Ben Bolton-Grant

Background: Against the backdrop of hundreds of studies documenting negative stereotypes and stigma held by the public regarding people who stutter, a substantial number of investigations have attempted to improve public attitudes and measure their results with a standard instrument, the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S). Although the majority of interventions have been moderately to quite successful, a substantial minority have been unsuccessful. Purpose: This study sought to determine what properties of interventions and demographic variables were predictive of least to most successful interventions. Preliminary to that, however, it required the division of samples into clearly differentiated categories of success. Method: Twenty-nine different study samples containing 934 participants were categorized into four levels of success of interventions according to pre versus post POSHA–S summary mean ratings. Intervention properties and demographic characteristics and for each success category were analyzed for their predictive potential of successful attitude improvement. Results: Interventions characterized by high interest or involvement, meaningful material, and content that respondents found to be relevant, but not excessive, tended to be associated with more successful interventions. In contrast, demographic variables were weak predictors of intervention success. Conclusion: The authors hypothesize that maximally effective interventions reflect optimal matches between participant characteristics and intervention features, although the critical variables in each are not yet apparent.

Previous studies show that interventions to improve attitudes toward stuttering yield inconsistent results on the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S). Comparisons of pre- and post-intervention samples indicate that success depends on the percentage of respondents who improved rather than the magnitude of change. A “crossover” effect emerged: respondents with the most positive pre-test attitudes showed lower post-test ratings, whereas those with the most negative pre-test attitudes showed the greatest improvement; respondents with intermediate attitudes showed little change. Similar patterns appeared in non-intervention samples, where one-third fell into positive, minimal, or negative change groups. The study analyzed 943 respondents from 29 intervention samples classified as unsuccessful (U), marginally successful (MS), successful (S), or very successful (VS), plus 345 respondents from 12 non-intervention samples. Using non-intervention data as a baseline, we calculated percentages shifting among the three change groups. In the VS category, interventions moved people from the negative and minimal change groups into the positive change group. In the S category, gains in the positive change group came from the negative change group. In the MS category, all intervention-related changes began in the negative change group, yielding modest growth in the positive and minimal change group. The U category showed shifts into both the positive and negative change group, mainly reducing the minimal change group. These findings suggest that interventions to improve attitudes toward stuttering should apply strategies tailored to individuals in positive, minimal, and negative change groups.