Research Update: Barriers And Opportunities with Videoconferencing for People Who Stutter

By Karin Patzke and Shaomei Wu

As one of our initial projects, AImpower.org has started to conduct preliminary research focusing on understanding the impacts of videoconferencing tools for people who stutter. Here we share some initial findings and excerpts from a research paper currently under review.

While it can be easy to say that a technology is all “good” or all “bad”, the data indicate that the reality is more complicated. Videoconferencing tools like ‘Zoom’ and ‘Skype’ create new opportunities for people who stutter to manage their speaking environment and even conceal their stuttering, but the design of VC technologies has also posed new challenges for people who stutter. Below is an abbreviated version of the research paper which outlines the benefits and challenges of videoconferencing platforms for people who stutter. We hope you find this update to our work informative and engaging. We welcome your thoughts and questions in the comment section and appreciate the time you take to leave constructive comments!

On Zoom, your voice is so important for you to communicate than before. They can not see your body, your gestures. Your words carry more meaning. You have to impress people with your words. For someone who stutters, that [videoconferencing] is a disadvantage.

Research Interview Participant, 2022

As we enter a new era in which videoconferencing becomes the dominant and normalized mode for interpersonal and professional communications, videoconferencing comes with unique challenges, such as the reduction of non-verbal cues (Bailenson 2021, Neate et al 2022), turn-taking confusion, connectivity/technical difficulties, and generally “Zoom Fatigue.” It is crucial to understand videoconferencing’s impact on and potential challenges for people who stutter. In this work, we explore the experience of people who stutter with videoconferencing technologies through interviews with adults who stutter to understand the challenges, benefits, and strategies for people who stutter during video conferences, in comparison to in-person meetings. We hope our insights will uncover unique challenges for the stuttering community while contributing to the design and development of a more inclusive video-based communication environment for all.

Our research is inspired by the recent breakthrough in stuttering research and therapy that emphasizes the subjective experience of stuttering rather than the perspectives and observations of the listeners (Constantino et al 2022, Tichenor and Yaruss 2019). This epistemic shift led the field to understand that the biggest struggle with stuttering moments is not the disfluencies but the feeling of “being stuck” and and “losing control” (Plexico et al 2005, Tichenor and Yaruss 2019), and people who stutter find it most satisfying when their speech is spontaneous, regardless of how fluent it is (Constantino et al 2022).

Notes on Our Methods

For this research we conducted fourteen semi-structured interviews with adults who stutter from the United States and the United Kingdom to learn about their experience of videoconferencing. The participants were recruited through speech therapy groups, and various stuttering communities. Understanding the multiple forms of suppression at play during professional and public communications, we prioritized the recruitment and inclusion of participants with multiple marginalized identities besides stuttering, such as, women, first-generation immigrants. 

During interviews, we asked participants about their: 

• Personal background and characteristics of one’s stuttering. 
• Use of videoconferencing technologies.
• Experience of videoconferencing
• Future of videoconferencing

Overall, participants used videoconferencing in professional and/or personal settings and reported various degrees of satisfaction with their video conferencing experiences. As the trend with videoconferencing persists, interview participants’ perception of it evolved. For those who started serious videoconferencing during the pandemic, experiences improved over time. Importantly, videoconferencing presented both benefits and challenges to interviewees. 

Benefits: Creating Safe Spaces For People Who Stutter

Although the usage and context for videoconferencing varied, all of the interview participants saw some benefits throughout the Covid pandemic. While all the benefits noted by participants are applicable to people who do not stutter, some of these benefits are particularly appreciated in the context of stuttering, 

As presented in the interview quotations below, videoconferencing created a “safety distance” that allowed for some people who stutter to have more control over their environment, participation in meetings, and self representation: 

“In terms of me leading a meeting, or facilitating something, events like if I’m in the hot seat, at this point – that I never would have said this before the pandemic – I would actually rather do it virtual. I actually don’t have a lot of experience facilitating, or panel, in person, because a lot of those opportunities came to me during the pandemic. The idea of doing a live TED Talk freaks me out, but I’ve just done a half hour presentation over the computer, and I loved it!”

“I can manage my energy a little bit better on VC, because you are in your own environment. For people who stutter, going to a bar is very challenging, the office can have a similar effect.[…] you just have more control on VC than in person environment.”

Benefits: Reduced Barrier to “Show Up” and Identifying a General Trend Towards More Inclusive Meeting Behaviors.

Research has shown that adults who stutter suffer from heightened social anxiety and are more likely to avoid social situations as a result (Iverach and Rapee 2014). While stuttering is often a very isolating and heavily stigmatized experience, interview participants were able to leverage videoconferencing platforms to connect with others who stutter and build communities that were safe yet supportive. 

