This article by Candace Lyle Hogan first appearred in MS Magazine, May 1982, p. 36-38.

Stuttering: What It Is, What It Isn't, And What Worked for Me


Stuttering happens most often on the first sound you try to make after a period of silence.

In the bad old days, women who stuttered were among those burned as witches. These days stutterers just burn from the inside out. Think about the number of times a day you have to talk and you begin to understand the searing dread of one who never can be sure when she opens her mouth that a sound will come out and the more she tries to speak, the more impossible it becomes.

At school, pretending not to be preoccupied with fear, I giggle with girlfriends. Mine is a gallows laugh; at any moment I may be called on to read aloud and end up hanging in humiliation on a word like "the."

Now I'm a teenager in the sixties. I still don't know I have something in common with Charles Darwin, Lewis Carroll, Somerset Maugham. and Moses. At the movies, I'm amazed at the way Marilyn Monroe talks -- puckering her mouth in a slowly quivering breathy pout. Now it is said that she was directed to do this to camouflage her stutter, to turn it into a sexy come-on.

An alien on a fluent planet, I avoid talking. People tell me I am such a good listener. On dates I'm grateful for the tradition that requires the gentleman to order for the lady. By the time I'm in college, I'm so far into hiding that I consider only those careers demanding little or no talking. I will become a librarian, pressing finger to lips for silence, writing little notes when asked a question.

Bad speech therapy had only made my condition worse; it was based on an erroneous idea that stuttering is an emotional affliction of unknown psychological origins. No proven cause, no known cure. I may as well give up.

But I didn't. In 1968 I discovered a speech therapy program at UCLA under the direction of the only other stutterer I'd ever met. Dr. Joseph Sheehan welcomed me into mecca when he opened the door onto a roomful of 30 people -- old and young, female and male, wits and dullards, the adjusted and the unstable -- stutterers all, and none alone any more.

Sheehan's program, which takes the taboo off rat-tat-tat stutter-talk, is a form of behavioral psychology called acceptance therapy. According to Sheehan, stuttering is whatever stutterers do to try not to stutter. So I stopped trying not to. What was left of my stutter, after giving up those extraneous behaviors (facial grimaces, tongue clicking, eye clenching, shoulder hunching, foot tapping) that we use to try to avoid stuttering was the relatively simple repetition of the first s-s-sound of a syllable. That Porky Pig variety of speech impediment hadn't handicapped the success of Mel Tillis. country rock star, or Winston Churchill. Why should it destroy me?

I gave up hiding, learned to keep eye contact while stuttering, and to observe the reactions of others without internalizing their discomfort into self-doubt and anxiety.

Throughout the 14 years since Sheehan's program. I've gained more confidence and pride than I ever would have had: the challenge of stuttering compelled me to know the person I was behind my suffering speech. But this year I found something even better, death to the suffering itself -- a new kind of therapy by which stutterers can learn to control their speech so that it sounds fluent.

A miracle cure? No, but a method that can work wonders. Dr. Ronald L. Webster, director of the Hollins Communications Research Institute in Roanoke, Virginia, does not call his therapy a "cure" but rather the "Precision Fluency Shaping Program" (PFSP). Webster doesn't believe that stuttering is caused by emotional trauma. He thinks it has a physical base, due to a genetic trait or predisposition that runs in families, that disturbs the feedback loop between the ear and the voice.

Although fluent people can afford to rely on that hearing-associated feedback mechanism to monitor whether they're properly producing speech sounds, approximately one percent of the world's population cannot. For those stutterers, Webster has developed a three-week marathon that teaches them the muscle movement necessary to control voice and respiration. This is called "motor kinesthetic feedback," a skill similar to the one athletes develop for reading other kinds of sensory feedback information and then using it to control their physical performance.

Ninety percent of more than 2,000 graduates of the program have succeeded, Webster says, including Annie Glenn, wife of Senator John Glenn; Austin Pendleton, Broadway director; and John Stossel, a consumer reporter on New York television. And now me. Not only can I talk about stuttering, I can talk about anything, and you'd never know I'm a. stutterer unless I wanted you to. Neither achieving nor maintaining fluency is easy, but with daily practice of the speech skill we've learned, fluency is now possible.

