Office Hours: The Professor Is In -- featuring Steve Hood, Walt
Manning, Larry Molt, Bob Quesal, Nan Ratner Ken St. Louis, Woody
Starkweather, and Scott Yaruss

Thank you for your interest and participation in the Second International Stuttering Awareness Online
Conference. The conference officially ended October 22, 1999. The papers and what is on the
threaded discussions will remain at this address and you are welcome to read and/or copy them. The
papers will be permanently archived on the Stuttering Home Page. However, the presenters have
concluded their responsibilities for checking and answering any questions posted, so will not be
responding here anymore.

DAF/FAF use

From: gert.reunes@compaqnet.be
Date: 10/1/99
Time: 7:24:08 AM
Remote Name: 194.78.221.32

Comments

What are the personal meanings of using DAF/FAF devices?


Re: DAF/FAF use

From: 
Date: 10/1/99
Time: 9:22:41 AM
Remote Name: 131.204.63.26

Comments

Hi Gert! I'm not sure what you mean by "personal meanings" of using DAF/FAF devices, so my answer may
be off-base - please let me know. My viewpoint is that one use of DAF/FAF devices (as well as
metronome/pacing devices and auditory maskers) is as a form of "prosthesis" - a fluency aid, similar to
glasses, hearing aids, canes, etc., for other disabilities. Many individuals are not currently in a position to
seek traditional treatment for their stuttering or have not had success in the past and are desperately searching
for something that would help. DAF and FAF, as well as auditory masking devices such as the Edinburgh
Masker fit the bill for many people. Herb Goldberg, who received the "Honors of the NSA" last year for his
work in helping people via his efforts in distributing masking devices, is a wonderful example of what a
masking device can do - had a fairly severe stutter, therapy hadn't helped much - he went to the Edinburgh
masker, used it for many years and gradually weaned off of it, but gained so much confidence in his ability to
produce fluent speech through using it that he no longer needed it. Marty Jezer has written eloquently on the
list-serves about how he uses several devices as tools to help him in certain situations - they don't eliminate all
stuttering, but they give him enough confidence and control that he feels more comfortable in the situation.
The downside is that they don't work for everyone, and they may lose their effectiveness over time in some
individuals. But as an SLP, and a person who stutters, I see nothing demeaning or negative in the use of such
tools. 

Larry Molt


daf

From: Ashley Kirk
Date: 10/1/99
Time: 8:55:31 AM
Remote Name: 150.216.146.24

Comments

I am currently a graduate student at East Carolina University and am enrolled in a stuttering class. I was
wondering, do you think a hearing aid type device that provides delayed auditory feedback will produce fluent
and normal sounding speech in a person who stutters? I understand that DAF does reduce the amount of
stuttering, but can it actually be used in all contexts and be considered normal speech? 


Re: daf

From: Larry Molt
Date: 10/1/99
Time: 10:52:43 AM
Remote Name: 131.204.63.26

Comments

Hi Ashley Hope all goes well at ECU and that you didn't get hit by the floods from Hurricane Floyd - the
pictures from Greenville look like it was pretty bad there! ( and please say hello to Drs. Shine, Rastatter, and
Kalinowski for me). On to your question. In my viewpoint and experience, there are a variety of factors that
probably play a role in well how a person responds to DAF: this includes how they employ the DAF - as a
tool in producing a slower speech pattern, as a distractor that causes them to ignore the auditory feedback loop
entirely, as a new feedback source for motor control, etc., as well as probably a wide variety of organic
factors and even psychological/psychosocial factors. Not all individuals benefit equally from DAF, and not all
use it the same way. Decisions need to be made about what delay setting to use, and choices might be made
that negate some of the effects. Others seem to adapt faster and begin to see diminishing effectiveness.
Probably the placebo effect plays a role for many individuals. 

You ask if it will provide normal sounding speech? The mechanism that its being used for will have an effect
on that - I've used DAF in therapy as tool in teaching the use of slower speech with continual phonation, in
which case the individual may be very fluent, but will not have normal sounding speech. For some individuals
who employ it more for its effects on possible feedback links, some may end up with normal sounding
speech, but many won't. 

Can it be used in all contexts? - my glib reply would be "only as long as the batteries work, and probably not
real great if you're talking to someone while showering", but we do see varied uses - some people chose to
only use it for certain situations, such as the telephone. It would also depend how the device operates - if there
is an active microphone that is on all the time, then its also going to be picking up all the sounds surrounding
it, so in a noisy environment (because the DAF feedback has to be very loud in the first place to be effective)
what comes through the receiver may be useless. This could be overcome by using a throat-level
accelerometer type of microphone, that would only respond to the speaker's own vocalizations. A final
comment on the last part of your question - can it be used in all contexts and result in normal speeech - my
guess would be "no" for many individuals. Its a tool, its effectiveness varies among users, and I would guess
that some situations will have too many negative factors working against the device, reducing or even
completely negating its effectiveness. 

I'm interested to see what others have to say - any comments from people who personally use DAF? 

Warmest Regards, Larry Molt



acquired stuttering

From: Kate Clay
Date: 10/1/99
Time: 5:03:28 PM
Remote Name: 150.216.96.95

Comments

I was wondering, from a neurological standpoint, how does one "acquire" stuttering. Also, is there a
difference in the brain between a person who developed stuttering and one who aquired stuttering?


Re: acquired stuttering

From: J. Scott Yaruss
Date: 10/4/99
Time: 8:58:49 AM
Remote Name: 128.147.90.204

Comments

Hi Kate The term "acquired stuttering" is typically used to refer to stuttering that has late, sudden onset -- due
to some type of neurological or psychological trauma. In the case of neurological trauma, there would
definitely be a difference in the brains of people with acquired stuttering since there is presumed to be a
specific cause for the stuttering with acquired stuttering, but no such specific cause has been identified for
people with so-called "developmental" stuttering. Some good papers on this can be found in Dick Curlee's
recent book: Stuttering and related disorders of fluency (Thieme, 1999). Check out the chapter by Nancy
Helm-Estabrooks (pp. 255-269). 

Good luck! JSY


DAF succes after one month use

From: Gert Reunes chair Belgium selfhelp student university slp
Date: 10/2/99
Time: 5:17:16 AM
Remote Name: 194.78.219.250

Comments

Hi, We are now doing research on DAF long term use at the university GHENT-BELGIUM. After one month
of use the results are amazing. Of course nobody is the same, but DAF seems to help a lot for heavy
stutterers. Also in extreem stress situations the stuttering is less. Ofcourse the research is in full expantion and
we have to do alot of research more. But off the record the people who uses DAF now for a month are
enormous happy about the device. They also change their attitudes towards the stuttering problem. When they
become more fluently they have less problems in being themselves. We hope to decrease the size of the DAF
units so there will be more exceptance to use the device in ALL situations. If we can bring the size to a hearing
aid I think there will be an eartquake in stuttering therapy. 

I am also a stutterer and I can say that DAF for me is also a good trick to speak more fluently. 90% more
fluent. Also FAF effects my speaking in the good way. I do not understand why some SLP see no solution in
using DAF. I think that DAF/FAF in the therapy room also can make the stutterers aware of speaking fluently.
Acceptance of being a stutterer will be more easy when you become more fluently. In Belgium not many SLP
uses DAF...??? I do not understand why... 



Re: DAF succes after one month use

From: Larry Molt
Date: 10/5/99
Time: 9:00:48 AM
Remote Name: 131.204.63.26

Comments

Hi Gert! 

I'd really love to know more about the methaodology employed in your clinic's DAF Program - especially as
to how DAF is used. What are the instructions given to the participants when using DAF (i.e., is it used to
promote a slower, prolonged speaking pattern, as a timing device for speech production, as an auditory
distractor, etc.?).


Re: DAF succes after one month use

From: Ken St. Louis
Date: 10/7/99
Time: 9:36:19 AM
Remote Name: 157.182.15.69

Comments

Hi Gert, 

I'm glad you have observed such good success with DAF both in yourself and in others. There is no doubt
that it can make a dramatic difference in stuttering in a short period of time. 

In this country about 30 years ago, Israel Goldiamond, and experimental psychologist, announced that he had
solved the problem of stuttering with his DAF research. Obviously, he had not, for there were many that did
not like the kind of speech that they were left with. Also, there were many who had not been trained to speak
WITHOUT the DAF machine. 

For these reason, most clinicians in the USA who now use DAF do so for a relatively short period of time at
the beginning stages of therapy, typically progressing from about 220-250 msec delay to essentially no delay
in about 50 msec steps. They use the machine to show the client how to prolong vowels, slow the overall
speech rate, and "run one word into the next." This usually eliminates all or most of the stuttering. Then they
demonstrate to the client, perhaps by turning the device on and off, that it is possible to speak the same way
without the DAF influence. Once the client can maintain his or her gains without the DAF, then it is removed
while transfer activities are undertaken. At this point, recent clinical research suggests that stutterers are much
more likely to continue to use the news speech pattern if it sound reasonably natural or normal sounding. (Of
course, this is true of all fluency shaping approaches.) It is important to "wean" the client from the DAF
device, or make him/her less dependent on it, if the goal is to be able to speak fluently without it. This takes
time, effort, and lots of systematic practice. 

Again, I'm glad you have had such good luck with DAF in Ghent. 

The FAF device is quite different. I have not used it clinically, although the preliminary results I have seen
reported are encouraging. 

Ken 



Depression and Stuttering

From: Ira Zimmerman
Date: 10/2/99
Time: 10:18:49 AM
Remote Name: 152.163.201.51

Comments

What is the percentage of stutterers who suffer from clinical depression and is it necessary for effective
stuttering treatment to have a psychologist treat that depression?



Re: Depression and Stuttering

From: Larry Molt
Date: 10/5/99
Time: 9:14:52 AM
Remote Name: 131.204.63.26

Comments

Hi Ira! 

I'm not aware of any research indicating that the incidence of clinical depression is any higher in the stuttering
population than in the general population. What anecdotal evidence I've seen/heard on the stuttering list-serves
also tends to bear this out - while a few participants report bouts of clinical depression, the majority don't.
Relative to the second part of your question, is it necessary for successful stuttering therapy to employ the
services of a psychologist to treat the clinical depression if present, it would depend on the nature of the
clinical depression and its effect on the fluency therapy. Depression takes many different forms, and some
forms may limit the ability of the individual to participate fully in therapy, in which case, physcian assistance
might be very desirable. In addition, because of possible neurochemical links for both depression and
stuttering, it could be that neuropharmaceuticals being used to treat the depression may help or hinder fluency
therapy; the professionals treating the disorders should both be aware of this, be alert for signs, and be in
communication with each other. 


Re: Depression and Stuttering

From: Ken St. Louis
Date: 10/7/99
Time: 9:46:37 AM
Remote Name: 157.182.15.69

Comments

Hello Ira, 

I second what Larry Molt wrote in response to your query. I simply wanted to add that a series of studies
were carried out by Cantwall and his asociates on the US west coast from 1979-1987 looking at the likelihood
of psychiatric disorders among speech, language, or hearing disordered individuals. Stuttering was not
isolated specifically but included in one of the groups. You might want to check out Cantwell, D. P. & Baker,
L. (1987) Prevalence and type of psychiatric disorder and developmental disorders in three speech and
language groups. Journal of Communication Disorders, 20, 151-160. 

Not sure if this will help or not. 

Ken



DAF

From: Mike Hughes
Date: 10/2/99
Time: 12:33:00 PM
Remote Name: 142.166.254.48

Comments

Larry, 

I am pleased to see credit being given to electronic fluency devices. Personally, I think that the greatest good
was generated the first weekend I used the Edinburgh Masker. It taught me something that I had come to
doubt. THAT FLUENCY WAS POSSIBLE! After 30 years of failure and diminshing self-esteem, it was a
wonderous feeling to discover that I could actualy speak. I could go on for hours, but the point has been
made. When your stuttering has convinced you that you can not speak fluently, an electronic fluency aid might
just be the "crutch" your broken speech needs!



Re: DAF

From: Ken St. Louis
Date: 10/12/99
Time: 8:41:07 AM
Remote Name: 157.182.15.69

Comments

Hi Mike, 

Your comment about fluency devices is important. For some people they provide dramatic relief. See several
of the related comments in some of the other discussion. 

Ken


Child vs. Adult use of DAF

From: Mckenzie Thompson
Date: 10/2/99
Time: 12:35:56 PM
Remote Name: 152.163.197.77

Comments

While using DAF or FAF, has there been any evidence thus far to show that children or adolescents
experience different effects than adults? This does not neccessarily have to be based on age differences, but
possibly the persons amount of life experiences, their resistance level, or other factors. 

Also, does the feedback delay time differ in children as compared to adults?


Re: Child vs. Adult use of DAF

From: Nan Ratner
Date: 10/3/99
Time: 11:35:11 AM
Remote Name: 205.188.197.178

Comments

Work on the responses of children to DAF is very old and not easily interpretable. There is some suspicion,
and we have evidence from our current study to support this, that very young children (3-4) do not show
much response to DAF (if you can get them to participate!). Then typically developing children seem more
destabilized by DAF than older individuals, presumably because they are not as automatic in their speech. I
don't know of a literature looking at the fluency responses of kids under DAF, but it would be interesting to
see if it facilitates fluency. I don't think anyone knows. Do they, readers? 

Eye Contact

From: Jonathan Bashor
Date: 10/3/99
Time: 1:19:18 PM
Remote Name: 207.174.156.61

Comments

Where would you put maintaining eye contact in importance for a severe stutterer on a scale of 0 to 5 with 5
meaning critical ?

Re: Eye Contact

From: Steve Hood
Date: 10/3/99
Time: 7:41:51 PM
Remote Name: 205.188.193.163

Comments

Jonathan 

You have asked a good question, for which I don't think there is a simple answer. Eye contact is important in
stuttering, especially in cases of severe stuttering, but I think this needs to be put into perspective. 

Lack of eye contact, or loss of eye contact, is often associated with perceived guilt and/or shame regarding
stuttering. Often this is the case. We often look away when we are uncomfortable. Many "normally fluent
speakers" also have difficulty with eye-contact. PWS's are not alone with this. 

Some people "blame" poor eye contact on stuttering, and insist that PWS's need to work on eye contact
"because" they stutter. Another way to look at it is by saying people should work on eye-contact because this
is the pragmatically polite thing to do to maintain optimum interpersonal communication between speakers and
listeners. Appropriate eye contact (and this does NOT mean staring the person down) is simply the polite and
apropriate thing to do -- regardless of stuttering; albeit during severe stuttering, often there are PWS's who
look away. 

NOW -- to rate the importance of this? I cannot say. Eye contact is but one of many factors to consider in
severe stuttering. Others include, but are not limited to, overall behavioral severity in terms of the frequency
the person's stutters, the amount of effort/tension/struggle involved, the duration of how long stuttering
moments last, and the type of stuttering (repetitions, blocks, prolongations, etc.) In addition to these
behavioral factors we also have such things as the PWS's perceived feelings of confidence in the situation,
whether they have something worthwhile to say, whether they feel at ease in the situation, seem relaxed, give
the listener the impression that they are o-k with their stuttering (e.g., that they are comfortable with it, etc.) 

Eye-contact should be kept in perspective, and related to other behavioral and emotional correlates of
stuttering. But to rate/rank it on a scale is potentially misleading. 

Hope this helps. 

Steve Hood 

Re: Eye Contact

From: Peter Louw
Date: 10/12/99
Time: 9:11:35 AM
Remote Name: 196.36.184.252

Comments

I agree that eye contact is important - but it also has a downside. I have found that eye contact can draw my
attention away from using my speech technique. 

My own procedure is to establish eye contact so as to promote communication, but thereafter I immediately
slightly lower my gaze in order to apply my fluent-speech technique. This is necessary, as applying a speech
technique requires some effort and concentration. Then, after I have said what I wanted to say, I again
re-establish eye contact. 

When averting my gaze, I usually drop it so that I look at the person's nose. Apparently people get the
impression that you are having eye contact when you are in fact looking at their noses (try it! Look at
someone's nose, and then ask him / her if he / she notes the difference!). Regards.

Sibling behaviors

From: Jennifer Tanner
Date: 10/4/99
Time: 3:03:00 PM
Remote Name: 192.231.71.108

Comments

A great deal of research has been done involving parental behaviors influencing their children who stutter. Do
you think sibling behaviors influence stuttering?

Re: Sibling behaviors

From: Steve Hood
Date: 10/4/99
Time: 3:40:44 PM
Remote Name: 199.33.133.50

Comments

This is a good question, and I'll make a few comments based on clinical experiences. I am not aware of
specific, well controlled research that deals specifically with this guestion. 

I think sibling relationships can make a difference. Above and beyond the general topic of "sibling rivalry"
there is subcomponent that I think of in terms of "verbal competition." When there is a lot of verbal
competition (between kids, adults, adults and kids) this can increase communicative pressure and stress.
When people are interrupting and contradicting, when people are bombarding each other with questions,
where there is verbal interrogations, etc, this is often stressful. AND, then these things are going on, there is
usually more excitement in the verbal exchanges, and people often talk faster and louder. 

For some, this can be stressful. For some, this puts more pressues and demands on the child than the child
has the capacity to deal with. 

In our clinic, we do lots of work with children who are stuttering, and we work on things such as turntaking.
My turn..pause..your turn. We model talking that is a bit slower, more melodic, with slight paused between
turn-takes. We do this with the child and his/her clinician. Later, when the child is talking more easily, we
gradually begin to bring in the parent(s) and sibling(s), and we ALL work on turn taking, reducing
interruptions, etc. (We might do this with a board game such as "Shoots and Ladders" -- where we also need
to take turns. 

Often, this is a helpful component of therapy. 

Hope this helps, 

Steve Hood

Making those AAF devices smaller!

From: Mark Facer
Date: 10/4/99
Time: 4:52:01 PM
Remote Name: 216.100.157.39

Comments

Hello Professors! 

Two simple questions: 1) what is the smallest FAF (or DAF) device available; and 2) is there more
development being done to miniaturize these devices? 

I'm an electrical engineer (in electronics and communications) and in my mind I can EASILY imagine an
anti-stuttering device worn like a hearing aid and linked via skin-coloured wires (or maybe via an infra-red or
a radio link) to a throat microphone. Instead, all I'm aware of is a near-$USD600 not-quite-pocket-sized
device. I'm sure there are many PWSs who would support development of a smaller and more sophisticated
late-1990s device. 

Thanks and keep up the good work! 

Re: Making those AAF devices smaller!

From: Steve Hood
Date: 10/5/99
Time: 9:30:05 AM
Remote Name: 199.33.133.50

Comments

Hi, Mark 

I am not sure I am in a good position to answer your question, but I think I can steer you in a good direction. 

You might try to contact Thomas David Kehoe. He is a person who stutters, and an engineer. The most recent
addresses I have for him (hope they are current) are: 

E-Mail: kehoe@netcom.com Phone: 303/417-9752 Web Page: http://www.casafutura.com 

His company, Casa Futura Technologies manufactures a number of different units for such things as delayed
auditory feedback,, frequency altered feedback, etc. 

You might find this information helpful. 

Steve Hood

Re: Making those AAF devices smaller!

From: Gert Reunes
Date: 10/5/99
Time: 2:20:56 PM
Remote Name: 194.78.220.149

Comments

Hello, I have good contacts with the firm LERNOUT and HAUSPIE THE firm who makes that computers
can understand our voices. The president of the firm Mister Jo Lernout himself was impressed by the problem
'stuttering' He will do an investigation in his firm of there are possibilitis to make the DAF and FAF devices
as small as a hearing device. First they want more investigations of the university Ghent how the DAF works
after long term use. So it is up to engineers to do the job for making those divices real small. Also Bill Gates
is participating in Lernout & Hauspie!!! 'We have to give this man an E-mail to sponsor such a project' ;-) I
hope also that one day there will be such a small device!!! 

