The following incident happened in Florida at one of the "Weekends with the Experts" where speakers lectured for 6 hours on Saturday and 4 hours on Sunday -- usually about 20-25 people in audience so we had lots of opportunity to question and also get to know each speaker. One of the weekend speakers was Dean Williams, a PWS and a well-respected SLP professor. The first day was spent lecturing regarding foundational information about stuttering. During the lecture, he was sometimes dysfluent. At the beginning of the second day's lecture, one of the audience members (a professor of mine at the time) raised his hand and said, "Well, Dean, if you know so much about stuttering and how to treat it, how come you still stutter when you talk?" We all slid down in our seats and groaned--thought we should be embarrassed, but Dr. Williams got us all "off the hook" with his attitude. He replied, "Well, of course, I can control my fluency more closely--and just so that you know I'm being truthful, I'll be fluent for the rest of the day (and he was). "However," he said, "part of who I am is a person who stutters. If I am perfectly fluent, I am not comfortable in my own skin. Therefore, I don't exert constant control of my speech. I have eliminated much of my dysfluency and am now functioning at a level that is comfortable for me." As a clinician, that was a "lightbulb" moment for me -- that was when I realized that perfect fluency was not the ultimate goal for PWS or for me as a clinician.
Talking techniques that require constant, conscious monitoring by the talker are not desirable. Using "techniques" can be very effective, but only when they have become part of the talker's habituated speech usage -- to be used if and when the talker has need for these specific tools (i.e. not all the time) -- and that takes PRACTICE and PATIENCE. You have to want to stay in treatment long enough to develop automaticity in usage of those tools (just like learning any other motor task). The important point is not to obtain perfect fluency, but to feel good about oneself as a talker--and comfortable with the act of talking--even when dysfluencies occur. Catastrophic and negative emotional reactions to dysfluency result in learned behaviors -- escape and avoidance behaviors -- that interfere much more with communication than do the initial repetitions and prolongations of dysfluent speech. A good self-image promotes effective communication regardless of any dysfluency statistics.