Bullying in Adolescents Who Stutter:
Communicative Competence and
Self-Esteem
Gordon W. Blood
Ingrid M. Blood
The Pennsylvania State University, University Park
A dolescence is a time of self-exploration,
experimentation, and identity development,
with many problems being episodic in nature
and not persisting into adulthood (Lerner & Galambos,
1998; Steinberg, 1999). Although the research for the past
two decades confirms that this period of development is not
ABSTRACT: This study examined the perceived communi-
cative competence, self-esteem, and vulnerability to
bullying of 53 adolescents who stutter and 53 adoles-
cents who do not stutter. Adolescents who stutter were at
a significantly higher risk of experiencing bullying
behavior (43%) than were adolescents who do not stutter
(11%). The majority of adolescents who stutter (57%)
rated themselves as having poor communicative compe-
tence. In contrast, only 13% of the adolescents who do
not stutter rated themselves as having poor communica-
tive competence. Seventy-two percent of adolescents who
stutter scored within 1 SD from the mean on a standard-
ized measure of self-esteem, which is indicative of
positive self-esteem. Students with low self-esteem and
poor confidence in their communicative competence
were more likely to be victimized by bullies. The
importance of perceived communication skills, especially
in establishing and maintaining positive social interac-
tions, and their relationship to potential victimization by
bullies is discussed. Social and communication skills
training programs may be an important part of treatment
programs for some adolescents who stutter to manage
potential bullying behavior.
KEY WORDS: bullying, stuttering, adolescents, self-esteem
CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS • Volume 31 • 69–79 • Spring 2004 © NSSLHA
1092-5171/04/3101-0069
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inherently problematic and dysfunctional, some difficulties
have negative lifelong impact. Bullying, peer rejection, and
victimization during adolescence are problems that lead to
serious, negative long-term outcomes (Garbarino & deLara,
2002; Garrett, 2003; Geffner, Loring, & Young, 2001;
Olweus, 1993; Rigby, 1997; Thompson, Arora, & Sharp,
2002). Research reports from interviews of bullies about
their “targets” suggest that they mark students who are
perceived as cautious, anxious, quiet, passive, withdrawn,
unassertive, insecure, and unhappy (Byrne, 1994; Olweus,
1993). Students with mild and moderate disabilities are also
at high risk for bullying (Dawkins, 1996; Sweeting & West;
2001; Wilde & Haslam, 1996).
The systematic study of stuttering during adolescence has
been neglected. Few studies have examined peer relations,
communicative competence, personal development, social
adjustments, and internalization of personal value systems
within the context of stuttering (Blood, Blood, Tellis, &
Gabel, 2001, 2003; Blood et al., 1998; Davis, Howell, &
Cooke, 2002). However, the developmental challenges and
transformations that define adolescence may be significantly
influenced by stuttering. Negative stereotypes about
students who stutter are common. Students who stutter are
described as more withdrawn, insecure, introverted, tense,
anxious, fearful, shy, nonassertive, and fearful of communi-
cation than students who do not stutter (Lass, Ruscello,
Pannbacker, Schmitt, & Everly-Myers, 1989; Lass,
Ruscello, Schmitt et al., 1992; Ruscello, Lass, Schmitt, &
Pannbacker, 1994; Silverman, 1982; Turnbaugh, Guitar, &
Hoffman, 1979; Woods, 1978; Woods & Williams, 1971;
Yairi & Williams, 1970; Yeakle & Cooper, 1986). These
69
negative stereotypes are remarkably similar to how bullies
define their “targets,” and may place adolescents who
stutter at high risk for being bullied and victimized in
school settings. The underlying framework for this study
includes (a) the relationship between social and communi-
cation skills in adolescents, (b) the negative effects of
bullying behavior, and (c) the possible relationship between
bullying and stuttering.
SOCIAL AND COMMUNICATION SKILLS
Social relationships and belonging to peer groups play
critical roles in adolescent development (Parker & Asher,
1987, 1993; Parkhurst & Asher, 1992). Peer relationships
influence adolescents’ social identity, self-esteem, and
social status. A number of studies report on the influence
of peer acceptance and peer rejection (Brown & Lohr,
1987; Callaghan & Joseph, 1995; Espelage, 2002;
Espelage & Holt, 2001; Hodges, Boivin, Vitaro, &
Bukowski, 1999; Lerner & Galambos, 1998; Sharp, 1995,
1996). Peer acceptance is linked to popularity in groups,
closer friendships, positive self-concepts, academic
success, and expanded social competencies. During this
time, how adolescents perceive themselves (e.g., the “in”
group, part of the clique, leader in a group) often be-
comes a self-fulfilling prophecy. Social status, academic
and/or athletic achievement, physical appearance, socio-
economic class, and social norms all play important roles.
