Sam SimpsonAbout the Authors:

Sam Simpson is a speech and language therapist and person centred counsellor with a particular interest in critical disability studies, stammering activism and what stammering can teach us about ourselves and the world. She lives outside London and enjoys gardening and walking her dog in her free time.Christopher Constantino

Christopher Constantino lives in Tallahassee with his wife, Megan, and sons, Augustine and Sebastian. He is a speech-language pathologist at Florida State University. He works clinically with, teaches classes on, and researches how to improve the experience of stuttering. Chris enjoys riding his bicycle.

Together with Patrick Campbell, Chris and Sam co-edited the book Stammering Pride and Prejudice: Difference not Defect in 2019.

The measurement of stuttering is usually a quantification of how stuttering negatively affects an individual. One-dimensional measurements might just look at fluency or a speaker’s lack thereof. More nuanced measures might look at the negative impact of stuttering on quality of life. There is nothing wrong with these measures and they can provide useful information, however they do not paint a complete picture. We must always remember that with stuttering, as with most human experience, one size does not fit all. There is more to stuttering than fluency and negative life impact. It is also something many people around the world have gained from, formed a community around, and take pride in. Unfortunately, what we measure can all too often constrain and limit the stories we tell about our stuttering. If we only measure what is problematic about stuttering, our stories become problem-saturated. With this in mind, we set out to design a more comprehensive self-rating scale that expands our understanding of stuttering.

In particular, we wanted to capture two experiences commonly overlooked by stuttering measures. The first is the experience of prejudice or the way society can disable people who stutter. The second is the experience of stuttering pride or the way stutterers can gain from the experience of stuttering. Drawing on research into minority stress, the chronic stress and distress faced by members of minority social groups, we have created a scale that honors both negative life impact as well as stutter-affirming lived experience and ways of making positive meaning around stuttering. Thus, questions explore prejudice events, such as discrimination, stigma awareness and agreement, self-stigma and concealment, as well as intersectionality, stutter-affirming identity, community connectedness and pride.

What you will see below is the first draft. We have not pilot tested the scale, we have not studied its psychometrics, and it is not intended for research use. Rather, we are submitting it to solicit feedback from stutterers and stuttering allies to see whether you think it is a measure worth further development. We hope you will complete it and let us know your experience filling it out. Which questions were you naturally drawn to? Which were more challenging? We would also welcome your thoughts on the balance of questions included, the language used and whether you feel there are any omissions – plus anything else you would like to share!

The Stuttering Pride & Prejudice Scale

Instructions: For both sections put a tick (✓) next to an item for which you have ever agreed. We are not measuring frequency or intensity of experience, just an experience’s presence or absence. For example, if you currently work a job you enjoy and have not had vocational trouble in a long time, but previously had difficulty with job interviews, you would still put a tick (✓) next to number 2 in the Prejudice section. Likewise, if you often dislike stuttering but, in the past, attended a stuttering group and made friends with other people who stutter, you can still put a tick (✓) next to number 4 in the Pride section.