How does acting create fluency?

From: Leslie Brewer
Date: 10/4/99
Time: 6:00:04 PM
Remote Name: 150.216.146.137

Comments

Just recently I watched a video that presented the assumption that people who stutter become fluent while
acting because they are able to free themselves from the world and become someone else for the time being. I
would have to disagree with this assumption. I conclude that acting is similar to choral reading and singing in
that a different part of the brain is used. Therefore, I believe fluency is created because of a neurological
component rather than "freeing yourself from the world and the person you actually are". I am interested to
hear what your opinion is on this matter. Could you please write me back at lmb0924@mail.ecu.edu. Thank
you, Leslie Brewer

Re: How does acting create fluency?

From: Ken St. Louis
Date: 10/7/99
Time: 10:07:09 AM
Remote Name: 157.182.15.69

Comments

Hi Leslie, 

Good question about acting but, like most you might read in this section, one in which a simple answer will
not suffice. 

I had one client who was a student training to become an actor. He had no difficulty at all on stage; in fact it
was the easiest situation on his hierarchy of speaking situations. I also have stories from a number of others
who stutter saying essentially the same thing. On the other hand, most of the clients I work with are terrified
of getting up in front of others on stage (as in giving a speech). 

Accordingly, I would have to say that "It all depends..." I'm not sure that either explanation you mention
(freeing oneself from the cares of the real world or speaking as in singing or choral reading) is wholly
satisfactory, especially since the experience of being free of stuttering on stage is not at all universal. There are
probably examples wherein these explanations for the salutory effect of acting on stuttering apply. But there
may be many more. Some people are just "hams" and feel very comfortable in the limelight. Others may do
very well with memorized material, not so much because it is memorized but that it becomes essentially
artificial in terms of communication intent. 

Many years ago, Victor Frankl, a Holocaust survivor and psychiatrist, in his little book called "Man's Search
for Meaning" described a new approach to psychotherapy called "logotherapy." He gave an example in the
book of having stutterers play the role of stutterers in plays and finding that in such roles, they could no
longer stutter. Food for thought.... 

On a related note, I have had two occasions, one about a year ago, where I was asked to coach acting students
who were trying to learn how to fake stuttering convincingly on stage. Hmm.... 

And, when I was in high school trying my hand at acting, I stuttered. 

Thanks again for your question. 

Ken

Re: How does acting create fluency?

From: Walt Manning
Date: 10/7/99
Time: 11:12:52 AM
Remote Name: 141.225.97.53

Comments

Leslie- 

My thoughts parallel Ken's and I will also add that the combination of using a stage voice, speaking with a
dialect or accent combine with playing a role (especially with a costume, etc) all help to induce fluency while
acting. I often wish that I would have had the courage to take part in school plays when I was younger but had
no idea that I might be fluent in such a situations. I have known several clients who were able to be very fluent
while acting and I don't think that it's unusual. James Earl Jones is very fluent in his stage voice but much
less so when simply conversing. So, I guess I'm agreeing with you that fluency while acting can be an escape
from one's usual role, enhanced fluency is better explained by the unique ways in which one is speaking in
such a situation. 

Stuttering Cured after TBI/Stroke/Disease?

From: Kim Mills, ECU
Date: 10/4/99
Time: 9:57:24 PM
Remote Name: 207.115.18.66

Comments

I appreciate this opportunity to ask questions on stuttering as I am just now getting my first taste in this
fascinating area. I have heard about people developing a form of stuttering after a stroke and was wondering if
there has been any evidence of a person who stutters actually being "cured" of their stuttering after a stroke,
Traumatic Brain Injury, or a disease such as Alzheimers. I was curious if something like this that does disturb
brain function or activity would actually have an impact on the stuttering of a person. (This may be a far
fetched question.) 

Again, thank you for your time. This online conference is great! 
Re: Stuttering Cured after TBI/Stroke/Disease?

From: Judy Kuster
Date: 10/5/99
Time: 11:51:53 AM
Remote Name: 134.29.30.79

Comments

There is a short article in New Scientist magazine 9/25/99 by reporter Alison Motluk which begins, "A stroke
has cured an elderly man of his lifelong stutter, according to doctors in Japan."
(http://www.newscientist.com/ns/19990925/newsstory7.html). Would be interesting to read the article in
Neurology referenced in this short report.

Re: Stuttering Cured after TBI/Stroke/Disease?

From: Larry Molt
Date: 10/5/99
Time: 11:55:07 AM
Remote Name: 131.204.63.26

Comments

Hi Kim - good question. As Scott Yaruss wrote in a reply to an earlier question concerning acquired
stuttering, the dysfluencies we see following some instances of stroke, disease, or trauma aren't necessarily
stuttering - they are a form of fluency disorder, but differ from stuttering in several behavioral patterns. So I
wouldn't necessarily expect that disease or injury that causes one type of fluency disorder would have a
bearing on a different type of fluency disorder. 

Off the top of my head I can't think of any research examining this, although I am aware of several anecdotal
reports. Vicki Schutter, who is a frequent participant on the STUTT-L list serve, has written about her
experience, following a severe head injury. Her stuttering disappeared at first, but returned after about eight
months, as her recovery from TBI continued. 

There's probably a good reason why we haven't heard of many cases like this - for such an occurence to
happen, the injury or disease would have to affect the part of the brain where the hypothetized neurological
cause of the stuttering behavior had its root, and affect it only in a certain manner (either knocking it out so it
loses the effect, or altering the effect in a positive way rather than exacerbating the problem), without other ill
effects on communication. In other words, it would a take a very fortuitous set of circumstances! Keep asking
questions - and be sure to ask the fluency folks at ECU these same questions (and lots more!) Warmest
Regards, Larry Molt

Re: Stuttering Cured after TBI/Stroke/Disease?

From: Larry Molt
Date: 10/5/99
Time: 3:52:33 PM
Remote Name: 131.204.63.26

Comments

Hi again, Kim! 

As I was thinking about your question some more, I did remember coming across a couple of articles on this,
some time back, and I tracked down the references. Here they are: 

Helm-Estabrooks N. Yeo R. Geschwind N. Freedman M. Weinstein C. Stuttering: disappearance and
reappearance with acquired brain lesions. Neurology. 36(8):1109-12, 1986 Aug. 

(This is a report of a single case, following TBI) 

Miller AE. Cessation of stuttering with progressive multiple sclerosis. Neurology. 35(9):1341-3, 1985 Sep. 

(Miller reports two individuals whose stuttering disappeared as their MS progressed, and he speculated that
the disappearance was linked to cerebellar influence. The bad news is that other communication disorders
surfaced as the disease continued.) 

Re: Stuttering Cured after TBI/Stroke/Disease?

From: Ken St. Louis
Date: 10/7/99
Time: 10:14:22 AM
Remote Name: 157.182.15.69

Comments

Hi Kim, 

Let me weigh in on this one too. 

I have had my students collect interviews wherein folks were asked to "tell their stories" of stuttering. One
student interviewed the wife of man who after a lifetime of stuttering, had a stroke, recovered, and no longer
stuttered. (No one offered an explanation.) And the famous/infamous (?) study by Jones who found that
language laterality for four stutterers who underwent brain surgery no longer stuttered and experienced a shift
of language laterality to the unoperated side. 

Just to add to the mystery..... 

Ken

Amygdala role in stuttering

From: Mario Moretti
Date: 10/5/99
Time: 9:41:28 AM
Remote Name: 193.132.159.5

Comments

I red the news about the impaired interemisferic auditory cortex syncronization and in may opinion is very
interesting. As you know the emotion like fear produce the stuttering also in a normal people. Do you think
that amygdala could produce some interference with the auditory cortex syncronization process ? 

Re: Amygdala role in stuttering

From: Larry Molt
Date: 10/5/99
Time: 2:51:40 PM
Remote Name: 131.204.63.26

Comments

Hi Mario 

I think there are many possible ways that the amygdala (and other limbic structures) may play a modulating
role in some aspects of stuttering behavior, although my own feeling, at least at first glance, is that its role in
interhemispheric auditory synchronization would be minimal or more likely nonexistent. There is a
considerable amount of research indicating central auditory abnormalities in at least some PWS, and this was
done without the subject speaking (which should minimalize or negate limbic influences). 

As I said, there are many other opportunities for the amygdala to influence stuttering behaviors. Darrell
Dodge, who is just finishing his degree at the University of Colorado with Peter Ramig, has long been a
proponent of an amygdalar role. I would encourage you to visit his website, where he posted a very
well-written and insightful theoretical model for stuttering dealing with reactive inhibition. The url is:
http://telosnet.com/dmdodge/reactinh.html 

Warmest Regards, 

Larry Molt 

Re: Amygdala role in stuttering

From: Darrell Dodge
Date: 10/6/99
Time: 1:32:34 AM
Remote Name: 152.166.249.183

Comments

Thanks, Larry, for referencing my Web article on the role of reactive inhibition and the limbic circuits
(including the amygdala) in stuttering. It's intended as a "jumping off" place for people, so Mario should find
plenty of grist for the mill (to mix a metaphor). I haven't received a lot of critical feedback on the article from
people with knowledge of neurology and psychology and would really welcome that. 

My impression of the body of research on organic differences between stutterers and fluent speakers is that the
*deficits* found during non-speech measurements were relatively minor. I emphasize *deficits* because
that's what the researchers were usually looking for. Unfortunately, that means they may have trashed a lot of
results that indicated *increased neurological sensitivity* or hyperactivity of stutterers in a number of areas.
Read Jerome Kagan for some ideas suggesting that stuttering could even be a "temperament," with a physical
basis in many cases -- including (but not limited to) hypersensitivity of the amygdala. Conversely, I've often
wondered if the presence of a continuing habitual pattern of violent inhibition of key brain functions could
have a lingering effect on those specific functions during non-speech activities. 

The key missing data are the neurological characteristics of children who go on to stutter. Without that, we're
whistling in the dark. I don't think that measurements of people who have been stuttering for 20 or 30 years
are very useful for finding the original neurological cause of stuttering. 

Regards, 

- Darrell Dodge

Handedness

From: Jaime Fernandez , graduate student 
Date: 10/5/99
Time: 8:16:31 PM
Remote Name: 205.188.192.48

Comments

A relative of mine ,who is in his seventies,told me that when he was a child, students who were left handed
were forced to learn how to be right handed. When they tried to make him right handed, he began to stutter.
His teachers finally gave up when they realized that this child was not going to become a "rightie", and he was
fluent again. Is this because he was using a different part of the brain when trying to write with his right hand
instead of the left? How is this linked to stuttering? And would a person who stutters become fluent if they
tried to write with their less dominant hand?

Re: Article 30 (Handedness issues)

From: Larry Molt
Date: 10/6/99
Time: 9:12:44 AM
Remote Name: 131.204.63.26

Comments

Hi Jaime! 

Forcing left-handed children to use their right hand was a fairly common practice even into the 1950's - I
come from a family where everyone is left handed except me - and my older brothers were both forced to
write right-handed in school (until my parents found out and raised a ruckus). There isn't, as far as I know,
any evidence that this created many stutterers - although it probably created another communication disorder -
several generations of kids with poor handwriting, as they were forced to use their non-dominant hand. 

As to your relative's experiences, it points out a common problem we have with reports of anectdotal
experiences like this - what speech behaviors was he exhibiting, was it actually stuttering, were there
symptoms before the forced hand change, etc., before one could postulate cause and effect. 

The issue of handedness and cerebral dominance for speech was exhaustively examined in the 1930's & 40's
in attempts to support the Orton and Travis cerebral dominance theories. I'd encourage you to read Oliver
Bloodstein's "Handbook of Stuttering" for a very thorough review of the research in that area. 

Finally, you asked about switching hand usage in individuals who stutter. Charles Van Riper, in his book
"The Nature of Stuttering" (1971) writes about his own attempts at this, wearing a cast on his right arm for
several months to keep from using it, and doing a daily quota of 50 pages of simultaneous talking & writing
with his left hand. He reported no benefit, and abandoned his efforts (pg. 354). 

Warmest Regards, Larry Molt 



Re: Article 30

From: Steve Hood
Date: 10/6/99
Time: 7:41:23 PM
Remote Name: 152.163.201.67

Comments

Hello, Jaimie 

Larry molt gave you a good answer and said some of the things I would have otherwise said. Since he said
these things, I'll take a different tack, and then add some personal anecdotes. 

I'm not sure if it is the attempted change of handedness per se that **might** make some different, or
associated stress. Those who would force a child to change handedness, might want to change lots of other
things, including speech patterns, and this could be stressful. ((Left handers are bad -- stutterers are bad.)) 

I am a normally fluent speaker, although I talk rapidly, and occasionally run syllables together. I am very
mixed dominant. UNILATERAL activities fine me left handed: I play tennis left handed, write left handed, eat
left handed,throw a ball left handed. "BILATERAL activities find me using my right hand: I play golf and
hockey right handed, bat a baseball right handed. My right eye is dominant. 

As a kid my printing and penmanship was terrible. I was initially using my left hand. We tried slanting the
paper to the left, slanting the paper to the right..... nothing worked. I'd come home after school with ink all
over my left sleeve. My mother was on my case to not get ink on my shirt. 

After spending several months writing left handed, my third grade teacher "switched me to right handed" and
we tried this for several months. Didn't make any difference in my penmanship,nor (to best of my
knowledge) my fluency. 

To this day my penmanship stinks. I prefer the keyboard, and find computers to be a wonderful substitute to
the inked word. (I was also, and still am, a miserable speller. I find spell-check programs a delight. 

And -- speaking of spelling -- When I don't have a dictionary handy, I will switch words and circumlocute in
order to avoid a word I cannot spell. 

For what it's worth........ 

Thanks for posting to ISAD, 

Steve Hood 


Male to Female Ratio

From: Amy Medlin
Date: 10/5/99
Time: 10:57:20 PM
Remote Name: 208.25.244.140

Comments

I have always been interested in the fact that so many more males stutter than females. Are there some concrete
reasons for this? Or are there many theories on this?

Re: Male to Female Ratio

From: scott yaruss
Date: 10/6/99
Time: 9:04:07 AM
Remote Name: 128.147.90.204

Comments

Hi Amy You've asked a good question...I'm afraid I don't know the answer...I do know that there has been
some debate recently about exactly what the M/F ratio really is and what it means. Take a look at the paper by
Bobbie Lubker here on the ISAD list for a little more from an epidemiologist's point of view. As to what it
means...Good Q...the common answer I hear is that males are more susceptible to most disorders than
females...I never found that answer too satisfying, though I have used it from time to time... S

Re: Male to Female Ratio

From: Larry Molt
Date: 10/6/99
Time: 11:05:13 AM
Remote Name: 131.204.63.26

Comments

Hi Amy 

Just want to follow up Scott's comments. Norman Geschwin has written some thoughts on the possible role
of testosterone on shaping brain development and that might play a role in the higher number of males with
various developmental problems and disorders. Off the top of my head, I think that David Rosenfield (who
has an article further down screen in the "Poster Section" of the ISAD2 conference), might have had some
comments on that in his article on the brain and stuttering, that appeared in the Jornal of Fluency Disorders,
(about 1980). 

Good Question! 

Larry

Re: Male to Female Ratio

From: Walt Manning
Date: 10/7/99
Time: 9:53:17 AM
Remote Name: 141.225.97.53

Comments

Hello Amy- 

The research and writing that I have seen indicates that, at the outset of stuttering, boys and girls begin to
stutter at about the same frequency but that, for a variety of reasons (linguistic, motoric, etc.) females are more
likely to "recover" from stuttering tham males. Thus, around the time of early adolescence, we see a ratio of 3
or 4 males for every female who stutterers. There has also been some suggestion in the literature that females
who stutter may be more "severe" than the typical male but I don't know of much supporting evidence for
this. Thanks for posting. 

Botox Injections

From: Jennifer Harper
Date: 10/5/99
Time: 11:20:10 PM
Remote Name: 208.25.244.140

Comments

I was recently reading an article on the internet that discussed Botox injections as a means of reducing
stuttering. I was curious as to what exactly these injections do and have they proven to be effective?

Re: Botox Injections

From: Nan Ratner
Date: 10/8/99
Time: 10:07:32 AM
Remote Name: 129.2.24.18

Comments

Although Brin (1994) has a study suggesting that some folks got benefits from Botox injections, work done
by Ludlow and Stager at NIH suggested that Botox was not a useful treatment for stuttering. Not only did
stuttering not improve for all subjects, the resulting weak breathy voice was just as undesirable as the fluency
disorder. Few people who have had Botox injections pursue them for additional rounds (it wears off and must
be readministered periodically). So, while Botox may aid a select few individuals, it is not likely to emerge as
a standard effective treatment for most people who stutter. 

regards, Nan Ratner 

Re: Botox Injections, answering another question in your post

From: Nan Ratner
Date: 10/8/99
Time: 3:17:17 PM
Remote Name: 205.188.198.42

Comments

I am sorry, I missed one of your questions. You asked how Botox injections work for stuttering. They
weaken the laryngeal muscles, thus softening the strength of vocal contacts. 

Nan 

Vocal-cord spasms causing stuttering

From: Peter Louw
Date: 10/6/99
Time: 9:43:13 AM
Remote Name: 196.36.184.252

Comments

Dear Sir/Madam 

Some people are saying that the root cause of stuttering is a vocal-cord spasm triggered by tension. I would be
most obliged if you could give your opinion. Thanking you in anticipation. Sincerely yours. 

Re: Vocal-cord spasms causing stuttering

From: Judy Kuster
Date: 10/6/99
Time: 10:23:56 AM
Remote Name: 134.29.30.79

Comments

Hi Peter! 

I would suggest that you might also want to post this question to Fran Freeman after reading her interesting
article below. 

Judy

Re: Vocal-cord spasms causing stuttering

From: Walt Manning
Date: 10/7/99
Time: 10:08:27 AM
Remote Name: 141.225.97.53

Comments

Hello Peter- 

Vocal-cord spasms in one form or another have often been implicated as a cause of stuttering. This view was
especially popular in the late 1960s and 1970s and many people thought that the vocal folds were at the "core"
of stuttering. Since the vocal folds provide the most constricted point for closure in the vocal tract and since
they often respond to various forms of tension or effort (physical and/or emotional) by constricting, vocal fold
closure is characteristic of many stuttering form-types. Conture's research using fiber optics and other
research in the area of vocal fold physiology do not support the idea that stuttering developes as a result of
aberrant vocal fold functioning. Stuttering is lots more multidimentional than that. Thanks for your post. 

Sensory Delay

From: Katie Kiser
Date: 10/6/99
Time: 10:06:37 AM
Remote Name: 168.191.248.70

Comments

I have observed both delayed auditory feedback and delayed visual feedback increase fluency. Has anyone
studied a tactile approach to the delayed feedback theories. If so, what methods were used, and was it
effective? 

Re: Sensory Delay

From: Ken St. Louis
Date: 10/12/99
Time: 8:48:37 AM
Remote Name: 157.182.15.69

Comments

Hi Katie, I did not respond to your question immediately, waiting to see if one of the other readers might have
a definitive answer for you. Let me say that I don't know of any research that has attempted to do some kind
of delayed tactile feedback. It would be fun to see what would happen to say some finger movements with
some sort of elaborate tactile delay arrangements. I wouldn't speculate as to whether it would disrupt
movement the same way DAF disrupts speech or not. As I think about it, my impression is that it would be
VERY DIFFICULT TO PRACTICALLY IMPOSSIBLE (Oops! We should not use the "i" word, should we?)
to devise an arrangement to simulate delayed tactile feedback for say the tongue tip during speech. 

