The Monster Study
The Monster Study is the name given to a stuttering experiment performed on twenty-two orphan children in Davenport, Iowa in 1939. It was conducted byWendell Johnson at the University of Iowa. Johnson chose one of his graduate students, Mary Tudor, to conduct the experiment and he supervised her research. After placing the children in control and experimental groups, Tudor gave positive speech therapy to half of the children, praising the fluency of their speech, and negative speech therapy to the other half, belittling the children for every speech imperfection and telling them they were stutterers. Many of the normal speaking orphan children who received negative therapy in the experiment suffered negative psychological effects and some retained speech problems for the rest of their lives. Dubbed "The Monster Study" by some of Johnson's peers, who were horrified that he would experiment on orphan children to prove a hypothesis, the experiment was kept hidden for fear Johnson's reputation would be tarnished in the wake of human experiments conducted by the Nazis during World War II. The University of Iowa publicly apologized for the Monster Study in 2001.
Patricia Zebrowski, University of Iowa assistant professor of speech pathology and audiology, notes, "The body of data that resulted from Johnson's work on children who stutter and their parents is still the largest collection of scientific information on the subject of stuttering onset. Although new work has determined that children who stutter are doing something different in their speech production than non-stutterers, Johnson was the first to talk about the importance of a stutterer's thoughts, attitudes, beliefs, and feelings. We still don't know what causes stuttering, but the 'Iowa' way of approaching study and treatment is still heavily influenced by Johnson, but with an added emphasis on speech production."
The research began with the selection of twenty-two subjects from a veterans' orphanage in Iowa. None were told the intent of her research, and they believed that they were to receive speech therapy. Tudor was trying to induce stuttering in healthy children and to see whether telling stutterers that their speech was fine would produce a change. Included among the twenty-two subjects were ten orphans whom teachers and matrons had marked as stutterers before the study began. Tudor and five other graduate students who agreed to serve as judges listened to each of the children speak, graded them on a scale from 1 (poor) to 5 (fluent) and concurred with the school's assessment. Five were assigned to Group IA, the experimental set, and would be told that their speech was fine. The five in Group IB, the control group, would be told that their speech is "as bad as people say".
The remaining 12 children were chosen at random from the population of normally fluent orphans. Six of these were assigned to IIA. These children, ranging in age from 5 to 15, were to be told that their speech was not normal at all, that they were beginning to stutter and that they must correct this immediately. The final six children in Group IIB, similar in age to those in IIA, were normal speakers who were to be treated as such and given compliments on their nice enunciation.
On the first visit, Tudor tested each child's I.Q. and identified whether they were left-handed or right-handed. A popular theory at the time held that stuttering was caused by a cerebral imbalance. If, for example, you were born left-handed but were using your right hand, your nerve impulses would misfire, affecting your speech. Johnson did not believe the theory, but still suggested Tudor test each child's handedness. She had them draw on chalkboards and squeeze the bulb of the dynamometer. Most were right-handed, but left-handed children were present in all of the groups. There was no correlation between handedness and speech in this subject crop. During this period, they assigned numbers to the children, such as "Case No 15 Experimental Group IIA..."
The experimental period lasted from January until late May 1939, and the actual intervention consisted of Tudor driving to Davenport from Iowa City every few weeks and talking with each child for about 45 minutes. She followed an agreed-upon script. In her dissertation, she reported that she talked to the stuttering youngsters who were going to be told that they did not stutter. She said to them, in part, "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."
To the non-stuttering youngsters in IIA, who were to be branded stutterers, she said: "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."
The children in IIA responded immediately. 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 childrens' 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.
Mary Tudor herself wasn't untouched. Three times after her experiment had officially ended she returned to the orphanage to voluntarily provide follow-up care. She told the IIA children that they didn't stutter after all. The impact, however well meaning, was questionable. She wrote to Johnson about the orphans in a slightly defensive letter dated April 22, 1940, "I believe that in time they . . . will recover, but we certainly made a definite impression on them."
