Eye to eye: Stuttering and the gaze

eye

This is a review of the article, "Avoidance of eye gaze by adults who stutter," from the research publication the Journal of Fluency Disorders., 37 (2012) pgs 263-274.

The research was conducted and documented by Robyn Lowe, Adam J Guastella, Nigel T.M. Chen, Ross G. Menzies, Ann Packman, Sue O'Brian, Mark Onslow. They are with the Australian Stuttering Research Centre and the Brain & Mind Research Institute, both of the University of Sydney, Australia.

The experiment

The experiment described in this article examines how people who stutter (PWS) display behaviours associated with social anxiety disorder, namely the avoidance of eye contact, and the implications of this behaviour. Social anxiety disorder occurs higher among stutterers than in the general population, with estimates of between 45% - 60% experiencing it, making it the most common type of anxiety disorder amongst PWS. The condition is characterized by a disproportionate fear of social situations, and an overriding, chronic fear of social humiliation and embarrassment.

The experiment consisted of sixteen PWS and sixteen non-stuttering individuals to act as a control group. Each person gave a three minute speech, in front of a video camera, on a neutral topic. While they spoke they watched a screen displaying an audience, purportedly listening to their speech and reacting to it. In actual fact the audience was pre-taped, and each audience member had been instructed to display either approving, disapproving or neutral expressions. The eye movement of the speakers were tracked as they spoke and watched the audience on the screen.

Results

The results of the experiment showed that the PWS looked less overall at the audience members than the control group, and more at the background. They also looked less at the positive, friendly faces. They did not have a greater tendency to look at the disapproving faces.

Why would PWS avoid looking at an encouraging, friendly face when giving a speech to an audience? Those suffering from social anxiety are inclined on the whole to disregard positive social information, and to focus more on their own inner feelings rather than external signals and cues. Their avoidance behaviours are perpetuated by the belief that they are continually being harshly judged by others.

Maintaining beliefs and behaviours

It is human nature to not want our beliefs challenged, particularly beliefs about ourselves. Maintaining beliefs and behaviours is, in the end, more comfortable than change. To acknowledge a positive response infers a possibility of change, of taking further risk, of the possibility of seeking acceptance. If it is true that many stutterers in treatment suffer from social anxiety disorder, it is one possible explanation for the tendency for many to relapse and to fail with any long-term speech maintenance program. As the article states:

These results may begin to explain why long-term speech treatment gains are impaired in those with anxiety related mental conditions. SLPs can provide clients with evidence that self-focused attention and avoidance of social stimuli may play a role in maintaining anxiety. Further, this information may alert SLPs to clients who would benefit from psychological interventions such as cognitive behaviour therapy (CBT). CBT is designed to reduce self-focused attention and increase the processing of disconfirmatory information from the external environment.

Conclusion

This research uncovers common behaviour patterns of PWS characteristic of those suffering from social anxiety disorders, even though the subjects were not chosen based on any evaluation of the disorder. Further research in this area could indicate more effective and holistic treatment for people who stutter that would improve outcomes.

The above is a summary and subjective interpretation of an article. Those interested in this topic are recommended to read the original article in it's entirity.