Not sure if this helps or not. 

Ken

How can I as an individual who has intermittent contact with a
9 y.o. boy who stutters help?

From: Regine Neiders (childs godmother)
Date: 10/6/99
Time: 11:13:33 PM
Remote Name: 206.63.34.176

Comments

I see my godson about 2 - 3 x per year. He initially had problems with th and several other sounds as he
began speaking. He saw a speech therapist and this mostly cleared up. Then around the age of 5-6 he began to
stutter during the divorce of his parents. During the summers the stuttering would subside and then as school
started it would start again and now it seems to be getting more frequent with longer blocks, etc. Finally, it
has been determined that he also has dyslexia and is currently being tutored in his reading skills. Where would
I as an outsider start, to provide information and assistance to his mother? Is there anything I can do? Also,
his mother has been given this website.

Re: How can I as an individual who has intermittent contact
with ...

From: Dear Ms. Neiders,
Date: 10/7/99
Time: 8:54:54 AM
Remote Name: 157.182.15.69

Comments

I posted a reply to your question earlier but am not sure it went through. I'll wait to see. If not, I'll try again. 

Ken

Re: How can I as an individual who has intermittent contact
with ...

From: Ken St. Louis
Date: 10/7/99
Time: 9:18:44 AM
Remote Name: 157.182.15.69

Comments

Dear Ms. Neiders: 

Sometimes computers make me crazy. I hit the wrong "Post" button in spite of the careful instructions in an
earlier reply. Then, as you see, I put your name in the slot of my second test message where my name was to
go. Oh well, let me try again. ------------------------------------------------ I am sure that it must be frustrating
indeed to stand on the sidelines and watch your godson's speech getting worse. I appreciate your concern and
am sure that you will be able to help. 

I don't know how old your godson is, but I assume he is in or beyond elementary school. In any case, I also
assume he is getting speech therapy now for his stuttering along with tutoring for his reading problems. Those
services are necessary and should continue, perhaps for some time. 

From your description, it seems to me that your godson is not quite typical of most youngsters who stutter.
His early articulation problems, reading difficulties, and stuttering suggest--but by not means prove--that he
has a physiological problem that affects several manifestations of his language system. At the same time, the
fact that he reportedly began to stutter concurrent with a divorce and that he gets worse before each school
year, indicates that psychological stress probably plays a role as well. (It makes sense that school would be
stressful since he has a reading problem.) I could not say with confidence without evaluating your godson,
but such psychological factors usually don't play a major role in the "cause" of the stuttering; instead, they
usually serve as "triggers" to make it emerge or become worse. 

You asked what you should do. If a second opinion is possible financially, I would suggest you find the link
in the Stuttering Home Page to the Stuttering Foundation of America and search for a speech-language
pathologist who has indicated a willingness and interest in evaluating and treating stuttering. I would also
suggest looking seriously at university or hospital clinics that have access to other professionals such as LD or
AD/HD specialists, neurologists, psychologists, etc. A second opinion, while not guaranteeing optimal advice
is the best way to find approaches to treatment that have the best chance of success. If your godson's mother
decides to get a second opinion, she should talk candidly with his current SLP and tutor (who might be doing
great jobs) and assure them that she is only wanting to better understand her son's problems. 

If a second opinion is out of the question, then the Stuttering Foundation of America has lots of inexpensive
materials that his current SLP could get to assist her/him. There will be lots of additional information in this
ISAD2 Conference. 

In your two to three times a year that you get to spend with your godson, give him lots of loving attention
(which I am sure you do), listen to him carefully without filling in stuttered words or offering advice on how
to talk, and enjoy your times together. If you have this kind of interaction, he will remember it his entire life
regardless of stuttering, reading problems, or any other problems he encounters. 

Good luck. 

Ken

Re: How can I as an individual who has intermittent contact
with ...

From: Jerry Johnson
Date: 10/14/99
Time: 10:52:26 PM
Remote Name: 134.29.30.79

Comments

Dear Godmother Neiders: What a caring person you must be. I am impressed with your willingness to help
your godson. Keep caring. People need people and you can do so much good if you don't become
discouraged. Your godson needs you. Please keep trying to connect. Intermittent contact need not always be
physical. Call your godson as often as your can. And you know something, a letter means so much more
because you took the time and effort to actually write something to him. Email is great too, but there is
something special about a handwritten, I love you and care about you, note. Pick out a special postal stamp
too. Kids love the whole presentation. You are computer literate person. Good for you. Is your godson? How
did you become a 21st century person anyway? Now then. Is your godson REALLY stuttering or is he
expressing himself in a disfluent behavioral mannor? He is 9 years old and he is going through much hell.
What kind of divorce counseling is he getting? Are his parents still talking? Are there other children in the
family? Ages and how are they taking it? Are they talking? There are so many questions to ask. Lets not
overlook the trees for the forest. Is stuttering the primary problem or are there other unanswered questions?
Did deeply into the family situation as it exists now and in the past to find some answers and possibly
solutions as to this boys future. How much influence do you have? You are his godmother--are you related in
any way? How far do you live from this boy? The list goes on. Have you received counseling? And now
getting back to your godson. What is going on anyway? Speech is the barometer of the soul. He feels much
pain and torment. What is being done to solve this problem? What about his home and school environment. Is
there a school person who could be his mentor and confidant? Search one out. I would suggest an
environmental analysis be done. Log on to this website again and key into the Other Homepages About
Stuttering and pickout the Gerald Johnson Library. You will find much information there to help caregiver like
yourself. Look for "Stuttering Information For Caregivers, Children and SLPs." Please continue to care for
your godson. He needs you to be a constant in his life. Care about him. Love him. Call him. Write to him.
Offer support to his mother and father too. Do not cut anyone out of your life and continue to care deeply
about your godson. There is much to talk about but you have made the right step. I would suspect that his
"stuttering" is the tip of the iceberg. Keep trying to help, be generous in your love and understanding. Hold
him close to your heart. My tears and emotions are to share with those of your own. Hold strong and
steadfast. My love to you for your depth of caring. Best wishes. Jerry

Male to Female Ratio

From: Woody Starkweather
Date: 10/7/99
Time: 3:37:21 PM
Remote Name: 155.247.229.217

Comments

Of course, we should mention genetics here too. Genetic differences between males and females are expressed
in a number of behavioral characteristics, and it doesn't seem unreasonable to conclude that because of these
behavioral tendencies, males are more likely to react to the frustration of early stuttering more intensely, for
example, or that female children, because of superior early lang- uage skills are better able to cope with the ex-
perience of early stuttering. 

Woody 

Question  regarding the article Reaching Out To Kids who
Stutter

From: Juli Merrick
Date: 10/7/99
Time: 6:59:10 PM
Remote Name: 205.188.198.58

Comments

Hi, I am a student and I had an assignment to read one of the articles. I really enjoyed the article by Bonnie
Weiss. I was wondering if there is going to be any information presented on new treatment approaches on
stuttering to these children and their parents at the workshop. My e-mail address is
julimatthews@hotmail.com. Thank you.

Cure for stuttering

From: Jonathan Corazon       (Puerto Rico)
Date: 10/8/99
Time: 9:52:21 AM
Remote Name: 206.99.218.242

Comments

Hi, I am doing my research of stuttering to my science fair , I am going to try to find the cure of stuttering, but
i need help because i have only 16 year old If you want to contact me: write me to : Jonathan Corazon Calle
Juan R.Ramos l-7 urb,Santa Paula Guaynabo P.R. 00969. write as possible you can. only for researches and
Doctors

Re: Cure for stuttering

From: Ken St. Louis
Date: 10/8/99
Time: 2:25:53 PM
Remote Name: 157.182.15.69

Comments

Hello Jonathon, 

When I was 16 years old I had just experienced my first summer of speech therapy at the University of
Wyoming. I was so successful in controlling my stuttering, that I decided then and there to enter the field of
speech therapy. My goal was to solve the problem of stuttering and find a cure. 

I haven't yet come close to achieving my goal. But what a wonderful goal--to find a cure for stuttering. Maybe
you will. Most of us who have worked in this field for many years have become rather cynical, believing that
no one will ever really find a cure. If anyone tells you that, understand that that person no doubt knows a great
deal and is aware of incredible complexities surrounding the disorder of stuttering. But never underestimate
your own potential. Go after your goal. If you don't succeed, you will no doubt make significant progress in
helping us better treat this mysterious disorder. If you succeed where so many have failed, life will be better
for millions on this planet. 

I suggest you start by reading all the papers in this on-line conference. See where it takes you. My guess is
that you might well end up with a fine science fair project. 

Good luck, 

Ken

Re: Cure for stuttering

From: Nan Ratner
Date: 10/8/99
Time: 3:13:07 PM
Remote Name: 205.188.198.42

Comments

Hi. It is good to pick a topic such as stuttering for a Science Fair project. However, I think you will have a
better product if you check out some of the very good library resources on this topic. Try a basic text, such as
one written by professors Curlee or Starkweather in this conference, or by Oliver Bloodstein, Barry Guitar or
Ed Conture. Also look in PubMed on the internet for abstracts of scholarly articles on the subject. Your
teacher will probably find these sources more appropriate for such a research assignment. The Stuttering
Foundation of America also has good resources, including some written in Spanish. 

best regards, 

Nan 

Re: Cure for stuttering

From: Judy Kuster
Date: 10/8/99
Time: 8:11:00 PM
Remote Name: 198.110.207.99

Comments

Hi Jonathan, 

I am glad you found this conference! There are also some good ideas for High School Science Experiments
that were suggested by Tom Kehoe. You can find his ideas at
http://www.mnsu.edu/~stutter/kids/scienceexperiments.html 

Good luck with your interesting project! 

Judy Kuster

Distractions

From: Peter Louw, Cape Town, South Africa
Date: 10/8/99
Time: 10:15:11 AM
Remote Name: 196.36.184.252

Comments

Dear Panel 

As a PWS I have on many occasions used light, inconspicuous distractions, such as a slight movement of the
head etc., being well aware that these should not be allowed to get out of control so as to become a problem in
itself. Charles Van Riper also mentions distractions as a real factor in stuttering. Naturally distractions should
not be used as real therapy, as they are obviously of limited value and have negative potential. However I have
recently read articles suggesting that distractions are no longer recognised as a scientific fact in stuttering. 

I would be most obliged if you could give me the current view on distractions in stuttering. If distractions are
no longer recognised as an entity, what have I been doing all these years? Thanking you in anticipation and
kind regards. 

Re: Distractions

From: Joe Kalinowski
Date: 10/8/99
Time: 1:01:17 PM
Remote Name: 150.216.147.209

Comments

Arm movement, head jerk, facial contortions etc. are a group of self-initiated motoric behaviors which PWS
use to release themselves, in a partially successful manner, from a stuttering moment. 

The argument in not whether PWS initiate these behaviors in anticipation and/or in reaction to stuttering-- to
that there is no debate. 

PWS usually perform a series of ancillary behaviors to release themselves from a block (stuttering moment).
However, the refutation of distraction hypothesis by Stuart (1999) as a testable phenomena is not a refutation
of the behaviors exist-- but in the "intuitive construct" espoused by "founders of stuttering modern stuttering
therapy". These constructs were shaped by how they viewed stuttering and their notions of "communicative
responsibility". This "communicative responsibility" was alleviated via head, neck, leg, and arm movement
(How? We do not Know!!)-- Dr. Stuart and I challenge the notion of " communicative responsibility" in much
further in the next issue of JSHLR. 

Stuart (1999) did not dismiss the behaviors of leg movement, arm movement., and so forth. He dismissed the
attribution to the construct of "distraction". That is, the distraction construct suggests that the purpose of the
behaviors is to pull attention away from a locus of attention. He challenged this notion's testability in a
scientific realm. 

My colleague speaks for himself,--but I believe that the gestures of the arm, leg, neck, etc are an attempt to
jump start a system in oscillation- Not to "DISTARCT". This is similar to banging on an engine that is "riding
rough". The behaviors are not to distract but more likely to create sensory-motor input to the CNS which will
break the oscillatory cycle. We use it as a preventative measure after learning that it works. However, it is a
poor tool and as it has not fixed of the locus of the problem. Sort of like banging on the set of a TV or a rough
riding engine" .. The whack helps for awhile, but then the initial problem worsens.. 

I'll let Dr. Stuart speak for himself… 

Stuart, A. (1999). The distraction hypothesis and the practice of pseudoscience: A reply to Bloodstein (1998).
Journal of Speech, Language, and Hearing Research, 42, 913-914. 

Re: Distractions--Please Ignore My prior reply-computer
messed up

From: Joe Kalinowski
Date: 10/8/99
Time: 1:13:21 PM
Remote Name: 150.216.147.209

Comments

Arm movement, head jerk, facial contortions etc. are a group of self-initiated motoric behaviors which PWS
use to release themselves, in a partially effective manner, from a stuttering moment. 

The argument in not whether PWS initiate these behaviors in anticipation and/or in reaction to stuttering-- to
that there is no debate. 

PWS usually perform a series of ancillary behaviors to release themselves from a block (stuttering moment).
However, the refutation of the Distraction Hypothesis by Stuart (1999) is not a refutation that the behaviors
exist-- but a refutation of the "intuitive construct" of distraction espoused by "founders of modern stuttering
therapy". 

These constructs (distraction, stuttering lies in the ear of the listener …etc.) were shaped by how the founders
of modern stuttering therapy viewed stuttering and their notions of "communicative responsibility". This
"communicative responsibility" was somehow alleviated via head, neck, leg, and arm movement (How? We
do not Know!!)-- 

Dr. Stuart and I challenge the notion of " communicative responsibility" in further in the next issue of JSHLR.

Stuart (1999) did not dismiss the behaviors of leg movement, arm movement., and so forth. He dismissed the
attribution to the construct of "distraction". That is, the distraction construct suggests that the purpose of the
behaviors is to pull attention away from a locus of attention. He challenged this notion's testability in a
scientific realm. 

My colleague speaks for himself,--but I believe that the gestures of the arm, leg, neck, etc are an attempt to
jump start a system in oscillation- Not to "DISTARCT". 

This is similar to banging on an engine that is "riding rough". The behaviors are not to distract but more likely
to create sensory-motor input to the CNS which will break the oscillatory cycle. We use it as a preventative
measure after learning that it works. However, it is a poor tool. It is a poor tool because it has not fixed of the
locus of the problem. Sort of like banging on the set of a TV or a rough riding engine" .. The whack helps for
awhile, but then the initial problem worsens and the whack no longer helps.. 

I'll let Dr. Stuart speak for himself… 

Re: Distractions--Please Ignore My prior reply-computer
messe...

From: Peter Louw
Date: 10/14/99
Time: 7:42:18 AM
Remote Name: 196.36.184.252

Comments

Hi Joe 

Thank you for your response which I found very interesting. Just one further question: should the definition
of "distractions" not be broader than just encompassing actions such as gestures, blinking etc.? Shouldn't we
also include things such as stress? Also stress due to illness, exhaustion etc.? 

I can remember that Van Riper (was it in The Nature of Stuttering?) mentioned the case of a member of a
submarine crew. He was a PWS, and one day an emergency arose in the submarine while deep below sea
level. Despite being under severe pressure, this guy managed to utter a series of emergency commands 100%
fluently, and they all survived. In retrospect he ascribed his fluency at the time to distraction. He said that he
completely forgot about stuttering at the time due to the intense stress. 

This seems to me to be a case of distraction due to stress, and being a PWS myself I can relate to this - I have
also found that stress, which usually aggravates my speech, can occasionally help my speech. 

My experience of distractions is that about anything can act as a distraction. For me, it can be the stuttering
itself, or an unobtrusive blink, or the application of a fluent-speech technique - but also exhaustion, illness etc.
When I speak very fast, it can also act as a distraction for me. Whilst travelling abroad I can be 100% fluent
due to the unfamiliar surroundings, though after a while the effect wears off. Surely this, too, amounts to
distraction? 

PS Though the guy in the submarine survived, his hair turned grey that day ... 

Male to Female Ratio

From: Andy Floyd
Date: 10/8/99
Time: 11:28:33 PM
Remote Name: 152.163.207.83

Comments

This question has always intrigued me. About 8 years ago, I saw a report on a show like 20/20 that had male
and female toddlers. The mothers put their son and/or daughter behind a barrier (separating mother from child)
and waited. A significant number of boys tried to push through the barrier to reach the mother, whereas the
girls sat down and started to cry. Now, I know this is far from scientific, but I've always wondered if at least
one reason more boys stutter is that boys try to "fight" through aversive stimuli whereas most girls may not.
Just a thought.

Re: Male to Female Ratio

From: Ken St. Louis
Date: 10/11/99
Time: 7:44:54 AM
Remote Name: 157.182.15.69

Comments

Hi Andy, 

Interesting hypothesis. I don't know of any solid data that directly supports the notion that boys being more
inclined to "struggle" or "fight" through a physiological barrier is related to the sex ratio in stuttering. Woody
Starkweather's post on this topic is germane to your query. Reaction to stress, indeed, might play a role. 

My guess is that it is much more complicated that all of this, reflecting multiple influences. 

Ken

Laughing At Ourselves

From: Ira Zimmerman
Date: 10/9/99
Time: 12:07:22 PM
Remote Name: 205.188.197.57

Comments

There is a big difference between laughed at or laughing at ourselves because of stuttering situations we find
ourselves in. I think that it is healthy to tell funny stories about stuttering situations I find myself in. Not only
do I feel better about myself but I believe it puts the listener at ease. I had one incident that I first found
frustrating but I later saw the humor in it. I'm an American Online (AOL) subscriber. When you connect to
AOL, the first thing you get is a verbal "Welcome" greeting. For months, I had intermittent problem of not
getting beyond a stuttering "WelWelWelWelWelWel..." greeting. It would go on forever. To get out it, I
would have to power down my computer and reboot. It usually worked fine the second time around. I must
admit that I was too embarrassed to call AOL about it because I thought they would think this was a prank,
that is, a stutterer having a stuttering computer problem. When I finally did contact AOL when the problem
was occurring repeatedly, they didn't take me too seriously. I then contacted an on the air Los Angeles TV
station computer guy who calls himself "cyberguy." He first thought I was crazy or this was some kind of
publicity stunt. Although he immediately saw the humor in situation as did I. But I had videotaped the
stuttering computer glitch to prove that I wasn't lying. He called a top Executive at AOL and with their help
we solved the problem. Last Thursday, the LA TV station sent a video crew to my home to interview me for a
news broadcast next week in a segment that I'm sure will be funny to many, including myself. 

Is this a healthy attitude or am I just in denial about the seriousness of my stuttering? Didn't Dr. Manning do
some research on humor being a measure of one's attitude toward their stuttering?

Re: Laughing At Ourselves

From: Walt Manning
Date: 10/10/99
Time: 5:19:35 PM
Remote Name: 141.225.225.37

Comments

Ira- 

I haven't done any research on the topic but I have pulled together some research and suggestions from
health-related fields about the value of humor as a variable in the process of change. The literature indicates
that as one is less overwhellmed and helpless about a situation or condition, begins to get some distance from
the problem, and starts to shift their conceptual view of what is going on, there is the opportunity to see
humor in the situation. Clearly, much of stuttering is far from humorous, but I think that you are correct in
suggesting that a humorous interpretation of events can signal change and progress both in and out of formal
treatment. I have seen many clients share wonderfully humorous stories as they get some distance and begin
to see their situation from a greater distance. 

It would be great to document this aspect of change during treatment. 

