Stuttering in young females and males

Abstract

Stuttering is a relatively common speech disorder and most people have met someone who stutters. Symptoms of stuttering are repetitions, prolongations and blocks that stop the natural flow of speech. However, the symptoms can vary greatly and often resemble repetitions, pauses and lengthening that also occur in the speech of people who do not stutter. In addition, many persons who stutter become skillful at covering the obvious stuttering symptoms. Thus, a person may stutter and find that the stuttering has a strong negative impact on their quality of life even though people around them do not perceive that the person is stuttering. Clinical experience suggests that females tend to use avoidance strategies more often than men as a way of coping with stuttering. However, whether there are differences between the way girls/women and boys/men experience stuttering and how this develops during childhood is scientifically a largely unexplored area.

This thesis includes four studies. In Study I, differences in self-reported experience of stuttering between teenage females and males who stutter were analysed. The results showed that stuttering had a more negative impact on females compared to males. Females reported, to a greater extent than males, that because of their stuttering they avoided speaking and avoided social situations. When attitudes to communication among teenagers who do not stutter were examined, a considerably smaller difference between the sexes appeared.

Study II again targeted self-reported experience of stuttering among young females and males, but also the relationship between self-rated severity of stuttering and speech and language pathologists’ (SLPs) assessment of stuttering severity. The results showed that stuttering had a greater negative impact for females compared to males. There was only a weak correlation between the females self-rated stuttering severity and the SLPs’ assessment, while the correlation between the males’ and SLPs’ estimates was stronger.

Study III investigated the self-reported experience of stuttering in 162 children, adolescents, and young adults who stutter and whether there were differences in self-reported impact of stuttering at different ages and between sexes. The result was that stuttering had an increasingly negative impact on older girls and boys up to the age of 18, after which the individuals were less negatively impacted. Females reported on average a higher level of negative experience than males, and the sex difference was the greatest in adolescence.

Study IV was an interview-study with young women who experience a problem with stuttering but due to covering coping strategies and avoidance behaviour, characteristic symptoms of stuttering are not perceived by listeners. The women's incentives for choosing the strategy, the behavioural changes required by the strategy, and its consequences, were examined. The analyses identified three main themes in the women's narratives: (i) Personal aspects, (ii) Stuttering as a phenomenon, (iii) Managing stuttering. Shame and the desire to fit in emerged as motives for hiding stuttering. The development of self-esteem and self-image had also been strongly negatively affected, resulting in social anxiety. Moreover, stuttering had come to control the women's life choices and daily lives to a large extent. A particular vulnerability of being a woman who stutters was expressed, partly based on societal norms about women's expected behaviours, partly based on society's stereotypical view of stuttering.

In conclusion, the studies in this thesis provide insight into how females who stutter have a more negative experience of their stuttering and are more likely than males to cover overt stuttering symptoms. Females who stutter are therefore at risk of not getting adequate support because it may appear as if the stuttering has disappeared.