This was the question Dr. Jan McAllister and colleagues from the University of East Anglia set out to answer, and here she introduces the findings from their research.
What is the impact of stammering on a person’s education and employment? This is an important question, and one that has been addressed in a variety of ways in stammering research. In interview studies, respondents have sometimes reported that stammering has had a detrimental effect on their own education and employment. Some describe their schooldays as the time in their lives most adversely affected by stammering. Many people who stammer (PWS) also believe that prejudice about the condition has made it difficult for them to find employment, to be promoted, or to achieve their career potential. Some even turned down jobs or promotions because of fears that their stammer might prevent them from carrying out their role effectively.
This is not surprising; stammering can interfere with a person’s ability to communicate effectively, which may lead to poorer performance in school activities that require speaking aloud. Some children who stammer may be reluctant to ask questions in class if they don’t understand something, which could lead to poorer academic performance. Stammering is also associated with negative peer responses including bullying, which makes school an unpleasant experience and can result in avoidance of speaking situations. Continuing to use avoidance as a coping strategy into adulthood could lead people to miss out on employment opportunities in just the way that interview respondents reported. Furthermore, if the negative prejudices of non-stammering children are not challenged or corrected, they might be carried into adulthood, which could well give rise to the kind of employment discrimination that some PWS report.
Interview studies tend to focus on the personal experiences and opinions of fairly small numbers of people. An alternative approach is to gather objective evidence about the educational and employment achievements of PWS by asking whether they are more likely as a group to attain lower levels of educational and employment success. The results of such studies have been mixed. One Australian study found very similar educational and employment profiles when they compared 200 adults who stammered with 200 matched controls who didn’t. Another Australian study investigated the relationship between stammering severity and educational attainment among adults seeking speech therapy. Researchers found a significant negative association between highest educational achievement and self-reported stammering severity: e.g., a person who rated their severity as high would be likely to reach a relatively low level of educational qualification, and vice versa.
Many other factors beyond fluency influence levels of educational achievement and employment success, including cognitive ability, the socio-economic circumstances of the family in which the person grew up, childhood bullying and gender. Considering that some of these factors are also associated with stammering, it is important to try to work out whether stammering has an impact on educational and employment achievement independent of other predictors.
Evidence from a birth cohort study
In research carried out at the University of East Anglia, we tried to determine the impact of stammering on educational and employment outcomes when these other factors were controlled for. We analysed data from the National Child Development Study (NCDS), a British birth cohort study that has followed a group of over 18,500 people born in 1958 from birth and throughout life, which has given rise to over a thousand publications covering aspects of human development. It has collected data from cohort members as well as their parents, teachers and doctors, covering topics as diverse as health and development, cognitive abilities, socio-economic circumstances, education, employment and relationships. When the members were 7, 11 and 16 years-old, their parents were asked to say whether their child stammered. By the time they were 16, 217 stammered. We compared educational and employment outcomes for these members with those for the other 16 year-olds taking part in the study.
With regard to education, we investigated the factors that influenced whether or not the cohort members stayed on at school beyond the minimum leaving age and the highest level of educational qualification they obtained by age 50. The employment analyses investigated the impact of stammering on the likelihood of being unemployed prior to age 23, pay at 23 and 50, and social class of occupation at 23 and 50. In all the analyses we determined whether there was an association between stammering and the outcome variable, and then looked at what happened when we controlled for the other factors. This second ‘multivariate’ analysis provides a more valid assessment of the impact of stammering on the outcomes.
In terms of the educational outcomes examined, there was no difference between those who stammered at 16 and those who did not. Despite considerable evidence from previous studies implying an unhappy experience of school for many PWS, we found that those who stammered at 16 were statistically no more likely than their non-stammering peers to leave school at the earliest possible opportunity, and there was no statistically significant difference between the two groups in terms of the highest academic qualification achieved by age 50. An individual person who stammers may well be disadvantaged with respect to the other factors that predict the educational outcomes, and as a result may be at risk of poorer academic attainment in future years, but as a group there was no evidence in our analyses to suggest that PWS attain poorer educational outcomes. As noted above, a study did find evidence of an association between stammering severity and highest educational qualification in adulthood; however, in that study the participants were adults seeking therapy for stammering, who might not be representative of PWS as a whole. A community sample such as the NCDS is more likely to be representative.
There was a limited amount of evidence that adolescent stammering might have a negative impact on later employment outcomes. Those reported to stammer in adolescence were not significantly more likely than controls to experience unemployment lasting a month or longer at the start of their working lives, nor did they earn significantly less at 23 or 50, or have a greater likelihood of being in a lower-status occupation at 23. But they were more likely to be in an occupation in a lower socio-economic class at 50. This may arise because of discrimination on the part of employers. Alternatively, it may be the result of the use of avoidance on the part of those who stammer. Many occupations with higher socio-economic status (professional and managerial posts) require, or are perceived to require, good verbal communication abilities, and PWS may avoid such jobs through fear that they will have no chance of being offered such work or that their stammering may prevent them from carrying out the role effectively. They may instead seek occupations that are lower in socio-economic status, which may nonetheless be as rewarding in financial and other terms.
No research study is perfect. In our study, we had to rely on parental reporting of stammering rather than a professional diagnosis, which might have affected the results. On the other hand, other studies have found that parental judgements about stammering are usually pretty accurate, and one would expect that by the time a child is 16 their parents would be able to say with confidence whether they stammered or not.
Could there be differences?
Although we did not find any differences between the two groups in terms of the educational outcomes that we examined, this does not mean that no such differences exist. As we noted earlier, there were many ways in which we could have analysed the NCDS data set, and although neither of the educational outcomes we examined were associated with stammering, it is possible that other measures might display such an association. For example, if we had looked at highest educational performance at various other life stages, a different picture might have emerged.
One of the strengths of the NCDS data is that it covers such a large portion of the lifespan, enabling us to track individuals’ lives. The drawback of this long-term window is that when we look at what was happening to the cohort members earlier in their lives, we have to acknowledge that the factors that influenced outcomes at that time may not be the ones that are relevant today. For example, the cohort members were making decisions about whether to stay on at school in the mid 1970s; the fact that society has changed so much in the intervening decades means that we need to be cautious in generalising these findings to present-day adolescents. These questions need to be continually re-evaluated against the factors that prevail in the present time. Fortunately, several birth cohort studies have been initiated since then. Researchers need to keep raising stammering on the research agenda to ensure that it continues to be a variable that is examined in the later birth cohort studies.
It is reassuring that our study shows few significant differences between educational and employment outcomes for those who stammered as adolescents and those who did not. Our findings suggest that stammering per se is not necessarily a barrier to aspirations. PWS need to identify their educational and career goals on the basis of their preferences and non-speech aptitudes, and then be encouraged to pursue them.
This study is part of a bigger study on The Impact of Speech and Language Abilities, and Jan worked alongside Professors Jacqueline Collier and Lee Shepstone.
From the Spring 2013 edition of Speaking Out, p18-19