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From: William Rosenthal
Date: 08 Oct 2006
Time: 19:02:32 -0500
Remote Name: 67.169.60.208
Gunnars, I think that it is helpful to think about stuttering as a two component process. The first component consists of motor speech behaviors, the second of psychodynamic features that influence the course of treatment. You can think of these as two, orthogonal normal distributions. If a person is high on the psychodynamic distribution, psychotherapy will be an essential part of treatment. If they are high on the organic distribution, then speech management/modification will be more effective. You can play around with various positions on these distributions and see that for some people, both approaches are essential, if for example they are high on both distributions. I think your 6) and 7) could result from either an intractable organic loading, or severe psychodynamic impasse. Many treatment approaches emphasize intervention along only one of the dimensions. It may be either the wrong dimension for a particular individual, or it may be inadequate because both dimensions must be attended to. What do you think? -Bill