UCF APA Format Term Paper in 2006

The Use of Bibliotherapy to Help Adults Who Stutter By

Promoting Personal Growth

By: Matthew Crowner

I. Introduction

Stuttering affects about 1 out of a 100 adults in

their personal and professional lives. Stuttering or stammering is a condition that has psychological and organic components. “Stuttering is a communication problem in which spoken words or sounds are involuntarily repeated, drawn out, not completed or skipped.” Healthwise (2004) Many aspects of stuttering such as: exact cause, environmental and emotional triggers, and a cure are still a mystery to medicine.

There are many neurological theories to the cause of stuttering; including coordination between the left and right hemispheres of the brain and also timing between impairments between muscle functions used during speech. “No, people who stutter do not have brain damage. There is no evidence of brain damage on neurological exams, CT scans or standardized neuropsychological tests (designed to be very sensitive to brain damage).” Foster (1996) It is rare to have stuttering as a result of brain damage. When it comes to stuttering neurology and psychology are intertwined. “Our emotional state influences, and is influenced by, the activity of our brain. Unless one holds over-simplistic and outdated views of the way the brain functions, it should come as no surprise that our emotional state may be capable of influencing other aspects of brain functioning. In athletics, it is common knowledge that one's psychological state can affect one's performance on tasks that rely on motor performance.” Foster (1996) Emotional factors may onset stuttering and agitate the condition afterwards. “Environmental factors, such as a stressful environment, or biological influences, such as developmental delay, may trigger stuttering, especially in people who have inherited the tendency to develop the disorder.” Foster (1996)

Anxiety and stuttering are closing related. Stuttering can be triggered and prolonged by emotional tension; usually caused by social situations and fear of embarrassment. “Much research has suggested that those who stutter are likely to be anxious…. There are good reasons to believe that the anxiety of those who stutter is related to expectancies of social harm… Results suggested that, as a group, a clinical population of people who stutter has anxiety that is restricted to the social domain…. These results were taken to suggest that those who stutter differ from control subjects in their expectation of negative social evaluation, and that the effect sizes are clinically significant.” Messenger, Onslow, Packman, and Menzies (2004) If the person feels calm, collective, and confident to any audience; they may be more fluid; since anxiety negatively exacerbates stuttering. “Findings indicate that trait anxiety is higher among people who stutter compared to fluent speakers, thus indicating that anxiety is a personality trait of people who stutter. State anxiety in social communication is higher among severe stutterers as compared to mild stutterers and fluent speakers. Thus,

state anxiety is related to stuttering severity” EzrtiVinacour and Levin (2004)

Helping a person control their feelings and be nonchalant can reduce stuttering. “Persons who stutter often report their stuttering is influenced by emotional reactions, yet the nature of such relation is still unclear. Psychophysiological studies of stuttering have failed to find any major association between stuttering and the activity of the sympathetic nervous system. A review of published studies of heart rate in relation to stressful speech situations indicate that adults who stutter tend to show a paradoxical reduction of heart rate compared with non-stuttering persons.” Alm (2004) Signs of nervousness empirically seen by heart rate are related to increased stuttering. Bibliography may help with this negative response to stress and aid fluid speech.

II. Review Of Literature

Helping stuttering can be more efficient by

treating and concentrating the elements that can be controlled. Moreover, allowing the one who stutters to gain acceptance and a sense of peace. This reduces anxiety, embarrassment and comes full circle to also reducing stuttering. “It is well documented that adults can control stuttering if they use certain novel speech patterns referred to generically as prolonged-speech.” Cream (2003)

Although optimistically, stuttering maybe reduced

significantly, it is very important to view each client as a person; one who feels poorly and sometimes is melancholy about the stuttering on their professional and personal lives. “Stuttering persists after therapy, but PS does provide a form of control for it… Despite the novel experience of control the speech motor system after therapy, adults continue to experience feelings of being different from people who do not stutter.” Cream (2003) This study reported that stutters (even after treatment) felt so “frustrated” they avoided social, educational, and occupational opportunities. Treating stuttering is more than treating stutters it is helping people who stutter and helping their attitude as apart of being functional.

