Listener Impressions of Spasmodic Dysphonia: Symptom Severity and Disclosure of Diagnosis During a Job Interview
Isetti, Derek Duane
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The U.S. government has attempted to address inequality in the workforce for those with disabilities through the passage of the Americans with Disabilities Act of 1990 (ADA). Because the ADA is a complex legal document, Chapter 1 is presented as a review article, serving as a tutorial for speech-language pathologists as to how the tenants of the ADA might be applied to individuals with voice disorders. Under the ADA, disclosure of a disability is not mandated. However, job-related accommodations can only be requested if the presence of a disability is disclosed. This decision to disclose a disability during the hiring process is likely complex, involving variables related to the setting, the motivation behind the disclosure, as well as the specific medical condition. Chapter 2 proposes a theoretical model that summarizes the factors an individual with a communication disorder might consider prior to making a disclosure decision during the hiring process. In this proposed model, the apparentness of symptoms is believed to factor heavily into disclosure decisions. Individuals with health symptoms that are more hidden may have the option to refrain from disclosure, whereas those with more apparent disabilities (i.e., stuttering) do not have the option of concealing what is already evident to the observer. Chapter 3 attempts to provide a baseline for how speakers with a particular communication disorder (spasmodic dysphonia or SD) are perceived by unfamiliar listeners pre-disclosure, when no information about the condition is provided. In general, speakers with SD were judged more negatively on certain traits, suggesting that the presenting symptoms of this voice disorder are noticeable and can lead to negative judgments by communication partners. However, the results of Chapter 3 suggest that it is the severity of symptoms that may be important to consider, as some speakers with very mild SD were not penalized by listeners. Chapter 4 explores the issue of symptom severity in greater depth within the context of a simulated job interview. Listeners consisting of human resources personnel (HRP) with experience in hiring were asked to discuss their reactions to the same job applicant with SD in one of two listening conditions: pre-BOTOX/severe or post-BOTOX/mild. Prior to any disclosure, HRP noticed the voice to a different degree and described the voice of the applicant differently between the two conditions. A unique subset of employer concerns emerged for the applicant with severe symptoms. Upon an eventual disclosure of SD, those same HRP rated their preferences for supplemental information and stated their rationale for or against disclosure in both severity conditions. Findings suggest that severity may play an important role in whether or not disclosure of SD is ultimately recommended by employers. Earlier disclosures were preferred most often in the severe condition, while disclosure was often discouraged when symptoms were mild. This suggests that the symptoms of each individual patient with SD must be taken into account in lieu of making unilateral disclosure recommendations in this population.
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