Arab and American Teachers

Attitudes Toward People Who Stutter:

A Comparative Study
Farzan Irani
Texas State UniversitySan Marcos

Fauzia Abdalla
Kuwait University

Rodney Gabel
University of Toledo

entral to the societal perception of stuttering is

the phenomenon of stereotyping. Stereotyping
is defined as an exaggerated belief associated with a category and functions to justify (rationalize)
ones conduct in relation to that category (Allport, 1986,
p. 191). A review of the literature indicates that the speech
of people who stutter (PWS) is often subject to negative stereotyping by various groups of listeners, including
educators (e.g., Dorsey & Guenther, 2000), health care
professionals (e.g., Silverman & Bongey, 1997), employers

ABSTRACT: Purpose: A limited number of studies have explored attitudes toward people who stutter (PWS) in different
cultures. Recent studies have looked at the attitudes of Arab
parents toward PWS. The current study explores attitudes
reported by Arab teachers from Kuwait and provides a preliminary comparison with attitudes reported by teachers from
the United States.
Method: This study used an English version and an Arabic
translation of a 14-item semantic differential (SD) scale (Burley & Rinaldi, 1986) to assess differences in American and
Arab teachers attitudes toward PWS.
Results: A majority of Arab teachers from Kuwait reported
neutral to positive attitudes toward PWS on the SD scale.
However, ~1/3 of the Arab teachers reported relatively negative attitudes toward PWS on items relating to social skills
and employability. A comparison of the American and Arab

12

CONTEMPORARY ISSUES

(Hurst & Cooper, 1983a), vocational counselors (Hurst &

Cooper, 1983b), speech-language pathologists (SLPs; e.g.,
Cooper & Cooper, 1996), lay people (e.g., Ham, 1990),
and college students (e.g., Ruscello, Lass, & Brown, 1988).
Findings from these studies indicate that PWS are characterized using descriptors such as shy, anxious, withdrawn,
nervous, tense, hesitant, self-conscious, less competent,
introverted, and insecure. A limited number of studies have
explored why these stereotypes occur (Doody, Kalinowski,
Armson, & Stuart, 1993; MacKinnon, Hall, & MacIntyre,

teachers results indicated generally positive attitudes toward

PWS; however, the American teachers reported significantly
more positive attitudes on 11 of the 14 items in the scale.
Discussion: The significant differences between the 2 groups
may be attributed to a variety of cultural factors related
to perceptions and beliefs about communication disorders,
including stuttering. Familiarity with PWS could be another
factor related to the differences reported. The differences
found between the 2 groups indicates a need for future
studies using different methods to corroborate the results of
this study and further explore factors responsible for the difference in responses. Limitations with the present study and
recommendations for future research are discussed.
KEY WORDS: stuttering, attitudes, crosscultural, teachers,
stereotyping

INCC
OMMUNICATION
SCIENCE
AND D ISORDERS
Volume
39 1220
Spring
2012 Spring 2012 NSSLHA
ONTEMPORARY
ISSUES
IN C OMMUNICATION
SCIENCE
AND D ISORDERS
Volume
39 1220

1092-5171/12/3901-0012

2007; White & Collins, 1984). MacKinnon et al. (2007)

elaborated on previous literature indicating stereotype formation via an anchoring-adjustment process. According to
this notion, people often form stereotypes about stuttering
based on their own experiences with normal disfluencies
and associating these with the self-perception of anxiety.
For example, when a person who does not stutter is nervous and experiences disfluencies, it is associated with the
stuttering-like disfluencies that are experienced by a person
who stutters. Perceptions such as these may contribute to a
negative stereotype of PWS and lead to behaviors and actions that can discriminate against them (Smart, 2001). This
in turn can contribute to a negative self-concept among
PWS (Manning, 2010; Silverman, 1996).

Impact of Stereotypes on the Individual

People with disabilities, including PWS, often internalize negative stereotypes and accept them as the truth
about themselves (Smart, 2001). This internalization may
be exacerbated if such stereotypes are repeated often and
from authority figures. For children in school, teachers are
authority figures who can have a significant impact on their
lives. Previous studies (Lass et al., 1992, 1994; Yeakle &
Cooper, 1986) found that teachers and school administrators held largely negative stereotypes about PWS. Yeakle
and Cooper (1986) found that teachers who reported having
experience with PWS or coursework in speech disorders expressed more realistic attitudes toward PWS, thus indicating
that familiarity and/or education can help improve teachers
perceptions of PWS.
More recently, Irani and Gabel (2008) found a positive shift in kindergarten to 12th-grade (K12) teachers
attitudes toward PWS compared to people who do not
stutter (PWNS). The results of the study by Irani and
Gabel indicated that K12 teachers reported significantly
positive attitudes toward PWS as compared to PWNS for
three items on a semantic differential (SD) scale. These
items included the descriptors sincereinsincere, physically
normalphysically abnormal, and intelligentunintelligent.
The results of this study are promising and in keeping with
the positive trend noted by Cooper and Cooper (1996), who
found a similar positive shift in attitudes by teachers over
2 decades.
Another important effect of stereotyping has been discussed by Smart (2001) as paternalism. Paternalism has
been defined as acting upon ones own idea of what is
best for another person without consulting that person
(Anderson, 1987, p. 177). Paternalism is often done in
consideration of the best interests of the person with a
disability (PWD) and can be considered appropriate and
justified when the PWD may make a decision that would
cause harm to him- or herself. However, paternalism can
be undesirable and unethical when decisions are made for
individuals who are capable of making their own decisions, including PWS. A study by Irani, Gabel, Hughes,
Swartz, and Palasik (2009) explored role entrapment of
PWS by K12 teachers using the Vocational Advice Scale
(VAS; Gabel, Blood, Tellis, & Althouse, 2004). The survey

