As I undertake writing this essay, I am not sure exactly what
insights I will impart to the reader. In fact, this essay may be a
selfish exercise on my partan attempt to vent some frustration,
perhaps. Or perhaps an exercise in self-exploration. Or perhaps a
chance for me to try to organize my thoughts about some issues that
have concerned me for quite some time. I believe that I am guilty of
much of what I will talk about in this essay. I suppose I could
pretend that I am the only totally objective person around, but I
know that isn't true. So as I make my points, please realize that I
am pointing a finger as much at myself as I am at any other
The idea for this essay arose as I visited the various papers
during the 1998 International Stuttering Awareness Day Internet
Conference. At that time, many people visited the various papers and
had left comments to the authors. Some of the comments (from a
relatively small number of individuals) suggested, at least to me,
that the writers were trying to force their views on a variety
of perspectivesit seemed to be difficult for them to view
stuttering in any broader context than their experience. Based on
that, the original title for this essay was going to be "When
the only tool you have is a hammer, everything looks like a
nail." That's an old saying, probably a trite one. But that's
what often comes to my mind when I read or hear what certain other
people have to say about the disorder of stuttering. This essay will
be a plea, of sorts, for us to all open our minds a bit more about
Do you believe that all people who stutter are the same? Or, more
specifically, do you believe that all people stutter for the same
reason? I'd wager that most people would answer "no" to
both of those questions. In fact, nearly any question that we would
ask about stuttering: "Is there one best therapy for all people
who stutter?" "Do all people who stutter have the same
types of disfluencies?" "Are all stutterers' personal
histories similar?" etc., would be answered "no" (at
least by most people who have some knowledge of stuttering). It
seems that there is considerable diversity among those of us who
stutter, and those of us who study the disorder. This diversity
should hold a lot of importance for our understanding of stuttering.
It seems, however, that a lot of people want to disregard the
diversity and focus on the commonalities of stuttering.
Looking for commonalities is not a bad thing. Certainly, any
characteristic(s) that we can find that is common to any group helps
point us in the right directions. My concern is when traits or
attributes that are assumed to be commonalities are forced on those
for whom they are not true. It is these overgeneralizations that I
will address during the rest of this essay. My list of
overgeneralizations is not meant to be exhaustive, but represents
some of the statements I have read or heard from others. I will use
some of my experiences and observations to expand upon some of the
Let me say, in advance, that my intent here is not to disparage
others or to diminish what they have to say. My views, like those of
anyone else, contain a certain degree of bias and are subject to
criticism. I hope, however, that they will provide some food for
- Stuttering is a genetic disorder.
Many researchers have spent their lives looking for a genetic
component to stuttering. There is no question that stuttering tends
to run in families. Many people who stutter have a number of
relatives who stutter. However, many other people who stutter have
no relatives who stutter.
If stuttering is a genetic disorder, the pattern of transmission is
not a simple one. A "faulty gene pool" explanation of
stuttering may be a more accurate one. In my family, for example, I
am the only person who stutters. I have many male relatives,
however, who have "differences" ranging from ambidexterity
to auditory processing difficulties and learning disabilities. My
"faulty" genes manifested themselves as stutteringin
other cases, the faulty genes led to other.
Stuttering is not solely a genetic disorder, although many people who
stutter may have a genetic component to their stuttering. I think it
is safe to say, however (although others may disagree), that many
people who stutter have no genetic factors that contribute to their
Stutterers have faulty speech motor systems.
Other researchers (e.g., Caruso, Max, & McClowry, 1999) have
spent their lives looking for a motor component to stuttering.
Certainly, if one simply watches many stutterers "in
action" the most obvious factor tends to be effort and struggle.
Getting our speech structures moving and/or keeping them moving
smoothly is a major part of the effort that we experience.
Motor skills manifest themselves in areas other than speech, of
course. Handwriting, athletic skills, coordination, even dancing
ability are "markers" of motor competence. If one uses
those four factors to determine whether I am a "motor"
stutterer or not, there is no question that I would fall under the
"motor" heading. My handwriting is illegible, my athletic
skills extend to being a superior channel surfer, I'm not very
coordinated, and I won't even attempt to dance unless I've had a
considerable amount of alcohol.
