 2009). The problem of stuttering has been classified under two sub-categories that include developmental stuttering and neurogenic stuttering. Developmental stuttering is the most common type of stuttering that occurs in infants and children who are yet to master language and speech skills (Logan & Willis, 2011). Studies reveal that developmental stuttering occurs when the ability of the child to communicate using language and speech is not adequate to meet the verbal demands of the children. Developmental stuttering has been analysed to result from environmental complexities as well as genetic inheritance. Research studies indicate, that mutations within the GNPTAB, NAGPA and GNPTG genes might lead to stuttering. In addition to this, it should also be noted that the genetic makeup of the individuals who stutter to individuals who do not stutter vary considerably (Iverach & Rapee, 2014). On the other hand, Neurogenic stuttering generally occurs after a stroke or a massive brain injury. The condition is characterized by the brain facing difficulties to ensure coordinated communication between the different regions of the brain that are involved in the process of speech and language (NIDCD, 2018). Therefore, it leads to problems with clear and fluent speech. The condition is generally diagnosed by a speech-language pathologist who evaluates whether or not the child would continue stuttering or would outgrow the problem. Several factors are responsible for governing the continuity of the stuttering process. The family history of stuttering, the consideration of the stuttering time-frame which means considering whether the child has presented stuttering in his speech for more than six months and whether or not the child has exhibited speech and other related language problems form important part of consideration areas while diagnosis. Stuttering practically has no specific treatment interventions but can be minimised with the use of stuttering therapy and self-help groups that are imparted by speech-therapists. In addition to thus, studies have further indicated that motivating children and using the process of active listening can help in significantly reduce stuttering in children (Logan & Willis, 2011).
Research Rationale:
Stuttering is an extremely common problem among students. However, the problem has not gained much attention by the researches. Studies have increasingly focused on accessing the cause of stuttering and not on studying the impact of stuttering on the quality of life of the individuals (Menzies et al., 2009); (Link et al., 2001). This study would investigate and analyse the impact of stuttering on the quality of life of the affected individuals. In addition to this, it would also help in identifying the investigating the attitude and perception of the people connected to stuttering across diverse cultures. It would also analyse the existing relationship between societal perception and self-stigma and at the same time explain the role of self-stigma on the efficacy of the self-recovery process. This would help in creating mass-awareness about the negative impact of societal perception on stuttering and foster an optimal environment that could minimise self-stigma. This in turn would alleviate the quality of life of the affected individuals and at the same time also expose them to a wide range of therapeutic interventions that are available for the treatment of the problem.
According to Austin (2011), methodology forms a critical aspect of any research study. This section usually comes after the literature review section. It critically considers the available research studies and extracts relevant information about the concerned topic. On reviewing the available set of relevant literatures, an appropriate methodology procedure can be designed that would govern the further steps of the research (Austin, 2011). In order to proceed with the devised research study an effective systematic review would be carried out. The devised research study design that would be adapted by the researcher would be systematic review and the study approach would be qualitative and would include secondary research data as retrieved from the literatures.
Literature Search:
In order to proceed with the literature review, the first step would include conducting a thorough search on the popular databases in order to retrieve research articles that are aligned with the research aim. In order to make the search an effective one a set of key-terms were used that enables the researcher to identify all relevant studies in a systematic manner. Further, it should also be noted that in order to make the search authentic, the researcher would use a set of inclusion and exclusion criteria that would help in filtering out all irrelevant and unnecessary information.
Key words:
As stated by Aveyard (2014), the initial stage of identifying relevant research studies must proceed with the use of key words. The key words make the search authentic and aligned with the key concepts of the research. The key terms were used to search literatures across popular electronic databases that included Google Scholar, CINAHL, MedLine, PubMed and Cochrane Library. The key words would include the following: stuttering, self-stigma, societal perception, discrimination, stigma, stuttering therapy, types, statistics, emotional impact, quality of life.
Bibliographic Aids:
In order to search relevant literatures, an intensive search would be carried out online over the internet. The search would not just remain restricted to the electronic databases that comprise of research journals but would also include, informative news articles, blogs, discussion forums and support community websites.