instrument included an open-ended question at the end of

the scale, requesting participants to provide their rationale
for not recommending certain jobs to PWS. A majority of
the teachers who responded to the open-ended questions
indicated that they did not recommend certain careers to
PWS because they were keeping the students best interest
at heart. These were often careers that required more speaking. These results could be interpreted as representative of
paternalism.

Culture and Stereotyping of PWS

A comparison of past and recent research related to attitudes toward, and stereotyping of, PWS in America
indicates a positive change in attitudes over the past
several decades, with various societal groups reporting
more neutral to positive attitudes toward PWS on SD
scales. However, there is limited research about attitudes
toward, and stereotyping of, PWS in different countries
and cultures.
Our understanding of cultural differences in attitudes
toward people with various disabilities, including stuttering, is extremely important. In the case of stuttering,
a review of the literature indicates that the vast majority
of treatment research published is primarily from North
America, Australia, and the United Kingdom. Thus, it is
important for SLPs working with culturally and linguistically diverse populations to understand cultural differences
in attitudes toward people with various communication
disorders. Additionally, SLPs from other nations are also
consumers of research literature printed in top tier, peerreviewed publications. It is pertinent that SLPs are aware
of cultural differences that could impact the conduct of
treatment for a variety of communication disorders. For
children who stutter, an SLP needs to consider cultural
differences when implementing treatment. This can include
changes in the structure of the program to account for
cultural differences, but also education of individuals who
are relevant to the childs life and treatment process. For
school-age children, a considerable amount of time is
spent in the schools. Thus, it is important to understand
teachers attitudes toward PWS.
A number of studies have found cultural differences in
the knowledge about, and attitudes toward, people with
communication disorders in general and stuttering specifically (Bebout & Arthur, 1992; Mayo, Mayo, Jenkins, &
Graves, 2004). These studies indicate that negative stereotypes concerning PWS, established by studies looking at
various societal groups in the United States, exist across
cultures. Studies that have explored perceptions and attitudes about stuttering among different cultural groups
indicate varied beliefs about the cause of stuttering, ranging
from a more contemporary perspective that stuttering occurs in early childhood to less traditional conceptualizations
of stuttering (Al-Khaledi, Lincoln, McCabe, Packman, &
Alshatti, 2009). The less contemporary conceptualizations
include beliefs that stuttering has a psychological (Mayo
et al., 2004) or emotional (de Britto Pereira, Rossi, & Van
Borsel, 2008) basis.

Irani et al.: Comparison of American and Arab Teachers Attitudes Toward People Who Stutter

13

The Arab Culture and Attitudes

Toward Stuttering and PWS
Abdalla and Al-Saddah (2009) explored the knowledge,
beliefs, and attitudes of teachers in Kuwait about stuttering
using an Arabic translation of the Public Opinion Survey of
Human Attributes Inventory (POSHA-E; St. Louis, 2005).
They also conducted qualitative interviews to gather data
about PWS school experiences from three children who stutter. The survey results indicated that although some teachers reported positive trends in perceptions and knowledge
of stuttering, there remains a lack of adequate knowledge
about stuttering in teachers in Kuwait. For example, results
indicated that a vast majority of teachers responding to
the survey believed that stuttering is caused by a frightening/traumatic event or is psychological in nature. A common
theme identied during the qualitative interviews was that of
time pressure: All three participants reported that they feel
that some teachers would not give them time to speak freely.
It is interesting to note that although the results from the
survey indicated largely positive trends, the reports from the
participants who stutter suggested otherwise.
The most striking was a report by one of the participants,
who stated that teachers request she ask questions only after
class or during break time. Suggestions such as these can
have a negative impact on a child and possibly result in
feelings of marginalization. It is important for school-based
SLPs to develop a plan to address these situations and reach
an amicable solution such that the child can be provided
with equal opportunities. Although generalizations cannot be
made based on reports from only three participants, it does
indicate that each individuals experience in the school system is different, and it is important for an SLP working with
a child in the school system to address the childs particular
school experience.
A study by Al-Khaledi et al. (2009) explored Arab parents
knowledge and beliefs about stuttering using an Arabic translation of the POSHA-E. In general, they found that many
parents attributed the cause of stuttering to psychological or
emotional factors, and more than half of the respondents believed that stuttering is caused by parents overreacting when
the child has disuencies. On questions regarding attitudes
and beliefs about stuttering, half of the respondents believed
that PWS should not occupy inuential occupations such as
lawyers, doctors, and teachers, indicating some role entrapment, as described by Irani et al. (2009). Many parents also
held stereotypical beliefs that PWS are shy or fearful. On a
positive note, a majority of the parents reported positive attitudes, and there were no indications of associating stuttering
with reduced intelligence. Overall, the results of this study
appear to be in agreement with the results of the study by
Abdalla and Al-Saddah (2009), which stated that the level of
knowledge about stuttering is limited and there is a need to
disseminate scientic information about stuttering in Kuwait
and possibly other Arabic-speaking countries.