Prejudice: Place a tick  (✓) next to every prompt with which you agree
1 I have had difficulty participating in education or vocational training related to stuttering
2 I have had difficulty finding employment or keeping employment, or have been denied promotion in relation to stuttering
3 I have had difficulty using or accessing technology as a consequence of stuttering
4 I have been rejected or distanced from friends or family in relation to stuttering
5 I have heard negative statements about people who stutter
6 I have been verbally harassed or teased in relation to stuttering
7 I have been threatened with physical harm as a consequence of stuttering
8 I have been pushed, shoved, hit, or had something thrown at me on account of stuttering
9 I have encountered difficulty finding a partner or have had an intimate relationship end related to stuttering
10 I have to repeatedly explain my stuttering to people or correct the misunderstandings people have about stuttering
11 I have to work hard for people to see my competence as a communicator
12 I have been forced to speak against my will (e.g. read aloud in class, give a presentation, attend stuttering therapy, demonstrate my stuttering to others)
13 When I share that I stutter people have minimized it or not believed me
14 To protect myself from negative listener reactions, I change the way I talk and contribute in speaking situations
15 Stuttering is not well represented in the media
16 Stutterers are not respected in my ethnic/racial community
17 Stutterers are not respected in my cultural/religious community
18 Stuttering makes it harder for me to express my gender or sexual identity because of society’s norms and expectations
19 To protect myself from negative listener reactions, I steer clear of certain speaking situations
20 There are things about my stuttering that I keep to myself
21 I fear that if I stutter openly, employers will not employ me due to stereotypes around excellent communication
22 I fear that if I stutter openly, people will think I am unintelligent or less capable than people who don’t stutter
23 I fear that if I stutter openly, people will mistakenly think I am anxious, nervous, or shy
24 If I stutter openly, I could be mocked or discriminated against
25 I try to conceal stuttering and pass as fluent to better navigate social interactions
Add up all your ticks (✓), this is your Prejudice score /25
  Pride: Place a tick  (✓)  next to every prompt with which you agree
1 Being a stutterer is an important part of who I am
2 I am comfortable with people knowing that I stutter
3 To create a stuttering-friendly speaking environment, I share that I stutter
4 I feel connected to other people who stutter
5 I have the right to be heard and am comfortable asking my listener to give me equitable speaking time
6 Stuttering invites others to develop listening practices that create safer and more inclusive speaking environments
7 Stuttering is a form of speech variation not a pathology
8 Stuttering is a gift
9 Stuttering openly is an act of resistance to fluent norms and ideals
10 It takes two to stutter – my listener has a shared responsibility to make space for my stuttering
11 I am comfortable stuttering openly
12 The two-way nature of interaction creates an opportunity for every listener to meet the openness and authenticity of stuttering in a way that fosters shared respect and intimacy
13 When interacting with members of the stuttering community, I feel a sense of belonging
14 Together, people who stutter have improved our culture through their contributions to the arts, humanities and social advocacy
15 My stuttering is a positive part of how I speak
16 I am proud to be a person who stutters
17 Stuttering offers a unique insight into the power of words, the subtlety of language and the importance of listening
18 I feel that the stuttering community makes a valuable contribution to our society
19 Stuttering pride helps me to reject society’s privileging of fluent speech
20 Stuttering brings spontaneity and joy to my life
21 Stuttering brings vulnerability and intimacy to my interactions with others
22 We are a better culture because there are people who stutter in it
23 Stuttering offers me a richness of experience that I would miss out on if I didn’t stutter
24 Stuttering is a unique and interesting aspect of my identity
25 My understanding of other aspects of my identity (e.g. race, ethnicity, gender, sexuality, religion) positively informs the meaning I make of my stuttering
Add up all your ticks (✓), this is your Pride score /25

Once you complete the scale, make a note of which score was higher, your pride or prejudice score? We invite you to reflect on what might need to change in society to lower your prejudice score and raise your pride score? What are some active steps we could all take to change either in the right direction?

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Comments

The Stuttering Pride & Prejudice Scale – Sam Simpson, Christopher Constantino — 21 Comments

  1. Hi Sam and Chris!
    I absolutely love the idea of this scale, and I think it can absolutely highlight perceptions and core beliefs and raise important topics to talk about in therapy and support meetings.
    For me, the pride section was very clear and intuitively I could tell yes/no and I think the phrasing was right on point (using terms like “giving space”, authenticity, fluent norms, love it!!).
    In the prejudice part I was a bit overthinking, because obviously there were parts there that happened at some point in my life, but it felt a bit wrong to tick them as so much time had passed and they are no longer applicable. Plus, I kept thinking that even if I don’t experience some sort of prejudice myself, I know it exists, so that got me a bit confused whether some statements should be ticked or not. Can’t wait to see t-tests for cultural differences and effects of support group participation 🙂 well done!

    • Thank you for your positive and constructive feedback, Shiran.

      It is helpful to hear about the words/phrases you could relate to more readily and the questions that were more difficult to engage with.

      I agree that presenting the questions in a binary format relating to presence or absence lacks nuance, particularly if the question relates to an experience that is located in the past and no longer feels applicable. We considered other options that allowed for the quantification of intensity, but given the tight turnaround time decided to keep it simple. Something for us to return to going forward.

      What stands out for me in your feedback is that you feel the questions could invite helpful reflection on perceptions and core beliefs and raise important topics for discussion in therapy and support meetings.