“Fitting in” is often one of the keys for peer acceptance,
with rigid group expectations for appearance, prosocial
and antisocial behaviors, and communication styles and
skills. Buhrmester (1996) suggested that peer relationships
mature during adolescence through increased social and
communicative activities, including initiating interactions,
self-disclosure, and intimacy in conversations and activi-
ties. Effective social and communicative skills become the
foundation for social interactions. Richmond and
McCroskey (1998) reported that “effective communicators
exhibit assertiveness, responsiveness, and versatility. These
skills allow speakers to make requests, actively disagree,
express their feelings, initiate, maintain, and disengage in
conversations” (p. 85). They also allow individuals to be
more flexible in multiple settings and with different
conversation partners. Effective communicators show a
willingness to communicate and to engage in social
interactions. Richmond and McCroskey reported that
perceived communicative competence is positively related
to high self-esteem, confident attitudes toward communi-
cation, and adept social skills. Perceptions of communica-
tive competence are related to individuals’ willingness and
desire to communicate and are a critical predictor of
positive peer relations and acceptance. As friendships
evolve and peer interactions intensify, supportive peer
relationships, healthy self-concepts, positive self-esteem,
and effective communication also play protective roles
against victimization (Garbarino & deLara, 2002; Garrett,
2003; Geffner et al., 2001; Olweus, 1993; Thompson et al.,
2002).
70 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE
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In contrast, peer rejection may lead to loneliness,
depression, poorer academic performance, lower self-
esteem, aggression, withdrawal, irritability, an increased
likelihood of antisocial behavior, and high risk for victim-
ization and bullying (Parker & Asher, 1987, 1993; Pope &
Bierman, 1999). Peer rejection has also been identified
along with poor social skills and perceived low social
status as part of the bullying cycle. Peer rejection and
victimization during adolescence can have negative lifelong
effects. Successful interventions have been reported that
were designed to improve both social and communicative
interactions and social competencies (Smith & Ananiadou,
2003; Smith & Brain, 2000; Steinberg, 1999; Welsh,
Domitrovich, Bierman, & Lang, 2003). However, children
who fail to develop or display important communication
skills may be less likely to build or maintain social and
interpersonal peer relations. These children may also be at
higher risk of being bullied. Perceived poor communicative
competence has been related to communication apprehen-
sion and fear, isolation, loneliness, introversion, and
shyness (Daly, McCroskey, Ayres, Hopf, & Ayres, 1997;
McCroskey & McCroskey, 1988; Richmond & McCroskey,
1998; Richmond, McCroskey, & McCroskey, 1989).
Studies have also suggested that children with communi-
cation disabilities are more likely to be rejected by peers
and ignored in social interactions (Botting & Conti-
Ramsden, 2000; Brinton & Fujiki, 1999; Fujiki, Brinton, &
Todd, 1996; Hadley & Rice, 1991; Knox & Conti-Ramsden,
2003; Rice, Sell, & Hadley, 1991). It appears that children
with even mild disabilities are at risk for peer rejection and
lower social status in the classroom. Adolescents who are
perceived as “different,” or who perceive themselves as
“different” due to the absence of or lack of skills in using
peer-sanctioned social and communication skills, may be at
high risk for victimization or bullying.
EFFECTS OF BULLYING BEHAVIOR
Bullying is a subtype of aggression and an international
problem for school-age children (Olweus, 1993; Thompson
et al., 2002). American schools are often perceived as a
dangerous place by many students. Fried and Fried (1996)
reported that more than 160,000 children missed school
daily due to fear of attacks and victimization by bullies. In
a typical week, students receive an average of 230 verbal
put-downs, or approximately 30 per day (Garrett, 2003). In
an extensive study of 15,686 students in the United States,
nearly 30% of all children in schools are involved in
bullying behavior (Nansel et al., 2001). Thirteen percent of
the children in their study self-identified as bullies, 11%
self-identified as victims, and 6% self-identified as both
bullies and victims. The researchers defined bullying as
“when a teenager’s behavior is purposely meant to harm or
disturb another child, when it occurs over time, and when
there is an imbalance in power between the kids involved”
(p. 2992). Types of bullying include disparaging verbal
comments, shunning, spreading rumors, unwanted physical
contact, beatings, stealing, and threats.
AND DISORDERS • Volume 31 • 69–79 • Spring 2004
 Although males and females are bullied equally (Banks,
1997; O’Moore, Kirkham, & Smith, 1999; Rigby, 1997,
1999; Whitney & Smith, 1993), males are more likely to
use direct bullying (e.g., threats and physical hitting)
whereas females tend to use indirect bullying (e.g., verbal
insults and isolation). Victims of bullying were perceived
as different from peers in dress, speech, and personal
hygiene. Dawkins (1996) reported that children with
visible disabilities were twice as likely to be bullied as
children with no visible disabilities. Children with
physical, intellectual, and sensory disabilities such as
cerebral palsy, epilepsy, spina bifida, hearing/visual
impairments, emotional problems, severe intellectual
disabilities, hyperactivity, or cleft palate have an increased
risk of victimization (Bond, Carlin, Thomas, Rubin, &
Patton, 2001; Johnson et al., 2002; Sheard, Clegg,
Standen, & Cromby, 2001; Sweeting & West, 2001).
