The presenter of this paper, A Speech Processing Approach for the 
Treatment of Stuttering has consented to have a personal email 
address posted here if you wish raise further questions and/or 
comments. Barbara Dahm - 

A Speech Processing Approach for the Treatment of Stuttering
From: Jean O'Conor
Date: 10/2/98
Time: 2:05:56 PM
Remote Name:
Please comment on how this approach is used with young children.

Re: A Speech Processing Approach for the Treatment of Stuttering
From: Barbara Dahm
Date: 10/3/98
Time: 2:13:43 PM
Remote Name:
The exact procedures used with children depend greatly on the age, 
attention span, etc of the child. However, the basic principle applies. 
We don't focus on fluency or stuttering. The child is aware that we 
are going to show him/her how to make it easier and more 
comfortable to talk. 

The focus is on producing a voice in order to talk. We play lots of 
vocal games and help the child to enjoy vocalizing. We want the child 
to be able to produce a voice that contains lots of intonational 
variation and enjoy it. 

Conceptually we take the focus away from words. We teach the child 
that s/he can say anything as long as the "speech motor" (voice) is 
working. We do start with shorter utterances, but once the child gets 
the idea of how to produce speech in this way, they quickly move 
into utterances that are within the child's ability to produce 

We also do a language eval, and if necessary simultaneously work at 
strengthening language skills. All the work is done at a normal rate 
of speaking. 

Parents are also involved in the therapy so that they can support the 
therapy goals at home. 

Dahm's article ..stuttering processing
Date: 10/2/98
Time: 5:48:18 PM
Remote Name:
Please tell me about the meat of your therapy procedure, as 
specifically as possible. Do you work with vowel stretches, easy 
onset, breath control, etc. from sound levels to conversation? Please 
respond. Thank you.

Re: Dahm's article ..stuttering processing
From: Barbara Dahm
Date: 10/3/98
Time: 2:55:10 PM
Remote Name:
We don't work on the fluency shaping targets of full breath, easy 
onset and stretched syllables. With most older children and adults 
there is a stage of therapy in which syllables are lenthened but this 
only to help them to see in slow motion how the speech production 
system works. We get to a normal rate of speaking as soon as they 
are cognitively ready and understand functionally the different ways 
of producing speech. 

I do have all the exercises written down step by step. It's very long, 
however, and couldn't be posted here in full. One example of a motor 
level activity is for the clients to first learn to produce a voice 
without any effort and without pushing out air. This is not gentle 
onset as any vocal intensity is okay as long as the voice is produced 
without contracting muscles that inhibit phonation. Then they 
produce various syllables using this kind of voicing. They do this 
while focusing on producing the voice. There is no effort to produce 
speech sounds. They see that articulation becomes secondary. Once 
they can do this they begin to produce multisyllabic utterances and 
move into spontaneous speech. A lot of work is down developing 
spontaneous ideas. 

Linguistiaclly, one exercise is to speak without phonating at all, not 
even whispering. Just developing ideas continuously and letting the 
articulators move automaticly. This is not always easy for some 
people who stutter to do without having stops in the movement of 
the articulators. When they are able to do this they add the 
phonation that they have learned to produce without changing the 
other processes. We also use an exercise where they produce voicing 
without articulation then do it the same way while articulating 

I hope this is understandable. It's really hard to explain without 
going through it step by step.

Re: Dahm's article ..stuttering processing
From: Judy Kuster
Date: 10/4/98
Time: 8:17:40 AM
Remote Name:
I need to mention here that Barbara Dahm's entire therapy program 
is also available commercially, although her approach does not 
require purchasing the commercial program. It is called Generating 
Fluent Speech and is available through Thinking Publications (their 
website may have more information about it). Both of the therapy 
presenters agreed they were going to focus on their approach and 
not on a product in this online conference so we can learn first-hand 
about two very different approaches to stuttering therapy.