Re: Laughing At Ourselves

From: Benedikt Benediktsson
Date: 10/11/99
Time: 5:35:42 AM
Remote Name: 194.144.199.10

Comments

Ira I think it is healthy to be able to laugh at yourself, even if it is because of the stuttering. Life is wonderful
and why not see the positive aspects of everything. 12 years ago I started therapy for my stuttering. The
psycologist I went to, who was supposed to have some knowledge of stuttering, told me after two sessions
that he couldn't help me. My attitude towards the stuttering was so positive and I could see the humour in it,
but he expected to see a depressed stutterer.

Re: Laughing At Ourselves

From: Gina Waggott
Date: 10/20/99
Time: 10:46:19 AM
Remote Name: 148.88.17.28

Comments

Hey Ira 

Great story... as a matter of fact, AOL used to do that to me, but it stopped by itself... I'm kinda glad that I'm
not the paranoid type ("My God! Even the computers are out to get me!" ;-) 

I find that bringing humour (or humor, as you USA people spell it) into a situation with strangers always
helps. When people see you are not so "hung up" on your stuttering, and are comfortable and informal
through joking about it - it makes people relax more. At least, that's what I've learned from experience. 

I've devised a bunch of "sayings" and bad pick-up lines with reference to stuttering... but I'm going to make
you read my paper to see what they are! :-) 

Best, 

-Gina

What does the research say regarding family environment and
stuttering?

From: Regine Neiders
Date: 10/9/99
Time: 12:09:04 PM
Remote Name: 206.63.34.185

Comments

I am interested how family environment i.e. divorce, single parent family, counseling for other concerns (i.e.
trauma of divorce), parental overload, etc. are shown to interact or not with stuttering? for children ages 3 - 9?

Re: What does the research say regarding family environment
and s...

From: Nan Ratner
Date: 10/9/99
Time: 1:05:05 PM
Remote Name: 205.188.192.179

Comments

Many families try to find an explanation for a child's stuttering in the environment. A stressful environment
can make it difficult to families to deal constructively with ANY childhood disorder (that is, respond most
effectively to it), and stress can negatively affect MANY childhood conditions and exacerbate symptoms,
including asthma and allergies. Stuttering would not be unique in these respects. However, there is no
evidence to suggest that specific factors in the family environment CAUSE stuttering. 

best regards, 

Nan 

Re: What does the research say regarding family environment
a...

From: Woody Starkweather
Date: 10/18/99
Time: 5:22:21 PM
Remote Name: 155.247.229.71

Comments

Although there is little research in this area, it would be a mistake to conclude that family issues do not
influence children who are in the process of developing stuttering. Other aspects of childhood functioning are
strongly influenced by such issues, and I think it would be the height of foolishness to assume, in the absence
of evidence, that stuttering is somehow an exception. 

In my own experience, the family issues can have a potent effect on the course of treatment for stuttering,
particularly when the issues center around stuttering itself. 

One of our early failures in the stuttering pre- vention center was with a child whose parents were divorcing.
Unfortunately, they each blamed the other for causing the stuttering. Try as we did to dissuade them from this
destructive course, they persisted and the child did not recover. I met him later and, still stuttering, he was
con- vinced that his father had caused him to do so. 

Woody

Questions concerning Basal Ganglia's possible role in
stuttering

From: Stefanie Thibodaux Prothro (graduate student)
Date: 10/10/99
Time: 10:32:32 AM
Remote Name: 166.72.156.251

Comments

Questions for Online Conference Stefanie Thibodaux Prothro Southern University-Baton Rouge 

1. If the basal ganglia is involved in stuttering, are there any specific treatment options to remediate stuttering? 

2. Would surgery or medication be involved in the remediation of stuttering? 

3. Is there a specific difference between an adult male/female or child male/female if the basal ganglion is the
cause of the stuttering? 

4. Is there a specific cultural difference among the various ethnic groups? 

5. What types of treatment or therapy options are available to a school based speech language pathologist? 

6. Is there any specific intervention strategies, in your opinion, that would benefit a classroom teacher who
has a student who stutters? 

7. What are some future topics for research? 

8. Is cerebral dominance the cause for language based stuttering? Why or why not? 

9. If language based stuttering is influenced by the cerebral dominance theory would treatments differ? 
For Stefanie

From: Judy Kuster
Date: 10/10/99
Time: 12:41:43 PM
Remote Name: 134.29.30.79

Comments

Stefanie, 

Thank you for your participation and interest in the online conference. I am going to leave your questions
here, but would suggest that you choose one of your questions about basal ganglia involvement and post it for
Larry Molt after you have read his paper below. If any of the professors keeping "office hours" for this
conference wishes to answer that question or any of the others, they of course are welcome to do that. But
nine questions in one post gets a little overwhelming and confusing in a conference like this. I hope you
understand. 

Judy 

Re: Questions concerning Basal Ganglia's possible (response
to questions 1-4) role in stuttering

From: Larry Molt
Date: 10/13/99
Time: 9:15:58 AM
Remote Name: 131.204.63.26

Comments

Hi Stephanie! 

First, never apologize for asking questions – that’s part of the purpose of a conference like this, and its what
we need – the next generation of SLPs continuing to question and explore. I’ll tackle the first few of your
questions with this posting, and reply to the remainder in a few more postings. 

1. If the basal ganglia is involved in stuttering, are there any specific treatment options to remediate stuttering? 

It certainly opens up a number of options that might not be considered in traditional SLP therapeutic
approaches. This includes viewing stuttering from a different paradigm and changing therapeutic emphasis, or
such things as the use of neuropharmaceutical adjuncts to therapy/management 

2. Would surgery or medication be involved in the remediation of stuttering? 

I certainly don’t see surgery as an option; the majority of basal gangliar disorders are not dealt with surgically,
and there have been few successes with the surgical attempts. There has been some limited speculation about
surgery in light of the transcranial magnetic stimulation research on PWS currently being carried out by Drs.
Peter Fox, Roger Ingham, and Janice Costello Ingham. This technique can be used to temporarily disrupt
neural activity within specific regions of the brain, and the researchers are investigating its effects on several
regions identified in previous PET studies as showing aberrant function in (some) PWS. The outcome of their
research may have many different implications for treatment, and surgery has been hypothesized as one (i. e.,
if electromagnetically "knocking out" a certain area results in normal fluency with no other observable negative
side effects, then surgical ablation of that area might be considered an option). Personally I have doubts that
will be the outcome – the majority of attempts to deal with neurological dysfunction seem to carry a price tag
of unwanted side effects that is often too high to pay. 

Medication is currently being considered as an option, although its important to point out that no medication
has yet to be found 100% effective for ameliorating stuttering, and all have noticeable side effects. I wrote an
article for last year’s ISAD Conference on the use of neuropharmaceutical agents, and its still accessible via
The Stuttering Home Page (ISAD98 Online Conference) – I’d encourage you to check it out if you’re
interested in this area, and especially the writings of Dr. John Brady: 

Brady, J. P. (1991). The pharmacology of stuttering: A critical review. American Journal of Psychiatry, 148,
1309-1316. 

Brady, J. P. (1998). Drug-induced stuttering: A review of the literature. Journal of Clinical
Psychopharmacology, 18, 50-54. 

3. Is there a specific difference between an adult male/female or child male/female if the basal ganglion is the
cause of the stuttering? 

I’m a little bit unsure of your question. There are differences in male-female ratio patterns for many of the
basal gangliar disorders, and also evidence of differences in recovery rate between the sexes. Tourette
syndrome is a good example of this, with a male-female ratio pattern that looks similar to that reported for
stuttering. 

4. Is there a specific cultural difference among the various ethnic groups? 

The research hasn’t held this out to be noticeably true in stuttering. One of the areas of research explored in
attempts to support Wendall Johnson’s Diagnosogenic theory was that as attitudes to communication (and
success/competition) varied among cultures, so would the prevalence of stuttering – yet the research results
generally support a prevalence figure fairly close to 1% across all cultures. I’d encourage you to look at a copy
of Oliver Bloodstein’s "Handbook of Stuttering" which should be available at your university library for a
nice summary of the research in this area. 

If it turns out that some cases of stuttering are caused by basal ganglia involvement that is hereditary, it is
possible that there would be ethnic differences (but there doesn’t have to be differences). For example, several
years ago there was some speculation that sickle cell anemia, a hereditary disorder that is more prevalent in the
African/African-American population might put children with it at slightly higher at risk for stuttering. 

Great questions, Stephanie! I’ll tackle the rest in my next posting. 

Warmest Regards, 

Larry Molt 

Re: Questions concerning Basal Ganglia's possible role in
stuttering (reply to questions 5-9).

From: Larry Molt
Date: 10/14/99
Time: 9:14:00 AM
Remote Name: 131.204.63.26

Comments

5. What types of treatment or therapy options are available to a school based speech language pathologist? 

I assume you’re referring to the possibility of a basal gangliar link, and what options that would leave the
school-based SLP. First, if for some individuals medication might alleviate some of the symptoms, then the
relationship between the SLP and the prescribing physician would be a vital one – with the SLP providing
feedback to the physician to help with getting blood levels set correctly – reporting on symptoms – both how
well the stuttering is being addressed as well as the presence of side effects – to achieve the best therapeutic
dosage. But I would expect much more would be needed from the SLP. Currently, none of the dopaminergic
drugs totally alleviate stuttering symptoms, and the SLP would be vital in dealing with the remaining
symptoms. (as has been suggested by Dr. Gerry Maguire, at Univ. California-Irvine, in his research with
risperidone). There’s a second point to be made, however, and that is that the presence of a BG link need not
mean that the SLP may have to make many changes in the therapeutic approach. Many of the therapeutic
techniques currently in use are ones that have positive effects on BG disorders. The psychological/counseling
approaches aimed at alleviating fear would help to reduce triggering by the limbic/BG links; motor
simplification techniques taught in fluency shaping approaches attack some of the neuromotor components.
These techniques have shown great success in reducing stuttering symptoms in a large percentage of the
population; they just haven’t been effective at removing all stuttering (possibly because of the underlying
neural function abnormalities that still remain, at least in some PWS). 

6. Is there any specific intervention strategies, in your opinion, that would benefit a classroom teacher who
has a student who stutters? 

As I mentioned in the previous answer, what has worked well in the past still works well today, even if our
etiological models may shift for some PWS. Techniques aimed at reducing fear towards stuttering and
towards speaking situations, and techniques aimed at changing and simplifying speech production are still
vital and useful strategies. 

7. What are some future topics for research? 

Great question! It’s always fun to prognosticate. Continuing the research into genetic links is vitally
important, for it should give us much greater insight into the disorder. Further brain imaging studies during
speech production are also vital – we’ve learned so much already, and we’re just seeing the tip of the iceberg.
Another key component is doing more research in very young children – examining what is going on as
stuttering first starts to appear – we’ve got lots of great researchers examining this right now – Ehud Yarii,
and Nan Ratner, and Scott Yaruss come immediately to mind but there are plenty more. This is particularly
vital information. And we need much more research examining physiological and neurophysiological
components in these young children – Tony Caruso has been emphasizing that for more than a decade. But
there are other important research areas that need emphasis that don’t directly involve etiology. These include
systematic investigation of therapeutic techniques and continuing the search for new and innovative
techniques. Lots of people are attempting to apply new approaches to therapy – for example, Woody
Starkweather and Janet Givens’ use of gestalt approaches; and similarly, the use of REBT, talked about by
Gardner Gately about a decade ago and now being pushed vociferously by Gunars Neiders; and even other
cognitive psychotherapies. 

8. Is cerebral dominance the cause for language based stuttering? Why or why not? 

Well, I’ve got to admit you’ve got me nervous in your choice of words, both with "cerebral dominance" "
language based stuttering". I’m not comfortable with the latter – for it implies we are confident of the etiology,
and I don’t think we are at all. I would agree that in some PWS language adeptness, or rather a degree of
ineptness, plays a vital role – but is that the sole source of the stuttering? Lots of kids have much worse
language disorders or delay - but they don’t stutter – what makes the difference? Its got to be more than just
language. As to your use of the former term, cerebral dominance implies that it works the same way for
everybody, and I don’t think that’s necessarily true at all. As a brain imaging researcher – I’ll tell you that
language appears to be all over the brain, both in left and right hemispheres, subcortically, even cerebellar,
with brainstem, and even corticospinal components. We can talk about a predominant hemisphere for
language, where damage or disorders result in more easily seen symptomotology, but there are activities going
on everywhere, and disorders anywhere have the potential for disrupting the exquisite temporal demands of
such an incredibly complex system of systems that is language, and thus impairing fluency. 

The imaging research does demonstrate altered patterns of activation across myriad levels of neurological
function in PWS when stuttering, some of which don’t exist when they speak under fluent conditions. I still
feel we don’t have enough information to determine what is really important, and what’s not, in trying to
make a determination about altered hemispheric dominance in PWS. 

9. If language based stuttering is influenced by the cerebral dominance theory would treatments differ? 

Returning to my answer to question 8, above, I really don’t think we have enough information on what’s
wrong or different in PWS, or what the "correct" pattern is, to think about changing treatment approaches. 

Thanks for your interest, Stephanie. Southern University is lucky to have a student with such a bright,
inquisitive mind. Keep asking questions! 

Warmest Regards, 

Larry Molt 

stuttering in other forms?

From: Salena
Date: 10/10/99
Time: 12:54:40 PM
Remote Name: 209.181.170.236

Comments

I have heard of a few rare cases of people who stutter, stuttering while using sign language. Have any of you
ever heard of or seen this? Why do you think this might happen?

Re: stuttering in other forms?

From: Ken St. Louis
Date: 10/11/99
Time: 8:06:33 AM
Remote Name: 157.182.15.69

Comments

Dear Salena, 

Yes, it is fascinating to see "stuttering" in other behaviors besides oral speech. There are numerous cases in
the literature (mostly anecdotal) of "stuttering" during sign language (as you indicate), but also speaking with
esophageal speech (after laryngectomy), sending Morse code, playing the trumpet, signing one's name,
reading silently, doing finger tapping patterns, and so on. 

I don't have a good explanation of the causes of these unusual "stutters." It would be easy to speculate that
stuttering reflects a generalized motor or linguistic deficit that can appear in a variety of performances. The
problem with such an explanation across the board is that, typically, stuttering does not occur in such
behaviors. 

No doubt we will have lots of unexplained phenomena to explore about this disorder for a long time. 

Ken

Addendum to questions concerning Basal Ganglia involvement

From: Stefanie Thibodaux Prothro (graduate student)
Date: 10/10/99
Time: 5:28:11 PM
Remote Name: 32.100.25.103

Comments

Panel: I am terribly sorry, in my haste to post my questions I failed to introduce myself. My name is Stefanie
Thibodaux Prothro and I am a second year graduate student in the Master's Degree Program at Southern
University- Baton Rouge. I was intrigued by the article by Larry Molt, "The Basal Ganglia's Possible Role in
Stuttering", from reading that article I was able to generate the list of questions that are in your possession. I
work in the school system in Rayne Louisiana, I presently have three students (males) with a fluency
disorder, from working with them I am concerned with treatment options and the possible causes of
stuttering. Your input on the questions that I submitted would be greatly appreciated. I thank you in advance
for taking the time and patience to read and answer my questions. 

Thank you, Stefanie Thibodaux Prothro 

questions concerning stuttering

From: Stefanie Thibodaux Prothro
Date: 10/10/99
Time: 5:39:22 PM
Remote Name: 32.100.25.103

Comments

Dear Panel: I apologize for the list of questions that I presented. As a graduate student I am constantly
searching for more answers. I am submitting just one question and I apologize for the inconveince it may have
caused you. Thank you, Stefanie 

"Is there a specific difference between an adult male/female or child male/female if the basal ganglion is the
cause of the stuttering?" 

FAF, DAF in "Real" Life Situations

From: Mark Facer (Sydney, AU)
Date: 10/11/99
Time: 3:14:01 AM
Remote Name: 203.109.239.84

Comments

Hello Again Professors! 

Has there been any research work done to study the effects of AAF devices in real life situations? 

Specifically: 1. What is their effectivness in reducing stuttering in life situations? 2. Comfort level - how do
PWSs feel after hearing the feedback for an extended period? 3. Comfort level - how do PWSs feel about
wearing the device? 4. Statistically, how do PWSs as a group sound while using AAF devices? 

Thanks in advance! 

Regards, Mark Facer

Re: FAF, DAF in "Real" Life Situations

From: gert.reunes@compaqnet.be
Date: 10/11/99
Time: 11:36:20 AM
Remote Name: 194.78.220.105

Comments

Hello, There is now a research at the unicersity of GHENT BELGIUM with 10 people who are using DAF
(duration = 3 months) in life situations. Results are espected in june 2000. You can mail me for the results in
september 2000. Best regards, Gert Stutterer and student slp 

Stuttering and stress

From: Peter Louw
Date: 10/11/99
Time: 9:05:03 AM
Remote Name: 196.36.184.252

Comments

Dear Panel 

Being a 49-year-old PWS who has been involved with self-help groups for PWS for many years, and who
wrote a book on my experiences, I am fascinated by the important role of stress in stuttering. Time and again
one hears the same story: stuttering is worse during times of university examinations, or when speaking to an
authority figure, or when changing jobs / spouses, or when feeling "under pressure" etc. etc. I know that
"stress" and "tension" are vague terms, but so be it. I also know that stress control / management is not the
whole answer to stuttering, even though many people should benefit from it. It would seem that many (if not
all) people who stutter have a stress or tension threshhold which, if exceeded, will result in stuttering. 

My question is: would you agree with the (admittedly wide and non-scientific) statement that, for most people
who stutter, excessive stress or tension of one form or another probably accounts for more than 60% of their
stuttering problems ? (Also having regard to the fact that much "stress / tension" has become fixed and
habitual through conditioning.) 

My own view is that the whole issue of "stress" is not at all getting the formal and academic attention it
deserves, to the detriment of therapy. 

Many thanks and kind regards.

Re: Stuttering and stress

From: Bob Quesal
Date: 10/11/99
Time: 12:05:40 PM
Remote Name: 143.43.201.99

Comments

Hello Peter: 

You make some good points. I think you’ve hit on a couple of important points: First, terms like "stress" and
"tension" are vague. They may be difficult to operationalize and therefore study in a systematic way. The other
issue is that much of what we “know” about these factors comes from anecdotal evidence. 

I don’t know where your “60%” figure comes from, but my take on things is this: in at least some stutterers,
the motor system is more prone to interference from “stress,” and when “stress” is introduced, the system is
more likely to break down. In many cases, when we analyze our “bad days,” we find that there are nonspeech
“stressors” at work--a test, an interview, a bill that is due, an upcoming trip, etc. These factors may be
sufficient to interfere with the operation of our motor systems, and therefore we are more likely to stutter. 

I like to ask my clients to do an “inventory” when their speech is not going well. Frequently, they are able to
identify a variety of (nonspeech) things going on in their life which *could* contribute to fluency breakdown.
One of the skills to learn is to be able to “perform” in the face of heightened “stress” or “emotional arousal.” 

I hope this helps to address your question. 

Bob Q.

Re: Stuttering and stress

From: Ken St. Louis
Date: 10/11/99
Time: 4:18:55 PM
Remote Name: 157.182.15.69

Comments

Dear Peter, You bring up a pivotal point about stuttering, i.e., the role of "stress." I don't believe there is any
question that stress plays a role in the occurrence of stuttering in most stuttering individuals. In fact, at least
half of the nonstuttering population will admit to "stuttering" at least once in their lives (meaning that they
knew what they wanted to say but momentarily could not get the word(s) out), and this typically occurs in
stressful situations. The problem comes when we try to ascribe causation. Those who stutter don't always
stutter in stressful situations and sometimes stutter in very unstressful situations. (But perhaps that's why you
speculated that stress is related to about 60% of the problem). I would hypothesize that there is a minority of
those who stutter who have over-reactive autonomic nervous systems. That is, they simply react to stimuli
with physiological reactions that would be more vigorous than normal. My prediction would be that such
individuals would almost always stutter more in stressful situations. But I have seen a few individuals for
whom stuttering is not the least bit stressful and for whom external stress makes very little apparent
difference. 