The results of the study were freely available in the library of the University of Iowa, but Johnson did not seek publication of the results. The experiment became national news in the wake of a series of articles conducted by an investigative reporter at the San Jose Mercury News in 2001, and a book was written to provide an impartial scientific evaluation. The panel of authors in the book consists mostly of speech pathologists who fail to reach any consensus on either the ethical ramifications or scientific consequences of the Monster Study. Richard Schwartz concludes in Chapter 6 of the book that the Monster Study "was unfortunate in Tudor and Johnson's lack of regard for the potential harm to the children who participated and in their selection of institutionalized children simply because they were easily available. The deception and the apparent lack of debriefing were also not justifiable." Other authors concur claiming the orphan experiment was not within the ethical boundaries of acceptable research. Others, however, felt that the ethical standards in 1939 were different from those used today. Some felt the study was poorly designed and executed by Tudor, and as a result the data offered no proof of Johnson's subsequent hypothesis that "stuttering begins, not in the child's mouth but in the parent's ear" -- i.e., that it is the well-meaning parent's effort to help the child avoid what the parent has labeled "stuttering" (but is in fact within the range of normal speech) that contributes to what ultimately becomes the problem diagnosed as stuttering.
On 17 August 2007, six of the orphan children were awarded $925,000 by the State of Iowa for life-long psychological and emotional scars caused by six months of torment during the Iowa University experiment. The study learned that although none of the children became stutterers, some became self-conscious and reluctant to speak.  A spokesman of the University of Iowa called the experiment "regrettable" and added: "This is a study that should never be considered defensible in any era...In no way would I ever think of defending this study. In no way. It’s more than unfortunate." Before her death, Mary Tudor expressed deep regret about her role in the Monster Study and maintained that Wendell Johnson should have done more to reverse the negative effects on the orphan children's speech. In spite of Wendell Johnson's role in the creation of the Monster Study, Tudor still felt she had made many positive contributions to speech pathology and stuttering research..
The lawsuit was an outgrowth of a San Jose Mercury News article in 2001 conducted by an investigative reporter.
The article revealed that several of the orphans had long-lasting psychological effects stemming from the experiment. The state tried unsuccessfully to have the lawsuit dismissed but in September, 2005, the Iowa's Supreme Court justices agreed with a lower court in rejecting the state's claim of immunity and petition for dismissal.
Many of the orphans testified that they were harmed by the "Monster Study" but outside of Mary Tudor, who testified in a deposition on Nov. 19, 2002, there were no actual eye witnesses to the events. The advanced age of the three surviving former orphans on the plaintiff's side helped expedite a settlement with the state. The Iowa attorney general's office said in a press release on Aug. 17, 2007, that the settlement of $925,000 was fair and appropriate, although the state refused to accept liability for any potential harm caused to the orphans.
"For the plaintiffs, we hope and believe it will help provide closure relating to experiences from long ago and to memories going back almost 70 years. For all parties, it ends long-running, difficult and costly litigation that only would have run up more expenses and delayed resolution to plaintiffs who are in their seventies and eighties." (DM Register)
Despite the settlement, the debate remains contentious over what harm, if any, the Monster Study caused to the orphan children. Nicholas Johnson, the son of the late Wendell Johnson, has vehemently defended his father. He and some speech pathologists have argued that Wendell Johnson did not intend to harm the orphan children and that none of the orphans actually were diagnosed as "stutterers" at the end of the experiment. Other speech pathologists have condemned the experiment and said that the orphans' speech and behavior was adversely affected by the negative conditioning they received. Letters between Mary Tudor and Wendell Johnson that were written shortly after the experiment ended showed that the children's speech had deteriorated significantly. Mary Tudor returned to the orphanage three times to try and reverse the negative effects caused by the experiment but lamented the fact that she was unable to provide enough positive therapy to reverse the deleterious effects. (Ethics and Orphans. San Jose Mercury News).
Today the American Speech-Language-Hearing Association prohibits experimentation on children when there exists a significant chance of causing lasting harmful consequences. It may be unfair, however, to judge the study by the formal ethical standards that were only created later. The negative consequences of this study appear minor when compared with ethical violations in human subjects research in other fields, conducted throughout the second half of the 20th century. These latter cases, reviewed, approved and funded in major research institutions, sometimes resulted in the death of subjects.
The study was "suppressed" in the sense that Wendell Johnson made no attempt to pursue publication of his results, reportedly on the advice of colleagues, who warned him that the experiment could tarnish his career. However, the thesis was bound, catalogued, and made available in the university's library in identical fashion to all other masters theses. It was often checked out over the years. It was referred to in academic and general publications.