Signal-to-noise ratio
From: Ed Feuer
Date: 10/3/98
Time: 12:25:15 AM
Remote Name:
Barbara, If I understand your article, you seem to perceive the 
"speech generating system" as a closed one. However, that is not the 
case, and people who stutter know that all too well. Stuttering 
involves the body, the mind, and other people. There is something in 
our "wiring" which gives us an adverse signal-to-noise ratio. Effective 
stuttering therapy should have the effect of providing a filter to 
improve the signal-to-noise ratio. Van Riper spoke of the "noise" as 
fluency disruptors. Those of us who stutter have a lower threshold to 
speech breakdown caused by the stress of the these fluency 
disruptors. Memories of past stuttering-related consequences have 
created highly conditioned maladaptive struggle behaviors. Fluent 
speakers are not immune from perceived outside inputs. That is why 
fluency students display such great resistance to going out to do 
pseudo-stuttering. I would suggest to anyone who wants to 
understand the real-world realities of the problem to go out into the 
streets and stores and do some comprehensive pseudo-stuttering. It 
will help them understand that an intensive in vivo desensization 
program as well as activities that promote healing and strengthening 
are essential if working on inappropriate speech mechanics is to be 

Re: Signal-to-noise ratio
From: Barbara Dahm
Date: 10/3/98
Time: 3:33:29 PM
Remote Name:
Ed, you are absolutely correct and are agreeing with what I said in 
the paragraph before the last under the heading "Deviations in an 
Interactive System". Also paragraphs 5 and 6 in the same section 
refer to the influence that others have on the person who stutters. 

Where I think we don't agree is that you seem to be saying that 
people who stutter produce speech like everyone else but stress 
causes the breakdown. I think that people who stutter have a 
tendency to produce speech in a different way than non-stuttering 
speakers. I think they speak this way much of the time whether or 
not the speech is perceptually stuttered. Therefore, if they don't 
change the way they produce speech, it will be very difficult to cope 
with stress. Producing speech incorrectly is stressful. I know this 
because I have learned how to do this and immediately feel the 
stress. I have also taught other non-stuttering speakers to do this 
and they also say it stressful. 

While people who stutter are becoming desensitized and learning to 
deal with their past experiences,they also have to learn how to 
rewire the system. 

The brian, the mind, feelings, attitudes, the speech muscles are all 
part of the system. We have to treat all areas simultaneously, not as 
separate entities. Understanding ones speech production system and 
how it works does counterbalance the fear of stuttering. Developing a 
positive approach counterbalances the feelings of shame and guilt. 

Re: Signal-to-noise ratio
From: Ed Feuer
Date: 10/3/98
Time: 10:14:28 PM
Remote Name:
Barbara, I would say there are fluent speakers out there who donŐt 
meet your high standards in speech mechanics Ń and yet they donŐt 
stutter. I would also say that we who stutter also know how to 
breathe, and believe it or not, we even know how to talk. Some of the 
time, even most of the time we speak with very high mechanical 
standards. But it is that very knowledge that produces the 
fragmented self. Reintegrating the fragmented self must accompany 
acquiring any new speech mechanics if the latter is to have any 
chance of lasting. From what I have read about your method, it 
seems to me there is too much emphasis on the mechanics. You are in 
effect trying to cure combat veteran shell-shocked soldiers by 
sending them back to boot camp. Once again, I suggest you go out 
into the streets and stores and do some pseudo-stuttering, an activity 
which I think would help you and other gain empathy and insight 
into the real dynamics of the stuttering problem. Ń Ed Feuer

Re: Signal-to-noise ratio
From: Barbara Dahm
Date: 10/4/98
Time: 9:03:53 AM
Remote Name:
Ed, If you look in the research you will see many studies that show 
differences between people who stutter and people who do not both 
in speech mechanics and brain processing . I don't know why this is 
so, but it has been shown to be true. This does not necessarily mean 
that there are diffeerences in anatomy and physiology, but there are 
differences in functioning. I most certainly agree that attitudes, 
feelings and past experiences play a role. Noting differences is not in 
any way meant to be an insult. We are all concerned in finding 
solutions to the stuttering enigma, so I don't think we should hesitate 
to note differences when we see them. 

Concerning breathing, I have also found that my clients know how to 
breath, but often when they go to speak they try to take control of 
their breathing to make the words come out. This makes it very 
difficult to produce voicing that supports continued speech. By the 
way in most cases we hardly even relate to breathing. The idea is to 
speak while breathing, not to breath for getting words out. 

