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From: Huang Haiyin
Date: 10/5/02
Time: 9:04:05 AM
Remote Name: 211.144.124.152
I agree “most stutterers show a temporary improvement after physical or mechanical speech therapy. It never seems to last though.” However, with the new progress in neuroscience research on “brain plasticity”, I think that the prevalent view that “without changing the mindset of a stutterer there is just no hope of a permanent improvement” is too pessimistic and needs further discussion. In this paper, Dr.Nathan Lavid gave us a very important information, not the confirmation that a genetic component to development stuttering, but the novel concept of brain plasticity. In 2000, the American psychiatrist Eric Kandel was awarded the Nobel Prize for Physiology and Medicine for his contribution to the understanding of the molecular mechanisms of brain plasticity. Brain plasticity is the ability of the brain to remodel its structure and function in response to outside stimuli. In other words, the brain is not a static, "hardwired" organ, but rather a plastic, malleable organ that changes itself to perform better. I believe that the concept of brain plasticity can be applied effectively in the treatment of adults who stutter(including chronic stutterer). Then, let us discuss the view that “without changing the mindset of a stutterer there is just no hope of a permanent improvement”. If the mindset means abnormal gene or gene expression, then we have to change the gene or gene expression to get permanent improvement. There are two ways for doing the task: 1. to replace the abnormal gene with normal gene. To my knowledge, gene therapy is still premature with some unexpected consequences, thus this way is almost impossible at present time. 2. In the light of brain plasticity, new gene expression and subsequent brain modulation is possible throughout life. The amount of change, and hence improvement, depends on the quality and amount of stimulation and practice. It is possible, through effective speech therapy and unremitting practice, to change the gene expression in the brain of adult stutterer. Then the “mindset” of a stutterer is changed and permanent improvement (or clinical recovery) is achieved. My recovery from chronic stuttering and other successful cases provide clinical evidence in support of the theory of brain plasticity. If you are interested, please read my article “one chronic stutterer’s path to fluency and his supposition” for the online conference in the same website. In my opinion, if a chronic stutterer speaks fluently when he talks to himself, that stutterer has the potential to speak fluently at other circumstances. It is true that there is no causal relationship between the psychological factor (such as fear of stuttering) and stuttering, but the psychological factor has a strong influence over stuttering. Why is chronic stuttering so difficult to recover from? One of the causes is that the difficulties in removing the psychological obstacle has been greatly underrated: the fear for stuttering has been so firmly memorized in the brain that some biochemical changes at the protein or RNA level might have taken place. In addition to correct therapeutic techniques, practicing speaking in everyday life was equally important. Only by unremitting practice, can the memory of fluent speech gradually replace of painful memory of stuttering. In the same time the biochemical materials in memory of fluent speech are produced and stored in the brain.When the painful memory of stuttering is completely replaced by the memory of fluent speech, the psychological obstacle is removed successfully, and recovery of chronic stuttering ensues. I was excited to find that the brain plasticity theory advocated by Dr.Nathan Lavid is in support of my opinion that chronic stutterers can be trained effectively and have the potential to fluency, persistent practice and stimulation can change the gene expression in the brain! My recovery from chronic stuttering provided clinical evidence for the theory of brain plasticity, too.