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From: Peter Reitzes
Date: 14 Oct 2011
Time: 07:55:31 -0500
Remote Name: 206.211.69.253
Laura, thanks for asking such great questions. You write, “I have often thought that some stuttering is caused by ‘abnormal’ breathing.” I can understand why you say this, but I have a different view. In my view, that is like saying “stuttering is caused by foot tapping” or “stuttering is caused by clenching the eyes.” When a person stutters, we learn ways to cope, or push, or struggle with stuttering. Some of these ways are more productive than others. For example, stomping a foot to get out of a stutter is typically seen as less productive then using a light articulatory contact. In my experience, what may be perceived as a breathing issue may really just be the speaker trying to cope in some way with stuttering. And sometimes, as mentioned earlier in this comments section by Bob Quesal, the secondary behaviors we see may be artifacts of previous therapy. You write, “I notice often that this client's breathing is off which in turn sometimes causes this person to block, have to repeat, or start or end vocalizations with inadequate breath support.” Perhaps this is a chicken and the egg question. Which came first, the breathing or the stuttering? Now I don’t know this client so I am not speaking about him or her, but generally speaking, a major component of treatment is identifying tension and releasing tension. I don’t view that as breathing work. For example, if a person is tensing their jaw during a stutter, I wouldn’t say that he or she has a chewing problem – I would say that he or she is tensing the jaw. You ask, “My question is, why has costal breathing not been researched more if it seems to work for some people?” Well, I don’t know, but let me suggest some possibilities. Costal breathing appears to be largely used as peer counseling. In other words, the majority of people teaching costal breathing to people who stutter are not speech-language pathologists (SLPs). The closer you get to the university, it seems, the better chance you have of your treatment being researched. Also, costal breathing is generally used in intensive work that includes other goals such as facing fears and increasing confidence. These programs have a strong self help component because there are many people who stutter working together. So, piecing apart the physical speaking strategy of costal breathing from other components of treatment is not easy. And lastly, as we say in the paper, “The costal breathing speaking strategy contains several contradictions, and many of the physiological explanations of costal breathing reviewed in this paper are simply not logical…” My guess is that some, perhaps many researchers who know of costal breathing may share this view. Here is a link to a 2005 study by Blomgren and colleagues on the Successful Stuttering Management Program (SSMP) – an intensive treatment program which appears similar in some ways to programs which use costal breathing - http://jslhr.asha.org/cgi/content/abstract/48/3/509 Perhaps some day there will be a similar study on programs which use costal breathing. Thanks again for your great questions.