When it comes to determining the form of therapy, the so-called "experts" disagree on whether or not
desensitization to stress is necessary. Some believe that reducing stuttering is sufficient to reduce any attendant
stress. Others, e.g., Van Riper and his followers, believe that desensitization is necessary in order for
stutterers to maintain control or attention to fluency targets in difficult speaking situations. I have begun to use
desensitization activities more and more in the past few years and have been more successful. 

Ken

Re: Stuttering and stress

From: Steve Hood
Date: 10/11/99
Time: 8:42:44 PM
Remote Name: 205.188.198.174

Comments

Hi, Peter -- 

You have raised an interesting issue, and I think Bob Quesal and Ken St. Louis have hit some important
issues -- and I agree with Bob and Ken. 

For whatever reason (and I think and for many PWS's the original, etiologic factor(s) may have been
"organic" in some type of neurobiologic way) by the time stuttering has developed into a more advanced and
severe form, things have changed. It is not a question of Nature **VERSUS** Nurture, but rather, it is a
question of both Nature **AND** Nurture. 

To me, stress and increases in stuttering are corrlated, but correlation does not show cause-effect. Correlation
means that two things are related to others. In the case of authority figures, exams, giving a presentation at
work -- we have examples of negative stress. There are also examples of positive stress: being excited while
telling someone about a positive experience, telling the puchline of a funny joke, gong off on a family
vacation, upcoming holidays, birth of a child, etc. 

So -- we have both positive and negative stress. 

It seems reasonable that the PWS is for some reasons (some unkown combination of possible some organic
PREDISPOSITIONAL plus learned emotional factors) make the PWS more susceptible and vulnerable to
breakdown: e.g., the motor break-downs that have been discussed earlier. 

As for the 60% figure..... I dunno. I suspect it is a high persent, but would be on thin ice to speculate. 

Good question, Peter. I hope others will offer their opinions. 

Steve Hood

Re: Stuttering and stress

From: Peter Louw
Date: 10/13/99
Time: 3:27:08 AM
Remote Name: 196.36.184.252

Comments

Dear Ken 

Many thanks for your valuable comments and those of the other panel members. May I make the following
comment regarding those PWS who stutter even in seemingly relaxed circumstances, i.e. where there are no
obvious external stressors: 

I suspect that, here too, there is a stress link, but that in these cases the tension / stress comes from inside. I
feel that these people, or at least some of them, suffer from what has been called "word stress" (or sound
stress). It is "internal stress" rather than "external stress". The mere fact of these people speaking results in
some stress, and the resultant stuttering. PWS who stutter even when alone also suffer from word stress,
according to this model. 

Word stress is mainly learned. The subconscious "remembers" all the previous stuttering of the past, and
when you want to say the difficult word, the past "pops" out of your subconscious and you stutter. 

In other cases the physical act of speaking may also create some muscle tension, resulting in stuttering. Again
in other cases there may be internal stress which is not obvious to an outsider, or even to the PWS himself.
Stress experts say that many people are in fact not aware of their own stress levels, even though this may have
an effect on the PWS. 

In all of these cases the stress factor is present. I am not saying that stress causes stuttering; but I do suspect
that stress / tension has an effect on some or other part of the PWS's physical apparatus. What that "some or
other part" is - well, that's the big question, but it seems that, in the PWS, that part is extremely sensitive to
any kind of tension / stress. 

Stuttering, according to this model, can only be understood when one understands stress in all its
manifestations. 

Kind regards.

Re: Stuttering and stress

From: Ken St. Louis
Date: 10/13/99
Time: 8:09:56 AM
Remote Name: 157.182.15.69

Comments

Hi again Peter, 

Your thesis that stress plays a role in stuttering even when the speaker is unaware of it is very similar to some
of Bloodstein's writing about expectancy. He, as you no doubt know, postulates that stuttering is an
anticipatory avoidance reaction which could be triggered by anything that makes the person believe that speech
is difficult. This was a more generic version compared to Wendell Johnson's view of stuttering as reaction to
others' reactions to essentially normal disfluency. 

In any case, when the research on anticipation (or expectancy) did not show that stutterers could identify every
single stutter in advance (i.e., anticipate them), Bloodstein hypothesized that expectancy (which could almost
be viewed as latent anxiety) occurred at a "low level of consciousness." 

You are in good company with your position. Personally, I would rather not invoke something that cannot be
measured or perceived to explain such stutterings. I believe that, with a compromised mechanism, stuttering is
simply the natural result of trying to talk. Here's an oblique example: I have intermittently tried for years to
speak at my usual rate under delayed auditory feedback in a class demonstration, but I simply cannot ignore
the delay. My speech is VERY, VERY FRACTURED AND REPETITIVE. I repeat syllables anywhere in the
word, even while enjoying the experience. I do stutter from time to time. But this does not in the least feel like
real stuttering to me. 

OK. This is not real stuttering, but the point is that the disruption the DAF causes me simply results in
repetitions, hesitations, retrials, etc. Why is it such a large jump to assume that the same sort of thing could be
happening with some stutters in most stutterers or with most or all stutters in a very few stutterers? 

I don't expect we'll agree, but the debate is fun. 

Ken

Re: Stuttering and stress

From: Woody
Date: 10/18/99
Time: 5:30:45 PM
Remote Name: 155.247.229.71

Comments

Of course there are many ways to measure stress and no clear agreement on what way is best 

A study done in the Netherlands a few years ago, and I don't remember exactly who the authors were, but it
was done by Herman Peters' group, found that stutterers were no more anxious before speaking than
nonstutterers were, but that AFTER speaking the stutterers were more anxious. I don't remember how they
measured anxiety in this study, but assuming it was one of the traditional measures, and that the experiment
was carried out with the same care that Herman's group always uses, it shows pretty clearly that we assume
too much when we assume that the anxiety that is known to be associated with stuttering is causal. 

Woody 



Does technique matter?

From: Joe Kalinowski
Date: 10/11/99
Time: 1:34:27 PM
Remote Name: 150.216.147.209

Comments

When I was getting my master's in speech pathology back in 1982-85, I was instructed in Johnsonian
techniques of parent counseling, reducing speech demands--never mentioning the word "stuttering" . A good
number of patients "recovered" from stuttering with this method --and I was taught this to be true and fair. 

Now I am much older and getting back to notions about therapy and the pendulum has swung the other way.
Now children who stutter get much better BUT with direct intervention and modification of "stuttering' Not
only that, but the term "stuttering" is used freely. 

If the end result is the same, how can I attribute the results to diametrically opposed therapies? Or does
technique matter? 

Help 

Re: Does technique matter?

From: Walt Manning
Date: 10/11/99
Time: 2:24:31 PM
Remote Name: 141.225.97.53

Comments

Hi Joe- 

It is technique you are talking about or overall treatment strategy? If a clinician is going to use a technique it's
probably best to do it correctly. On the other hand, some variation (intentional or not) of a techique may well
work pretty well in many cases. While techniques are important, other things are probably more important- the
timing of the techniques, the enthusiasm of the clinician, the motivation of the client, the understanding of the
technique. Specific techniques associated with an overall treatment stragegy and the choice of the strategy
probably matters also. It's OK, I think, that many strategies and techniques appear to "work" to lessen the
handicap of stuttering and to decrease the frequency of stuttering. I do think it's silly to spend a lot of time and
research effort trying to find which stragegy/technique "works" best (whatever thay may mean). That type of
"race horse" research was done several years ago in psychology. The results indicated that some approaches
won some of the time and other approaches at another time. It's easy to get into discussions about which
approach is the "correct" one but I think that is missing the point. We (the client & clinician)often need to
experiment for a while to see what will be the best thing to do at a given time. Fortunatly, lots of things often
help. 

Re: Does technique matter?

From: gert.reunes@compaqnet.be
Date: 10/11/99
Time: 4:34:59 PM
Remote Name: 194.78.219.118

Comments

Hello Dr. Kalinowskij, I have to write down this story that happened this evening. One client of the research
DAF group has phoned me today with the following message: '' FOR THE FIRST TIME IN MY LIFE I
HAVE GIVING AWAY AN INTERVIEW IN A NEWSPAPER'' Nobody has asked him to do this, now not
only his stammering has changed with the device but also his way of thinking and his way of self-esteem!!! 

(5 weeks ago... he was an introvert person and also very ashamed about his stuttering... So why are we
waiting for to make a device that has DAF/FAF/MAF and even LAF MODE and is so small as a hearing
aid????????????????????????? Why we have to wait for technical aid if other handicaps have there own
devices. Schindlers list in mind... we cann't save a whole nation but we can save/help a single unique person
who has also the rights to become free of his handicap. 

Best regards, Gert

Re: Does technique matter?

From: Steve Hood
Date: 10/11/99
Time: 8:59:17 PM
Remote Name: 205.188.198.173

Comments

Hi Joe -- 

The old Johnson notion, following his diagnosogenic theory, seemed to be telling the parent: don't lable it,
don't call it anything, don't react to it, and it will go away. This was pretty simplistic, I think. Many kinds had
more than just the "normal nonfluencies" that Johnson referred to (or fluency failures if you follow Brutten
and Shoemaker, or discontinuities if you follow Starkweather.) These kids had enough stuttering to be
concerned about in terms of frequency, effort, duration, and degree of fragmentation (sound syllable reps,
prolongations, hard contacts/tense pauses, etc.) 

We know each other, so I can say this: I did my master's work a few years prior to the time you did. When I
was a master's student, the idea was that therapy should be "indirect." -- e.g., do NOT work directly with the
child, but work with parent counseling. 

In our clinic, we do work directly with the child, and with the parent(s) and sometimes siblings when
possible. We work directly on talking: easy talking, "turtle talking." We work on the pragmatics of
speaker-listener interactions: e.g., turn-taking, pausing between speaking. We add some increased prosody to
our speech (intonation, pitch, melody, inflection.) We work to reduce stresses such as being interrupted,
contradicted, put on verbal displan, given verbal demands. We work to reduce verbal competition among
family members: both the children in the family, and the adults. 

I really cannot answer your question in terms of how this relates to techniques, or the old Johnson notions. 

I do suspect that the "techniques" may have some things in common, even though the way clinicians go about
them may be diffent. Johnson died in about 1965. Maybe we have learned some things in the past 34 years.
Maybe if we have not learned "new things" maybe we have learned to do the "old things" in newer and
hopefully better ways. 

NOTE: My response to your very good question is geared to Kids in the beginning stages of developmental
stuttering. i am not referring at all to techniques that might be applicable to more confirmed/chronic/severe
cases of stuttering. 

Thanks, Joe -- thanks for your question. 

Steve Hood

Re: Does technique matter?

From: Bob Quesal
Date: 10/12/99
Time: 8:15:56 AM
Remote Name: 143.43.201.99

Comments

With all due respect to my friend and colleague Steve Hood, and as (apparently) the only living "Wendell
Johnson apologist" (even though I'm really not all that old), I think that Steve has continued to present the
simplified and distorted picture of Johnson's views. If one reads Johnson's "Open Letter to the Mother of a
Stuttering Child," it is clear (at least to me) that the things we are doing today with children who stutter are
*very similar* to the things that Johnson suggested in that letter. Not that Johnson had it all right, but as Steve
points out, 34 years of research has a way of changing one's view of ideas from 30, 40 or even 50 years ago. 

As far as "techniques" are concerned, I agree with Walt Manning. One could use a very "Johnsonian"
approach with parents (don't label it, don't make a big deal about it, etc.) and get a good outcome. Similarly,
one could be more direct, both with the parents and the child, and get a good outcome. Conversely, if we
intervene and don't know what we're doing, or if parents and clients react negatively to our information or
clinical style, we may get a bad outcome, regardless of the approach we use. (Shameless plug: Have a look at
my essay, "One Size Fits All" which is posted on this online conference.) 

Anecdotally, we always hear people say "I used to stutter and I grew out of it." The extent to which those
folks truly "stuttered" is subject to question. The point is, there are a lot of variables that we are dealing with
when it comes to treating stuttering. Our outcomes, as Walt pointed out, are based on a lot more than just the
"technique" we choose. 

Interesting question, Joe. Hope this addressed it at least to some extent. 

Bob Q.

Re: Does technique matter?

From: JSYaruss
Date: 10/12/99
Time: 9:49:26 AM
Remote Name: 128.147.90.204

Comments

interesting dialogue...I hate to bring up, but kind of have to...that at least some of these kids would have been
likely to recover anyway. I don't know how many...that's another thread...BUT, the fact that even some get
better on their own, regardless of what we do, makes it difficult to know what is the technique and what isn't.

Plus, it's also likely that different types of intervention can lead to the same outcome. It may be that the two
intervention approaches would work for everybody equally well, or that one would work better or some than
for others. We just don't know that yet...but it's an interesting and important question to ponder. 

Thanks Joe! Scott

Re: Does technique matter?

From: JSYaruss
Date: 10/12/99
Time: 9:49:29 AM
Remote Name: 128.147.90.204

Comments

interesting dialogue...I hate to bring up, but kind of have to...that at least some of these kids would have been
likely to recover anyway. I don't know how many...that's another thread...BUT, the fact that even some get
better on their own, regardless of what we do, makes it difficult to know what is the technique and what isn't.

Plus, it's also likely that different types of intervention can lead to the same outcome. It may be that the two
intervention approaches would work for everybody equally well, or that one would work better or some than
for others. We just don't know that yet...but it's an interesting and important question to ponder. 

Thanks Joe! Scott

Re: Does technique matter?

From: Woody
Date: 10/18/99
Time: 5:37:55 PM
Remote Name: 155.247.229.71

Comments

What Scott, and the others, say is true enough, but that doesn't mean that technique doesn't matter. When
parents refuse to talk to their child about stuttering, it naturally creates the impression that stuttering is
something that can't be talked about. Surely this contributes to or causes outright a sense of shame in the
child. Johnson may have had some things right, but in my opinion he was very wrong on this one. I
understand that the parents mean well when they do this, but it still hurts the child. 

Woody

Re: Does technique matter?

From: Bob Quesal
Date: 10/19/99
Time: 9:07:23 AM
Remote Name: 143.43.201.99

Comments

Allow me to quote from Johnson's "Open Letter to the Mother of a Stuttering Child": "2. Do nothing at any
time, by word or deed or posture or facial expression, that would serve to call Fred's attention to the
interruptions in his speech. Above all, do nothing that would make him regard them as abnormal or
unacceptable. If he has begun to notice his own hesitatings help him to feel that they are understandable under
the circumstances and so, of course, acceptable. In doing this, however, do not make the mistake of
"protesting too much." You can make Fred self-conscious about his speech even by praising it—if you praise
it to excess. Err, if you must, on the side of approving it a bit more than is justified. 

"I am not suggesting that you 'pay no attention to Fred's stuttering.' You may often be given advice in these
exact words. The people who give it to you have good intentions. Meanwhile, the wording of the advice is not
quite right, in my judgment. Here is what I mean: If Fred repeats and hesitates (speaks disfluently) in the
ways that are more or less ordinary for his age and for the sorts of situations in which he is talking, he is
simply not doing anything that might usefully be called by such a grave-sounding name as 'stuttering' in the
first place. He is just speaking normally, and normal speech is more or less disfluent. If he is more hesitant in
speech than most children are, and especially if he hesitates with strain or tension, look about him, and at
yourself, and try to find out the reasons. Then do what you can to remove them. Don't 'pay no attention' to
the unusual reactions Fred is making to the unusual things in his surroundings that need to be changed." 

[Lots deleted] 

"Unless the speech problem that you and Fred are in together is in some way exceptional, or has developed
into a truly serious form, these suggestions should prove helpful. You will not, I am sure, expect more from
the printed page than would be reasonable and you will remember that Fred is only human. His speech-or
yours or mine—will never be as fluent as a faucet. All children hesitate and repeat and stumble more or less in
speaking—and so do all adults. Even the most silver-tongued orator makes an occasional bobble. But if
within six months or so you feel, for any reason, that Fred is not talking as smoothly and easily as he should,
I hope you will consult a speech clinician—preferably, of course, one who is certified by the American
Speech and Hearing Association [sic]." 

I think the "Open Letter" should be required reading for folks who try to "say what Johnson said." Most of
the advice in the "Open Letter" is what many of us do today with early childhood stuttering. Johnson's advice,
as I read it, applies to children who are disfluent, but who are not clearly "stuttering." It's almost exactly what
we do today. (I have a copy of the "Open Letter," but I am not sure if it is still copyrighted or if it is in the
public domain. I contacted the publisher, but have not heard back from them.) 

Once again, I feel like the sole Wendell Johnson apologist on the planet. But I feel that a careful reading of the
"Open Letter" gives a much more complete sense of what Johnson was talking about than to say "he told
parents not to talk about it" or "he told parents to ignore it and it would go away." 

FWIW 

Bob Q. 

Stutterer being a SLP????????????????

From: gert.reunes@compaqnet.be
Date: 10/12/99
Time: 1:01:50 PM
Remote Name: 194.78.219.189

Comments

Hello, Can a stutterer be an effective SLP? 

Re: Stutterer being a SLP????????????????

From: Bob Quesal
Date: 10/12/99
Time: 2:38:25 PM
Remote Name: 143.43.201.99

Comments

Well, I'm a stutterer and I'm an SLP. I'll leave it to others to determine "effective." ;-)>> 

I know lots of SLPs who stutter. Some of my best students have been stutterers. Some of the best clinicians I
know stutter. Some of my best friends are stutterers and SLPs. (Some fit in only one category, some fit in
both.) 

Oh, and by the way, some of the worst SLPs I have known have been nonstutterers. 

Re: Stutterer being a SLP????????????????

From: gert.reunes@compaqnet.be
Date: 10/12/99
Time: 4:10:23 PM
Remote Name: 194.78.219.207

Comments

Hello BoB, 

Thank you for the support. I am also a slp student (last year university Ghent-BELGIUM). Here in Belgium
many slp's find it real bad that a stutterer becomes a slp. If a succeed in june 2000 I am the first slp (university
degree) who will succeed. Some schools will not allowed a stutterer to become a slp...can we do anything
about it, to make this stupid thought dissapear? 

Thanks, gert

Re: Stutterer being a SLP????????????????

From: Steve Hood
Date: 10/12/99
Time: 5:02:38 PM
Remote Name: 199.33.133.50

Comments

Gert 

Good luck in your quest to be an SLP who is a PWS. In the United States, there are some university
programs that encourage and support PWS's who which to become SLP's. Unfortunately, there are other
univertity programs that openly frown on this, and make life pretty miserable for the student. 

The Stuttering Foundation of America has published a book entitled: ADVICE TO THOSE WHO STUTTER.
Listed below is a partial list of contributors. ALL of these people are both SLP's and PWS's. 

Dorv Breitenfeldt, Hugo Gregory, Lois Nelson, Joseph Sheehan, Fred Murray, Peter Ramig, Dean Williams,
Harold Luper, David Daly, Joe Agnello, Richard Boehmler, Bill Murphy, Larry Molt, Walter Manning,
Rebert Quesal, Gary Rentschler, Kenneth St. Louis, Charles Van Riper. Above and beyond this list, there are
dozens and dozens more. 