PURPOSE OF THE STUDY

To the best of our knowledge, only two studies (Abdalla &
Al-Saddah, 2009; Al-Khaledi et al., 2009) have explored

14

CONTEMPORARY ISSUES

IN

COMMUNICATION SCIENCE

AND

stereotyping of PWS in Arabic-speaking countries. The

results of these studies indicate a lack of knowledge and
awareness about stuttering by two important societal
groups; namely, teachers and parents. This lack of knowledge can result in negative stereotyping of PWS, putting them at a disadvantage in schools and possibly also
vocationally. According to Heite (2000), who explored
Icelandic teachers attitudes toward stuttering and classroom decision making, most teachers lack knowledge about
stuttering, and listeners tend to make judgments based on
cultural mythology and their own stress reactions. A lack
of knowledge about stuttering by teachers could lead to
negative stereotyping of PWS by the anchoring-adjustment
process (MacKinnon et al., 2007) wherein teachers might
form negative stereotypes about stuttering based on their
own experiences with disfluencies.
A vast majority of previous research has explored attitudes of the Western culture toward stuttering. Exploring
non-Western attitudes about disorders such as stuttering is
also important, both because we are living in an increasingly pluralistic society and because such knowledge has
important scientific value. A limited number of studies have
explored attitudes and beliefs of populations outside the
United States toward stuttering. Additionally, a majority of
the treatment research in stuttering is published in North
America, Australia, and the United Kingdom, with a majority of the participants belonging to the Western culture.
Very little is known about cultural differences in attitudes
toward stuttering and how that might influence treatment
choices. It is important for SLPs to understand cultural differences when making treatment decisions because attitudes
toward the cause, effect, and treatment of a disorder held
by the client and the clients family and community can
have a significant impact on the treatment process (Bebout
& Arthur, 1992).
The purpose of this study was to explore Arab teachers
attitudes toward PWS and make preliminary comparisons
with attitudes reported by American teachers to look for
possible cultural differences using an SD survey instrument.
The study posed the following research questions:
What attitudes do Arab teachers report toward PWS,
when measured on an SD scale?
Are there quantitative and qualitative differences in attitudes reported by Arab and American K12 teachers
toward PWS?

METHOD
Instrumentation
An SD (Burley & Rinaldi, 1986; Collins & Blood, 1990)
scale was used in this study to measure participant attitudes. The scale was a 14-item instrument consisting of 14
adjectives paired with their 14 antonyms found in dictionary listings. The bipolar pairs (e.g., sincereinsincere) were
randomly distributed to either the low (1) or the high (7)
ends of the scale in an equal number of items to reduce the
likelihood of participants responding in a stereotyped

DISORDERS Volume 39 1220 Spring 2012

manner, thereby reducing the order effect (Silverman,

1977). A 7-point scale was inserted between the adjectives,
and participants were asked to circle the number on the
scale that is closest to the adjective they feel best describes
a person who stutters. For scoring purposes, all negative
items were placed on the high end of the scale, and all
positive items were placed on the low end of the scale.
Thus, a higher score indicated a more negative attitude, and
a lower score indicated a more positive attitude. In order
to ensure that all responses and ratings were based on the
participants internal standards, no specific definitions of
stuttering were provided to the participants. SD scales, like
the one used in this study, have been used previously to
measure peoples attitudes toward PWS (Burley & Rinaldi,
1986; Collins & Blood, 1990; Gabel, 2006; Horsley &
FitzGibbon, 1987; Silverman & Bongey, 1997; Woods &
Williams, 1976).

Participants and Survey Distribution

The study was completed in two phases. The first phase of
the study evaluated the attitudes toward PWS reported by
teachers from Kuwait; it answers the first research question.
The second phase compared attitudes reported by the teachers from Kuwait with attitudes reported by teachers from
the United States; it answers the second research question.
Kuwait teachers attitudes toward PWS. Two hundred
and fifty-eight participants were recruited to gather data
about Kuwait teachers attitudes toward PWS. Participants
were recruited from three of six governorates in Kuwait
from which approval to conduct the study was obtained.
A governorate is roughly equivalent to a province or state
in the United States and is an administrative division in
the country. Three of the six governorates were randomly
selected for conducting this study. The questionnaire was
distributed to 15 schools, five in each governorate. Teachers
in Kuwait are assigned to different governorates depending
on the need for teachers in a particular governorate, and
many expatriate teachers from other countries are hired and
are placed in schools across the country. Hence, we believe
that the sample of teachers responding to the questionnaire
was most likely representative of the general population of
Kuwait. Principals of the schools contacted for the study
facilitated recruiting participants for this phase of the study.
Two professional EnglishArabic translators translated the
SD scale used for the first phase of this study to Arabic.
Two independent linguists from Kuwait University then
checked the translation for accuracy. Research assistants
from the department of communication sciences at Kuwait
University provided the school principals with packages
containing a cover letter, consent form, and the translated
14-item SD scale. The principals then distributed the packages to teachers in their respective schools. The completed
packages were returned to the research assistants by the
school principals. The cover letter specified that anonymity would be maintained, and teachers were not asked to
provide their names.
A total of 700 questionnaires were distributed to Arab
(Kuwaiti and non-Kuwaiti) teachers from a total of 15

