We are the biggest team researching stuttering in the United Kingdom with six full-time members of staff and three PhD students. We also have many undergraduates who work with us, young people on work experience and students from the US doing internships. Our main source of support is the Wellcome Trust which is a UK-based charitable trust. We are located in the Psychology Department of University College London. This brings a different perspective to our work to many other research groups. In the UK, treatment for developmental stuttering is provided mainly through the National Health Service and most clinics specializing in the disorder are separate from University-based research groups (in fact, UCL did not have a Communications Disorder department until recently). Having said that, we work with two clinics in the London area, one of which is based at City University. It trains pathologists as well as being involved in our programme of research and is run by Roberta Williams. The other clinic we have been involved with is the Michael Palin centre headed by Lena Rustin.
To return to the implications of being located in the Psychology Department, first let us tell you a little bit about UK psychology departments and how the group got established in our department rather than some other that might be considered more appropriate. When people acost you at parties about psychology, they usually assume that you're a clinical psychologist. Howell, the head of this group is Professor of Experimental Psychology. Experimental Psychologists study behavior in general (be warned however, do not express your interest in "behavior" to your party-going acquaintance else he or she will put you down as a representative of a totalitarian political party). Clinical psychology is an important part of psychology but, in the UK, you get qualified by taking a vocational course after you have a general degree in psychology (which is what our department psychology but, in the UK, you get qualified by taking a vocational course after you have a general degree in psychology (which is what our department provides to undergraduates though we offer postgraduate courses in clincal psychology too). The sort of things Howell is involved with include teaching students how to understand theories, develop hypotheses from the theories, design, run and statistically analyse experiments to test them. His particular area of expertise (predating his involvement in research on stuttering) is in language perception and production and hearing (you might have a look at his textbook on these topics written with Stuart Rosen of the Phonetics Department UCL to get an idea of the general area).
We think that it's fair to say that psychologists have a different focus of interest to speech pathologists. Howell recalls a colleague commenting when he was involved in all the areas just mentioned telling him that he was "narrow" in his research focus. What would she think now when he's restricted his interest to speech production alone! Another difference in emphasis is that a lot of psychologists are not so interested in practical goals like understanding what causes a disorder and doing something about it as using people with disorders to test ideas about how normal behavior proceeds. Obviously speech therapists have the opposite emphasis. Our training, on the one hand, and our involvement with therapists, on the other, has led us to occupy the middle ground trying to meet both ends half way (if you see what we mean).
The experimental emphasis reveals itself in some of the first work we did on stuttering - investigating whether speakers who stutter have physiological deficits in the auditory periphery (middle ear system and bone-conduction sound-transmission system). Though we could not find any such deficit that others had hypothesised, the deductive reasoning involved did lead on to us testing for the first time the effects of frequency-shifted feedback on people who stutter back in 1987. This manipulation has dramatic effects on the fluency of people who stutter. The influences of this manipulation are immediate and last as long as the frequency alteration is made. It has practical signficance, even when the effects are short-term, as it allows people who stutter to use telephones, speak in public and so on. An experimental psychologist would think it wrong to dismiss frequency-shifted feedback because it elicits a fluent response short term. Rather, colleagues in the animal learning field, like Phil Reed at UCL who we work with, are easily able to indicate how to use this form of altered auditory feedback to produce persistent effects. The group has been investigating how frequency-shifted feedback leads to fluency improvement and what similarities and differences it has with other short-term effective treatments like delayed auditory feedback. Both forms appear to affect cerebellar timing systems (albeit in slightly different ways).
One final note raised by frequency-shifted feedback and the apparent involvement of cerebellar timing systems: The group are not of the view that there is anything wrong with this part of the brain of people who stutter, these are really effects only seen when the system is functioning when producing dysfluent speech. This seems to stand at odds with the views of the many research groups investigating central nervous system activity in people who stutter. However, we believe that they are measuring functional rather than structural effects. If there was a structural problem, why does the pattern of developmental stuttering change from involving repetition of function words in childhood to dysfluencies like prolongations on content words in adulthood (i.e. from "I, I, I, split" to "I ssssplit")? It does not seem feasible to suppose that the same defective part of the brain results in these very different speech patterns. Our own theoretical work offers an explanation how the early form of stuttering arises out of normal nonfluencies all children exhibit and why the pattern changes in this way. It leads directly to improved ways of diagnosing stuttering and, as some research we have submitted recently show, helps identify which children will respond to therapy. You can see the way in which psychological theory comes full circle and starts to generate hypotheses that have practical implications.
In this note, we have tried to indicate the ways in which working within a psychology department with the therapist community in the UK has affected our research perspective. We've pretty much only touched on speech and language issues and only mentioned some of our colleagues here at UCL in the Phonetics and Human Communcations departments. There are other colleagues at UCL who have had input into research we have conducted. In our own department, for example, we have educational psychologists who aided us in looking at children's socialization in the school room, experts on laterality effects and genetics, and a whole pile of people looking at a range of developmental disorders. There are also internationally renowned institutes that we're affiliated with and work alongside closely like the Institute of Cognitive Neuroscience, Institute of Movement Neuroscience and Institute of Child Health. Last and not least, we never cease to be surprised and encouraged by the children and their parents who give generously of their time in helping us in our explorations with no benefit to themselves. Thanks to you all!