As COVID-19 disrupted lives and blurred work-life boundaries, our research indicated that some people developed increased empathy towards others in the context of video conferencing. Interviewees noticed that people became more patient and more understanding with speaking-related challenges, which alleviated some pressure for people who stutter to participate fluently. As one participant noticed, “even fluent speakers have difficulties on Zoom, […] having challenge of being heard is more understood now”. Overall, participants saw a cultural shift towards more inclusive meeting expectations and behaviors that empowered people who stutter to speak up. As another participant noted: 

“10 years ago, it was perfectly acceptable to just have one person speak in the entire meeting; but now, if there is only one person speaking, I will definitely call it out.“

Challenges: The Stress Of “Self View” And “Turn Taking” Remains In Video Conferencing. 

Numerous studies have shown seeing oneself in a mirror can induce self-evaluation and distress (Bailenson 2021, Gaine 2020, Wicklund 1975), and the effect is stronger for certain social groups such as women and Asian, as compared to men and White, respectively (Ratan, Miller, and Bailenson 2022). Not surprisingly, the “self view” function – turned on by default on most video conferencing platforms – stands out as one of the top challenges with videoconferencing for interviewees. Almost all participants indicated some discomfort with the self-view, finding it “distracting” and anxiety-triggering. By default, many videoconferencing platforms rely on audible sound to detect and switch the current speaker, making the first sound/word crucial to signal one’s turn. However, several of the interviewee participants found themselves struggling the most with initializing a sentence. With a limited channel for non-verbal communication strategies such as body language over videoconferencing, they would often be held back by that very first word.

Challenge: Emotional Connection And Social Cues Are Reduced On Videoconferencing Platforms

With a strong association between stuttering and social anxiety, people who stutter are more sensitive to negative evaluations from others, and more likely to engage with safety behaviors such as loss of eye contact (Iverach and Rapee 2014). While the reduction of social cues during video calls has made many feel less connected to their conversation partners (Bailenson 2021), the lack of emotional support could exacerbate the social anxiety experienced by people who stutter, causing further behavioral and emotional struggles. As one participant stated: 

It’s hard for people to know who to look at on Zoom. In terms of eye contact, who do we keep eye contact with? Even if we all know who we want to keep eye contact with, do they know that? How can they tell? They probably can’t. 

Videoconferencing disabled some interviewees’ existing strategies for social and emotional support available in-person meetings. For example, when attending in-person group meetings, some participants described choosing to sit next to friendly, familiar people to feel more relaxed. Small talk and chit chat immediately before a meeting were other strategies participants described. 

To compensate for the lost connections with others, our participants extensively utilized additional channels to make a conscious effort in communicating their emotions and intentions. For example, several participants deliberately lifted the position of their camera to the eye level so that they could mimic the in-person eye contact. Interview participants also described leveraging their identity as people who stutter to better connect with others in virtual meetings. Most participants had proactively disclosed their stutter in high-stress video conferences (e.g. job interviews, presentations, orientations) to build a connection with their audience, and found this strategy was effective at reducing mental stress and bringing in emotional support, even though it did not change how fluent they were. Some participants purposefully embraced the vulnerability that came with the identity as a person who stutters as a way to empower others to all be more open and collaborative in virtual meetings.

Going Forward: The Hidden Costs of Video Conferencing. 

Despite the benefits identified by the interview participants, videoconferencing has introduced significant emotional and cognitive costs to people who stutter. The constant close-up view of their facial features and speaking behaviors contributed to heightened self-consciousness and more negative thoughts. Although the challenge with the “Zoom gaze” is widespread (Bailenson 2021, Gaine 2020), people who stutter are more likely to pay disproportionate attention to “negative” behaviors (e.g. stuttered words, facial tension) that reinforce existing self stigma and social anxiety (Iverach and Rapee 2014). The increased difficulty with turn taking over videoconferencing platforms posed structural barriers for people who stutter to have their voices heard and points across, deepening people’s existing feeling of social isolation and rejection and preventing some participants from seeing themselves as leaders. The uncertainty with turn taking and audience reactions further contributed to a sense of loss of control, one of the defining characteristics of stuttering and a direct cause of many negative emotional and cognitive reactions when people stutter (Tichenor and Yaruss 2019). While the emotional connection with their conversation partners was highlighted by several of participants as the hallmark of their most rewarding communication experience, many interviewees felt systematically disadvantaged in seeking and sharing emotional support now, as their previous strategies – such as physical proximity, hugs, and good eye contact – were largely unsupported by videoconferencing technology.