schools. Arab teachers were those who circled Arab as

their ethnicity and indicated speaking Arabic as their first
language. Of the 700 questionnaires that were distributed,
346 (49.4%) were returned, and 258 (36.8%) of those were
completed and usable. The remaining 88 questionnaires
could not be used for the study because nine participants
reported that they stuttered, and 79 surveys were incomplete.
Table 1 presents the demographic information for the
Arab teachers who participated in the study. The average
age of participants was 35.4 years, and only 29.9% were
40 or more years of age. The majority of the teachers were
female (70.2%). More than 40% of the teachers taught at
the elementary level, 29.5% at the middle school level, and
30.2% at high schools. The two largest nationalities were
Kuwaiti (52.6%) and Egyptian (35.7%). The remaining
teachers (11.6%) were citizens of various Arab countries:
Bahrain, Iraq, Jordan, Saudi Arabia, Syria, Tunisia, Mauritania, Lebanon, and Morocco. Although only 32.4% were
currently teaching a student who stutters, a larger proportion (61.1%) had taught PWS in the past.
Comparing attitudes toward PWS. This phase of the
study involved collecting data from the 83 participants
in the United States. The data gathered from teachers in
Kuwait were then reduced to match participant characteristics of the data gathered in the United States to allow for
comparison of teachers attitudes toward PWS.
Data for the U.S. teachers was gathered in a previous
study (Irani & Gabel, 2008). Participants from this phase
Table 1. A summary of demographic data for the participants
in phase 1 of the study.
Demographic item

Arab (N = 258)

Age of participants

Mean = 35.4 (SD = 9.0)

Range = 2262

Gender

Male = 77
Female = 181

Age group

39 = 162
>40 = 69
No response = 27

Citizenship

Kuwaiti = 131
Egyptian = 89
Other Arab = 29
No response = 9

Years of teaching experience

Mean = 9.78 (SD = 7.9)

Range = 132

Do you stutter?

Yes = 0 No = 258

Grade level presently teaching?

Elementary = 104
Middle = 76
High = 78

Have you taught people who stutter?

Yes = 154 No = 98
No response = 6

Do you presently have a student

in your class who stutters?

Yes = 82 No = 171
No response = 5

Irani et al.: Comparison of American and Arab Teachers Attitudes Toward People Who Stutter

15

(U.S.) were identified via an Internet search of K12

schools in each state. There were 550 potential participants (names and school address) selected randomly from
this convenient population of possible teachers. The list
included teachers of all disciplines and grade levels. Each
participant was mailed a copy of the questionnaire and was
asked to complete it and return it to the researchers. The
mailed packets contained a demographic questionnaire, the
SD scale, a cover letter, an informed consent form, and a
postage-paid return envelope. Participants were excluded
from the study if they reported on the demographic questionnaire that they stuttered. It was expected that teachers
with this background might have a positive bias toward
PWS and might report different attitudes than the remaining
population.
Of the 550 questionnaires that were mailed, 101 participants returned the questionnaire (response rate of 18.36%).
Of the returned questionnaires, 83 (15.09%) were completed and usable. Of the 18 questionnaires that were not
usable, four participants reported that they stuttered. The
remaining questionnaires could not be used because the
participants did not complete the entire questionnaire.
To enable comparison of the responses of teachers in
the United States with those in Kuwait, responses collected from both countries (United States and Kuwait)
were matched on demographic variables of age, gender,
and grade presently teaching, yielding a total of 166
participants (83 American and 83 Arab). Within the Arab
participants, 37 were Kuwaiti nationals, 37 were Egyptian
nationals, eight were from other Arab countries like Syria
and Saudi Arabia, and one did not provide nationality. The
teachers were trained in their respective countries and met
the teaching certification criteria for employment by the
Ministry of Education to teach in Kuwaiti public schools.
They were all college or university trained. Table 2 summarizes demographic information for the American and
matched Arab teachers responding to the questionnaire.