Some of the PWS's who are also SLP's (both listed above, and not listed above) will be contributing to the
ISAD program. I hope they will respond to your question. 

Thanks for your question. 

Steve Hood



Re: Stutterer being a SLP????????????????

From: Ken St. Louis
Date: 10/13/99
Time: 8:22:24 AM
Remote Name: 157.182.15.69

Comments

Thanks, Steve, for providing the "Advice to Those Who Stutter" reference relative to stutterers becoming
speech clinicians. I also agree with Bob's answer as well. 

I do think that it is incumbent on those of us who train SLPs and who also stutter to be open about it and to
perhaps work a little harder to be as controlled or fluent as possible. (Reactions to this statement could keep
me busy for the next week!) 

But, Gert, of course, stutterers should be able to become SLPs. Yet, Steve is correct. In spite of some
laudible examples to the contrary, there are many in this country--and yours--that do not want the profession
filled with those who are not examples of speaking excellence. These folks populate universities, school
programs, hospitals, clinics, and our national officers. How short-sighted this view is! Where would we be
without Charles Van Riper, Joseph Sheehan, Wendell Johnson, Einer Boberg, etc. etc.? 

I wish you well in your quest. 

Ken

Re: Stutterer being a SLP????????????????

From: Darrell Dodge
Date: 10/14/99
Time: 1:04:54 AM
Remote Name: 171.208.160.106

Comments

Hi Steve: 

Since you invited new (or almost new) stuttering SLP's to respond to Gert's comment here, I thought I'd add
a "word or two." 

Gert, it might interest you to know that the entire field of speech pathology in the U.S. (and, hence, the
world) was virtually started by PWS in the American midwest in the 1920's. Charles Van Riper (one of the
founders) is not only known as a PWS therapist for stuttering, but was until just a few years ago considered
the pre-eminent therapist in the world for articulation and phonological disorders as well. His work in that area
is still taught in most grad schools. 

It is very sad and somewhat perplexing that you are not getting the support that many PSW get in U.S.
graduate schools. Not only can PWS be effective and senstitive clinicians in the full range of communication
disorders -- even including aural rehabilitation (speech reading) and aphasia therapy -- but we can also be very
valuable members of a graduate school, providing examples of therapy in action and giving students an
invaluable opportunity to learn first-hand about stuttering from people who are down in the trenches with
them. 

My school -- the University of Colorado at Boulder -- almost always includes at least one or two people who
stutter on the graduate class rolls. Of course, they must also meet the academic and entry requirements. I have
received nothing but total support here and there was never a question that I could raise and discuss my doubts
and fears with anyone on the faculty, just as any other student can. 

Regards, 

- Darrell Dodge

Re: Stutterer being a SLP????????????????

From: Jerry Johnson
Date: 10/14/99
Time: 9:22:26 AM
Remote Name: 205.188.192.26

Comments

Hi Gert: And why not? I would think however that the PWS should have his/her stuttering under pretty good
control and be able to communicate very effectively. I do remember a statement attributed to Dr. Van Riper
that given a choice he would prefer the fluent speaker but this was because he was afraid that the PWS would
not be able to objectively treat other stutterers. Personally I have found this not to be the case. I have known
many PWS and have found them, for the most part, to be very objective about their own stuttering. How
many times have I heard from parents and others that they were glad to have a PWS treat them because they
felt that PWS would know more (?) about the disorder and how to treat it and how it "feels" to be one. Good
luck to you. Damn the torpedoes and full speed ahead.

Topics? 6th worldcongress ISA BELGIUM 2001

From: Martine De Vloed
Date: 10/12/99
Time: 4:16:34 PM
Remote Name: 194.78.219.207

Comments

Which topics are hot at the moment for the 6th worldcongress of ISA?

Re: Topics? 6th worldcongress ISA BELGIUM 2001

From: Ken St. Louis
Date: 10/22/99
Time: 1:57:08 PM
Remote Name: 157.182.15.69

Comments

Hi Martine, 

I had hoped someone else might tackle your question, but let me try before the the conference is over.
Obviously, the answers would differ based on the person answering. 

I believe that the ISA 2001 Congress should continue to foster new international member organizations that
serve the stuttering community. Obviously you will do that! (I have been very impressed with the remarkable
progress that has been made already.) 

Here are a few ideas for what you might want to consider for the Congress. At some point, as has happened
to some extent in the USA, consumers will no doubt need to begin to assist speech therapists, logopedists,
SLPs, or whatever they might be called to get better academic and hands-on training in treating fluency
disorders. Maybe a round-table discussion on that might be useful. In addition, you might want to get a report
from the Specialty Commission on Fluency Disorders in the USA. This is not a new concept in Europe, but it
is the first specialty program to get "off the ground" to recognize specialists in this country. (Current members
of the Commission are Dick Curlee, Diane Hill, Glyndon Riley, Michael Sugarman, and myself). 

I don't know if there would be any interest in other fluency disorders such as cluttering or stuttering
coesixting with other conditions, such as Tourette's Syndrome, phonological problems, language problems,
etc. These people are typically not in the forefront of the self-help movement. In fact, many clutterers are
unaware that they have a problem until someone intervenes and says, "Hey, your speech is hard to
understand." It would be wonderful if those who stutter could help get these people identified and into
treatment programs if they choose to try to get some help. And the problem of spasmodic dysphonia... It
would be cool to have someone in that new and emerging self-help movement interface with those in the
stuttering self-help movement. 

My last thought is public attitudes toward stuttering. I was singularly pleased, honored, and humbled when
Dr. John Van Borsel invited me to be a speaker at the 2001 Ghent Congress on the topic of international
public attitudes toward stuttering. (See the last paper in this ISAD2 Conference.) I think that public opinion
will become a hot topic in the future. We need to know if there are differences in public attitudes around the
world and, more important, what kind of public education campaigns change attitudes and what kinds do not. 

Well, there are a few thoughts. Good luck. 

Warm regards, 

Ken

WHAT AGE?

From: Petra Velghe
Date: 10/12/99
Time: 4:20:14 PM
Remote Name: 194.78.219.207

Comments

At what age can you start a therapy for children?

Re: WHAT AGE?

From: Ken St. Louis
Date: 10/13/99
Time: 8:27:57 AM
Remote Name: 157.182.15.69

Comments

Dear Petra, 

I'd start therapy at any age (even 2 years) if they have been stuttering for more than a few weeks. There seems
to be very little risk of needless therapy compared to the risk of becoming worse without therapy. But see the
paper in this conference by Dick Curlee for a different perspective. 

Ken

Re: WHAT AGE?

From: Scott Yaruss
Date: 10/13/99
Time: 10:46:33 AM
Remote Name: 128.147.90.204

Comments

I've started therapy pretty early with some (as early as 2 1/2) but this is mainly in cases where there is a clear
family history of persistent stuttering or other apparent risk factors (family hx of speech/langugae problems or
apparent speech/language problems in the child). 

Otherwise, I try to wait just a little bit -- not too long -- before beginning direct intervention with the child
because of the clear evidence that many very young children recover early. How long? Hard to say...depends
upon the situation, but I might wait 3 months before beginning formal intervention with the child. 

Of course, in nearly all cases, I immediately provide information to the parents about the nature of stuttering,
the developmental course of stuttering, and things they can do to help the child develop fluent speech. This
often takes the form of a short course of "parent training treatment" -- 4 to 6 sessions. I never just say "wait
and see" -- the work with the parents is clearly aimed at being an intervention of sorts, though it doesn't
require me seeing the child on a regular basis. Then, I schedule a re-evaluation to see if the child requires more
direct treatment. 

My colleague David Hammer and I will be presenting a seminar at ASHA this year on the parent training
component -- a formalization of common recommendations often made to parents about how to facilitate their
children's fluency. We do this for several reasons, not least of which is to help the parents stay calm during a
period of fluctuation in the child's fluency. This also keeps us in the loop in case the child's stuttering seems
to persist. AND, though there ain't much data, it seems to help the child's fluency. 

Whew! Long answer. Hope this helps. 

Thanks for a good question. JSY 

Re: WHAT AGE?

From: Woody Starkweather
Date: 10/18/99
Time: 4:41:52 PM
Remote Name: 155.247.229.71

Comments

Age, I think, has little to do with it. We had a very successful intervention with a child who was 15 months
old. Of course, what you do with the child depends strongly on his (or her) age, but not WHETHER you
intervene. I too usually wait a little bit -- a couple of months -- particularly when the behaviors are relatively
simple. But if the child is already struggling (as was the 15 month old) or avoiding, then there is no point in
waiting because stuttering, and not just the risk of it, is already present. 

Woody Starkweather

Cerebral Dominance in Stuttering

From: Stefanie Thibodaux Prothro
Date: 10/12/99
Time: 9:49:08 PM
Remote Name: 32.100.25.186

Comments

Panel: My name is Stefanie Thibodaux Prothro. I am a second year graduate student at Southern University in
Baton Rouge. After reading the article written by Larry Molt "The Basal Ganglia's Possible Role in
Stuttering" I was intrigued and motivated to generate a list of questions that you have in your possession. I
apologize for the list of questions that I submitted to you, it was unfair of me to present so many questions. I
would, however, like to submit the following question to the panel in hope for a response. Thank you in
advance for taking the time and patience to consider my request. 

Thank you again, Stefanie Thibodaux Prothro 

"Is cerebral dominance the cause for language based stuttering? Why or why not?" 

Re: Cerebral Dominance in Stuttering

From: Ken St. Louis
Date: 10/13/99
Time: 8:40:00 AM
Remote Name: 157.182.15.69

Comments

Dear Stephanie, 

Apology accepted. Your questions were good ones, but tough, like, "What is the meaning of life?" It kind of
depends, doesn't it? 

I don't if language-based stuttering is due to cerebral dominance or not. I don't know for sure that there is
language-based stuttering, although I am reasonably sure there are subgroups of stutterers. You would have to
be specific about what you mean. Also, I assume you are referring to something atypical about language
dominance in your question, not language dominance, per se. If I am correct, I still cannot answer the
question. I would say that there is evidence that stutterers (unselected samples) show differences in language
dominance compared to nonstuttering controls. The weight of the evidence from dichotic listening studies,
blood flow studies, EEG studies, tachistoscopic reading studies suggest less distinct left hemisphere
dominance among stuttering samples than nonstuttering samples. 

If this is not what you were searching for, sorry. That's the best I can do. 

Ken

Re: Cerebral Dominance in Stuttering

From: Woody Starkweather
Date: 10/18/99
Time: 4:48:05 PM
Remote Name: 155.247.229.71

Comments

I would like to second Ken's comments, and then add my own special take on the cerebral dominance issue. 

One of the pieces of information that is often overlooked in this discussion is that people with other disorders
of communication tend also to lack clear dominance for language. It's not just stutterers, but also language
delay, articulation disorder, learning disability, and hearing loss. 

So it seems to me that we ought to consider the possibility that the presence of a communication disorder, of
any kind, during early development causes the brain to develop with less clear domi- nance for language.
Such a developmental response has substantial survival value in providing more flexible options for a brain
that might not be developing normally. 

Woody Starkweather

Helping the PWS, or allowing him to finish the words
himself?

From: Peter Louw
Date: 10/13/99
Time: 10:05:34 AM
Remote Name: 196.36.184.252

Comments

When we hear a person stuttering severely, do we help him/her, or do we allow him to finish the words
himself? 

Traditional wisdom has it that one should allow the PWS to finish the words himself, and it would appear that
the majority of PWSs hold to this opinion. However I would suggest that one should not be too dogmatic as
far as this is concerned. 

As a child there were many occasions when I actually prayed for someone to help me out, and I have since
then also met others who would welcome appropriate help. 

In my book "Coping with stuttering" I mention the case of a young boy, a PWS, who attended a magician's
show. The boy was part of the audience, and suddenly the magician asked the boy his name, probably with a
view to inviting (or ordering!) him to participate in a magical trick. It was a disaster. The boy stood up, but
was completely unable to pronounce his name and stuttered severely. Some of the other children in the hall
began to giggle, and the result was that the boy ran from the hall in tears. This was a very traumatic experience
for him, and he never forgot it. Some people who knew him were also in the audience, and surely if they had
helped him in saying his name it would have prevented the trauma. 

So my question is: are we not being too dogmatic when we say that "the PWS should be allowed to say the
words him/herself"? Surely this depends on the individual and the circumstances. In appropriate
circumstances it may be a good idea to ask the PWS whether he/she would like to be helped. 

Kind regards.

Re: Helping the PWS, or allowing him to finish the words
himself?

From: Walt Manning
Date: 10/13/99
Time: 10:23:08 AM
Remote Name: 141.225.97.53

Comments

Hello Peter- 

At last, a question I feel quallified to answer...I enjoy watching Larry and Ken respond to the really heavy
stuff. I agree with you and think it's silly to say that a listener should "never" say a word for someone.
Usually it's not a good idea to be such a "verbal bandit" as Dr. Van used to say. It can make a bad experience
even worse. But, in the circumstance you describe, it probably would have prevented the situation from
becoming more traumatic. It's virtually impossible, I think, to predict what might be the best response in
many of these situations but taking the view that you should NEVER say a word for someone is rather narrow
minded.

Re: Helping the PWS, or allowing him to finish the words
himself?

From: Bob Quesal
Date: 10/13/99
Time: 3:01:15 PM
Remote Name: 143.43.201.99

Comments

Dogma is never a very good thing, and it's usually a pretty strong word. In this case, I'm not sure if the
dogma really exists. I'd say it's more of a "rule of thumb." I think Wendell Johnson (or maybe it was Yogi
Berra) said "'Always' and 'never' are two words we should always remember never to use." So to say we
should NEVER fill in words for a stutterer is too strong. We have to use our best judgment in any situation,
and if someone is really struggling, I think it is probably appropriate to offer some assistance. It's a lot easier
if we know the stutterer, because we probably have some sense of how they feel about this type of assistance.
With strangers, we have to make a best guess. If they don't want us to do it, they will likely let us know in
some way. 

"One size does not fit all." 

BQ

Re: Helping the PWS, or allowing him to finish the words
hims...

From: Woody Starkweather
Date: 10/18/99
Time: 4:52:41 PM
Remote Name: 155.247.229.71

Comments

Of course, as Bob and Walt noted, there are times when helping the person out is both appreciated and
occasionally can prevent even more painful events from transpiring. But it is also worth noting that there is a
cost to helping the person out by finishing their sentence. Even if they appreciate your doing it, and even if it
saves them from something more painful, when you finish someone's sentence you are in effect telling them
that they are not competent to finish their own sentences. That cost needs to be weighed against the cost of not
helping them. 

Woody

Stammering & Breathing pattern

From: Sandeep Desai, Bombay, India
Date: 10/13/99
Time: 12:26:45 PM
Remote Name: 134.29.30.79

Comments

I have been feeling of late that stammering happens on account of an unnatural breathing pattern that a PWS
has learnt over a period of time. Now this breathing pattern is natural and smooth at times when the PWS
experiences smooth and fluent speech, but on occassions the breathing pattern changes that does not facilitate
speaking. 

Now this unnatural breathing pattern which makes a PWS stammer is triggered off by certain states of
mind........like speaking on phone, speaking to authority figures etc........thats the reason stammering is
more pronounced in some situations. 

Has any research on stammering been done to look into the "state of mind" and tackling it so that the breathing
pattern remains smooth? I was reading about Neuro Linguistic Programming and I feel maybe the answer to
control the state of mind lies here. 

Tell me what you speech patholoists and experts feel about this theory

Re: Stammering & Breathing pattern

From: Ken St. Louis
Date: 10/13/99
Time: 2:30:27 PM
Remote Name: 157.182.15.69

Comments

Dear Sandeep, 

You are certainly not alone in speculating that abnormal breathing patterns play a major role in stuttering. Lee
Edward Travis, the "father of speech pathology" in the USA, carried out some very sophisticated studies of
the breathing patterns of stutterers in the 1920s which followed other investigations carried out earlier (e.g.,
Fletcher, 1914). As you suggested in your question, Travis found that stuttered speech was characterized by
lots of breathing abnormalities, such as anagonistic thoracic and abdomenal movements, prolongations of
inhalation, clonic and tonic spasms of the breathing musculature, and so on. In 1932, Murray found that
stutterers even had a number of breathing abnormalities when they were reading silently. And since that time,
investigators (e.g., Hutchinson, 1975) have looked at aerodynamic measures of stuttered speech. Others have
looked at voicing irregularites, and many others have investigated articulatory abnormalities. 

The point is that breathing movements are often distorted in stuttering, but so are air pressure and airflow,
voicing, and articulation. And if you think about it, you cannot have speech without breathing, voicing, and
articulation. In stuttering, the problem occurs when you try to decide which system is the most basic to the
problem. In the 1970s researchers were quite sure that the larynx was the seat of the central problem of
stuttering, but more recent writing has suggested that this may not necessarily be so. 

So this "expert" (perhaps meaning: "ex" = "has been" and "spurt" = "drip under high pressure") would say
that the problem of stuttering might be in breathing, but it might just as well be in voicing, articulation, motor
programming, central reprogramming as a result of auditory/tactile/kinesthetic feedback, etc. I believe that
stuttering is far to complex to ascribe unitary causes to it, that take into account only part of the behavior that
characterizes this disorder. 

When I talk to stutterers or my students, I tend to agree with many in this country and elsewhere that stuttering
probably reflects a neuromotor timing/coordination problem in breathing, voicing, and articulation. But I use
that explanation primarily to differentiate the problem from a habit or a psychological problem (but even those
factors are present). In fact, I look forward to authentic genetic explanations of measurable neurochemical
changes, affected by autonomic and emotional changes and conditioning, which in turn lead to repetitions,
prolongations, and blocks. In the meantime, I'll join everyone else as one more blind man describing the
elephant of stuttering. 

Incidentally, Travis was instrumental in forming a lateral dominance theory of stuttering, which he later gave
up to embrace a psychoanalytic view. And a few years before he died, while dean of a theological seminary, I
heard him speculate that neurochemistry would be the field in where the most significant advances would
come from. 

This has been too long, so I'll leave it to the real "experts" to speculate about NLP in treating stutterers. 

Ken

Re: Stammering & Breathing pattern

From: Woody
Date: 10/18/99
Time: 4:57:48 PM
Remote Name: 155.247.229.71

Comments

When Ken says he will leave it to the "real experts" that has a way of cutting off debate. But seriously, what is
so difficult about this, and many other such notions, is that one cannot distinguish very easily the cause from
the effect. As Ken notes all kinds of things are abnormal dur- stuttering. Stuttering is not a normal way of
talking. So how can we know whether the abnormalities are a cause of the disorder, an effect of the dis-
order, or whether they simply ARE the disorder? I don't think there is a satisfactory answer to that question. 

Woody

Changing the name "stuttering" ?

From: Peter Louw
Date: 10/15/99
Time: 3:39:01 AM
Remote Name: 196.36.184.252

Comments

Is the stigmatised name "stuttering" really appropriate for this defect? And if not, should we perhaps think of a
better term? 

"Stuttering" as a word mainly reflects sound repetition. But we PWSs do so many other things. We
prolongate sounds, have silent blocks so that we cannot say anything, we avoid difficult words and use easier
ones, we distract ourselves, or we simply remain quiet because of our fear of speaking. Why then is the defect
known under a name which describes just one of the many things we do? Does this misnomer not add to the
ignorance and confusion so prevalent among the general non-stuttering public as far as stuttering is
concerned? 