Ed, therapy is not boot camp. It is a co-operative process in which 
both the clinician and client are interested in seeing what makes 
stuttering happen and what we can do to make speaking less 
stressful and more enjoyable. What I have written in my paper is 
what my clients have taught me. After having seen so many 
different people who stutter I simply put it all together and what 
came out was a diffeerent approach to stuttering. Within a short 
period of time most of my clients experience the two ways of 
producing speech. They confirm that there are different ways of 
producing speech. One way is less stressful and the speech is fluent. 
One way is stressful and results in speech that is often disfluent. 

Concerning pseudo-stuttering, I have done that, but I will never be 
able to experience what it feels like to have no alternative. I do 
prefer to have the alternative and that is what I want people who 
stutter to have as well. 

concepts of achieving fluency skills
From: Willem Snijders, the Netherlands
Date: 10/9/98
Time: 1:25:42 PM
Remote Name:
I'm very lucky to have the opportunity to be in your course at this 
very moment. You've added some new concepts to understanding 
fluent and non-fluent speech. Still I believe there has to be more; for 
instance temperament and the motive's stutterers sometimes have to 
speak. I remember from my early days that I wanted to speak to 
demonstrate my fluency. These motives are contraproductive in your 
program, however, can they be shaped into more appropiate motives, 
because they have maintained for so long. 

Kindest regards, 

Willem Snijders

Re: concepts of achieving fluency skills
From: Barbara Dahm
Date: 10/17/98
Time: 9:51:53 AM
Remote Name:
Willem, it was a great pleasure to have you as a participant in my 
workshop. I do understand that some people who stutter do like to 
show others the progress they have made. Although, I do believe 
that it is counter-productive to focus on fluency, such a person could 
demonstrate the different way he has learned to produce speech. In 
this case, the speech would be fluent, but that would be secondary to 
the process being used to produce the speech. 

Speech Processing Approach to Stuttering
From: Roxie Flicek
Date: 10/12/98
Time: 1:24:32 PM
Remote Name:
I found this idea for therapy to be most interesting. Can you provide 
specifics for achieving the short-term goals? Thank you!

Re: Speech Processing Approach to Stuttering
From: Barbara Dahm
Date: 10/17/98
Time: 9:34:02 AM
Remote Name:
The short-term goals are achieved carrying out various exercises that 
have the speakers focus more on vibrating the vocal folds as the 
major activity rather than trying to control word formation. They 
learn to vibrate the vocal folds as an isolated activity. Then they see 
that by doing this they can actually produce all words and speech 
sounds without paying consciouss attention to the internal speech. I 
have briefly mentioned in an earlier post on this thread a few of the 
exercises that they do. Although I can't go into all the details here, I 
will summarize by saying that we look at the speech production 
system in a rational and logical way and see what the person who 
stutters can do to make it easier to produce speech. If you would like 
to see all the exercises, they are described in the therapy kit.

Speech Process Approach to Stuttering
Date: 10/22/98
Time: 7:44:17 AM
Remote Name:
I recall a model developed by Dodd (sorry I don't the reference at 
my disposal at the moment) that was used to explain the processing 
components in developmental apraxia of speech. There are many 
similarities between your model and Dodds. This prompts me to 
wonder if the same processing difficulties could lead to suttering in 
one individual and developmental apraxia of speech in another. 

Recently, I met a young man who suspects a neurological basis for 
his stuttering. He notes the same type of hesitancies in his writing. 
Has it been your experience that clients have success with a speech 
processing approach to treatment if they believe that their stuttering 
is due to neurological differences? 

Re: Speech Process Approach to Stuttering
From: Barbara Dahm
Date: 10/22/98
Time: 4:51:53 PM
Remote Name:
My belief is that there are differences in neurological functioning in 
all people who stutter. Recent Pet Scan research has also shown that 
there are differences. However, it is not known if these differences 
are the result of physiological or cognitive factors. If this man is 
already focused on the neurological process involved in speech 
production, he would probably be a good candidate for speech 
processing therapy as he would be willing to explore internally what 
he is doing when generating speech.

workshop in Generating Fluent Speech
From: Mariette Embrechts
Date: 10/22/98
Time: 3:29:45 PM
Remote Name:
At te latest moment possible by this post I want to say that you, 
Barbara, did a wonderful job in presenting two workshops in 
Rotterdam and Nijmegen in the Netherlands. You made us think 
about a lot of things which are not yet clear... And till we know more 
we have to seek.... Good luck with the working on your program!