Data Analysis
Descriptive statistics. Descriptive measures (means and
standard deviations) were obtained for each item on the SD
scale. Due to the scoring system applied, a higher mean
score would be indicative of a negative attitude; a lower
mean score would be indicative of a positive attitude. This
analysis was completed for data gathered from both phases
of the study. Separate analyses were conducted to answer
the two research questions of the study.
Between-group comparisons. An analysis of variance
(ANOVA) was completed for the 14 items on the SD scale
as well as the overall mean score. This was first done
to explore differences in attitudes toward PWS reported
by participants from the United States and Kuwait. Thus,
group (American vs. Arab) was the independent variable
for this analysis, and the 14 items on the SD scale and the
overall mean score were the dependent variables. The initial alpha level (level of confidence) chosen for this study
was 0.05. Due to the large number of two-way comparisons
conducted, the alpha level was adjusted to reduce the risk
of a statistical Type I error (false positive). According to
the Bonferroni procedure, the target alpha of p < 0.05 was
divided by the total number of analyses conducted (14
individual items and the overall mean score), resulting in
a more conservative alpha value of p 0.003. The use of
the Bonferroni in this case could have contributed to the
increase in Type II error (Perneger, 1998) while controlling
for Type I errors.

RESULTS
Research Question 1
Table 3 lists the number and percentage (descriptive statistics) of Arab teachers who identified 14 traits of a person
who stutters as positive (scale points of 1, 2, and 3), nega-

Table 2. A summary of demographic data for the American and matched Arab participants in
this study.
Demographic item
Age of participants

Gender

American (n = 83)

Arab (n = 83)

Mean = 44.48 (SD = 9.4)

Range = 2563

Mean = 43.41 (SD = 7.79)

Range = 2562

Male = 24
Female = 59

Male = 24
Female = 59

Yes = 0

No = 83

Yes = 0

No = 83

Yes = 0

No = 83

Yes = 0

No = 83

Do you stutter?
Do you know someone who stutters?

16

Grade level presently teaching?

Elementary = 27
Middle = 27
High = 29

Elementary = 25
Middle = 28
High = 30

Have you taught people who stutter?

Yes = 64

No = 19

Yes = 55 No = 27
No response = 1

Do you presently have a student

in your class who stutters?

Yes = 73

No = 10

Yes = 22 No = 59
No response = 2

CONTEMPORARY ISSUES

IN

COMMUNICATION SCIENCE

AND

DISORDERS Volume 39 1220 Spring 2012

Table 3. Frequency of Arab teachers rating a person who stutters on 14 traits (item 1 to 14)
on a scale of 1 to 7, with 13 being positive, 4 being neutral, and 57 being negative.
Positive response
13
Adjective
Sincereinsincere
Likablenot likeable
Trustworthynot trustworthy
Decisiveindecisive
Physically normal
physically abnormal
Reliableunreliable
Good sense of humor
Poor sense of humor
Mentally stablementally unstable
Sociableunsociable
Friendlyhostile
Strong characterweak character
Intelligentunintelligent
Employableunemployable
Emotionally adjustedemotionally
maladjusted

Neutral response
4

Negative response
57

98
87
101
112
129

38.0
33.7
39.1
43.4
50.0

151
83
93
97
112

58.5
32.2
36.1
37.6
43.4

9
88
64
49
17

3.5
34.1
24.8
19.0
6.6

125
135

48.5
52.3

120
66

46.5
25.6

13
57

5.0
22.1

88
110
88
47
93
115
76

34.2
42.6
34.1
18.3
36.0
44.6
29.5

109
66
81
86
146
64
131

42.2
25.6
31.4
33.3
56.6
24.8
50.8

61
82
89
125
19
79
51

23.6
31.8
34.5
48.4
7.4
30.6
19.8

tive (scale points of 5, 6, and 7) or neutral (scale rating

of 4). Close to one third of the Arab teachers considered a
person who stutters not likeable (34%), unsociable (32%),
hostile (35%), of weak character (48%), or unemployable
(31%). At least 20% of the respondents identified a person
who stutters as being not trustworthy (25%), having a
poor sense of humor (22.1%), mentally unstable (24%), or
emotionally maladjusted (20%). A quarter of the teachers or
more reported a neutral standing (rating of 4) rather than
committing to a positive or negative direction.

Research Question 2
Descriptive statistics. Table 4 lists the mean score and
standard deviations for each of the 14 items and the overall
mean score on the SD scale. The scores on the individual
items on the SD scale for Group 1 (i.e., American teachers)
ranged from 1.93 to 2.94 and for Group 2 (i.e., Arab teachers) from 2.84 to 4.37, indicating that participants from
both groups reported overall positive to neutral attitudes toward PWS. On the SD scale used in this study, a score of
4 indicates neutral attitudes, lower scores indicate positive
attitudes, and higher scores indicate negative attitudes. The
overall mean score on the SD scale for Group 1 was 2.36
(SD = 1.12) and for Group 2 was 3.35 (SD = 0.78).
Between-group comparisons on the SD scale. An
ANOVA for each item on the SD scale was completed to
explore any significant differences between American and
Arab teachers reported attitudes toward PWS. Results are
displayed in Table 4 and indicate significant differences (p
0.003) on 10 items. These 10 items include likeablenot
likeable, trustworthynot trustworthy, physically normalphysically abnormal, good sense of humorpoor sense
of humor, mentally stablementally unstable, sociableunsociable, friendlyhostile, strong characterweak character,
employableunemployable, and emotionally adjustedemo-

