Improving the University Experience

Mahmoud Elsherif, a post-doctoral researcher at the University of Birmingham and key player in the FORRT initiatives around research reproducibility and neurodiversity, recently set up an online event, “The Hidden Voices of People who Stutter: Focussing on Higher Education”. I was one of six presenters. The event is available to watch back online. I’ll summarise proceedings here.

I was first to speak, describing Heterogeneity in Stuttering. I described one of my studies in progress which shows that fewer than 1% of stutterers engage with the stuttering community. This creates difficulties with representation for, and representativeness of, people who stutter. Broad generalisations based on work with participants from the stuttering community may not generalise to the more than 99% of stutterers who do not engage with the community. No particular style of stuttering advocacy can be considered to have a popular basis in these very low engagement levels. Rather, an engagement level this small creates a correspondingly large “nothing about us without us” problem. The situation presents unique challenges for growth and development of the stuttering community.

It follows that we do not know what university students who stutter might want, and we have no effective way of asking them. In the absence of any popular basis, there is a risk that advocacy could become ideologically biased. This creates a danger of dogmatic styles of advocacy which could traumatise, or re-traumatise, people who stutter. For example, students might be told they must follow certain therapies. Alternatively, students might be told they must resist certain therapies. Either extreme could be damaging, as could campaigns which promote other extreme views of stuttering. For example, attempts to counter perceived stigmas related to stuttering could have the effect of amplifying and reinforcing said stigmas. Prioritising such an agenda creates a new vicious circle for stuttering. In this vicious circle, deliberate attempts to seek out ridicule and denigration of those who stutter – even if carried out earnestly and with the aim of combatting ridicule and denigration – could instead perpetuate and intensify the perception of ridicule and denigration. Such a strategy creates a “forever campaign” within which those who stutter are perpetually diminished.

Rather than extension of such a negative and harmful prospectus, I recommended use of universal design in stuttering advocacy. Universal design is highly effective at reducing stigma, including self-stigma, because of its extremely high inclusivity – it aims to improve conditions for everyone. The classic example is ramps for building access. Such ramps are essential for many who rely on wheeled transport. They are also beneficial for those using prams, skateboards, bikes, trolleys, wheeled suitcases and so on. Everyone wins when access ramps are included as part of building design.

Universal design is particularly appropriate for those who stutter. This happens because the nature of stuttering is such that asking for accommodations can in and of itself present unique difficulties. However, with universal design, accommodations are provided to all automatically. The result is that there is no need to ask for accommodations, and universal design is therefore particularly appropriate for those who stutter. I concluded my presentation with examples of universal design appropriate for those who stutter in a university setting.

The next speaker was Ria Bernard, a speech and language therapist who holds a PhD in stuttering research and is the CEO of the charity “Action for Stammering Children”. Her presentation described the work of the charity. It amplifies the voices of children and young people who stutter, lobbies and influences policymakers, and undertakes original research of stuttering (e.g. with close partner the Michael Palin Centre for Stammering). Dr Bernard highlighted challenges facing stutterers who enter higher education. She gave examples of advocacy which the charity had recently championed. These included a Marks and Spencer name badge scheme, a film “Me and My Stammer” and a memoir, “Parts of Speech”, alongside long-running initiatives such as the “Stambassador” project. In partnership with international stuttering employment charity 50 Million Voices, and the speech and language therapist Sam Simpson, Action for Stammering Children have run a mentoring project aimed at 18–25 year olds. They have also begun a collaboration with the James Lind Alliance, seeking input from the stuttering community, and organisations which work with the stuttering community, to explore thinking about priorities for stuttering research.

James Leeper is a student on an apprenticeship scheme whose stuttering onset occurred shortly after induction, following ischaemic stroke. The stuttering was diagnosed with co-occurring functional neurological disorder. This combination led to him being put back a year in his studies. He was interviewed by Dr Elsherif about his lived experience. James Leeper explained how the experience of stuttering contributed to a substantial reappraisal of educational experience and career goals, and how he was supported by the disability team at his university. He described how the amount of his stuttering decreased over an extended period following stroke, with fluent and dysfluent experiences in differing scenarios. Adult onset stuttering is rare. It occurs for no more than about 0.2% of the population, with much of this in older people. It is unusual to hear of adult onset experiences from younger people, such as James Leeper, and I recommend listening to him.

Catherine Woolley, a speech and language therapist employed by the British Stammering Association, promoted a highlights reel from their “STAMMA” campaign. For university students, the STAMMA campaign recommends a minority model approach, with those who stutter encouraged to seek reasonable adjustments. Reference was made to a template letter, although this was unavailable at the time of the presentation. A variation of the template letter was described as having been developed with input from the NHS’s Stammering Network, for students sitting Objective Structured Clinical Examinations (OSCEs). Reference was also made to a report, “Supporting Students Who Stammer In Higher Education”, written with Claire Norman’s Stammerers Through University Consultancy (STUC) and London South Bank University.

Emma Kay described how her son, who stutters, was badly treated by the UK’s Universities and Colleges Admissions Service (UCAS). The situation she described could be summarised as a neglect of statutory duties. UCAS is a non-governmental provider of the application system for universities. It has been criticised for several questionable initiatives which seem to abuse its monopoly status, high profile and charity registration. Combined action by several groups (e.g. WeThe15) might be an effective strategy to engender improvement to the UK’s system for university and college admissions, since the issues described are unlikely to have been specific to stuttering.

Claire Tupling has nearly 20 years of experience in UK Higher Education. She drew attention to a scenario in which some speakers may feel disadvantaged due to what they perceive as restrictive, unrealistic or simply ignorant attitudes within their audiences. Examples included the promotion of time-bound initiatives such as the “three minute thesis” and the “90 second poster presentation”. Efforts made by universities to increase inclusivity and accessibility of educational provision might not yet have extended sufficiently towards those who stutter. Dr Tupling recommended going beyond request for reasonable adjustments. Her suggestion was to revise criteria for assessment of any type of presentation, with a de-emphasis on fluency.

