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From: Vasu Parameswaran
Date: 12 Oct 2004
Time: 15:06:23 -0500
Remote Name: 151.200.90.2
Hi John, Firstly, most words spoken by people who stutter are fluent - which means that we have fluency capacity and do not need to learn to speak fluently. Granted that this fluency breaks down in situations of higher stress but it is precisely in these situations that fluency shaping techniques also have a problem - I have seen many PWS have a problem with "transfer". In the therapy room, I can become comfortable quickly with the clinician and exhibit remarkable skill with all the techniques, but then put me outside and I go "Bbbbb...". Secondly, FSI fails to acknowledge tricks (word substitutions, running starts etc.) and the generally accepted neurological basis for stuttering. If the core of stuttering is neurological, fluency shaping would have little control over the occurrences, and we would have to fall back to an MSI approach anyway. My opinion is to just go with MSI - atleast it is honest enough to acknowledge that there are certain things beyond your control and the best you can do is to experiment with the word and release it. I would also go a step further and not just seek desensitization, which is necessary, but fear reduction as well. Desensitization is passive while fear reduction, where you actively seek challenging situations, goes a step further and needs to become a critical component of any therapy. I'd love to hear more on this discussion.