tionally maladjusted. It should be noted, however, that Arab

teachers in general reported positive to neutral attitudes
toward PWS on most of the items on the SD scale, as
indicated by the mean scores for each item (<4 indicates
positive attitudes). For the SD item, strong characterweak
character, the mean score for Arab teachers was found to
be 4.37 (SD = 1.59), indicating a slightly negative response
for that one particular characteristic.
An ANOVA was conducted for the overall mean score
on the SD to determine overall group differences in attitudes toward PWS. The results are displayed in Table 4
and suggest a significant difference between American and
Arab teachers in their overall attitudes toward PWS (p
0.003). A mean score of 2.36 was reported for the American teachers and 3.35 for the Arab teachers. Thus, both
American and Arab teachers reported positive attitudes,
with American teachers reporting slightly more positive attitudes overall.

DISCUSSION
This study used a 14-item SD scale to examine Arab teachers attitudes toward stuttering. Additionally, the study examined crosscultural (AmericanArab) differences in K12
teachers attitudes toward PWS as reported on an SD scale.
To answer the question of what attitudes Arab teachers
report toward PWS, we analyzed descriptive statistics for
a group of Arab teachers from Kuwait who responded to
the 14-item SD scale. A majority of the teachers responding to the survey reported neutral attitudes toward PWS on
all 14 items. However, it is important to note that close to
one third of the teachers considered PWS as not likeable,
unsociable, hostile, of weak character, or unemployable.
Although it is encouraging that a majority of the Arab
teachers reported neutral to positive attitudes on all items

Irani et al.: Comparison of American and Arab Teachers Attitudes Toward People Who Stutter

17

Table 4. Results of a comparison of responses by the American teachers (n = 83) and the Arab
teachers (n = 83) for each item on the semantic differential scale.
American teachers
Adjective

Arab teachers

SD

SD

F value

p value

Sincereinsincere
Likablenot likeable
Trustworthynot trustworthy
Decisiveindecisive
Physically normalphysically abnormal
Reliableunreliable
Good sense of humorpoor sense of humor
Mentally stablementally unstable
Sociableunsociable
Friendlyhostile
Strong characterweak character
Intelligentunintelligent
Employableunemployable
Emotionally adjustedemotionally
maladjusted

2.27
2.30
2.17
2.86
2.06
2.23
2.39
2.22
2.94
2.42
2.46
2.33
1.93
2.55

1.29
1.33
1.28
1.51
1.33
1.34
1.31
1.51
1.58
1.28
1.35
1.52
1.22
1.39

2.91
3.13
3.22
3.46
2.88
2.84
3.42
3.48
3.98
3.34
4.37
2.96
3.17
3.71

1.60
1.59
1.77
1.63
1.63
1.66
1.76
1.54
1.84
1.63
1.59
1.41
1.89
1.57

8.31
13.25
19.19
6.10
12.57
6.92
18.46
28.60
15.14
16.18
70.15
7.90
25.24
25.18

0.004
0.000*
0.000*
0.015
0.001*
0.009
0.000*
0.000*
0.000*
0.000*
0.000*
0.006
0.000*
0.000*

Semantic Differential mean

2.36

1.12

3.35

0.78

43.27

0.000*

*p .003.

of the scale, a fairly large number of teachers also reported

relatively negative attitudes. These results thus lend some
support to the study of Arab parents attitudes toward stuttering, reported by Al-Khaledi et al. (2009). They found
that half of the respondents believed that PWS should not
work in influential jobs and held stereotypical beliefs that
PWS are shy or fearful.
To answer the question of whether there are quantitative
and qualitative differences in attitudes reported by Arab and
American K12 teachers toward PWS, we compared the
mean scores reported by each group. Both groups reported
generally positive attitudes toward PWS, but the American teachers reported significantly more positive attitudes
toward PWS. Although the report of generally positive
attitudes toward PWS by the American teachers appears to
follow a trend that was noted by Irani and Gabel (2008),
there is no previous research exploring the attitudes of
Arab teachers. It should be noted, however, that the Arab
teachers reported positive to neutral attitudes toward PWS
with mean scores for each item on the SD scale around 4
or slightly lower (lower scores on the SD scale indicate
more positive attitudes).
One possible reason for this difference in attitudes could
be due to demographic variables such as prior experiences
with students who stutter. Seventy-seven percent of the U.S.
respondents had taught a student who stutters, and only
66.3% of the Arab respondents reported teaching a student
who stutters. Additionally, 88.0% of the U.S. respondents
reported currently teaching a student who stutters compared
to only 27.2% of the Arab respondents. According to Klassen (2002), individuals who have long-standing contact or
familiarity with a person who stutters reported fewer negative stereotypes than the general population. Thus, considering that a majority of teachers from both groups reported
teaching a student who stutters could be an important contributor to the responses obtained on the SD scale.