Similarly, children with learning disabilities, poorer
academic achievement, and special needs are also reported
to be at higher risk of being bullied (Mishna, 2003;
Nabuzoka, 2003; Nabuzoka & Smith, 1993, 1999; Whitney
& Smith, 1993). Recently, Knox and Conti-Ramsden
(2003) reported on the severity and risk of being bullied
in 100 children with specific language impairment (SLI).
They found that 36% of the children with SLI self-
reported being at high risk for victimization of bullying
behavior as compared with 12% of the non-SLI group.
Their findings support previous studies that children with
special education needs are at higher risk of being bullied.
Hodges and Perry (1999) reported that children who are
bullied are more likely to be disliked by their peers and to
have fewer friends than those who are not bullied. As
stated previously, peer relationships play an important role
in bullying behavior. Poor social skills, low social status,
and poor social relationships may be both a cause and a
result in the bullying cycle. Research suggests that victims
of bullying show similar characteristics: They tend to be
more cautious, anxious, quiet, withdrawn, passive, unasser-
tive, insecure, unhappy, and hypersensitive than children
who are not victims of bullying (Byrne, 1994; Garrett,
2003; Geffner et al., 2001; Olweus, 1993). Unfortunately,
these children tend to respond to their victimization with
greater avoidance of social situations, absenteeism, emo-
tional problems, and insecurities. These response behaviors
are the same ones that bullies report as the target behaviors
of their victims (Garbarino & de Laura, 2002; Garrett,
2003; Thompson et al., 2002).
Victims of bullying during childhood and adolescence
show long-term psychosocial and physical health problems
(Geffner et al., 2001; Olweus, 1993; Rigby, 1997, 1999,
2000; Smith et al., 2002). Students who are repeatedly
bullied report sleeplessness, lower self-esteem, poorer self-
concepts, increased rates of absenteeism, truancy, depres-
sion, loss of confidence, greater isolation, and poorer
academic performance than students who are not bullied
(Callaghan & Joseph, 1995; Garrett, 2003; Olweus, 1993;
Sharp, 1995). One purpose of this preliminary study was to
determine if stuttering contributes to the reported “stereo-
type of difference” that is characteristic of bullied adoles-
cents (Garrett, 2003).
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BULLYING AND STUTTERING
Although some research suggests that the majority of
adolescents who stutter do not suffer from stigmatization and
report positive self-esteem, a subgroup of adolescents who
stutter (15%–41%) report high communication fears, poor
communication confidence, and low self-esteem (Blood et
al., 2001, 2003; Yovetich, Leschied, & Flicht, 2000).
Recently, Davis et al. (2002) administered a sociometric
scale to assess the peer relationships of 16 children who
stutter and their 403 classmates. They found that the children
who stutter were rejected significantly more often than their
peers, were categorized as less “popular,” and were less
likely to be named “leaders.” Only 1 of the 16 students was
categorized as a “leader.” The students who stutter were
three times as likely to be categorized as “victims of
bullying” than their fluent peers and, as a group, demon-
strated low social status among peers.
Unfortunately, the same negative labels that are applied to
children who stutter are also reported as descriptors of
victims of bullying. Children and adolescents who are targets
for bullies are described as unassertive, insecure, more
sensitive, cautious, anxious, quiet, passive, withdrawn, and
less likely to interact and speak with other children (Hodges
& Perry, 1999; Olweus, 1990, 1993, 1997, 2003). It is
possible that some adolescents who stutter may be at high
risk for bullying due to their stuttering and/or a combination
of their stuttering and low social status among peers (Davis
et al., 2002). The potential negative effect of stuttering on
specific social interactions and verbal exchanges, coupled
with the negative stereotypes held by peers and low social
status, may place students who stutter at risk for bullying.
A number of exceptional books include sections on
dealing with bullying in children and adolescents who
stutter (Bloom & Cooperman, 1999; Conture, 2001; Guitar,
1998; Gregory, 2003; Shapiro, 1999; Silverman, 2004; Van
Riper, 1982). Authors have also contributed articles in
dealing with bullying and teasing behavior in individuals
who stutter (Murphy & Quesal, 2002; Ramig & Bennett,
1995). However, few studies have systematically reported
on victimization and bullying of adolescents who stutter
(Hugh-Jones & Smith, 1999; Langevin, Bortnick, Hammer,
& Wiebe, 1998; Mooney & Smith, 1995). Langevin et al.
(1998) developed a questionnaire for teasing/bullying for
children who stutter. Their pilot instrument was adminis-
tered to 28 Canadian children between the ages of 7 to 15
years who stutter. Results revealed that 16 of the 28
children were teased/bullied about their stuttering, and 81%
of the children reported that they were upset about the
teasing/bullying. The authors suggested that a larger sample
was needed to validate the scale. Another potential limita-
tion of their study was the wording in their questionnaire.