In my book "Coping with Stuttering" I mention that "stuttering" is a layperson's word. It is a term probably
coined by nonstutterers to describe our defect, and it as well as its derivations such as "stutterer" have to some
extent become stigmatised, so that these days we are known as "people/person(s) who stutter" (PWS) instead
of stutterers. So we are no longer "stutterers", but we still "stutter", and still suffer from "stuttering"! How
about taking this change further, so that "stuttering" and "stutter" are dumped into the wastebin together with
"stutterer"? Surely another and more appropriate term for our defect can be coined? 

Changing the term may have many benefits. From a marketing point of view, for instance, it could be a good
news item which would provide opportunities for getting public attention and promoting our cause. 

I would be most obliged to hear your comments. Many thanks and kind regards. 

Re: Changing the name "stuttering" ?

From: Bob Quesal
Date: 10/15/99
Time: 8:11:37 AM
Remote Name: 143.43.201.99

Comments

Idiot. Imbecile. Moron. No, I'm not talking about you, I'm talking about words that were intended to be
descriptive, and at one time were, that have since come to be misused. Obsessing about what to call
"stuttering" seems to me to be a waste of time. Regardless of what we call it, someone will decide that the
word is not good enough, and coin another one. And another one. And another one. And probably a few
more after that. And after that. And so on and so on.... 

"Stutter" and "stutterer" and "stuttering" seem to have held up pretty well until the last few years, when some
people decided that somehow calling it something different would make some sort of difference. I don't see
that happening. 

If you disagree, I guess you can call me an idiot. Or an imbecile. Or a moron. Or a stutterer. 

Bob Q.

Re: Changing the name "stuttering" ?

From: Ken St. Louis
Date: 10/15/99
Time: 8:12:12 AM
Remote Name: 157.182.15.69

Comments

Hi Peter, 

I should probably avoid the temptation to respond to your question about terminology, since my view may not
be particularly "mainstream" these days. But, I won't. Here goes. 

I just published a study this year in the Journal of Fluency Disorders which addressed the issue of person first
(e.g., "person who stutters") vs. direct label (e.g., "stutterer"). [Note the abstract of the article has these two
examples erroneously reversed.] I won't attempt to summarize all of the article for it has lots of pieces that
need to be all fit together. Nonetheless, the clear finding was that people (members of the lay public, SLP
students, current or former speech/language/hearing clients [including a substantial percentage of stutterers],
and parents of younger clients) all found the word "stutterer" no less pejorative than the phrase, "person who
stutters." The only words that *sometimes* made a difference were "person with leprosy" over "leper" and
"person with psychosis" over "psychotic." There were no significant differences, for example, for
murderer/person who murders, composer/person who composes, bed wetter/person who wets the bed,
stammerer/person who stammers, etc. This was so, even though *all* the groups were very uniform in their
ratings of 28 different terms, including such words as "moron," "person with cancer," "trustworthy," etc. 

I argued in the article that we should be very careful about changing terminology for the sake of attempting to
enhance sensitivity. What often happens is that language changes are equated with greater sensitivity, even
when basic attitudes are left unchanged. This, in my opinion, trivializes the issue and often leaves real victims
in the same situation they have always been. I don't honestly believe that calling someone a "PWS" or "CWS"
is more sensitive than calling someone a "stutterer," although I am fairly sure that you and many others would
disagree with that position. You will note that I do not use those acronyms in any of my postings in this
conference. As a stutterer myself, I would find them kind of silly and a little bit negative if applied to me on a
regular basis. I say that because I have never heard one time in my entire career where the word "stutterer"
was used by a clinician, researcher, or client in any kind of a pejorative sense. Sure it is often negative, but
will referring to someone as a "PWS" or "floggerer," or "reword maker" or whatever reduce the pain caused
by getting stuck on words? I doubt it. My research shows that we all know when a word is pejorative, and
then, such words should be changed. But doing so when the words are simply descriptors invites confusion,
creates artificial insensitivity (i.e., when some haven't learned the new politically correct terms), and shifts the
sensitivity issue to language useage rather than changes in behavior. 

Well, that's more than 2 cents worth. I hope some others who agree with you will also reply. 

And, to you, Peter, thanks for your thoughtful questions and proposals. Let us agree to disagree on this! 

Ken

Re: Changing the name "stuttering" ?

From: Walt Manning
Date: 10/15/99
Time: 10:36:07 AM
Remote Name: 141.225.97.53

Comments

Well Peter, since I'm on the panel and I'm "IN" today, I'll respond to your thoughts about using the word
"stuttering". My thoughts go along with the great responses of Bob and Ken. As a person who stutters
(although not much anymore) I understand why people would want to use person first terminology. But I also
that acronyms such ase PWS and CWS (not to mention terms like "fluenter")can easily add confusion to
layperson who is already mystified by the problem. Actually, I'm rather proud to be a stutterer, or PWS or
whatever. As I described in my contribution to this conference, for many reasons, dispite the shame and pain
and all that stuff, I now consider the fact that I stutter(ed) as as a gift. Had I not stuttered I very likely would
have been on the front lines in Viet Nam. I would not have met the many grand people that I have including
colleagues and clients. I would not have a career that I consider to be very rewarding. I suppose that it's up to
each person to decide what words are associted with some sort of stigma. But they are only words and it's
what we make of them that counts. Some people go a bit far, I think, and wear their stuttering as their "red
badge of courage" but if that helps them to take part in life, so be it. It's better than hiding and not taking part
and interacting with others, as scary as that may be. So, I like the word stuttering just fine. As Bob pointed
out, there will always be someone who will object to whatever term we might use. A good question though
Peter and I'm glad you gave us the chance to respond to the issue. 

Re: Changing the name "stuttering" ?

From: Steve Hood
Date: 10/15/99
Time: 10:13:33 PM
Remote Name: 152.163.204.36

Comments

WOW !!! What a question. 

You already have wonderful responses from Bob Quesal, Ken St. Louis and Walt Manning. I have known
these three guys for many, many years. Bob, Ken and Walt are "brothers of the tangled tongue" as Van Riper
might have said. I am the "bastard cousin" who is a "fluenter." This may temper your reaction to what I have
to say. 

Bob, Ken and Walt have made good points, so I'll not elaborate. But the fact remains that we need to "call it
something." And, I think this may be more than just the so-called lable. 

Society has been exposed to terms such as stuttering and stutterer. Ken has made reference to how folks in
general respond. If it is politically correct to use first-person-first language, as is often REQUIRED in some
journals, then I guess this is mandated. Fact is: lots of people really don't care. 

I think that for the person who stuterers -- e.g., the stutterer -- the issue is really more personal. 

Those who get overly hung up on terminology (e.g., stutterer, person who stutters, person who at times
speaks with stutering, etc.) seem often to have unresolved conflicts involving guilt, shame, self concept, self
acceptance, etc. 

Those who are still fighting the battle with stuttering seem overly concerned about this issue. Those who have
resolved (or at least largely resolved the issue) seem less sensitive. I suspect that this has to do with the fact
that they are more self acceptant, more tolerant, more at peace with themselves, and less in denial, etc. They
are moving on with their lives, moreso than living in the past. 

You have referred to your book. I am sorry to say I am not aware of it. Please post TITLE, PUBLISHER,
and other needed identifying information. 

Hope my comments have helped, and not muddied the waters. It is hard to write about this, on line, and not
be able to easily go back to edit.... I hope this all at least makes sense (not that you readers agree) but makes
sense in that you understand my point. This is an important topic, and one that is difficult to capture in words
-- especially in an ASAD format. 

I look forward to comments from others. 

Steve Hood 

throw in two bits-

From: Michael Sugarman
Date: 10/16/99
Time: 11:11:10 AM
Remote Name: 205.188.195.49

Comments

ISAD'99 has been very coool! -Professors, thank you for your active participation in the Internet Conference.
I look forward in a couple of years to an Oct.22nd video Internet conference to every university class on
fluency disorders and sites for consumers around the world. 

In the late 1970's National Stuttering Association members used the first person language in describing their
experiences as persons who stutter (PWS). (BTW at the 1978 ASHA convention there was a very heated
arguement about the linguistic shift from stutterer to PWS). Until there is a cure for stuttering, quality of life
issues and management skills confront PWS. Today, consumers with chronic disabbilities share these
concerns and are using the term person living with _______. For us it would be "person living with
stuttering" (PLWS). 

My second bit is for information. How did ASHA come up with Fluency and Fluency Disorders for Division
#4 rather than Stuttering? 

Its wild this internet conference-It keeps the mind active- no need for ginko, yet. 

kindly, michael 

Re: throw in two bits - for Michael

From: Judy Kuster
Date: 10/17/99
Time: 2:52:28 PM
Remote Name: 134.29.30.79

Comments

>ISAD'99 has been very coool! -Professors, thank you for your active >participation in the Internet
Conference. I look forward in a couple >of years to an Oct.22nd video Internet conference to every
>university class on fluency disorders and sites for consumers around >the world. 

Yikes!! What are you saying here, Michael?? That the ISAD online conference become a *video* conference
in a couple of years? Or am misunderstanding you? From my perpective a video ISAD would be very
problemmatic. 

Full videoconferencing is still difficult even in highly sophisticated and technologically very savvy places! I
suspect that good and cheap videoconferencing technology is still about ten years away. And that is from a US
perspective. What about participants from less technologically-advanced countries? Such a format would shut
them out of participation. 

There are other problems beyond just technology. First of all, half of the world is sound asleep when you are
awake. There would have to be at least two "videoconferences" running twelve hours apart to have any chance
of truly including the whole world. Second, for over half of the presenters, English is a second language.
Unless we have the same type of translation services that are available at the United Nations, effective
real-time video communication would be almost impossible. Third, in most non-US countries people pay for
internet access by the minute through their home phone lines. If the conference were a video conference, they
would have to hang on the telephone line for a LONG time, either to download the video clip or to stay online
for the video streaming. It would cost much to much. 

Michael, the great thing about this conference in its present format is that time and location don't matter much.
The format is simple enough to be accessible by almost anyone who has a computer and a modem, without
added costs. The people who need this conference most are the ones for whom a video conference would be
the most difficult to pull off. It's nice to aim high, but unless some miracles happen in the next couple years, a
video conference is technologically impossible and unforgiveably exclusive. Let's keep this conference as
simple and as accessible as we can for people all over the world, not just those who are lucky enough to live
in the cradles of modern Internet technology.

Re: throw in two bits - for Judy

From: Michael Sugarman
Date: 10/19/99
Time: 10:52:46 AM
Remote Name: 134.29.30.79

Comments

On technology, I do not feel the techniques that are used will continue to be expensive. I feel the virtual
classroom/conference will become a standard online format and will become a relatively inexpensive
commodity sold by various companies. I feel we can expect in the next few years the following service in the
United States and International: an online service that supports streaming Internet audio/video broadcast of a
panel of speakers in different locations. The viewers of the broadcast will interact with the panel by 1) online
chat or 2) phone call-in. The speakers will need access to high end video conferencing equipment with high
speed, low latency connectivity (like ISDN). Currently, in the United States, you can access such equipment
at any kinkos. The viewers will need a standard Internet connection and a PC. 

There is no intentions to replace ISAD Internet "threaded discussions" Conference. The ISAD online
conference is a valuable resource. The videoconference was for one day Oct. 22nd to bring consumers,
professionals and students together at a speech clinic, someone's house or classroom to discuss fluency
disorder-stuttering.

Re: throw in two bits-

From: Bob Quesal
Date: 10/18/99
Time: 8:15:17 AM
Remote Name: 143.43.201.99

Comments

Michael: 

Regarding why the name is "fluency and fluency disorders," there are other fluency disorders besides
stuttering. BQ

Re: throw in two bits-

From: Woody
Date: 10/18/99
Time: 5:14:13 PM
Remote Name: 155.247.229.71

Comments

And one of the "interests" of the Special Interest Division is the nature and development of normal fluency,
although this interest expresses itself but rarely. 

Woody

Re: Changing the name "stuttering" ?

From: Peter Louw
Date: 10/18/99
Time: 6:49:30 AM
Remote Name: 196.36.184.252

Comments

Dear Steve 

Many thanks to you and the rest of the panel for responding so thoroughly to my question! You have asked
for more details of my book, and here they are: "Coping with Stuttering", by Peter Louw, 1996, Delta Books,
Jonathan Ball Publishers, Box 33977, Jeppestown 2043, Johannesburg, South Africa. Their international
telephone number is (2711) 622 2900 and the international fax number is (2711) 622 3553 or 7610. The
e-mail address is therbert@jonathanball.co.za 

You and the other panel members have made some good points. Changing the name, if at all practically
possible, would obviously create some problems. At the same time the current terminology also seems to be
problematical. 

It would be interesting to study the terminology in other languages. The English "stuttering" is related to the
Middle Low German "stotern" (with the umlaut on the o) and the Old High German "stozan", meaning "to
push against", and this last word seems to derive from the Latin "tundere", meaning "to beat". 

It would also be interesting to look at other medical terms which have fallen into disfavour, for instance the
old "manic depression" which is no longer used by psychiatrists. Before making a serious attempt at changing
our own terms one would have to carefully study similar changes in medical language, and whether those
changes were in fact beneficial. In my book I did not propagate a change - I merely pointed to the current
terminology which I feel is unsatisfactory. I did pose the question on this discussion forum as it seems to be
topical and relevant. 

Anyway, thank you for an interesting debate! 

Kind regards. 

Re: Changing the name "stuttering" ?

From: Ira Zimmerman
Date: 10/16/99
Time: 5:09:51 PM
Remote Name: 205.188.197.26

Comments

Personally I like the term, "Repetitively Challenged." At least that describes my form of speech impairment.

Re: Changing the name "stuttering" ?

From: Steve Hood
Date: 10/16/99
Time: 9:49:23 PM
Remote Name: 205.188.193.182

Comments

Ira -- Hello, and thanks for your post. 

I guess for those whose major disfluencies are repetitions, "repetitively challenged" is o-k. But this might be
oversimplification. For example: 

But what about those who are are prolongers, repeaters, silent blockers, recoilers, word changers,
paraphrasers/circumlocuters, postponers, avoiders, etc. 

I'm not sure we can come up with a single unitary term that will be appropriate for a problem which is known
to be multidimentional. 

This, to me, is a continuously perplexing issue, and one which is not easily solved. 

Steve Hood 

Re: Changing the name "stuttering" ?

From: JSYaruss
Date: 10/18/99
Time: 10:29:28 AM
Remote Name: 128.147.90.204

Comments

Furthermore...not to be trite or to make light, but the problem is not with the repeating. The repeating is fine --
many people who stutter are quite good at repeating. So, it doesn't seem right to say they're "repetitively
challenged" the challenge is in not repeating. 

My ONE cent...

Re: Changing the name "stuttering" ?

From: Ira Zimmerman
Date: 10/19/99
Time: 7:48:08 AM
Remote Name: 152.163.197.208

Comments

Yesterday my interview was broadcast on KTLA-TV and I repeated the first sound of the word, "Download."
I call that being repetitively challenged. Would you rather call it, Verbally Challenged? What does it matter
anywhere now that speech pathology students are being granted ASHA's Speech Pathology Clinical
Competence Certificates without any required expose of those of us who are repetitively challenged? 

Re: Changing the name "stuttering" ?

From: Woody
Date: 10/18/99
Time: 5:03:00 PM
Remote Name: 155.247.229.71

Comments

All of the above, plus it is really difficult, and usually futile, to legislate language. It grows like Topsy and
doesn't seem to respond well to attempts to manipulate its growth. 

There is also the issue that using names in order to soften the stigma may simultaneously feed the stigma. If
this problem is so awful that we can't even call it by its proper name, it must be really unspeakably awful. 

No, I think it is better to call it what it is and show that we are not afraid of it. 

Woody

Changing the name "stuttering"

From: Ed Feuer
Date: 10/22/99
Time: 2:51:40 PM
Remote Name: 216.81.20.226

Comments

Bob Quesal said: "You say, " casual conversational sense, these words always imply some variation of
shame, failure or incompetence." I guess I fail to see how "stutter step" or "stutter dial tone" denote failure,
shame, or incompetence. " You cite the two benign examples. I can give you many, many more instances of
where the terms do connote shame, failure or incompetence in everything from good literature to the comics.
As I've said elsewhere in ISAD 2, some recent examples in Associated Press stories were reference to Dan
Quayle's "stuttering presidential campaign" or a foe of Senator John McCain saying that he was "stuttering
and stammering on the issue of abortion." The problem arises when people who know nothing about real
stuttering impose those attributes on people who really do stutter. Unfair discrimination in employment is a
key example of where the difficulties arise — such as when a personnel department staffer meets a job
applicant who really does stutter. His/her only point of reference is the casual, conversational useage —
leading in turn to fixed notions about what PWS *CAN'T* do. — Ed Feuer

Re: Changing the name "stuttering"

From: Bob Quesal
Date: 10/22/99
Time: 4:17:55 PM
Remote Name: 143.43.201.99

Comments

Ed, I'm sorry, but you won't convince me that the word has all that much power. Your statement implied that
*ALL* uses of the word "stutter" imply weakness or some other negative thing. I'm sorry if my two "benign"
examples were insufficient to refute your argument (in your mind). 

People who are strong are not highly offended by what others call them. People who are strong are not
personally offended by others' ignorance. People who are strong do not look for excuses or scapegoats. To
suggest that misuse of the words "stutterer," "stutter," or "stuttering" somehow contributes to the "opression"
of those of us who stutter is simply going way out on a limb that I prefer not to join you on. 

I think reasonable people can disagree. 

BQ

Differences in Stuttering Behaviors

From: Tara James (Graduate Student at Southern University)
Date: 10/18/99
Time: 2:47:13 PM
Remote Name: 209.62.40.127

Comments

In the literature stuttering behaviors have been defined as including repetitions, hesitations and blocks. I
would like to ask if there has been any research to find out if differences in stuttering behaviors differ among
ethnic groups? Do African Americans tend to have different stuttering behaviors than do Caucasians, Asians
or other ethnic groups? Also, is the stuttering behavior of African Americans characterized more by one
behavior than another behavior (is the stuttering behavior defined more by blocks than hesitations or
repetitions)? Thank you and I look forward to reading your response. 

Re: Differences in Stuttering Behaviors

From: Woody
Date: 10/18/99
Time: 5:10:11 PM
Remote Name: 155.247.229.71

Comments

There is only one study that I know of that bears on your question, and that was done by Leith and Mims
back, I believe, in the 60's. They found no difference between African-Americans and European Americans in
the overall frequency of their stut- tering, but they did find a tendency for the Afri- can Americans to use more
avoidance behaviors or secondaries. They attributed this difference to the historically strong value placed on
good communication among African Americans, as reflected particularly in the great Black orators and
rhetoricians. Where there is a tradition placing a high value on excellence of speech there must be a
corresponding stigma placed on its apparent opposite. That, at least, was the interpretation that Leith and
Mims made of their results, and it seems to make sense. 

Woody

Re: Differences in Stuttering Behaviors

From: Ken St. Louis
Date: 10/19/99
Time: 7:56:06 AM
Remote Name: 157.182.15.69

Comments

Dear Tara, 

Good question. I second what Woody wrote. Definitely take a look at Leith's work. There are also a number
of other articles that have appeared over the years in the Journal of Fluency Disorders about stuttering in other
languages around the world. 

I have been looking at cross-cultural research on attitudes toward stuttering and ran across a chapter in a 1977
book entitled "The Problem of Stuttering :Theory and Therapy" that was edited by R. W. Rieber and
published by Elsevier. The chapter is by Lorraine Kirk, who is apparently an anthropologist, reporting an
ethnographic study of of "Stuttering and Quasi-Stuttering in Ga." Ga, she says is a tonal language and a
member of the Kwa branch of the Niger-Congo language family. About 700k Ga people live near Accra,
Ghana. Kirk describes a sort of "normal stuttering" that is very common in Ga as well as an abnormal form.
Very interesting study! 