18

CONTEMPORARY ISSUES

IN

COMMUNICATION SCIENCE

AND

The results of this study, although not directly comparable to the Al-Khaledi et al. (2009) study, do indicate a
need to disseminate scientific information about the cause
of stuttering and its impact on the individual in Kuwait
and possibly other Arab-speaking countries. The Al-Khaledi
et al. study used the POSHA-E scale to explore attitudes,
knowledge, and beliefs that Arab parents in Kuwait have
about stuttering and found that negative stereotypes, misconceptions about stuttering, cultural beliefs, and a lack of
awareness of the disorder among parents in Kuwait exist.
Similarly, the current study found that teachers in Kuwait
reported less positive attitudes toward PWS as compared to
their U.S. counterparts. Information regarding the reasons
for their responses was not gathered as part of this study.
Abdalla and Al-Saddah (2009) indicated that teachers in
Kuwait possibly lack adequate knowledge about stuttering,
which negatively affected the school experiences of the
PWS who were interviewed.

Limitations and Future Directions

The major limitations of this study include the small
sample size for each group and the lower response rate for
the group of American teachers responding to the study.
Additionally, the low response rate received from both
populations could be reflective of a positive response bias.
Seventy-seven percent of the U.S. respondents and 66.3%
of the Kuwait respondents had taught a student who stuttered in their class, and 88.0% of the U.S. respondents
reported currently teaching a student who stutters compared to 27.2% of the Kuwait respondents. Thus, familiarity with the population under study could play a role in
the response patterns obtained in this study. The use of
alternate implicit methods such as those suggested above
would allow one to further document and corroborate these
results. Additionally, a combination of implicit and explicit

DISORDERS Volume 39 1220 Spring 2012

measures of attitudes could be used to explore and gain a

deeper understanding of the effect that education and experiences with PWS have on peoples attitudes toward PWS.
Future studies could use a mixed methods design to
assess teachers views about stuttering and the school
experiences of PWS to gain a more holistic understanding
of teachers attitudes toward stuttering and how that affects
students who stutter in the schools, in both the United
States and Kuwait, and possibly other countries as well.

Conclusion

perceptions of stutterers. Journal of Speech and Hearing Disorders, 55(1), 7581.

Cooper, E. B., & Cooper, C. S. (1996). Clinician attitudes toward
stuttering: Two decades of change. Journal of Fluency Disorders, 21, 119135.
de Britto Pereira, M. M., Rossi, J. P., & Van Borsel, J. (2008).
Public awareness and knowledge of stuttering in Rio de Janeiro.
Journal of Fluency Disorders, 33(1), 2431.
Doody, I., Kalinowski, J., Armson, J., & Stuart, A. (1993).
Stereotypes of stutterers and nonstutterers in three rural communities in Newfoundland. Journal of Fluency Disorders, 18,
363373.

A limited number of studies have explored attitudes and

beliefs about stuttering across various cultural groups. To
date, only two studies have explored stereotyping of PWS
in Arabic-speaking countries. Thus, the purpose of the
current study was to add to our knowledge of attitudes
toward PWS in Kuwait and to explore cultural differences
in attitudes towards PWS by K12 teachers using a 14-item
SD scale.
The results indicate that a majority of teachers from Kuwait reported neutral to positive attitudes toward PWS on
the SD scale. However, close to one third of the teachers
reported relatively negative attitudes toward PWS on items
relating to social skills and employability. A comparison of
both groups of teachers indicated reports of positive attitudes; however, the American teachers reported significantly
more positive attitudes as compared to the Arab teachers.
The differences found between the two groups indicates a
need for future studies using different methods to corroborate the results of the current study and explore factors,
including familiarity or long-standing contact with a person
who stutters, that may be responsible for the difference in
responses.

Dorsey, M., & Guenther, K. R. (2000). Attitudes of professors

and students toward college students who stutter. Journal of Fluency Disorders, 25, 7783.

REFERENCES

Irani, F., & Gabel, R. (2008). Schoolteachers attitudes towards

people who stutter: Results of a mail survey. Canadian Journal
of Speech-Language Pathology and Audiology, 32(3), 129134.

Abdalla, F., & Al-Saddah, A. (2009, October). Stuttering and

teachers in Kuwait: The story so far. Paper presented at the
International Stuttering Awareness Day (ISAD) online conference. Retrieved from http://www.mnsu.edu/comdis/isad12/papers/
abdalla12.html.
Al-Khaledi, M., Lincoln, M., McCabe, P., Packman, A., &
Alshatti, T. (2009). The attitudes, knowledge and beliefs of
Arab parents in Kuwait about stuttering. Journal of Fluency
Disorders, 34, 4459.
Allport, G. W. (1986). The nature of prejudice (25th anniversary
ed.). Reading, MA: Addison-Wesley.
Anderson G. R. (1987). Paternalism. In G. R. Anderson & V. A.
Glesnes-Anderson (Eds.), Health care ethics: A guide for decision makers (pp. 177191). Rockvile, MD: Aspen.
Bebout, L., & Arthur, B. (1992). Cross-cultural attitudes toward
speech disorders. Journal of Speech and Hearing Research, 35,
4552.