Gillian Rudd, a speech and language therapist and a trustee of the British Stammering Association, was scheduled to give a presentation but was unable to do so due to technical difficulty. Slides were made available, which describe the British Stammering Association’s “STAMMA Research Arena”. This is a recurring online event in which a sub-group of STAMMA campaign members and supporters, or related parties, participate in question and answer sessions following presentations given by researchers.

Prospects for Further Discussion

There was a lot to take away from this event, and I recommend watching the presentations. Many of the presenters had ideas worth exploring in detail. Unfortunately, there is no forum well-suited for development of the ideas which were generated by this University of Birmingham event. As such, I’ll develop one of the discussion threads here. This follows my proposal that oral presentations should become non-compulsory. Oral presentations can be difficult for those who stutter, and therefore their removal would seem to remove a social barrier related to stuttering. However, there were counter-arguments. One of these was that presentation skills are important for some vocations and should therefore be taught at universities. Another was that presentations are important practice for interviews. Yet another was that students who did not stutter would take advantage of a provision created for those who did stutter, with the underlying rationale being a proposed reduction in workload if oral presentations became non-compulsory.

These counter-arguments have merit. However, I think they can be accommodated. One strategy doing so is to more firmly decouple “oral” from “presentation”. So, presentations would remain compulsory. However, they would no longer need to be live oral events. Presentations could at the student’s preference be prepared in advance and delivered remotely, e.g. by submission of a web link to a multimedia presentation. If a live question and answer session was required following the presentation (e.g. for cross-examination), it would also be delivered remotely, using an option in which answers could be either provided by text (e.g. using a text chat function) or orally using video link.

A crucial aspect of this proposal is that students who prefer not to present orally, or even in person, should not be required to give a reason for their preference. There are many valid reasons why a student may prefer not to present in person, and stuttering is only one of these. It seems appropriate to me for such reasons to remain private – university students are adults, and I think the choice of whether or not to disclose personal detail should be at the discretion of the student. In this way, a decoupling of “oral” and “presentation” would have broad applicability. It is universal design for presentations. Provided that the substance of the presentation (i.e. content and structure) meets assessment criteria, and that students can respond satisfactorily to live cross-examination about their presentation topic, course requirements should be met whether the presentation is or is not in person. Students wishing to improve their oral presentation skills, or to benefit from an already existing facility with oral presentation, would of course be able to present in person (which might, in turn, come at the expense of improving remote presentation skills). Students could alternatively or additionally take an optional course module focussing solely on oral presentations. For example, such provision could be similar to that provided by public speaking groups such at the “Toastmasters” network. Such a spin-off would accommodate a popular and miscellaneous desire for unabashed promotion of the manner of delivery (e.g. Obama style hyper-fluency) as being of equivalent or greater importance than the substance of oral presentations. Persons favouring such an approach could continue to do so, but the tactic would no longer gain them advantage if compulsory oral presentations were removed from the core curriculum. Instead, the presentational playing field would be levelled. The underlying rationale is that it should be substance, rather than style, which is the basis of university grade assessments.

I think this elaboration covers several objections. One exception is perhaps the need for interview practice. However, why not change interview formats along the same lines just described for student presentations? Thus, should a candidate so wish, presentation for an interview could be prepared and submitted remotely, with question and answer via text chat. Legislation would be required to ensure that candidates wishing to interview in this way are not penalised. A counterargument to this proposal is that businesses are likely want to use the interview to get an idea what a candidate is like in person, before making a hiring decision. However, I would argue a fortiori than it is preferable to disallow businesses from interviewing in such a manner. The basis of my argument is that I think using interviews to make spot judgements of personality is fundamentally unjust, and is likely to lead to bad outcomes. For example, the highly popular panel interview format favours candidates who perform well within the panel interview format, but these are not necessarily the candidates best-placed to do a particular job. In another example, in person interviews create the possibility for all manner of discriminatory activity by interviewers based on a candidate’s appearance, behaviour or background. This can occur unconsciously, and is only partially countered by implicit bias training workshops. Thus, it is not just stutterers who are disadvantaged by currently widespread interview formats. Rather, it is anyone with a neurodivergence, a disability, or simply a personality or presentation which is not optimised for the brief, high pressure settings characteristic of formal interviews.

Businesses would still need a way to assess candidates in person before making a hiring decision. They could do so by following up interviews with paid, short-term job placements. These could either be for a single, preferred candidate, in which case they would comprise an additional probationary period (e.g. of 1–2 weeks) prior to the standard probationary period (typically measured in months). Or else they could be used for comparison between several candidates, in which case they would effectively extend the interview process. This latter scenario should have consecutive placements for the candidates (e.g. 1-2 days each) to avoid a game show style scenario in which candidates are competing with each other throughout the placement period for a single job.

The interviewing proposals just outlined may seem fantastical and unrealistic. However a very similar mechanism already operates de facto for many UK industries. This occurs through employment agencies. Casualisation of the workforce by successive British governments has created a “try before you buy” system which is by now engrained in many business sectors. This employment agency system could be formalised by increasing legal protections to ensure that candidates have the right to interview in the style of their choosing. Doing so could lead to improved matching between candidate skills and business needs, to the benefit of all parties involved.

Comments are open – I’d be very interested to hear opinions and ideas for ways to improve the presentation and interview processes, or anything else, for students who do and do not stutter. Thanks again to Mahmoud Elsherif for setting up the Birmingham event, and for their continued dedication to improving representation for those who stutter.