      Thanks again for taking the time to respond.

      Warmly, Sam

  2. Hi both, this looks interesting but I wondered if it might be worth mixing up the pride and prejudice construct with other beliefs about stuttering? So, this would become a multi-construct scale rather than a binary scale based on a pride-prejudice dichotomy.

    What I thought might work is a scale which assesses respondents on both social (“pride-prejudice”) and medical models for stuttering? This could be used as a tool during therapy. It might be used firstly to inform the counselling work which might comprise early stages of therapy, and in which the therapist responds to client preferences. An important part of this stage in adult therapy is conveying that fluency is unlikely to be a realistic or achievable goal, and that in any event fluency will not offer the kind of panacea to life’s various trials and tribulations that the client might hope for (i.e. similar to the “giant in chains” observation of Sheehan, and covered in this ISAD 2023 conference by Daniel Shaw and Ana Mumy: https://isad.live/isad-2023/papers-presented-by/research-therapy-and-support/mining-for-hope-expanding-the-world-of-possibilities-for-clients-who-stutter-daniel-shaw-ana-paula-mumy/). This counselling stage can be an important prelude to a decision of whether or not to do speech work, and to set up discussion of what that speech work might consist of. So, perhaps the tool would be used again following initial counselling sessions, enabling the clinician to appraise change in needs and attitudes.

    An advantage of the approach described is that it avoids the impression, present with a binary pride-prejudice scale, that any disadvantage accompanying stuttering is due to societal prejudice, and that the antidote to societal prejudice should be increased pride in stuttering. Such an impression could create pressure on those who stutter to feel increased pride in their stuttering. Indeed, stutterers may feel shame following a pride-oriented therapy if they perceive themselves to be insufficiently proud of their stuttering. This is a bit like the pressure those who stutter can feel to speak more fluently after fluency-oriented therapy. It is almost as if a fluency goal is being swapped for a pride goal. But some who stutter may not wish to take pride in their speech, just as others who stutter may not wish to speak fluently. I think it would be beneficial to those who stutter if therapy can cater to all belief structures.

    If you’re interested in this, I’ve been involved with preliminary work (supervising an MSc project) which included pilot of a questionnaire and focus group feedback from people who stutter. This work is currently stalled, but I’m happy to discuss how far we got.

    • Thank you for your comments Max and for making the time to share you thoughts on the scale.

      I agree that we offer a false binary by separating out the pride and prejudice questions. We started with a more integrated format but due to time constraints opted to simplify and focus on gaining feedback on the question types and language used rather than the design.

      We hadn’t considered integrating questions from both a social and medical frame of reference as we were keen to invite reflection on novel questions and language that are not generally found in standard assessment measures. That said, we were aiming for a more comprehensive measure, so this is something to consider going forward.

      Thank you for signposting Daniel Shaw and Ana Mumy’s paper – our intention in creating the scale was very much to expand the world of possibilities for people who stutter!

      I’d very much value a conversation about the preliminary work you are supporting. It feels very relevant as we have also discussed moving forward with focus group feedback.

      Thanks again for your feedback, Max.

      Warmly, Sam

  3. Hello Sam and Chris (and Patrick)
    I am a great admirer of your work for pride and against prejudice.
    Just a couple of technical points.On Prejudice 2 & 9 I feel each could be expanded to another point, rather than use ‘or’.
    I felt a little bit uncomfortable being judged on my ‘pride’as it could be higher!
    For your information my prejudice score was 12 and pride 8.
    On a personal level I put a lot more onus on the PWS to do the hard work than society.
    This obviously involves more open stammering and more talking about stammering.
    Good luck with your efforts in the future
    Tim

    • Thank you for your feedback, Tim.

      I appreciate your specific comments about the questions 2 and 9 on the Prejudice scale.

      Also, your honesty that rating yourself in relation to pride set up an implicit judgement as you wanted your score to be higher. I’d be interested to hear whether this personal acknowledgement has resulted in more open stammering and conversations about stammering as you identify these as possible ways forward…?