Gabel, R. M. (2006). Effects of stuttering severity and therapy

involvement on attitudes towards people who stutter. Journal of
Fluency Disorders, 31(3), 216227.
Gabel, R. M., Blood, G. W., Tellis, G. M., & Althouse, M. T.
(2004). Measuring role entrapment of people who stutter. Journal of Fluency Disorders, 29, 2749.
Ham, R. E., (1990). What is stuttering?: Variations and stereotypes. Journal of Fluency Disorders, 15, 259273.
Heite, L. B. (2000, October). Icelandic teachers attitudes towards
stuttering and classroom decision making. Paper presented at the
International Stuttering Awareness Day (ISAD) online conference. Retrieved from http://www.mnsu.edu/comdis/ISAD3/papers/
heite/heite3.html.
Horsley, I. A., & FitzGibbon, C. T. (1987). Stuttering children:
Investigation of a stereotype. British Journal of Disorders of
Communication, 22, 1935.
Hurst, M. I., & Cooper, E. B. (1983a). Employer attitudes toward
stuttering. Journal of Fluency Disorders, 8, 112.
Hurst, M. I., & Cooper, E. B. (1983b). Vocational rehabilitation counselors attitudes toward stuttering. Journal of Fluency
Disorders, 8, 1327.

Irani, F., Gabel, R., Hughes, S., Swartz, E. R., & Palasik, S. T.
(2009). Role entrapment of people who stutter reported by K12
teachers. Contemporary Issues in Communication Science and
Disorders, 36, 4554.
Klassen, T. R. (2002). Social distance and the negative stereotype
of people who stutter. Journal of Speech-Language Pathology
and Audiology, 26, 9099.
Lass, N. J., Ruscello, D. M., Pannbacker, M., Schmitt, J. F.,
Angela, K. M., Mussa, A. M., & Lockhart, P. (1994). School
administrators perceptions of people who stutter. Language,
Speech, and Hearing Services in Schools, 25, 9093.
Lass, N. J., Ruscello, D. M., Schmitt, J. F., Pannbacker, M. D.,
Orlando, M. B., Dean, K. A., & Ruziska, J. C. (1992). Teachers perceptions of stutterers. Language, Speech, and Hearing
Services in Schools, 23, 7881.

Burley, P. M., & Rinaldi, W. (1986). Effects of sex of listener

and of stutterer on ratings of stuttering speakers. Journal of Fluency Disorders, 11(4), 329333.

MacKinnon, S. P., Hall, S., & MacIntyre, P. D. (2007). Origins

of the stuttering stereotype: Stereotype formation through anchoring-adjustment. Journal of Fluency Disorders, 32, 297309.

Collins, C. R., & Blood, G. W. (1990). Acknowledgment and

severity of stuttering as factors influencing nonstutterers

Manning, W. H. (2010). Clinical decision making in fluency disorders (3rd ed.). Albany, NY: Delmar-Cengage Learning.

Irani et al.: Comparison of American and Arab Teachers Attitudes Toward People Who Stutter

19

Mayo, R., Mayo, C. M., Jenkins, K. C., & Graves, L. R. (2004).

Public knowledge of stuttering: Cross-cultural perspectives.
SpeechPathology.Com, 1 Retrieved from http://search.ebscohost.
com/login.aspx?direct=true&db=edsref&AN=BGBFDCCFE&site=
eds-live.
Perneger, T. V. (1998). Whats wrong with Bonferroni adjustments.
British Medical Journal, 316(7139), 12361238.
Ruscello, D. M., Lass, N. J., & Brown, J. (1988). College students perceptions of stutterers. NSSLHA Journal, 16, 115120.
Silverman, F. H. (1977). Research design in speech pathology and
audiology. Englewood Cliffs, NJ: Prentice-Hall.
Silverman, F. H. (1996). Stuttering and other fluency disorders
(2nd ed.). Needham Heights, MA: Allyn & Bacon.
Silverman, F. H., & Bongey, T. A. (1997). Nurses attitudes
toward physicians who stutter. Journal of Fluency Disorders, 22,
6162.

Smart, J. (2001). Disability, society, and the individual. Gaithersburg, MD: Aspen.
St. Louis, K. O. (2005, October 18). A global project to measure
public attitudes about stuttering. The ASHA Leader.
White, P. A., & Collins, S. R. (1984). Stereotype formation by
inference: A possible explanation for the stutterer stereotype.
Journal of Speech and Hearing Research, 27, 567570.
Woods, C. L, & Williams, D. E. (1976). Traits attributed to stuttering and normally fluent males. Journal of Speech and Hearing Research, 19, 247266.
Yeakle, M. K., & Cooper, E. B. (1986). Teacher perceptions of
stuttering. Journal of Fluency Disorders, 11, 345359.
Contact author: Farzan Irani, Department of Communication Disorders, 601 University Drive, Texas State UniversitySan Marcos,
San Marcos, TX 78666. E-mail: firani@txstate.edu.

Silverman, F. H., & Paynter, K. K. (1990). Impact of stuttering

on pereptions of occupational competence. Journal of Fluency
Disorders, 15, 8791.

20

CONTEMPORARY ISSUES

IN

COMMUNICATION SCIENCE

AND

DISORDERS Volume 39 1220 Spring 2012