Yet, I've known many stutterers who had beautiful handwriting. Bob
Love and Bo Jackson are just two examples of athletically gifted
stutterers. Many of my friends who stutter are good dancers. So,
once again, it would seem that not all stutterers have faulty motor
In general, stutterers as a group tend to perform more poorly and
more variably on various measures of speech and nonspeech motor
performance. However, in nearly all of these "motor"
studies, some of the stutterers perform better than their
nonstuttering counterparts, and nonstutterers frequently perform more
poorly than stutterers. Like genetics, if there is a motor component
to stuttering, it is not a simple one.
There is only one cause of stuttering.
This may be true, but evidence continues to suggest that there
are "subgroups" of stutterers. That is, the behavior that
we see is similar (disfluency), but the reasons underlying the
disfluency differ. This has been expressed as an analogy with the
"cause" of sneezingthe overt behavior may be due to a
cold, allergies, or some other irritant. We see the behavior, but
cannot easily determine the underlying cause.
When we examine the ways in which people stutter, I feel it gives us
some evidence of the subgroup notion. For example, some stutterers
repeat parts of words. Others "block," tightening up their
muscles and stopping movement. Others seem to have problems at the
level of the larynxstarting voicing or keeping it going.
Others seem quite fluent, but express considerable concern, perhaps
fear, about their ability to speak fluently.
Eugene Cooper (1999) has said "Sixty years of research lead many
of us to conclude that chronic stuttering results from the
interactions of multiple coexisting physiological,
psychological, and environmental factors." He goes on to say
that there are "many interactions of affective, behavioral, and
cognitive factors that result in a stuttering syndrome." (p. 10)
My observations lead me to agree wholeheartedly with Cooper.
If you are not highly disfluent, you are not
really a "stutterer."
Because I am a fairly fluent stutterer, one who
"manages" my speech fairly well, some have suggested that
I'm not really a stutterer, or that I can't understand what it's like
to stutter severely. Many of my nonstuttering colleagues (who, in my
opinion, really do understand the disorder and really care
about people who stutter and their families) have been basically told
that they will never understand what it's like to stutter.
I think these arguments have some merit, but not when carried to an
extreme. I would wager that I have had a number of
"episodes" in my life where I have been as disfluent,
frustrated, annoyed, ashamedyou name itas any other
stutterer. I've been fortunate, I suppose, that these have not
happened frequently, and as I've gotten older they've become less and
less frequent. But I've had my share of "stuttering
moments." Most other "fluent stutterers" have, too.
My colleagues who do not stutter have not had the same types of
experiences, but they have made it a point to talk to people who
stutter and to gain insight from those interactions. They probably
have had course work in counseling. They may be able to relate to
stuttering because they have been through other painful life
experiences. What my nonstuttering colleague who understand
stuttering do have in common are good listening skills, natural
empathy, and a strong desire to help others (that is not
What's most frustrating to me, I guess, is that this type of thinking
tends to make us fight against each other when we should be working
together. "Us against them" is always better than "us
People who stutter are ashamed of their stuttering.
Stuttering can be shameful, no doubt about it. Bill Murphy
(1999) writes eloquently about shame and guilt in stuttering. I
don't think Bill is wrongmany stutterers have significant shame
and guilt about their stuttering. But many other people, who by (at
least) all observational measures would be considered to be
"stutterers" seem unconcerned and unaffected by their
stuttering. We've met many of these folks. At a party or some other
setting, you start to talk to someone who is quite disfluent, who
seems to be struggling with his speech, and you mention either speech
therapy or a group like the National Stuttering Association (formerly
the National Stuttering Project), and he tells you that he had
therapy but is quite happy with the way he manages his speech. As
you talk more, you find that he truly does seem to be content with
his speech and his life. This person may stutter, but shame does not
seem to be a part of his stuttering problem. Other individuals may
have been ashamed of their stuttering at one time in their life, but
have now come to grips with the problem so that they no longer feel
I'm not trying to suggest that there are a large number of people who
would fit into this category. Many of those people who are disfluent
and seem unaffected by it may not be "stutterers" in the
way we think about itthey are simply highly disfluent
nonstutterers. Others, I suppose, may be in denial. But there are a
number of stutterers for whom shame and embarrassment do not enter
This is what I doif you do it, you can be fluent.