The questionnaire began with, “Students sometimes bully
kids at school by hurting or upsetting them in some way”
followed with the first question “Have you been teased/
bullied about your stuttering?” (p. 22). Unfortunately, the
orientation provided by the definition and the very general
first question may have limited value for assessing the
multiple levels of bullying and may have biased the results.
Blood • Blood: Bullying and Stuttering 71
 Hugh-Jones and Smith (1999) designed a 19-item
questionnaire and surveyed adults from the British Stam-
mering Association. Results from the 276 participants (31%
response rate from a mailed survey) revealed that partici-
pants recalled difficulties in peer relationships and bullying
during their school experience that were directly related to
their stuttering. Eighty-three percent of the participants
reported being bullied at school, with 18% reporting being
“bullied daily” and 41% recalling that they were “bullied
weekly.” The authors recognized that the recall technique
(in some cases recalling events that occurred more than 25
years ago), lack of a control group, low response rate, and
the fact that all participants were members of a self-help
group may have confounded their results. They suggested
that children who stutter could be at higher risk for poor
peer relationships and bullying due to their stuttering and
that further research should be conducted in this area.
CURRENT STUDY
The disruptive nature of stuttering during social interac-
tions, negative stereotypes held by peers, impact on peer
relationships, overrepresentation of students with disabilities
who are bullied, and retrospective research suggesting that
victimization/bullying occurs during the school years to
individuals who stutter, all seem to suggest a relationship
between bullying and stuttering. However, few studies have
explored the relationship between bullying and stuttering in
adolescents who are currently experiencing the behavior. It
is possible to examine the risk and frequency of bullying
currently being experienced by students using methodology
reported in the literature (Arora, 1994; Thompson et al.,
2002). It is also possible that students who stutter may not
perceive themselves as effective communicators and thereby
may reduce the actual behaviors necessary for fostering
positive social/peer relationships, thereby making them
more vulnerable to bullying. In response to negative
stereotypical reactions of peers, adolescents who stutter
may have developed negative perceptions of their own
communicative competence, avoidance strategies, and less
outgoing interaction styles. In light of the fact that research
on bullying clearly indicates that one of the devastating
results of being bullied is lowered self-esteem in victims, it
also seems important to clarify this relationship in adoles-
cents who stutter. Previous research suggests that adoles-
cents who stutter may have developed protective techniques
to maintain their positive self-esteem (Blood et al., 2003;
Yovetich et al., 2000). However, bullying may compromise
the ability of adolescents who stutter to apply these
protective techniques. The relationship between perceived
communicative competence and self-esteem may be
important in understanding the complex interactions among
bullying, stuttering, and psychosocial adjustment in some
fluency clients. Therefore, four research questions were
posited to examine how a number of factors are associated
with the experience of bullying in adolescents who stutter:
• Are there significant differences between adolescents
who stutter and adolescents who do not stutter on the
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risk of being bullied in a school setting?
• Are there significant differences between adolescents
who stutter and adolescents who do not stutter on a
measure of communicative competence critical to
developing and fostering positive peer relations?
• Are there significant differences between adolescents
who stutter and adolescents who do not stutter on a
standardized measure of self-esteem?
• Are there significant positive relationships among the
risk of being bullied, perceived communicative
confidence, and self-esteem in adolescents who stutter
and adolescents who do not stutter?
METHOD
Participants
Participants were 53 adolescents who stutter between the
ages of 13 and 18 years (mean age 15:2 [years;months])
and 53 adolescents who do not stutter (mean age 14:8) who
were currently enrolled in school. All adolescents met the
following criteria: no repetition of a grade level, no
placement in a special classroom, absence of a history of
chronic physical or psychological disabilities (diabetes,
asthma, or neurological, learning, reading, or mental
disabilities), and no history of chronic truancy. Adolescents
who do not stutter were matched with adolescents who
stutter on grade level, ethnicity, gender, and approximate
age. Assent and consent forms were completed before the
beginning of the study.
The demographic characteristics of the adolescents
included 89% (94) male, 11% (12) female, 85% (90)
Caucasian, 11% (12) African American, and 4% (4)
Hispanic American. Adolescents who stuttered were
currently enrolled in treatment with a speech-language
pathologist. Stuttering severity was rated by the Stuttering
Severity Instrument for Children and Adults (Riley, 1994).
The ratings revealed that 11% (6) of the participants’
stuttering was rated in the mild category, 40% (21) in the
moderate category, 26% (14) in the severe category, and
23% (12) in the very severe category.
