Stammering affects 1 per cent of adults worldwide, which would suggest that about 23,000 students and 4,000 staff in UK higher education struggle with this condition.

However, stammering seems to be the most invisible of ¡°hidden disabilities¡±. While it is defined as a disability and covered by the 2010 Equality Act, few people who stammer exercise their rights.

At Soas, University of London, for example, we found hardly any examples of students who stammered approaching our disability advisers.

One reason for this is the pervasive lack of awareness and the perpetuation of myths around stammering among the general public. The Stuttering Foundation, a US body akin to the British Stammering Association (BSA), highlights that common myths ignore the neurological roots of stammering and instead portray stammering as a reaction to nervousness or stress, which can be overcome by slowing down, taking a breath and thinking before one speaks.

ºÚÁϳԹÏÍø

Stammering is a neurological condition, with genetic and developmental influences, arising from malcoordination of brain networks that enable speech production. It is often described as an iceberg; the physical manifestations of stammering (ie, blocking, repetitions and prolongations) are visible above the surface but are only a small part of stammering.

Hidden underneath the water is a large experiential and emotional component of stammering. People who stammer often avoid difficult words and everyday speaking situations, such as talking on the phone, in order to avoid stammering. Hence, you might not realise that a person stammers at all.

ºÚÁϳԹÏÍø

Other hidden aspects include strong emotions towards stammering and oneself, such as frustration, anger, sadness, embarrassment, shame, anxiety, hopelessness and isolation. Therefore, stammering is not simply speech disfluency, but rather a complex communication issue that can affect one¡¯s confidence, self-esteem and self-efficacy.

As people who stammer in higher education, we would argue that it is debatable whether universities have woken up sufficiently to the needs and rights of students and staff who stammer.

Perhaps the lack of effective use of protective legislation also comes about because people who stammer themselves might not be able to easily find support for stammering.

The ability to access invaluable help from speech and language therapists can be a lottery based on postcode and income. In many areas, there are long waiting lists for NHS speech and language therapists, with some speech therapy departments unable to provide any support at all for people who stammer. People who stammer, therefore, often find support and information about stammering from self-help groups or charities such as the BSA.

Indeed, readers might want to reflect on the idea that staff and students who stammer are likely to have had limited support with their stammering.

Without effective knowledge and support for people who stammer being available, the hidden aspects of the stammering iceberg grow, alongside the environmental barriers that prevent fair and equal opportunity for people who stammer.

ºÚÁϳԹÏÍø

Stammering can have a significant impact on a student¡¯s ability to participate in class, get involved in group work and take part in both assessed and formative verbally based exercises.

Students might avoid modules that they would like to take because assessment is based on verbal ability.?This matters because verbal testing, individual presentation and group presentations are used increasingly in the sector.

ºÚÁϳԹÏÍø

This is the result of two distinct pressures. First, there is an increasing desire to test employment-relevant skills, and verbal presentation skills form part of the diverse approaches that allow skills to be assessed. Second, verbal assessment, particularly when it involves group work, can be a cost-effective approach to assessment. Either way, verbal skill is becoming important outside the more traditional areas that have tended to use oral testing, such as language acquisition.

In this context, it is vital that senior managers cultivate an environment that encourages staff, lecturers and personal tutors to think about the needs and rights of people who stammer.

At University College London, research led by Naheem Bashir, the co-author of this article, is taking place to assess support, knowledge and issues around stammering in higher education settings. Ultimately, strategies will be developed to ensure that higher education environments provide appropriate support, as well as equal and fair opportunity for people who stammer.

The Stammerers Through University Consultancy (STUC) partners with universities, including Soas and UCL, to help underpin inclusion campaigns. In addition, the BSA produces an information sheet that outlines for lecturers a host of ways to support people who stammer in informal classroom interactions and also suggests a number of adaptations that can be made to assessed verbal presentations.

These adaptations include providing people who stammer with the options of longer presentation times, the potential to record presentations, to present to smaller groups or to substitute presentations with other forms of assessment. Importantly, these are adaptations that aim to help students overcome their communication difficulties to showcase their understanding of a subject. Indeed, the discussion of stammering is useful in reminding academic colleagues that they need to ensure that they are rewarding content and not fluent speech in any assessed work (apart from those rare subjects where fluency is a genuine learning outcome).

Our view is that an environment that provides appropriate support and opportunities for people who stammer is one that is positive for all students and staff.

ºÚÁϳԹÏÍø

Deborah Johnston is professor of development economics and pro-director (learning and teaching) at Soas, University of London. Naheem Bashir is a PhD student at University College London, whose research, supported by the Dominic Barker Trust, explores the brain basis of stammering, and methods of reducing speech difficulty in people who stammer using brain stimulation techniques.