From: Luc De Nil
Date: 03 Oct 2012
Time: 15:21:31 -0500
Remote Name: 128.100.184.96
Congratulations to the authors for taking on this difficult but critically needed topic. As you point out, trying to define stuttering has been a topic of debate for a long time, kind of like trying to define 'health' or 'good weather'. I'm sure the debate will continue for a while still but your paper certainly is a very constructive step forward. While I like the overall conceptual framework of the definition, I do have a number of concerns that you may want to consider as you continue working on this: 1. the definition implies that an integration of language formulation and speech production is at the heart of stuttering. This certainly has been suggested by a number of people but there is as of yet no consensus of really strong data (see previous comment about stuttering being a speech motor problem, and the recent (2012) review paper by Nippold on language and stuttering). I think it is safe to say th at stuttering is not a language disorder per se, along the lines of SLI or Aphasia. Stuttering’s core feature really is a disruption of overt speech production, which is typically audible or visible, unless the speaker is trying to avoid or hide it. I think if you were to say "lack of integration of underlying processes of planning and producing that lead to fluency disruptions of overt speech production" (or something similar), you would stay away from a stronger hypothesis about cause, unless of course this is what you intended. 2. My main problem with the definition in its current form, however, is that in trying to capture everything the definition really has become too vague. As it stands now, one could include apraxia of speech under the definition, or even non-fluency aphasia or ESL. Each of these conditions may result in “interruptions in the acoustic speech signal” and may lead to “significant difficulties in communication and adverse impact on the speaker’s quality of life”. I think it is critical to have a definition that is sufficiently inclusive while at the same time sufficiently distinct from other communication disorders. One way to do this in the past was to include very specific references to sound/syllable repetitions, prolongations and blocks (mentioned in the current definition but it also includes the vague term ‘disfluencies’). No easy solutions here but just something to continue thinking about.