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Social model: new research paper

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Last updated 3rd April 2022.

An excellent new research paper discusses both benefits and limitations of understanding stammering through the social model of disability.

Journal of Communication Disorders

The paper Stuttering and the social model by Constantino, Campbell and Simpson is free to read and download until 22nd April 2022: https://doi.org/10.1016/j.jcomdis.2022.106200. One of the co-authors introduces the research paper in this twitter thread.

The social model suggests that “disability” is to be found not in the impairment itself but in the way society is structured, such as public attitudes, and buildings and infrastructure which are not designed for wheelchairs or blind people etc. For a wheelchair user, the disability is not the inability to walk but the fact that a building has steps with no ramp or lift. The social model contrasts with the “medical model” which sees the impairment as the disability.

The paper outlines the literature on negative consequences of stammering (p.2). Looking at these negative consequences uncritically, it says, we could be convinced that stammering is undesirable, and the logical solution is to reduce or eliminate stammering. However, the paper continues: “It is not clear that disfluencies in speech should garner any of these consequences (my emphasis). Why should repeating syllables result in anxiety [in social situations]? Why would prolonging a sound lead to lower financial outcomes [for example lower status jobs]? The social model helps us to tease apart the physical behavior, the stuttering, from the social consequences of that behavior. Once this separation is made, we can critically evaluate the causes of these negative consequences.” Society expects people to be “able-bodied”, including fluent, and stigmatises people who are not (pp.2-3).

The social model has important benefits, including its call for social change and removing the disabling barriers faced by people who stammer in their day-to-day life. Section 4 of the paper discusses ways of tackling these barriers, including legal protection. In 4.3 it discusses implications for speech therapy.

Limitations of the social model

However, as explained by the paper, the social model is not a full explanation of disabling effects related to stammering. At a stammering conference, people can speak to others who stammer and not feel judged. They may find this a liberating experience where speech is much easier. It could be seen as a place without the normal barriers created by negative social attitudes towards stammering. However even in this environment, many people who stammer may struggle to speak. Those who consider that their experiences of the impairment itself, not just outside barriers, are important in creating disability will need to consider alternative frameworks beyond the social model (p.7).

Also the social model is lacking for those who seek to find pride and solidarity in the act of stammering, since the model only allows disabled people to appreciate how society’s construction makes their lives more difficult. “Indeed, some members of the Deaf community have resisted the social model due to it not offering an understanding of deafness that includes the cultural and personal benefits of being Deaf.” The same applies for people who stammer looking to understand their experiences of disfluency as a source of spontaneity, creativity, and culture. The paper discusses possible alternative models that could help address these shortcomings in the social model (pp.7-8).

Comment

I think this is a really valuable paper, nuanced, thoughtful, and rich in ideas. There is much more than I am able to summarise here.

The paper acknowledges the important point that it’s unhelpful to be too dogmatic in one direction or the other. A radical social model might suggest that therapy should not aim to help someone’s speech as such, but focus on creating a stammer-friendly environment (p.5) – that it’s down to society changing rather than the disabled individual. However people should not be asked to “pick a side (e.g. either society changes or I change)”. The paper points out that a person who stammers may ask why they cannot both seek to maximise function (ie work on their own speech in some way, if they choose to) and reduce the social impact of stammering. It says “…rather than adopting a singular position that holds the medical and social model in direct opposition, an appreciation of the plurality of these different perspectives may be preferred, and progression towards more nuanced and multi-dimensional understandings of disability.”

Update: A further step towards challenging social attitudes is a stammering advert being shown in UK cinemas until October 2022: STAMMA in the cinema: “No diversity without dysfluency”.

A couple of legal points

In my view, evidence of negative responses to a person’s stammer could help to show the impairment has a “substantial effect” on normal day-to-day activities, so as to be a disability within the Equality Act 2010.

I think a particular issue is how far a person’s stammer is relevant to objective justification, in deciding whether an employer is justified in turning them down for a job where speech is important? This is unclear. Hopefully it would not be justified to turn someone down just because some customers/clients would “not want someone who stammers”, or because stammering does not fit with the company image. There are difficult questions though such as how long should customers be expected to wait for the employee to speak, for example. What should be the border between arguably “ablist” expectations of society and well-founded justifications for saying a person does not have the ability to do a certain job well? The answer may be different for different job roles. See too Excellent communication skills.

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