Good luck in your search. 

Ken

fluent speakers becoming dysfluent when speaking to folks
who stutter and about the topic of stuttering

From: Joan Morris > 

Seriously, I tend to go along with what the others say. People become more aware of their own disfluencies
(not dysfluencies) when in the presence of people who stutter. 

And, perhaps, they do something similar to what many of us stutterers do: in an attempt to "not be disfluent"
or "not stutter" they do things that interfere with their normal way of talking. 

BQ

Cluttering

From: Rachel Thomas/SECD 560 Southern University
Date: 10/19/99
Time: 8:29:23 PM
Remote Name: 206.160.145.26

Comments

What percentage of clutterers are misdiagnosed in the school system? Is cluttering more prevalent in particular
regions of the country?

Re: Cluttering

From: Ken St. Louis
Date: 10/20/99
Time: 8:01:54 AM
Remote Name: 157.182.15.69

Comments

Dear Rachael, 

Good questions on cluttering. Unfortunately, there is no specific research data that bears on either question.
We'll have to speculate. 

How many clutterers are misdiagnosed in the schools? In my limited hand-on experience with those who
clutter, reading on the subject, and participation in surveys of SLPs in the USA, Great Britain, Bulgaria, and
Greece, it seems that many if not most clutterers are diagnosed originally as articulation disordered, language
disordered, LD, ADHD, etc. These really are not misdiagnoses so much as *incomplete* diagnoses, similar to
a case with coexisting disorders wherein all the disorders are not completely diagnosed. 

Cluttering is hard to pin down. My opinion is that a clutterer must have a fluency disorder that is not stuttering
and also must have either a rapid or an irregular speaking rate. The disfluencies are often suspected to be
"language based," that is, the result of pushing the limits of their ability to produce speech fluently rather than
struggles to get specific words out. 

Are there regions where cluttering is more prevalent? Again, there is no solid data on this. I would be hesitant
to even speculate here. 

It's good to see that cluttering is beginning to be recognized in this country. 

Ken

Spontaneous recovery

From: Peter Louw
Date: 10/20/99
Time: 3:46:45 AM
Remote Name: 196.36.184.252

Comments

Dear Panel 

Yes, it's me again! I know that I have asked many questions at this conference, and hope that you will bear
with me. 

In the latest (Summer 1999) issue of Speaking Out, the British Stammering Association's magazine, there is a
letter on page 18 regarding spontaneous recovery which I found rather interesting. 

The writer of the letter, "John", from Clevedon, Somerset, mentions that he was a stammerer, but now talks
freely after falling in love about 5 years ago. It has given him tremendous confidence and he now believes in
himself again after years of negative thinking and low esteem. He is now 58 years old. 

Cases of spontaneous recovery, as you are aware, are mentioned in the literature. In particular I remember the
one mentioned by Van Riper (probably in The Nature of Stuttering?) of the boy who was apparently cured
after his father, in a moment of extreme irritation with his son's stutter, threw a bucket of fish on the boy's
head. 

In my own book, Coping with Stuttering (Delta Books, Jonathan Ball Publishers, Johannesburg, South
Africa, 1996) other such cases are mentioned, among them that of an elderly gentleman who was apparently
cured after watching a TV programme in which other stutterers told of their experiences. This gentleman later
said that he identified to such an extent with the individuals on the programme that he himself was cured. 

In my book I suggested that these people (provided of course that their accounts can be verified) may have
been cured due to a sudden and lasting drop in their baseline tension, i.e. a lasting and significant decrease in
their total combined stress level (not just anxiety levels - stress is a wider concept than just anxiety). Their
baseline tension has fallen far below their threshhold tension level, so that the stuttering response is no longer
activated. (In the discussion "Stuttering and stress" in this conference I refer to the concept of "threshhold".) 

I know that Van Riper's case seems, on the surface, not to support such a position, and I admit that it may
throw a spanner in the theory. After all one would expect the boy's stress level to increase significantly after a
nasty experience such as having a bucket of fish thrown over you! But again: the response to a stressor is
subjective. What is stressful for one individual may not be stressful to another. An event which can be
traumatic for Mr A, may result in a psychological catharsis for Mr B and a resultant release from anxiety,
leading to lower stress levels. Perhaps this is how Van Riper's case can be explained. 

I hope that this makes sense. I know the argument is not "scientific", but there may be some truth in it.
Anyway, I guess I will have to formulate all this into some kind of question, so here it is: assuming that
"John's case" above has been verified, how would you explain it? 

Many thanks.

Re: Spontaneous recovery

From: Larry Molt
Date: 10/20/99
Time: 9:18:31 AM
Remote Name: 131.204.63.26

Comments

Hi Peter! 

I've been enjoying your postings. This time, you asked: assuming that "John's case" (of spontaneous
recovery) above has been verified, how would you explain it? 

Alien abduction. A miracle. A sign from God that the apocalypse is almost upon us. Verification that stuttering
is indeed a psychological disorder. Proof that low self esteem is a critical factor in maintaining stuttering. John
suffered a subclinical stroke of which he’s unaware that altered bloodflow patterns or impacted on neuronal
activity in a critical site. Evidence of the limbic system's role in disrupting complex motor activity such as
speaking. Proof that the St. John's Wort (or any other herbal remedy/food supplement) he was taking to
control depression is the real answer to curing stuttering. John's realization that he could make big money by
selling his new "improve your self-esteem and cure your stuttering" therapy program over the internet was
such a positive factor that he was able to maintain fluency gains he had achieved . . . . . We could play the
game and go on and on with possible explanations. 

My point is that such speculations are a fun game, but bad science. Anecdotal reports are interesting. But
we’re missing any data to make the speculations meaningful in any way. Exactly how did John’s stuttering
begin; did it follow the typical developmental pattern; is there a familial history in John’s case; were any other
disorders or abnormalities also present; what type of therapy/treatment experience has he had in the past; what
would be the results of a comprehensive neuropsychological battery if performed premorbid to the recovery
(and results of one performed afterward); does John truly represent the typical stutterer; were there any other
changes going on in John’s life at that time – a change in diet, sleep patterns, job stress, etc. – we could and
should go on and on with questions that might somehow give us a basis for making speculations before
making any speculation. Otherwise, you’re doing bad science – only looking at data that fit your
models/theories. "Post hoc" paradigms are not good science, but one could then test use the theories
developed to set up a priori experimental paradigms with a better chance of finding an answer. 

Don’t get me wrong, I personally like the theory you propose of "critical stress levels/baseline tension levels"
as playing a role in the maintenance of stuttering. It’s been around a long time, and all kinds of different
etiological models have employed it. I think it’s useful in explaining the waxing and waning patterns of the
disorder we see in many people. As a stutterer myself, I tell my students and clients that my fluency (and
disfluency) is a pretty good barometer of how things are functioning in my life. Few stressors - good fluency
levels; hectic periods, lots of deadlines, money worries, etc. - I really have to work hard to hang onto fluency.
But in the question you pose – we don’t know anything to help us make a decision about why John
experienced spontaneous recovery. 

Warmest Regards, 

Larry Molt 

Re: Spontaneous recovery

From: Peter Louw
Date: 10/21/99
Time: 4:00:16 AM
Remote Name: 196.36.184.252

Comments

Dear Larry 

Many thanks for your thorough answer. I agree with most of what you are saying. 

The point is that I never intended my question to be "scientific". I was talking about my hunch. Maybe I did
not formulate the question clearly enough, but the issue still seems to be valid. 

I would not agree that speculations are just a fun game. Naturally they are not science, but they may well
become science, once studied and proven. Pure science has its place and role, but so does speculation, lateral
thinking and intuition. 

Kind regards.

Re: Spontaneous recovery

From: Woody Starkweather
Date: 10/21/99
Time: 11:37:38 AM
Remote Name: 155.247.229.97

Comments

I agree that anecdotal evidence has its place, but I think it is important that we keep in mind what that place is. 

Because I work in a university setting, I have seen many stutterers in their 20's, a time when falling in love is
common and frequent. I can't tell you how many stutterers I have heard tell me that their stuttering seemed to
have miraculously disappeared during this curious emotional time. And of course, there are known behavioral
differences during this time, as well as less well known, but surely equivalent brain chemical changes, which
must mediate the form of insanity that we call being in love. 

Another thing to consider is an old idea, which has some basis in the literature, but certainly not conclusive
evidence, that the original cause, the reason the young child produces repetitious speech may well disappear
with development, while the struggles to talk remain like a precipitate in a chemical experiment. Such a
mechanism could explain why at a certain age, it may take only a little nudge to push someone over the edge
into a cessation of stuttering symptoms. 

Woody

Re: Spontaneous recovery

From: Peter Louw, Cape Town, South Africa
Date: 10/22/99
Time: 4:06:11 AM
Remote Name: 196.36.184.252

Comments

My own speech is very much stress-related, so I have become very aware of my stress levels, and stress
management is very important for me. It is a continuous monitoring and meant much work for me in the past,
but with age I seem to have become a more relaxed person, with a concomitant improvement in speech. 

I well remember the time when I fell in love for the first time. I felt that I was completely at peace with the rest
of the world. I had no more cares and worries (for a while at least ... until she dumped me ...) and it was a
wonderful time. I was very fluent at the time, and my stress levels must have been at an all-time low. 

As this is the last day of the conference, I guess it's time to say goodbye. Many thanks to all the members of
the panel for patiently listening and responding, and for Judy for taking the initiative with this wonderful new
medium - the electronic conference. It is a fantastic idea, with enormous potential. The "global village" has
really become a reality! For next year, the goal must be to involve even more people. But surely this will
happen, as more and more people get PCs and get connected. All the best and keep well until next year. Peter

about family environment and stuttering ...

From: René Stes - Belgium - rené.stes@pandora.be
Date: 10/20/99
Time: 8:44:02 AM
Remote Name: 195.130.132.49

Comments

Hi Nan, Woody, Ken... thanks for your wonderfull job for international stuttering awareness day!! 

About ... environmental influence / research - stuttering ... some comments. 

A range of factors will make the stuttering persist (research evidence), even after recovery of other causal
factors (f.e. after recovery of possible cortical malfunctioning or after elimination of stress factors...). There is
evidence that negative emotional, cognitive and behavioral reactions on stuttering can and do contribute to
chronic stuttering problems. These emotional and cognitive reactions are both the consequence of personal
experience and from the environment (modeling, abstract modelin - in verbal labels, even instructions,
"vicarious learning"!). Stuttering children learn models on how to treat and manipulate problem-behaviors.
Parents and other persons in the environment play an important role in this process. In my opinion it's
unlikely that interventions of a speech therapist/pathologist - stuttering therapist ... psychologist .... and other
-ists ... can have any impact on a very important human behavior - speech, speech disorders and speech
problems ... and those of the environment not! Therefore, one should - at least with young children - always
work with children and/or via their parents. Our clininal experience in Antwerp and from mayn other
therapists, shows moreover that parents can have a very significant and a real positive influence on the speech
problem! René Stes 

Re: about family environment and stuttering ...

From: Nan Ratner
Date: 10/20/99
Time: 9:16:45 AM
Remote Name: 129.2.24.18

Comments

Thanks! I agree with you strongly. We always try to look at each family to detect those things that seem to
make a difference. Often parents are good problem solvers with us. If we ask them, when is your young
child's stuttering worse? we often identify situations, behaviors, circumstances that we can then adjust to
make the situation better. My work is not meant to suggest that parents do not play a role in stuttering: I
believe that they do. However, I become uncomfortable with blanket advisements for which we have no real
evidence, either through systematic studies or even series of carefully done case discussions. So, I do agree
with you: as Ed Conture and Trish Zebrowski said a while back, it makes no sense to consider stuttering
amenable to the intervention of speech language pathologists, but not parents. 

Best regards, 

Nan 

Re: about family environment and stuttering ...

From: Ken St. Louis
Date: 10/20/99
Time: 12:41:09 PM
Remote Name: 157.182.15.69

Comments

Hi Rene, 

Thanks for the kind words. This has been fun. 

I agree with you and Nan. Parents are extremely important in the process of treating children, if they are
available and able to help out. 

Ken 

Changing the name "stuttering"

From: Ed Feuer
Date: 10/20/99
Time: 2:52:59 PM
Remote Name: 216.81.20.114

Comments

As I have argued elsewhere in ISAD2, rather than changing the name, we should claim a monopoly over the
words "stuttering" and "stammering." I say that because when used in the casual conversational sense, these
words always imply some variation of shame, failure or incompetence. Given the massive public ignorance
about real stuttering, these attributes tend to automatically imposed on people who really do stutter. The
homosexual community now has a monopoly on the world "gay". Language useage does change. — Ed
Feuer edfeuer@escape.ca

Re: Changing the name "stuttering"

From: Bob Quesal
Date: 10/20/99
Time: 4:07:39 PM
Remote Name: 143.43.201.99

Comments

Ed: 

You say, " casual conversational sense, these words always imply some variation of shame, failure or
incompetence." I guess I fail to see how "stutter step" or "stutter dial tone" denote failure, shame, or
incompetence. 

Words are only "bad" to the extent that we allow them to be. I think Steve Hood's point is a good one: folks
who have come to grips with their stuttering don't seem to be bothered by what others call it. Folks who still
have "issues" to resolve seem to feel that the "label" somehow is the root of all trouble. 

I just don't see it that way. 

BQ

FAF "Life": Does it Last?

From: Mark Facer (Sydney Australia)
Date: 10/21/99
Time: 4:06:19 AM
Remote Name: 206.17.104.194

Comments

Hello! I have experienced using an FAF device for three days now: my life seems in control for the first time
since my intensive "smooth speech" course in the early 1990s. 

The questions are: Does anyone know how long this amazing effect lasts? In other words, do PWSs "adapt"
to the new (FAF) feedback and go back to certain disfluent "set points" and so "relapse"? 

Thanks again for all your good work! 

Regards, Mark Facer, Sydney Australia

Re: Will it last?  Oh God, will it last?????

From: Joe Kalinowski
Date: 10/22/99
Time: 8:03:16 AM
Remote Name: 150.216.147.209

Comments

Will it last? Oh God, will it last????? 

Will it last? Oh God, will it last????? 

Will it last--only empirical science will tell! No magic words from the guru atop the mountain. 

In our enthusiasm to find answers, as quickly as possible, to questions--- important questions-- such as; "Will
this fluency last???" ; Will I have to feel the bitter and inconsolable pain, disappointment, and rage that I have
felt time and time again when I have relapsed following therapy". 

"I don't want to get my hopes up too high. I don't want to have my dreams dashed!!" 

We can only circumvent the pain that PWS have felt when bombarded by all these "dog and pony acts",
anecdotal evidence of magical remissions, and cult-followings------ when we engage in comprehensive,
extensive, and independent clinical trials based on empiricism ----and not on belief-systems. 

These trials will show the true "successes" or failures" of the best laid plans of mice and me. 

We must embrace empiricism and leave belief systems and spiritual enlightenment to other domains. We must
not make stuttering an ethical, moral, or spiritual dilemma. Many times I have pondered: "Why do I have to
believe for this to work?" (I did believe, but THERAPY failed to work. I worked. I believed. THERAPY
FAILED!!"). 

Why if I fail, am I a non-believer, one of those who must fall into the pits of Stuttering with other lesser
souls--- lacking in moral fiber or character ?". This is crazy…. 

I believe in God. I believe in the love of people and the caring nature of the human soul. I shouldn't have to
believe in stuttering therapy and revere the founders of the aforementioned therapy. Criteria for remission does
not require belief nor reverence. . We can't blame the patient when one doesn't work and give praise to the
therapy and therapist when it does!! This is not science --it is a belief system. Belief systems are problematic
when mixed with science: Communism, Eugenics, Lysenkoism, evolution vs. creationism, Facilitated
Communication (FC), Psychoanalysis & Sigmund Freud, --we must move beyond Belief systems to
empirical and independent science. 

Stammering vs.Stuttering

From: Andrea Jones 
Date: 10/21/99
Time: 8:16:59 AM
Remote Name: 141.225.97.71

Comments

Does the European classification of stammering differ from the American classification of stuttering? If so,
how? 

Re: Stammering vs.Stuttering

From: Ken St. Louis
Date: 10/21/99
Time: 10:37:27 AM
Remote Name: 157.182.15.69

Comments

Dear Andrea, 

No, there is no difference. British infuence is evident in the use of the words "stammering/stammerer" and
American influence is seen in the use of "stuttering/stutterer." In the past, there were identifiable differences
between these words, but not now. Even so, there are still those who will insist that they "stammer" but not
"stutter" in the USA, even though the dichotomy has nearly faded away. 

Good question. 

Ken

THANKS -- THANKS FOR PARTICIPATING

From: Steve Hood
Date: 10/22/99
Time: 12:30:08 PM
Remote Name: 199.33.133.50

Comments

This may be my last opportunity to post anything before the 5:00-PM hour when the interactive portion of
ASAD comes to a close. 

I wish to thank those who asked questions, and the other professor who responded to the questions and
comments that have been posted. I believe that this, the second ISAD, has been a remarkable success. I have
enjoyed participating, have learned much, and have again come to realize how much more there is to be
learned. 

Good luck and best wishes to all. 

Steve Hood

Re: THANKS -- THANKS FOR PARTICIPATING

From: Walt Manning
Date: 10/22/99
Time: 1:56:06 PM
Remote Name: 141.225.97.53

Comments

Goodby and thanks to all. Like Steve, I've enjoyed the interactive nature of the conference and loved many of
the papers. I hate to see it end but I tend to get hooked on reading all the comments. I really need to be getting
on to other stuff that the taxpayers think they are paying me to do. Judy did an incredible job again this
year...but, knowing her, what would you expect.! Hope to meet many of you before too long or at least see
you back here again in the future. 

Re: THANKS -- THANKS FOR PARTICIPATING

From: Ken St. Louis
Date: 10/22/99
Time: 2:06:48 PM
Remote Name: 157.182.15.69

Comments

I'd like to add my thanks to everyone, along with those eloquent statements by Steve, Walt, and the others.
Yes, it has been fun, but challenging, trying to write sensible replies to all sorts of interesting queries and
comments. It feels a little bit like leaving a message on an answering machine. You're tempted to try to be
funny or cute, but if you screw up, your errors are there for posterity. I've "left a few messages" that I wish I
could erase. But, isn't this like calling and doing the real thing as a person who stutters? You gotta trust that
the person you called will understand that the stutters are unimportant to the real message. 

Peace! 

Ken 

Re: THANKS -- THANKS FOR PARTICIPATING

From: Bob Quesal
Date: 10/22/99
Time: 2:35:14 PM
Remote Name: 143.43.201.99

Comments

I, too, need to jump on the bandwagon here (although I hope to be around for a few more hours to answer
questions). This has been a great experience, and it's been a true honor for me to be in the company of Drs.
Hood, Manning, Molt, Bernstein Ratner, St. Louis, Starkweather, and Yaruss. In many cases, their
responses were much better than mine, and in others, they gave a better response before I had a chance to
reply. This forum has really been an interesting one, and I thank everyone who posted some truly outstanding
questions, and thank my colleagues for their thoughtful answers. I hope we can do this again next year. 

And many thanks to Judy Kuster and Michael Sugarman for all their efforts related to this online conference.
Great work! 

Bob Q.

Re: THANKS -- THANKS FOR PARTICIPATING

From: Woody Starkweather
Date: 10/22/99
Time: 4:16:56 PM
Remote Name: 155.247.229.217

Comments

I have probably missed the opportunity to add my words of appreciation. But it has indeed been a pleasure. I
am always astonished at how much we agree about such a complicated phenomenon. 

Woody