Procedures
The procedures used in the present investigation parallel
those reported in earlier studies (Blood et al., 1998; Blood
et al., 2001, 2003). Briefly, demographic information,
stuttering history, onset, duration, spontaneous speech
samples, and socioeconomic status (SES) were obtained
before the administration of the scales. SES was determined
using Hollingshead’s Four Factor Index (1975), which uses
parent’s educational level and employment position. All
participants were tested individually using the standardized
instructions that required them to complete paper and
pencil tests. Although the test battery consisted of a
number of scales and questionnaires, for the purposes of
this study, the results of the Life in School (LIS) checklist
AND DISORDERS • Volume 31 • 69–79 • Spring 2004
(Arora, 1994), the Rosenberg Self-Esteem Scale (RSES,
Rosenberg, 1965), and the Self-Perceived Communication
Competence (SPCC) scale (McCroskey & McCroskey,
1988) will be reported.
Instruments
LIS. The LIS checklist (Arora, 1994) is a published scale
that is used as an indirect, precise measure of bullying.
According to Arora, because the LIS never asks the
question “Are you bullied?” many of the problems with
other measures of bullying behavior are eliminated. She
reports that using the word “bullying” may elicit an
emotional response from participants and consequently less
accurate data due to shame, embarrassment, and/or concern
with identification as a victim of bullies. The LIS provides
more precise information about what is “actually happen-
ing” to the student within a specific time interval, the past
week. This eliminates the recall issue inherent in retrospec-
tive studies. The data obtained from students is based on
specific observable actions in the past week.
The LIS consists of 39 statements that a student might
experience during the past week in school. Each statement is
preceded by “During this week, another child in school…,”
and followed with one of the 39 statements. The student is
instructed to check one of the three columns labeled “no,”
“once,” or “more than once.” Half of the statements are
pleasant or neutral, such as “During this week, another child
in school…told me a joke; smiled at me; said something
nice to me; talked about TV with me; asked me a stupid
question.” The remaining statements are classified as
unpleasant occurrences that a student might experience, such
as “During this week, another child in school…said they
would tell on me; told me a lie; shouted at me; tried to get
me in trouble, was unkind about something I did.” Six of
the remaining negative items were labeled as bullying by
70% of secondary school students and teachers in samples
from two different countries (Arora, 1994, 1996; Arora &
Thompson, 1987; Smith, 1999). All of the items that were
selected by students and teachers included direct bullying
and were related to physical aggression. The six items
include “During this week, another child in school… 1) tried
to kick me; 2) threatened to hurt me; 3) demanded money
from me; 4) tried to hurt me; 5) tried to break something of
mine; and 6) tried to hit me.” Interestingly, indirect forms of
bullying (name calling, frightening someone, laughing at
someone) were categorized by less than 30% of the sample
as bullying and therefore are not included as part of the
Bullying Index.
The checklist can provide a Bullying Index, which Arora
states provides “a comprehensive picture of the student’s
life in school and a means of identifying individuals who
are likely to be victims of bullying” (p. 156). Instructions
for computing the Bullying Index are provided, as are the
criteria for children identified as most likely to be at risk
of being bullied. Studies show that more than 66% of the
children who select the “more than once” category later
admit to actually being bullied (Thompson et al., 2002).
Data have been collected on children in schools varying in
geographic location (rural, suburban, and urban) and size
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(schools with less than 100 students enrolled to more than
1,000 students enrolled). The LIS has been used with
children in regular classrooms, with special needs, with
learning disabilities, and with SLI (Arora, 1994, 1996;
Arora & Thompson, 1987; Johnson et al., 2002; Knox &
Conti-Ramsden, 2003; Smith, 1999).
RSES. Self-esteem was evaluated using the RSES
(Rosenberg, 1965). As mentioned in previous research
(Blood et al., 2003), this scale is one of the most widely
used scales for measuring self-esteem in the world
(Hagborg, 1996; Rosenberg, 1986). Scores on the RSES are
the average rating of the five positively worded (e.g., I feel
I have a number of good qualities) and 5 negatively
worded (e.g., I feel I do not have much to be proud of)
items. Higher scores indicate poorer self-esteem. Extensive
research has demonstrated the scale’s reliability and
validity. This scale has a reliability coefficient of .92.
Criterion validity of the scale has been demonstrated as the
scale correlates significantly with other measures of self-
esteem (Rosenberg, 1979). Researchers have demonstrated
significant positive relationships between self-esteem and
other measures of self-concept and self-regard for school-
aged children and adolescents (Hagborg, 1996).
SPCC. The SPCC scale (McCroskey & McCroskey, 1988)
is a 12-item self-evaluation measure of an individual’s
perception of his or her ability to communicate effectively.
Participants are required to rate their competence on a scale
from 0 to 100 in four settings (public, meeting, group, and
dyad) and among three communication receivers (strangers,
acquaintance, and friend). The overall SPCC score ranges
from 0 (completely incompetent) to 100 (completely
competent). According to the authors, higher SPCC total
scores (>87) indicate higher self-perceived communicative
competence; lower scores (<59) suggest low self-perceived
communicative competence. Subscores also range from 0 to
100 for the four settings (public, meeting, group, and dyad)
and among three communication receivers (strangers,
acquaintance, and friend). Specified subscores ranges are
also included. The SPCC has good reported reliability (0.92)
and good predictive and construct validity on a sample of
2,444 individuals (Daly et al., 1997; McCroskey, 1977, 1982,
1997; McCroskey & McCroskey, 1988; Richmond &
McCroskey, 1998; Richmond et al., 1989).