Rhythmic Literature has been used since ancient times as a means to heal. “Hexameter is the oldest rhythmic verse in ancient Greece…the Iliad and the Odyssey… which results in a convenient and regular breathing pattern for the speaker… Further more, data from many other studies investigating influences of low-frequency breathing patterns on [Hexameter recitation verse] HRV likely contain cardio-respiratory synchronization.” Cream (2003). (2004) The body and brain respond positively to rhythm. “Turner and Poppel (1983) have demonstrated that the use of meter in poetry is intrinsically connected with human biology, the rhythms of respiration, the dictates of the human neuro-physiology, and the human hearing mechanism. Poetic rhythm can be seen as a neuro-physiological command evoked by the brain’s demand for familiarity… The study of medicine reinforces sensitivity to rhythm and meter.” Rojcewicz and Stephen (1999) Poetry as well as other studies of literature can promote emotional and physical health.

Using Bibliotherapy Therapy, especially incorporating a large portion of this practice, poetry; can help people who stutter. “Bibliotherapy has been defined as ‘the therapeutic use of literature with guidance or invention from a therapist’ (Cohen 1994a. p. 40, 1994b)… According to this perspective, the therapist uses literature either to provide a focus for interventions or to advise the patient on specific reading (Hynes 1988). (Lanza 1996) refers to pathways in which Bibliotherapy ‘can provide emotional catharsis, active problem solving and personal insight.’… Poetry therapy has been defined as ‘the intentional use of poetry ... for healing and personal growth. (MIR INC. Bibliography/Poetry Library, MIR Glossary) McArdle, Hallam, and Byrt (2001) Literature and poetry can have profound affects on the psyche and the functions of the body; which includes speech.

Bibliotherapy can have a positive effect on the affective domain of a person, increasing their confidence and having a strong inner locus of control. Bibliotherapy can help stuttering clients deal with emotional problems from their personal pasts and help calm nervousness about future embarrassments by gaining a sense of normalcy. “Bibliotherapy, in particular can help adolescents understand that problems related to family breakdown, abuse, or placement in care are predictable, and that other people have dealt with them before.” Pardeck (1994) Poetry therapy can affect a persons whole life and increase their success in speaking by increasing the wholeness of themselves. “Poetry therapy works with participants toward the following therapeutic and development goals: 1. To promote change, increase coping skills, and improve adaptive functions in order to work through underlying conflicts. 2. To heighten participants reality orientation. 3. To enable participants to ventilate overpowering emotions and release tension. 4. To encourage positive thinking and creative problem solving. 5. To strengthen participants’ communication skills, especially their willingness to listen carefully and speak directly. 6. To enhance participants’ self understanding and accuracy in self perception. 7. To encourage participants’ awareness and personal relationships. To encourage participants capacity to respond to vivid images and concepts and the feelings aroused by them. 9. To encourage or balance participants’ creativity, self expression, and their greater self-esteem. 10. To help participants experience liberating and nourishing qualities of harmony and beauty. 11. To increase participants’ spontaneity and capacity for playing with words and ideas. 12. To help participants find new meaning through new ideas, insights, and/or

information. 13. To help participants integrate the different aspects of the self for psychological wholeness.” Rojcewicz and Stephen (1999) These thirteen goals all can aid a person communicate better, especially number five where it is implicitly cited. These are the goals of Poetry Therapy (Bibliotherapy), which many affect speaking indirectly. A stuttering can begin by a traumatic event that a person can overcome by resolving their emotional issues that go beyond just biological concerns. A person who stutters can become more comfortable with any given audience and become more fluid; Bibliotherapy may help.

III. Methodology

1. Subjects

a.Location: Two Poetry Semesters A and B at Seminole

Community College

b.Dean and teacher approval before experiment begins

3. The subjects will attend a poetry class for 2

semesters and give one oral presentation at least every other class. The subjects will be recorded and fill out a selfevaluation survey after each presentation, the FNE (Fear of Negative Evaluation, Watson and Friend). The baseline will be taken from one sample the two weeks of classes from a randomized system so that the speakers are unaware of any changes; the speakers will not know if the from the first day of the class to the end of the experiment which recordings will be used. The operator of the experiment will use recordings near the beginning and end of each semester. If a FNE survey is extremely negative for a particular day chosen for that day’s recording evaluation a another recording close to that date with a more typical survey from that student will be used. This is to account for finite outside factors that may influence scores for that one day.