Within the profession of speech pathology there is to this day no single, agreed-upon hypothesis of stuttering -- either as to its cause or a single, most appropriate therapy. (This statement is consistent with what is attributed to Patricia Zebrowski, above).
- ^ Dyer, Jim. "Ethic and Orphans: 'The Monster Study'". Mercury News. Mercury News. Retrieved 19 September 2011.
- ^ Reynolds, Gretchen. "The Suttering Doctor's 'Monster Study'". The New York Times. The New York Times. Retrieved 25 September 2011.
- ^ Reynolds, Gretchen. "The Suttering Doctor's 'Monster Study'". The New York Times. The New York Times. Retrieved 25 September 2011.
- ^  - New York Times
- ^ Huge payout in US stuttering case - BBC News
- ^ See generally, Robert Goldfarb, ed., Ethics: A Case Study from Fluency (Oxford and San Diego: Plural Publishing, 2005) -- which is probably the book the author of the entry above intended to reference -- especially chapter 9. http://www.nicholasjohnson.org/wjohnson/hsr/njhsr512.pdf
Now, perhaps you'd like the Psychiatric perspective of the "Ethics" of this, ...... uhhh, ....... "research": published in 2002.
"Michael Flaum, M.D., "Research Did Not Cause Stuttering"Guest OpinionThe Daily IowanSeptember 4, 2002, p. 8A
As someone involved with human-subjects research, I believe The Daily Iowan's reporting and editorials regarding the 1939 Tudor study disserve journalism, the university, and the Tudor study plaintiffs themselves. They simply perpetuate the mythology surrounding this master's thesis about the onset of stuttering.
The most decisive omitted fact is that the latest, impartial scientific evaluation of the study's data concludes that the researcher did not, indeed could not have, "caused stuttering" — or done any other lasting harm for that matter. See for
Ambrose and Yairi's article in the May 2002 Journal of Speech-Language Pathology
for the reasons.
The plaintiffs may, or may not, have suffered harm from something else before they entered the Davenport home, while they were there, or thereafter. But there is, so far, no proof any harm they may have suffered in life was related to this research. Indeed, the cited study indicates there is evidence that it could not have been related.
The authors also conclude there is little or no indication the researcher had any intention to do harm.
That really ought to be the end of the matter. If harm was neither intended nor done, what's the problem? Where's the "lack of ethics" your editorial headlined?
A former UI vice president for Research says the study "was well within the norms of the time." He's right. UI authorities approved not only this study but many others at the home. Those with legal responsibility for the orphans approved.
Even if harm was done — and apparently it wasn't — aren't "the norms of the time" the proper basis for moral judgment? Wouldn't you rather have your actions in 2002 judged by the standards of 2002 than by those of 2065?
But wait for the irony. In the late 1930s, there were no human-subjects ethical standards. And yet the standards self-imposed by this researcher and supervisor more than 60 years ago compare very favorably indeed with those of major
research institutions today.
They certainly compare favorably with the Tuskegee syphilis study, subjects exposed to atom bomb radiation, the 12,000 babies with thalidomide birth defects, or subjects deliberately injected with cancer and hepatitis. Such studies were approved by government and prestigious institutions decades after the 1939 study.
Now, there are very detailed ethical standards. And yet, within the past two or three years, the NIH has shut down eight major institutions for violations. In 1999, the FDA chastised the UI itself for "corrections promised but not implemented" in
1992, 1995, and 1998. In 2001, a volunteer subject in a research study at Johns Hopkins actually died.
There are many intricate issues surrounding the role of clinical trials and other uses of human subjects in research. Among those issues are the most appropriate legal and ethical standards (including those that unnecessarily inhibit needed research). That would be a worthy subject for The Daily Iowan's editorial treatment.
Picking on a dusty master's thesis from 1939, and repeating the myth that it did harm in unethical ways when it did not, is not only grossly unfair to the researcher and misleading to the public, it's also a rather bizarre choice of "news peg" from among the hundreds of timely and significant case studies available for editorial treatment."
Michael Flaum, M.D., director,
Iowa Consortium for Mental Health
And, if you look here;
You'll find one Michael Flaum MD as a Co Chair of the Text Revision Command of the last DSM's Schizophrenia Pills Sales Team.