Researchers have found negative correlations between
communication apprehension, neuroticism, and introversion
and the SPCC and positive correlations between self-esteem
and sociability in adults and adolescents and the SPCC
(Chesebro et al., 1992; Richmond et al., 1989; Rosenfeld,
Grant, & McCroskey, 1995; Zakahi & Duran, 1984, 1985).
Data Analyses
In addition to descriptive data analyses, separate t tests and
analyses of variance (ANOVAs) were computed between
the group mean total scores of the LIS (question #1), RSES
(question #2), and SPCC (question #3) to determine if
significant differences existed between the two groups of
participants. The subscores of the SPCC were also ana-
lyzed. In order to determine if significant relationships
existed among the measures, Pearson product moment
Blood • Blood: Bullying and Stuttering 73
correlations were computed for adolescents who stutter and Table 2. Means and standard deviations for adolescents who
adolescents who do not stutter (question #4). stutter and adolescents who do not stutter on the Self-
perceived Communication Competence scale total scores and
subscores.

RESULTS Adolescents Adolescents who

who stutter do not stutter
Performance on Bullying Measures
Scale M SD M SD
As shown in Table 1, 43% (23) of the adolescents who
stutter and 11% (6) of the adolescents who do not stutter
Total score* 65.7 14.3 79.9 12.8
checked at least one of the six bullying items in the “more Public* 55.4 8.1 70.8 5.9
than once” column, providing a measure for risk of being Meeting 68.1 8.5 71.3 7.9
bullied on the LIS during the past week. The severity of the Group discussion* 55.1 9.1 81.4 7.3
risk of being bullied was calculated by counting the number Interpersonal
conversations* 54.7 6.6 74.1 8.2
of items that individuals checked in the “more than once”
Stranger* 55.5 5.9 71.3 7.7
column. The severity was rated from 2 to 6. Table 1 also Acquaintance 82.1 6.1 80.1 8.4
presents the number and percentage of participants who were Friend 83.5 9.3 84.9 7.5
classified in each severity rating. It can be seen that there
were no students who do not stutter who checked more than *Indicates significant differences at the p < .001 level of confi-
three items. In contrast, 13 (24%) students who stuttered dence.
were not only at risk of being bullied, but with varying
degrees of severity of victimization. Only 3 (6%) students level of communication than were adolescents who stutter
who do not stutter reported varying degrees of victimization. (group M of 77.4; SD = 13.5). Results of the t test
The mean Bullying Index is also presented. Adolescents revealed that the group means were significantly different,
who stutter had a group mean Bullying Index of 9.3 (SD = t(103) = 8.9, p < .001. Significant differences (p < .001)
3.1); adolescents who do not stutter had a group mean were also found between the two groups on the public
Bullying Index of 6.6 (SD = 2.7). The higher the number, speaking, group discussion, interpersonal conversations,
the greater the risk of being bullied. Results of the t test and stranger subscores of the SPCC. The group discussion
revealed that the group means were significantly different, subscore data revealed poor communication competence
t(103) = 6.14, p < .001. Adolescents who stutter were at for 24 (45%) participants who stutter and 7 (13%)
higher risk of being bullied than adolescents who do not participants who do not stutter. The interpersonal conver-
stutter. sations subscore data revealed poor self-perceived commu-
nicative competence for 28 (53%) participants who stutter
Performance on the and 8 (15%) participants who do not stutter. The stranger
subscore data revealed poor self-perceived communication
Communicative Competence Scale
competence for 27 (51%) participants who stutter and 11
Table 2 shows that adolescents who do not stutter (group M (21%) participants who do not stutter. Similarly, the
of 66.2; SD = 10.4) were more confident in their perceived public speaking subscore data revealed poor communica-
tive competence for 28 (53%) participants who stutter and
Table 1. Number and percentage of participants who stutter 8 (21%) participants who do not stutter. The data revealed
and who do not stutter on the Life in School checklist. that participants who stutter had higher scores (poorer
performance) on four of the seven subscales of the SPCC.
Significant differences between groups at the p < .001
Participants Participants level of confidence were found for group discussions,
who stutter who do not stutter interpersonal conversations, stranger, and public speaking
subscores; no significant differences were found for
Risk between group means for the meeting, acquaintance, and
checked one or more friend subscores of the SPCC.
of six items 23 (43%) 6 (11%)

Severity Performance on the Self-Esteem Scale

checked one item 10 (19%) 3 (5%)
checked two items 4 (7%) 2 (4%) The results of the RSES revealed a range of scores from
checked three items 2 (4%) 1 (2%) 10 to 32, with a group mean score for adolescents who
checked four items 2 (4%) 0
checked five items 2 (4%) 0 stutter of 17.1 (SD = 4.5) and a group mean score for
checked six items 3 (5%) 0 adolescents who do not stutter of 15.9 (SD = 4.3). Results
of a t test revealed no significant differences between the
Bullying Index group means (p = 0.21). Adolescents who stutter reported
Group M 9.3 6.6
similar levels of self-esteem as adolescents who do not
SD 3.1 2.7
stutter.

