When Science Goes Wrong (37 page)

Even so, the indoctrination clearly had an effect. Here is part of Tudor’s report of an interview with one of the children in the NS group, 11-year-old Clarence Fifer, on May 2 – three-and-a-half-months into the study:

‘How is your stuttering today?’

‘I don’t know.’

‘When do you seem to have the most trouble?’

‘When I’m playin’.’

‘Tell me something about it.’

‘Well, most of the time I stutter.’

‘Do the other boys notice it?’

‘Sometimes.’

‘Do they ever say anything?’

‘No.’

‘How do you know they notice it?’

‘They kinda laughed.’

‘What did you do then?’

‘Walked away.’

‘Does it bother you much?’

‘Yes, feel pretty bad.’

‘What do you do about it?’

‘Next time try to keep myself from doin’ it.’

‘How do you do that?’

‘Sometimes I take a breath.’

‘How does it feel when you speak?’

‘Kinda strain my throat.’

His speech had a breathy quality and he took a breath after every few words whether he needed it or not.

During this interview, he had 25 speech interruptions. The stuttering phenomena added to the previous list were deep inhalation, excessive exhalation and eyes closed.

Since Tudor deceived the staff in the same way that she deceived the children, the staff could not have been in a position to give any kind of informed consent to the study. Whether there was any person at the orphanage, such as its administrator, who was informed about the true purpose of the study is not stated in Tudor’s thesis. Jim Dyer, who interviewed Tudor in 2000, when she was 84-years old, wrote that Johnson obtained permission for the study from orphanage officials, but he didn’t make clear whether Johnson actually told these officials what would be done to the children. It’s possible that Johnson felt he had
carte blanche
to initiate any kind of study that he considered appropriate.

So what was the result of the study? What happened to the children’s speech? In his articles in the San
Jose
Mercury News
in 2001, Dyer reported that most or all of the children in the NS group responded to being labelled as stutterers by stuttering. In doing so, Dyer said, they confirmed Wendell Johnson’s diagnosogenic theory. In addition to stuttering, Dyer reported that many of these children became withdrawn and isolated; they were reluctant to speak at all and what few words they did speak came out in single words or brief phrases rather than complete sentences.

When Dyer tracked down some of the children – now elderly adults – for his articles, they supposedly confirmed the findings of the study. Norma Jean Pugh, who was five at the time of the study and spoke normally, apparently told Dyer that she had been induced to stutter by Tudor’s experiment, and that her stutter persisted for years, gravely damaging her social relationships and her education. Now, at age 64, she was a near-total recluse. Mary Korlaske, who also spoke normally at the start of the experiment, was also induced to stutter, she told Dyer. She later got over the stuttering, but it recurred in 1999 after the death of her husband. She moved into a retirement home, where she rarely left her room. Dyer said that she stuttered when he interviewed her, although his description of her speech did not correspond closely to what a speech pathologist would call stuttering.

There is some evidence that Johnson too believed that labelling the children as stutterers caused at least some of them to stutter. In email correspondence, Johnson’s student Oliver Bloodstein told me that ‘In his lectures in the fall of 1942, Johnson made it clear that he thought the results of the Tudor study supported the diagnosogenic theory.’ Bloodstein also wrote (in a published article): ‘To the best of my recollection, he told us that one child actually did begin to stutter as a result of the procedure.’

Although Dyer visited the University of Iowa library, where Tudor’s thesis is archived, he did not say explicitly that he read the thesis, and most of his account is based on interviews with Tudor and the surviving subjects, along with readings of Tudor’s notes. (I was not able to locate Dyer for an interview.)

A totally different account of the Johnson-Tudor study was published in 2002 by Nicoline Ambrose and Ehud Yairi, the experts on stuttering at the University of Illinois. Ambrose and Yairi actually went back and read the 60-year-old typescript that was Tudor’s thesis, and what they wrote about it in the
American Journal of Speech-Language Pathology
contradicted the central assertion of Dyer’s articles: Tudor’s experiment, they said, did not cause any of the children to stutter.

This conclusion was based principally on the assessments of the children’s speech that were made at the beginning and end of the study by the panel of five blinded judges. Each judge independently rated the fluency of the children’s speech on a five-point scale, with 1 corresponding to the worst fluency and 5 to the best. At the beginning of the study, the average score for the children in the crucial NS group was 2.83 – roughly in the middle of the scale of fluency, rather than near 5 as one might expect. At the end of the study the average score for these children was 2.92. Statistically, the tiny shift of the average (by 0.09 units) was completely insignificant, and what’s more, it was a shift toward
improved
speech – the opposite of what Johnson’s theory would have predicted. The child in this group who showed the biggest shift was Mary Korlaske, who supposedly told Dyer that she was induced to stutter by the experiment. Her speech shifted by 0.8 units – in the direction of greater fluency!

The fluency scores given by the judges included sub-scores for individual kinds of disfluency, some of which (such as repetition of syllables) were symptoms of stuttering, while others were not. Even when Ambrose and Yairi looked specifically at the scores for the stuttering-related disfluencies, there was no significant change over the course of the study.

Besides the numerical score, the judges added written comments at the end of the study. For each of the five children, including Korlaske, the majority of the judges simply wrote ‘No stuttering.’ Some of the judgments included statements like ‘appeared hesitant’ or ‘answered briefly’, but not one judge stated that any child stuttered or mentioned repetition of syllables, the key symptom of stuttering.