Or: This speech therapy approach is the best.
Oh, baby, let's see: hypnosis, electronic devices, costal
diaphragmatic breathing, "not thinking about it," yoga,
talking slower, talking faster, easy onsets, full breaths, drugs
(legal and illegal), traumatic experiences, brain circuit
reorganization, changes in thinking, correspondence therapy, etc.,
Everything seems to work for some people who stutter. Nothing
(so far) seems to work for everybody. To suggest a
strategy is finewe can all learn a lot from each other. But to
imply (or express) that those who have not adopted our
"pet" technique or strategy are somehow in denial, don't
want to get better, have been co-opted by some "stuttering
establishment" is pretty insulting.
The ones I find really amusing are those who believe themselves to be
the iconoclasts. "My technique has to be good because it
is not embraced by the 'stuttering establishment' which has a vested
interest in the status quo." "My technique has to be good
because it is so different from any other currently available
treatments." When you ask these folks for some simple evidence
to prove that their treatment is effective they either respond with
testimonials from satisfied clients/customers, or they suggest that
data collection is something Ph.D.'s should do. "I'm too busy
helping people to collect data."
I believe that different people are helped by different therapies.
People should try different things. When they find something that
works, that's great. But what works for them is not necessarily
going to work for everybody. And (in spite of the title of this
paper), one size does not fit all.
Speech-Language Pathologists (SLPs) are not
trained to work with clients who stutter. All speech therapy is bad.
If you want to be helped, go elsewhere.
Once more, we are dealing in generalities that fail to capture
the essence of the true state of affairs. It is true that a person
can earn a Master's degree in Speech-Language Pathology without ever
having worked with a stuttering client. It is also possible (but
extremely unlikely) that a person can earn a Master's degree without
taking a class in stuttering.
The vast majority of SLPs, however, have had coursework in
stuttering. Most SLPs have probably had at least two courses in
stuttering, in which they learned about theories, characteristics of
people who stutter, and information about assessment and intervention
for stuttering. Even if someone hasn't had a class in
stuttering (or maybe didn't have a good class in stuttering), there
is a lot in the speech-language pathology curriculum that one can use
to work with stutterers. A typical SLP should know about speech
physiology, counseling, voice science and other things that could
prove useful in working with stutterers.
Not all SLPs realize that they can use that information. Many
professionals may say, "I never had a good class in
stuttering" or "I never had a stuttering client," as
a way to rationalize their dislike of working with people who
stutter, or their discomfort in providing therapy. It is best to
avoid these individuals. We can be "savvy consumers,"
however (Quesal, Yaruss, & McClure, 1999). We ask questions
about the qualifications of the person who puts a new roof on our
house. We ask about the features of a car we want to buy. We need
to learn to do the same with potential SLPs, to determine if they
will provide the kind of treatment we want and need. There are many,
many caring hard-working, competent, well-trained SLPs out there to
help people who stutter. If someone has had a bad experience, that
experience doesn't apply to all therapies or all SLPs.
This works for my other clients. You must be
doing something wrong.
I am very troubled by the suggestion that the reason some people
are unable to overcome their stuttering is because they don't work
hard enough. This implication usually comes from two primary
sources. One is SLPs who do not themselves stutter. Some (and I
emphasize the word some) SLPs seem to have the attitude
that any failure of their therapy results from some weakness on the
part of the client. These nonstuttering individuals cannot fathom
why a person cannot be fluentafter all, it is so easy for the
nonstutterer. It reminds me of my high school math teachers who
couldn't understand why the math concepts that they taught (and that
came so easily to them) were difficult for someone like me to
The second source of the "you're not trying hard enough"
perspective is the person who stutters who has been helped by a
particular therapy. Because this person has had success, they
believe that success is attainable by all stutterers. "I did
(fill in the blank) and now I am fluent. You just need to do the
same thing." Nothing is worse, in my opinion, than the
"recovered" stutterer who lords his fluency over those who
have not been able to achieve fluency.