74 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS • Volume 31 • 69–79 • Spring 2004

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 Figure 1 displays the group mean responses for all
participants. The higher scores are indicative of lower
self-esteem. The group mean and standard deviation for the
“at risk for bullying” group of 23 adolescents who stutter
was 20.7 (SD = 5.8) and for the 6 adolescents who do not
stutter was 19.1 (SD = 6.4). The group mean and standard
deviation for the “not at risk for bullying” group of 30
adolescents who stutter was 15.1 (SD = 3.9) and for the 47
adolescents who do not stutter was 15.3 (SD = 3.5).
Results of a one-way ANOVA revealed significant differ-
ences among the four groups (adolescents who stutter at
risk for bullying; adolescents who do not stutter at risk for
bullying; adolescents who stutter and are not at risk for
bullying; adolescents who do not stutter and are not at risk
for bullying), F( 3,102) = 25.4, p < .001. Tukey Kramer
HSD post hoc test revealed that adolescents who stutter who
were at risk for bullying had significantly lower self-esteem
(higher scores) than adolescents who were not at risk for
bullying. Similarly, adolescents who do not stutter who were
at risk for bullying had significantly lower self-esteem
(higher scores) than adolescents who were not at risk for
bullying. Participants who were at risk for being bullied had
lower self-esteem (higher scores), regardless of fluency.
It is possible that the number of years in current treat-
ment programs (Guitar, 1998; Shapiro, 1999; Silverman,
2004; Van Riper, 1982) that may have focused on self-
esteem, general well-being, and self-concept skills could
have a confounding effect on the data. Therefore, we
determined if any relationship existed between the number
of years in treatment and self-esteem scores. No significant
correlations were found between number of years in
treatment and self-esteem scores (r = +0.09; p = 0.41).
Figure 1. Group mean scores on the self-esteem scale for adolescents who are at risk and who are
not at risk for being bullied.
Mean Self-Esteem Scores
Adolescents Who Stutter
At Risk for Bullying
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Correlations Among Measures
Correlations between the Bullying Index (# of items
checked from 0 to 6) and the RSES total score and SPCC
total score were calculated. A significant, positive correla-
tion was found between risk of bullying and self-esteem (r
= +0.69; p < .001). As the risk of bullying increased
(higher scores), the likelihood of poorer self-esteem also
increased (higher scores). A significant, negative correlation
was found between the risk of bullying and communicative
competence (r = –0.51; p < .001). As the risk of bullying
increased (higher scores), all participants displayed poorer
communicative competence (lower scores). A low, negative,
significant correlation was also found between self-esteem
and communicative competence (r = –0.36; p < .001). Low
self-esteem (higher scores) was associated with poor
perceived communicative competence (low scores).
DISCUSSION
In this study, 43% of the adolescents who stutter and 11%
of the adolescents who do not stutter reported experiencing
bullying within the past week. The rates reported for
adolescents who do not stutter are similar to those reported
in other studies, suggesting that 10%–15% of all children
in schools are victims of bullying (Garbarino & deLara,
2002; Garrett, 2003; Nansel et al., 2001; Thompson et al.,
2002). Similarly, the significantly higher percentage
reported by participants who stutter parallels studies with
children with other mild and moderate disabilities who are
reported to be victims of bullying (Bond et al., 2001;
Adolescents Who Do Not Stutter
Not At Risk for Bullying Group Mean
Blood • Blood: Bullying and Stuttering 75
Johnson et al., 2002; Knox & Conti-Ramsden 2003; Mishna,
2003; Nabuzoka, 2003; Nabuzoka & Smith, 1993, 1999;
Whitney & Smith, 1993). According to Garrett (2003),
teasing and bullying top the list of school-age children’s
problems. For adolescents who stutter, social integration may
cause problems due to the daily variability in their communi-
cation interactions. This research suggests that adolescents
who stutter are at greater risk of being bullied and presents
another issue for consideration when planning the optimal
learning environment in schools for adolescents who stutter.
These data provide empirical support for programs that
address teasing and bullying issues in students who stutter
(Blood, 1995; Bloodstein, 1995; Bloom & Cooperman, 1999;
Conture, 2001; Gregory, 2003; Guitar, 1998; Manning, 2001;
Murphy & Quesal, 2002; Ramig & Bennett, 1995; Shapiro,
1999; Sheehan, 1970; Silverman, 2004; Van Riper, 1982).