      I agree that the format of the scale currently sets up a false binary and the numerical scoring invites a performance judgement that was unintended. Going forward we are considering offering the Pride and Prejudice questions in a more integrated format and inviting participants to rate each item along a scale or continuum. This would hopefully mitigate against any self-judgement and open up exploration of possible changes or active steps going forward.

      Your comment on putting more onus on people who stammer to do the hard work of change was also of interest to me. Experience has shown me that stammering doesn’t happen in a vacuum and I’m always struck by how contextual factors influence how stammering shows up. Given this intricate interplay between the personal and the environmental, it feels only fair that society gets involved in the hard work of change too. My hope is that the questions and language of the scale help to frame this responsibility as more shared than measures of stammering typically imply.

      Thanks again for making the time to offer us feedback, Tim.

      Warmly, Sam

      Warmly, Sam

      • Hi Sam
        Good to hear from you.
        I think rating each item along a scale would be a very good idea.
        I agree society should be involved. I just worry that some people who stammer put too much emphasis on society changing – rather than themselves. A person who stammers is surely more motivated to be ‘open’than a listener is to be ‘accepting’? I have heard several people who stammer say that when they have ‘come out of hiding’ they have been surprised by the non-reaction and indifference of the listener. I think there may well be a level of societal stigma, prejudice and discrimination, but on an individual level it may well be less?
        Where ‘I am at’ is documented in several articles in Your Voice on the Stamma website. Since I returned ‘to the fold’ a few years ago I was intrigued and attracted to Stammering Pride. I can do very little open stammering and talking about stammering, even with family and friends. I can do some more with other people who stammer or therapists.
        I have had lots of psychotherapy and discovered very high levels of anxiety and insecurity (possibly nothing to do with my stammer). I have deep levels of shame about my stammer, approaching high levels on a 1-10 scale. It is hard for me to imagine a state of pride about my stammer. A state of ‘no shame’ would be a more comfortable way for me to describe it.
        But at my age I doubt it will be achievable and I coming to terms with that.
        In my youth I probably wanted a cure for my stammer. In my middle age I was pursuing psychological cures for anxiety/depression and have realised that these do not exist either.
        Thank you for listening.
        Tim

        • Hi Tim,

          Sam and I talked a lot about how this scale should function and decided that for the purposes of the ISAD conference, simplicity was a virtue. But you’re right, there are formats which can give the scale more nuance.

          Pride does not resonate with everyone, nor do I think it has to. For many people, the more they come to terms with their stammering the more it recedes into the background so that other aspects of their identity can finally shine. Perhaps that corresponds more with your “no shame” goal.

  4. Hi Sam and Christopher,

    I admire the effort you have put into creating the scales. I have tried creating scales based on my version of Sheehan’s iceberg that is available on my personal page on Facebook (Gunars Neiders). As I said this is real hard work.

    What makes it even harder is to massage the scales to make them compatible with low attention span of general public.

    Each of the scales has 25 items. Could you help me to boil them down to ten items each? *More is not better!*

    It sure would help me with my research if you could come up with the two scales of ten items each! I would be so thankful if you could choose the ten items which you think convey the story of stuttering the best!

  5. Thank you for your feedback Gunars – I agree that creating a scale is hard work!

    I also appreciate your comment on the number of questions for each scale and that less is more.

    That said, reducing 25 items to 10 is going to be challenge!

    Warmly, Sam

  6. Hi Sam and Christopher,
    I found the questions you posed very insightful and thought provoking. I think the scale itself was well put and while I agree with others about certain phrasing points, it is hard work to create a totally comprehensive scaling method. I understand that this scale is not yet used in any research capacity but when it is fully tested and developed as you see fit, what kind of research could you see this scale used in?

    • I think treatment outcome studies would benefit from a scale that attempts to measure not just a minimization of the negative but a maximization of the positive.

  7. Hello, I am a student and ally. Just dropping a comment to say I appreciate the fact that this survey has a focus on pride that I would imagine could be a way for PWS to reflect on stuttering-affirming values and beliefs that could ideally lead to positive gains in self-awareness. I can also see how some people might feel uncomfortable rating their level of pride. Thank you for sharing and best of luck!

  8. Hi Sam and Christopher

    It’s so interesting that, when I fill it in today, and again fill it in with my thoughts going back to when I was a teen, the outcome is so incredibly different! And all thanks to people who get it, both PWS and stutter and allies of different kinds, who have shown me that I’m good enough just the way I am.