None of the other three groups showed any significant shift in their average speech fluency either. Even looked at individually, none of the children showed any substantial shift in the direction predicted by the theory. Thus, Ambrose and Yairi’s analysis showed that Dyer’s central claim – that the treatment caused the normally speaking children to stutter – was wrong. Nor, apparently, had the stuttering’ children been caused to stop stuttering by being labelled as normal speakers.

One might think on this basis that the Tudor study was actually a refutation of Johnson’s theory rather than a confirmation, since changing the children’s labels had no effect on their propensity to stutter. But no; it was worse than that, according to Ambrose and Yairi. They reported that the study was so poorly designed and executed that it could not have been expected to reveal anything about the theory, regardless of whether the theory was right or wrong.

Most crucially, Ambrose and Yairi reported that many of the children had been assigned to the wrong subject groups. If they had been correctly assigned, the children in the NS and NN groups should have been given scores near the 5 (fluent) end of the scale, and the children in the SN and SS groups should have been given scores near the 1 (disfluent) end of the scale. In fact, however, there were no significant differences between the average scores of any of the groups before the treatment began. There were several children who were clearly described as stuttering or repeating syllables who were put in one of the ‘N’ groups, and several children who were described as not stuttering who were put in one of the ‘S’ groups. Apparently, the ‘stuttering’ children were selected simply because the orphanage staff said that they stuttered, and the ‘normal-speaking’ children were selected simply because the staff said that they didn’t stutter, and even though these assignments were not always borne out by the judges’ assessments, the children were left in the groups they were assigned to.

Thanks to an interlibrary loan, I was finally able to lay hands on Tudor’s thesis myself, and I confirmed the truth of what Ambrose and Yairi said on these points. However, this problem is not as devastating to the credibility of the study as Ambrose and Yairi implied. For one thing, many of the items used for fluency scoring were not criteria used in the diagnosis of stuttering, and for these unrelated items there was no reason to expect that stuttering children should score differently from non-stuttering children. Also, Tudor was concerned with the effects of changing labels: thus in selecting children for the study what mattered most was how a child was labelled prior to the study, not whether he or she actually stuttered or not. In this sense, Tudor had good reason to depend on the judgments of the orphanage staff, who had been in contact with the children for years.

There were other reasons, however, why no solid conclusions could be drawn from the study. I already mentioned the fact that the children were too old to test the diagnosogenic theory if children’s susceptibility to criticism was limited to a developmental period around the age when children typically begin to stutter. Also, the children formed an unrepresentative sample in many respects, such as being institutionalised and also in most cases having below-average IQs. Furthermore, there were too few children in each group for it to be likely that significant effects of treatment would emerge.

Finally, the indoctrination of the children was done ineffectually. As already mentioned, the staff didn’t cooperate, leaving Tudor’s visits as almost the only ‘relabelling’ that the children experienced. It is hard to believe that just a few sessions with Tudor would somehow outweigh a lifetime of being exposed to the opposite labels. Tudor herself commented on this in the ‘Discussion’ section of her thesis: ‘As it was,’ she wrote, ‘the children received their stimulation almost entirely from the writer. If these children had been constantly reminded of their speech they would have undoubtedly reacted more positively [ie, by showing more signs of stuttering].’ And she predicted that ‘more extensive results’ could be expected if the experiment had been done in a ‘home situation’ with constant critiques from the children’s parents.

Although, in the ‘Results’ section, Tudor reported the onset of ‘stuttering phenomena’ during the treatment of some of the NS children, such as Clarence Fifer, she did not mention any induction of stuttering in her Discussion. This was presumably because neither the judges’ assessments nor her own numerical analyses of the children’s speech documented such an effect. But she did conclude that these children were affected in other ways:

All of the subjects in Group IIA [NS] showed similar types of speech behavior during the experimental period. A decrease in verbal output was characteristic of all six subjects; that is, they were reluctant to speak and spoke only when they were urged to. Second, their rate of speaking was decreased. They spoke more slowly and with greater exactness. They had a tendency to weigh each word before they said it. Third, the length of response was shortened. The two younger subjects responded with only one word whenever possible. Fourth, they all became more self-conscious. They appeared shy and embarrassed in many situations. Fifth, they accepted the fact that there was something definitely wrong with their speech. Sixth, every subject reacted to his speech interruptions in some manner. Some hung their heads, others gasped and covered their mouths with their hands; others laughed with embarrassment. In every case, the children’s behavior changed noticeably.

This description is similar to Dyer’s assertion that the children in the NS group became withdrawn, isolated and reluctant to speak. The notion that Tudor perceived that the children suffered this kind of harm is bolstered by the fact that, after completion of the study, she returned to the orphanage three times to ‘debrief’ the children in the NS group – that is, to reassure them that they were in fact normal speakers and to encourage them to speak freely.

After the first of these visits, in March 1940, she wrote to Johnson as follows: ‘I didn’t find them as free from the effects of the therapy I had inflicted upon them last year as I had hoped to. But as I am still a firm believer in the theory of evaluative labelling, I wasn’t too disappointed.’ This passage (quoted by Dyer) confirms that Tudor perceived that the children suffered some psychological harm from the study, and that this harm lasted at least through to the following year. In addition, it implies that she saw this as confirmation of Johnson’s theory. Either she was suggesting that the children were, in fact, stuttering, or she thought that any kind of difficulty in speaking, even a reluctance to speak motivated by low self-esteem, would count as a confirmation.