Although this study provides evidence that students who
stutter were faced with direct bullying during the past week
before testing, we did not obtain data on the perpetrators
who did the bullying, other students’ responses, teachers’
perceptions, and measures of indirect bullying. Future studies
are being conducted that will provide this additional
information.
The relationship between self-esteem and bullying is not
surprising. The literature is replete with studies document-
ing the negative effects of bullying on self-esteem. How-
ever, this study reports a higher percentage of participants
with low self-esteem than earlier studies (Blood et al.,
2003; Yovetich et al., 2000). In students who stutter, the
increased likelihood of being bullied may lead to negative
self-esteem. Of course, the inverse relationship may also be
valid, suggesting that low self-esteem makes students who
stutter more vulnerable to bullying. Bullies target specific
students. Adolescents who stutter may be perceived “differ-
ent” because of their communication skills. However, some
students who are perceived as different may develop specific
attributes that serve as compensatory strategies and assist in
developing and/or maintaining positive self-esteem and
healthy peer relations. Hodges et al. (1999) suggested that
having a close personal friend can actually serve to buffer
the negative effects of victimization and bullying. The
majority of adolescents who stutter (57%) did not report
being bullied in the past week. It is interesting to speculate
that these students have discovered successful ways to buffer
the negative effects of bullying while maintaining their
positive self-esteem. Although this study provides the
foundation for information about adolescent development in
the context of stuttering, there is a need for longitudinal
studies examining the influences of social and communica-
tive relationships within the school and family environments.
In view of the research that social and peer relationships
rely heavily on communicative competence and skills,
adolescents who stutter appear to have developed successful
strategies for dealing with a lack of communicative
confidence. The data show that a relationship exists
between communicative competence and the risk of being
bullied. The results also suggest that significantly more
adolescents who stutter (57%) reported poorer self-
perceived communicative competence than did adolescents
who do not stutter (13%), especially during public
76 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE
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speaking, group discussions, interpersonal conversations,
and when talking with strangers. If bullies tend to select
targets who show poor communication skills, avoidance
strategies, and unassertive behaviors, then treatment
strategies and programs that work on attitudes and feelings
appear to be warranted as a technique to build general
communication and social skills. For some adolescents who
stutter, changing motor speech behaviors may not result in
accompanying attitudinal and cognitive changes. Programs
that reinforce assertive skills, positive communication
models, acceptance of stuttering, and ways of dealing with
stuttering may actually assist in dealing with potential co-
occurring issues like bullying (Blood, 1995; Bloodstein,
1995; Bloom & Cooperman, 1999; Conture, 2001; Gregory,
2003; Guitar, 1998; Manning, 2001; Murphy & Quesal,
2002; Ramig & Bennett, 1995; Shapiro, 1999; Sheehan,
1970; Silverman, 2004; Van Riper, 1982).
Similar to earlier research, students with fluency disor-
ders reported less confidence in their communication skills
in public speaking, group discussions, interpersonal
conversations, and with strangers than did students without
disorders. The school environment promotes active learning,
small group interactions, and public speaking. Fears or
concerns about communicative participation in classroom or
school activities may compromise opportunities for social
interactions and skill building by adolescents who stutter. If
these skills are not developed and practiced, students who
stutter may be perceived as more introverted, quiet,
submissive, antisocial, and less outgoing. These perceptions
by peers could lead to negative stereotypes and could result
in increased risk of being bullied.
Low confidence in communicative competence was also
linked to low self-esteem. Avoidance strategies and a lack
of confidence in communication skills could be a direct
result of dealing with the negative consequences of
stuttering. It may be that students who stutter elect not to
participate in social interactions because of lack of experi-
ence, fear of failure, prior negative reactions, and increased
communicative pressure and stress. This could result in
increased isolation, negative stereotyping by peers, and
poor self-esteem. Fortunately, the majority of students who
stutter demonstrated positive self-esteem. As suggested in
other research, many students who stutter appear to have
developed protective techniques to maintain positive self-
esteem even while receiving negative reactions from peers,
teachers, and the public.
Our findings also support the earlier work of Hugh-Jones
and Smith (1999), Langevin et al. (1998), and Mooney and
Smith (1995), who reported that bullying and/or teasing
was a problem for individuals who stutter. The finding that
the risk of being bullied in adolescents who stutter is high
when compared to their fluent peers should be of consider-
able concern. Speech-language pathologists need to be
aware of this information as they often serve as the
strongest advocates for students who stutter in the school
setting. Concern about the potential for being bullied and
the need for school personnel and parents to take proactive
roles in monitoring and/or reducing bullying behaviors
appear warranted. These findings lay the foundation for
future research in this area.
AND DISORDERS • Volume 31 • 69–79 • Spring 2004

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Contact author: Gordon W. Blood, Department of Communica-
tion Sciences and Disorders, 110 Moore Building, The Pennsylva-
nia State University, University Park, PA 16802. E-mail:
f2x@psu.edu
Blood • Blood: Bullying and Stuttering 79