    But there were questions I found hard to reply to, as there is a greyzone. F ex if I’m proud to be a person who stutters. No, but I’m proud of the person I’ve become because of my stuttering journey. Is stuttering a gift? No. But it’s not something bad either. It just is. So instead of just yes or no, maybe it would be more helpful to have some more ways of answering, like a scale?

    Happy ISAD

    Anita

    • Thank you for this Anita. Your reflections are thought-provoking. If I may play devil’s advocate, it seems you were able to answer the questions without the grey zone though? For you, stuttering is not a gift. Likewise, your pride does not stem from the stuttering itself but from the journey of growth you’ve been on. It’s okay for us to have different answers to these questions. There are no right answers.

  9. Sam and Chris,

    I appreciate the novelty, creativeness and careful construction of these scales. I had my NSA chapter (Orange County CA) fill it out during our meeting the other night and it was a really liberating experience. One member mentioned how many of the items could be discussion points for future meetings. Both scales occasioned deep reflection and even some debate. The major theme was that members were usually surprised with their Pride score, which was higher than they expected. Some members had a wide divergence between the two scores while others were similar. It’ll be interesting to see what the distribution of scores are amongst a representative sample of PWS, and how they relate to demographic variables such as age.

    Some members where confused how the scales instruct you to check a box if you have “ever agreed”. Certain statements members agreed with now that they didn’t previously, and vice versa. To me, I wonder if the scale is truly dichotomous (was that the intention?) or if there is some item bias. I wonder if each pride and prejudice item was written to measure a particular construct (idea, attitude, experience) so that each item (e.g. number 11 Pride, Number 11 Prejudice) reflected an opposite, that could make it more truly dichotomous. E.g. 11. (Pride) “I am comfortable stuttering openly versus” 11. (making this up) I hide my stuttering in fear of social judgement.

    I wonder too if the scale should focus on general statements that reflect attitudes and application of self-stigma, versus providing experiences the respondent indicates having. The scales tap into feelings (affect) too. I wonder if these A B C components are worth teasing out.

    Thank you for creating this scale which has planted many seeds of cognitive change in myself and others. I credit both of you for your tireless work in the stuttering pride movement. I’d love to hear more on how scale refinement and validation goes – these factors are important in light of research and clinical intervention. Let me know of any other ways I can possibly help.

    Randy

    • Having your NSA chapter fill this out is so cool! I’m glad your members had higher than expected pride scores. Our journeys are so gradual, we don’t always realize how far we’ve come!

      You’re right that the constructs are not completely worked out. Are we measuring current feeling or past experience? This was just a first try at playing with these ideas and seeing if people who stutter find them at all helpful. Hopefully the next steps can make the constructs more exact and robust.

  10. Sam and Chris,

    Hello! Haleigh, Kiera, and Josie here – 3 master’s degree students commenting our appreciation for all of the hard work put into creating this scale. The Pride and Prejudice scale could be a wonderful tool to use in therapy planning for a client who stutters. Often, conversations about the prejudice people who stutter face is difficult to initiate and also difficult to maintain. We really think this scale would offer therapists good insight to the client’s own perspectives and feelings about stuttering. Answering questions in front of a therapist can be intimidating and people do not always tell the complete truth when face-to-face. This scale offers us information about the individual and their lived experiences which can help us shape therapy in the best individualized way in an effort to provide the most effective intervention. We can see where it may be difficult for a person who stutters to answer specifically “yes” or “no” and some questions may be better answered in a Likert scale design, but we understand the measure is to identify if it simply exists or not. We think this scale is also a good conversation starter that could be used in various environments, not just therapy. Lastly, we just truly appreciate the efforts of the measure to shy away from only identifying the negative effects/impact and including positive impacts and meanings surrounding stuttering. Thank you for sharing and allowing space for comments/suggestions! As future SLPs this makes us excited and motivated to continue growing and learning!

    Best,
    Haleigh, Kiera, Josie

  11. Thanks you three! Sam and I talked a lot about using Likert questions but for the purposes of posting here, to the ISAD conference, we opted for simplicity