To overcome these challenges, people who stutter had to adopt strategies that often required extra time, labor, and mental efforts, on top of the existing cognitive and emotional loads associated with stuttering. These hidden costs of video conferencing help to understand why interview participants reported feeling videoconferencing was particularly “exhausting”, “draining” and “unrewarding”, something that they – while still participating in – did “not look forward to”.

Even the named benefits of videoconferencing could lead to questionable long-term outcomes for the stuttering community. For example, the convenience and comfort of a familiar, controlled videoconferencing environment could potentially disincentivize participants from engaging in in-person meetings and social interactions. The ability to hide one’s stuttering behaviors and identity via videoconferencing is also a double-edged sword. Although it does serve people who stutter with better impression and identity management at the moment, it could also hold people back from accepting their stutter and stuttering identity, reinforcing negative emotions associated with stuttering such as embarrassment, guilt, and fear (Cheasman et al 2013). Collectively, if people who stutter all manage to hide their stutter and stutterer identity during video calls, speech-related challenges would be even less understood and further marginalized by mainstream society. While videoconferencing reduced the barriers for people who stutter to find and join the stuttering community, the bonding and commitment within the community might be weakened due to the difficulty in forming emotional connections via video conferences, making the community more fragmented and superficial.

To summarize, videoconferencing and videoconferencing technologies have substantially changed the dynamics and the structure of interpersonal communications, charging potentially profound emotional, cognitive, and social costs to people who stutter. The very design of the videoconferencing technologies that induced such costs (e.g. lack of non-verbal communication support), has also helped render these costs invisible, preventing public awareness on the structural barriers for people who stutter to participate and engage in the age of videoconferencing.

References

Note: in the abbreviated essay above, research findings from other scholars is cited in open brackets. Below are the complete citations to those findings. 

• Jeremy N. Bailenson. 2021. Nonverbal Overload: A Theoretical Argument for the Causes of Zoom Fatigue. Technology, Mind, and Behavior 2, 1 (feb 23 2021). https://tmb.apaopen.org/pub/nonverbal-overload.
• C. Cheasman, R. Everard, and S. Simpson. 2013. Stammering Therapy from the Inside: New Perspectives on Working with Young People and Adults. J & R Press. https://books.google.com/books?id=QZVdMwEACAAJ
• Christopher Dominick Constantino, Naomi Eichorn, Eugene H. Buder, J. Gayle Beck, and Walter H. Manning. 2020. The Speaker’s Experience of Stuttering: Measuring Spontaneity. Journal of Speech, Language, and Hearing Research 63 (2020), 983–1001. Issue 4. 
• Autumm Gaine. 2020. The Zoom Gaze.
• Lisa Iverach and Ronald M. Rapee. 2014. Social anxiety disorder and stuttering: Current status and future directions. Journal of Fluency Disorders 40 (2014), 69–82. https://doi.org/10.1016/j.jfludis.2013.08.003.
• Timothy Neate, Vasiliki Kladouchou, Stephanie Wilson, and Shehzmani Shams. 2022. “Just Not Together”: The Experience of Videoconferencing for People with Aphasia during the Covid-19 Pandemic. In Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems (New Orleans, LA, USA) (CHI ’22). Association for Computing Machinery, New York, NY, USA, Article 606, 16 pages. https://doi.org/10.1145/3491102.3502017  
• Laura Plexico, Walter H. Manning, and Anthony DiLollo. 2005. A phenomenological understanding of successful stuttering management. Journal of Fluency Disorders 30, 1 (2005), 1–22. https://doi.org/10.1016/j.jfludis.2004.12.001  
• Ronald M. Rapee and Richard G. Heimberg. 1997. A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy 35, 8 (1997), 741–756. https://doi.org/10.1016/S0005-7967(97)00022-3
• Rabindra Ratan, Dave B. Miller, and Jeremy N. Bailenson. 2022. Facial Appearance Dissatisfaction Explains Differences in Zoom Fatigue. Cyberpsychology, Behavior, and Social Networking 25, 2 (2022), 124–129. https://doi.org/10.1089/cyber.2021.0112
• Seth E. Tichenor and J. Scott Yaruss. 2019. Stuttering as Defined by Adults Who Stutter. Journal of Speech, Language, and Hearing Research 62 (2019), 4356–4369. https://doi.org/10.1044/2019_JSLHR-19-00137
• Robert A. Wicklund. 1975. Objective Self-Awareness11Much of the research reported in this paper as well as the writing of this paper were supported by NSF Grant GS-31890. Sharon S. Brehm, William J. Ickes, Michael F. Scheier, and Melvin L. Snyder are acknowledged for their suggestions and insightful criticisms. Advances in Experimental Social Psychology, Vol. 8. Academic Press, 233–275. https://doi.org/10.1016/S0065-2601(08)60252-X