1. Subjects:

1.N=40

2.10 male and 10 female stutters as the experimental group. 20 regular SCC students

3.All subjects must have a High school Diploma and:

either 2.5 GPA with a 600 minimum on the Verbal SAT or a 3.0 in College English Composition and take no more than 13 credit hours and have work schedules that

comply

4.All subjects must sign a letter of intent on completing the program (both semesters) and to be

recorded during each oral presentation

5.Subjects will be compensated for the fee of tuition and a stipend upon completion of the courses and project.

C.

1. The experiment will be conducted by two Ph.D SLP’s who at least one will attend each class and administer surveys and conduct recordings. Recordings will be analysis blindly by an independent SLP and 15% of these will go under review for accuracy by another party to maintain internal validly. The recording of each oral presentation is necessary to improve the speakers’ fluency at a wider “audience” and to record for recorders.

D.Variables:

The treatment and independent variable is taking

the poetry class and giving oral presentations. The dependent variable for increased fluency: This may show improvement for all subjects. The dependant variables are the students fluency, their self-evaluations (FNE) and how they compare.

E.Measures:

The baseline is a sample taken during the first two weeks. This is followed by a sample taken two weeks before the end of each semester and another sample taken two weeks into the second semester. A total of four random recordings are recorded during two semesters of Poetry classes per student. The surveys will be pared with the given oral presentations to compare changes and to evaluate any circumstantial issues the presenter might have had that particular day. The surveys will numerically be scaled and graphed for looks of overall improvement in the attitude toward public speaking. “Very little” will be valued as a “1” increase by one each time to “Much” which will be classified as a “4”. Each survey will be averaged and collectively averaged with the two independent groups (stutters or the control group.)

F.Method For Statistical Analysis:

The four sections of survey information will be a 2 by 2 and the means of the surveys will be compared for the control and experimental group using ANOVA to test for change in affective domain after oral presentations over time.

The findings for the recordings will be graded by comparison of MLU mean. The data will be compiled into a 2 by 2 group for the effect of treatment on the control and experimental groups and tested at a P<.05. An ANOVA will be run to test the effects of the groups by the treatment. If the ANOVA is not significant then a Post HOLC Sceffe test will be used to analyze the change of fluency of the control and experimental groups by comparing each MLU score with adjacent and nonadjacent domains of data.

References

Alm (2004). Stuttering, Emotions, and Heart Rate During Anticipatory Anxiety: A Critical Review. J Fleuncy Disord., 29, 123-133. Cream, A. (2003). International Journal of Language and Communication Disoders. , 38, 379-395.

Cysarz, D., Bonin, D., Lackner, H., Heusser, P., Moser, M., &

Bettermann, H. (2004). Oscillations of Heart Rate and Respiration Synchronize During Poetry recitation. Am J Phsiol Heart Cir, 2, 579-587.

Ezrti-Vinacour, R., & Levin, I. (2004). The Realationship

Between Anxiety And Stuttering: a Multidimensional Approach. J Fleuncy Disord., 29, 135-148. Foster, D. (1996). Neuropsychology of Stuttering. Retrieved August 22, 2006, from

https://www3.sympatico.ca/dforster/Stutt/FAQ.html#treaments

Healthwise. (2004, November 15). Yahoo Health. Retrieved August 22, 06, from

https://health.yahoo.com/topic/parenting/behavior/article/he althwise/ue5033;_ylt=AmlgCB6ELNQ6XnHpXAODTZEUu7cF

McArdle, S., Hallam, S., & Byrt, R. (2001). Fiction, Poetry and Mental Health: Expressive Therapeutic uses of Literature. Journal of Pyschiatric and Mental Health Nursing , 8, 517524.

Messenger, M., Onslow, M., Packman, A., & Menzies, R. (2004). Social Anxiety in Stuttering: Measuring Negative Social Expectancies. , , .

Pardeck, J. (1994). Using Literature to Help Adolescents Cope with Problems. Adolescence, 29, 421-427.

Rojcewicz, & Stephen (1999). Medicine and Poetry: The Sate of the Art Therapy. International Journal of Arts Medicine, 6, 4-9.

14

If you need to type anything after the reference list then start it on this page