Inclusion and Exclusion Criteria:
The use of exclusion and inclusion criteria assist the designing of an organized protocol to conduct the research in an organized manner (Bergh & Ketchen, 2011). It should also be mentioned in this regard that the exclusion and inclusion criteria help in filtering irrelevant and unimportant studies. The exclusion criteria would consider the research papers published prior to 2008 and published in foreign languages other than English. The other consideration would also include papers that focus on secondary research data. On the other hand, the inclusion criteria would include papers published in the English language and published between the years 2013 to 2017. It would also consider primary research papers that would be based upon a qualitative, quantitative or mixed design.
Conclusion:
Therefore, it can be expected that the research conducted by the researcher would be qualitative and would be based upon a deductive data analysis approach. Further, it should also be noted that the researcher would follow a positivism philosophy along with a descriptive research-study design style. The systematic review would include 10 research study articles and analyse the results based on thematic discussion.
In order to compare the validity of the research findings obtained after conducting the literature review, the researcher would also conduct a primary qualitative research. This would be done by conducting semi-structured interviews with 5 participants. The participants would be College students of [enter the name of your University/College] who are of diverse ethnic backgrounds and deal with the problem of stuttering. The researcher would proceed with a questionnaire of ten open-ended questions that would be asked to the researchers in order to analyse the impact of stuttering on the quality of life of the students. The responses obtained would then be analysed and discussed by the researcher on the basis of thematic discussions.
The time frame of the research would extend from 2019 to 2022 and would include a tenure of three years. It should further be noted that the project would be a self-funded project.
Fig: Proposed Timeline
Source: As created by Author
Objectives:
The research study objectives that can be formulated for the proposed research study would include the following:
References:
Abdalla, & St Louis, K. (2012). Arab school teachers’ knowledge, beliefs and reactions regarding stuttering. Journal of Fluency Disorders, 37, 54-69.
Austin, P.C., 2011. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate behavioral research, 46(3), pp.399-424.
Aveyard, H., 2014. Doing a literature review in health and social care: A practical guide. McGraw-Hill Education (UK).
Bergh, D., and Ketchen, D. J., 2011. Research methodology in Strategy and Management, 1st ed. Bingley: Emerald Group Publishing Ltd
Boyle, M. P. (2013). Assessment of stigma associated with stuttering: Development and evaluation of the Self-Stigma of Stuttering Scale (4S). Journal of Speech, Language, and Hearing Research, 56(5), 1517-1529.
Boyle, M. P. (2015). Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S), Journal of Fluency Disorders, 43, 17-27.
Gerlach, H., Totty, E., Subramanian, A., & Zebrowski, P. (2018). Stuttering and Labor Market Outcomes in the United States. Journal of Speech, Language, and Hearing Research, 61(7), 1649-1663.
Guitar, B. (2013). Stuttering: An integrated approach to its nature and treatment. Lippincott Williams & Wilkins.
Iverach, L., & Rapee, R. M. (2014). Social anxiety disorder and stuttering: Current status and future directions. Journal of fluency disorders, 40, 69-82.
Link, B., Struening E., Neese-Todd S., et al (2001). Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services 52:1621–1626.
Logan, K. J., & Willis, J. R. (2011). The accuracy with which adults who do not stutter predict stuttering-related communication attitudes. Journal of fluency disorders, 36(4), 334-348.
Menzies, R. G., Onslow, M., Packman, A., & O’Brian, S. (2009). Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists. Journal of fluency disorders, 34(3), 187-200.
NIDCD (2018). Stuttering. [online] NIDCD. Available at: https://www.nidcd.nih.gov/health/stuttering [Accessed 12 Dec. 2018].
Yairi, E., & Ambrose, N. (2013). Epidemiology of stuttering: 21st century advances. Journal of fluency disorders, 38(2), 66-87.
Yairi, E., & Seery, C. H. (2015). Stuttering: Foundations and clinical applications. Boston: Pearson.
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