Because I have had therapy, I am an expert on
This ties in with many of the points I have made above. It is
not uncommon to find a person who has had a few (or perhaps just one)
therapy experiences come across as an expert on stuttering treatment
and those who provide it. Based on their experiences, these people
may have been encouraged to do a little bit of reading about
stuttering therapy, and they combine their experiences and
"research" into self-proclaimed "expert" status.
Generally, what these people have to say is not wrongit is
simply incomplete. Because their experience is limited, their
perspective is limited. They fail to see the "big picture"
of stuttering treatment, how it has evolved, how many treatments are
similar at certain basic levels, what factors may make therapy
successful for one individual and not successful for another, etc.
We should all beware of the "expert" who possesses limited
People who stutter should be bothered by media
portrayals of stuttering.
I was unsure about including this point, because I'll probably
take some heat for it, but I felt it was important to include.
Stated simply, it is too easy to demonize Porky Pig or the media for
the problems that stutterers may experience. My question always is:
In what ways does the media portray anyone accurately? About 20 years ago, I worked in a nursing home and one morning when I went
to work, a lot of the staff members were talking about a show that
had been on TV the previous night. In that show, a character had
"gone undercover" in a nursing home to expose the many
abuses that took place there. My colleagues were upset that the show
would cause people to have negative attitudes about nursing homes, or
to make their existing attitudes worse. One administrator seemed to
feel that the show would have considerable impact on her nursing
home. Just today, I read an article in which someone said that the
movie "The Blair Witch Project" was unfair to witches
because it portrayed them inaccurately and fostered stereotypes. My
feeling is that anyone whose reality comes from the media probably is
not going to be swayed by the real world very much.
If we are going to spend our time worrying about the media and
stuttering, I think it would be healthy to examine how all
people are portrayed in the media. Other cartoon characters have
speech problemsnot just Porky Pig. Other disabilities are used
as plot device in many movies and TV shows. The ways in which these
disabilities are portrayed are almost universally
inaccuratethings are overstated, played for laughs,
"poetic license" is taken, etc. Certainly, the media has
some responsibility to be fair and attempt to be accurate (but a
discussion of whether they assume that responsibility is way beyond
this essay). But the important thing to remember is: it's just
make-believe. (Maybe that's why I don't cry at movies.)
I speak for all people who stutter.
I guess I can be accused of this one, based on what I've written
above. Basically, however, we all speak for ourselves, and usually
no one else. Those who believe that they somehow represent a larger
"stuttering community" are probably deceiving themselves.
Certainly, we have a number of "leaders" in
stutteringofficers in support organizations, leaders of groups
that fund stuttering research and information, officers of
professional organizations. But anything that anyone says has to at
least be colored by some extent by his or her biases.
So, let's all speak up for ourselves and let others speak for
themselves. Let's celebrate the things we have in common, but
respect our differences.. International Stuttering Awareness Day is
a great time to do that!
Caruso, A.J., Max, L., & McClowry, M.T. (1999). Perspectives
on stuttering as a motor speech disorder. In: Caruso, A.J. &
Strand, E.A. (Eds.) Clinical Management of Motor Speech Disorders
in Children. New York: Thieme.
Cooper, E.B. (1999). Speaking Out - Is Stuttering a Speech
Disorder? Asha, 41, 2, p. 10.
Murphy, B. (1999). A preliminary look at shame, guilt, and
stuttering. In: Ratner, N.B. & Healey, E.C. (Eds.)
Stuttering Research and Practice: Bridging the Gap. Mahwah,
NJ: Lawrence Erlbaum Associates.
Quesal, R.W., Yaruss, J.S., & McClure, J. (1999, Jun.) What NSP
members can teach speech-language pathologists about stuttering
therapy. Workshop at the Annual Convention of the National Stuttering
Project, Seattle, WA.
August 28, 1999