Think of a scientific study that uses orphans to investigate stuttering. The children are divided into 2 groups, with one group receiving positive therapy by means of encouragement and praise, the other group being told they were stutterers and belittled for stuttering.
Sounds like something that Dr Mengele would have done, right?
It was actually a study carried out in 1939 by American psychologist and speech therapist Wendell Johnson (1906 – 1965), pictured below.
The study was so horrific that Johnson’s peers referred to it as The Monster Study, the name by which it remains known to this day.
Johnson had himself grown up as a stutterer and spent most of his life trying to find the causes and cures for stuttering. As an undergraduate at the University of Iowa, he used various techniques to overcome this affliction – self analysis, writing, public speaking and forced vocalising. In the process he obtained a degree in English, a masters in psychology in 1929 and a doctorate in psychology in 1931, his thesis “Why I Stutter” being published commercially. Johnson’s aim was to investigate and devote his life to speech therapy so as to help children overcome the same adversity.
In 1939 Johnson began a new experiment.
At that time it was believed that the cause of stuttering was organic or genetic, that one was born a stutterer and that nothing could be done about it. Johnson did not agree. He was of the opinion that labelling children as “stutterers” could create or worsen the problem, a hypothesis to be tested by his experiment.
Firstly he selected as his assistant one of his graduate students, Mary Tudor, to conduct the experiment. Johnson would supervise her research.
Next, 22 orphans in ages between 5 and 15 were selected from a veterans’ orphanage. None of the children were told of the experiment; instead they were told they were going to receive speech therapy. Included in the 22 were 10 children identified by the orphanage personnel as being stutterers. The children were divided into 2 groups, with 5 of the stutterers in one group and 5 in the other group. The other children were randomly allocated to the two groups. The groups were known as Group A and Group B. Between January and late May 1939, Mary Tudor met with each child for 45 minutes each few weeks.
Group A was labelled “normal speakers”, the children in this group being told that their speech was fine and that they did not stutter. The fluency of their speech was praised. In her words, they were told "You'll outgrow [the stuttering], and you will be able to speak even much better than you are speaking now. . . . Pay no attention to what others say about your speaking ability for undoubtedly they do not realize that this is only a phase." In general, the children in Group A were praised no matter what they did.
In contrast, the children of Group B, the group labelled “stutterers”, were told that they were stutterers and were belittled for each speech imperfection. They were deliberately demoralised and were insulted for even the slightest error in speech, sometimes even when they didn’t make an error. They were lectured about stuttering and told to take extra care not to repeat words. Other teachers and staff at the orphanage were even unknowingly recruited to reinforce the label as the researchers told them the whole group were stutterers. In Tudor’s own words, these children were told "The staff has come to the conclusion that you have a great deal of trouble with your speech. . . . You have many of the symptoms of a child who is beginning to stutter. You must try to stop yourself immediately. Use your will power. . . . Do anything to keep from stuttering. . . . Don't ever speak unless you can do it right. You see how [the name of a child in the institution who stuttered severely] stutters, don't you? Well, he undoubtedly started this very same way."
According to Wikipedia:
After her second session with 5-year-old Norma Jean Pugh, Tudor wrote, "It was very difficult to get her to speak, although she spoke very freely the month before." Another in the group, 9-year-old Betty Romp, "practically refuses to talk," a researcher wrote in his final evaluation. "Held hand or arm over eyes most of the time."
Hazel Potter, 15, the oldest in her group, became "much more conscious of herself, and she talked less," Tudor noted. Potter also began to interject and to snap her fingers in frustration. She was asked why she said 'a' so much. "Because I'm afraid I can't say the next word." "Why did you snap your fingers?" "Because I was afraid I was going to say 'a.'"
All of the children’s schoolwork fell off. One of the boys began refusing to recite in class. The other, eleven-year-old Clarence Fifer, started anxiously correcting himself. "He stopped and told me he was going to have trouble on words before he said them," Tudor reported. She asked him how he knew. He said that the sound "wouldn't come out. Feels like it's stuck in there."
The sixth orphan, Mary Korlaske, a 12-year-old, grew withdrawn and fractious. During their sessions, Tudor asked whether her best friend knew about her 'stuttering,' Korlaske muttered, "No." "Why not?" Korlaske shuffled her feet. "I hardly ever talk to her." Two years later, she ran away from the orphanage and eventually ended up at the rougher Industrial School for Girls — simultaneously escaping her human experimentation.
Of the six 'normal' (non-stuttering) children in the stutterers group,, Group B, five began stuttering after the negative therapy. Of the five children in Group B who had stuttered before their 'therapy', three became worse.
In comparison, only one of the children in the group labelled 'normal', Group A, had greater speech problems after the study.
The findings of the study supported Johnson’s hypothesis and contributed to new and successful ways of treating people with stuttering.
Although the results of the study were available in the University of Iowa library, they were never published. It is believed that Johnson chose to do so on the advice of colleagues who questioned the ethics of his methods. Subsequently the study was kept hidden for fear that it would tarnish Johnson’s reputation in the light of Nazi experiments on humans during World War 2.
Sadly, for the children, there was inadequate post-study counseling and therapy. Tudor voluntarily returned to the orphanage three times after the study had ended to provide follow-up care. To the group labeled stutterers, she told them that they did not stutter after all. This served to make them only more confused.
In 1940 she wrote to Johnson: "I believe that in time they . . . will recover, but we certainly made a definite impression on them." In other letters she lamented the fact that they had not been able to provide sufficient positive counseling to overcome the significant deleterious effects of the study. Until her death she continued to maintain that the study had made important findings but that greater follow up care should have been provided. She also regretted her part in the study.
And there the matter rested until 2001 when an investigative reporter for the San Jose Mercury News wrote a series of articles about the study and a book evaluating the study was published.
Six remaining children of Group B sued the State of Iowa for life-long psychological and emotional scarring caused by the study. They complained of ongoing negative psychological effects, learning disabilities and, in some cases, speech problems. Although none had become stutterers, the evidence was that they had become self-conscious and unwilling to speak. The litigation was concluded with a $925,000 settlement in 2007.
The University of Iowa issued a public apology, calling the study “regrettable” and indefensible.
So how does one view the study?
On the one hand, the persons carrying it out thought that they were doing the right thing and were motivated by a desire to do good. There were no restrictions or guidelines on human experimentation at that time and even in the second half of the 20th century there were numerous funded studies using humans, some of whom died.
On the other hand, the children had no say in the experiment, they were not told of the experiment and were misled into believing they were receiving therapy. Staff likewise were not told the truth about the study and were made unwitting accomplices. The fact that the study was never published, notwithstanding the long term damage caused to the children and inadequate follow up, makes the study even more unethical.
There remains no single agreed-upon cause for stuttering or the most appropriate therapy.