Webster uses no tricks, no gimmicks. no permanent attachment to any of the mechanical devices promoted by so many newfangled speech therapies. His method rests on a clear-headed analysis of the functional physical components of speech production (Webster calls them "targets") and knowing through practice how it feels in your muscles and nerve endings when your speech organs are producing fluent sound. It is not that stutterers' speech organs are damaged goods, but that we need to learn how to use them in a way that bypasses that possibly faulty feed-back mechanism in the ear.

Clinician Deanna Morton at Webster's Communications Reconstruction Center in New York taught me to talk all over again, as if I were a baby starting from undifferentiated sound. I broke a bad breathing habit that a lifetime of stuttering seems to develop -- stopping the breath midstream, trying to talk on residual air or no air at all. I began to take slow full breaths from the diaphragm (full breath target). I learned to begin voicing at the top of the inhalation and to continue the voice on throughout the breath (loudness contour target).

If not forced to think about it, few realize that speech is a very complex behavior. It involves coordination of the organs responsible for respiration, voicing, and articulation, as well as a myriad of tiny peripheral muscles that are engaged simultaneously and rapidly. Fortunately, these muscles are extremely sensitive and can be felt, then controlled. By concentrating, you isolate where they are, focus on what they're doing, and change their bad habits into functional ones.

I used to assume that speech came from moving my articulators (tongue, vocal tract, teeth, lips). What a revelation it was to realize that it was the job of the voice (the breath stream rushing past vibrating vocal folds) to produce sound!

Although all the targets or components of speech production are important and work together, the "gentle onset target" is the key to fluency. Stuttering happens most often on the first sound of syllables, i.e., when the stutterer tries to start voicing again after a period of silence. Looking at sound-wave patterns of a normally fluent person on an oscilloscope, you see low amplitude sound vibrations (barely audible) proceeding to higher amplitude vibrations (loud enough for conversation) that fall off again to those of low amplitude in a kind of bell curve. What stutterers' sound-wave patterns lack are those low amplitude vibrations. We try to start the voice at the top of the curve.

Employing the gentle onset target simply means adding those low amplitude vibrations at the beginning of each syllable of a word. This helps immensely to excise the stutter, since starting the voice gently after a slow intake of air keeps the throat open for the breath stream and the vocal folds relaxed for the flow of fluent voicing.

The final targets involve articulation. I reduced the excessive pressure I used to apply with my lips and tongue against the teeth in my vain efforts to force out words that wouldn't exit easily or their own.

Not far from Morton's expert ear, I practiced these targets eight hours a day, six days a week (plus homework), in a slow-motion monotone with a stop-watch around my neck. It took so much concentration that I seemed to forget my own name. Almost daily I absentmindedly mislaid my wallet or house keys. But by the end of the third week, I put all the pieces together, added normal inflection, and went outside the clinic to use my new slow target speech for the first time.

Salesclerks -- the most intimidating of critical ears -- didn't bat an eyelash. Waiters who used to tap their pencils impatiently now took my order with a pleasant smile. Asking questions over the phone, another part of the process of transferring the new speech to the "out-side world," brought me a compliment I'd not heard in all my 33 years: "You have such a beautiful voice."

Needless to say, there's no stopping me now. Speaking will never be as automatic to me as to you, but by concentrating on feeling how my muscles make sounds, I can be as acoustically fluent as I choose to be. I'm still a stutterer, but you'd have to look on an oscilloscope to see how my sound vibrations differ from those of fluent people.

The ratio of male to female stutterers is about four to one. No one knows why more men stutter than women, but, according to Webster, "In all areas pertaining to communication neurologically the male seems to have more problems. Perhaps the mechanisms that process sound in the male are more susceptible to disruption. The middle-ear muscles in the male may not be as richly ennervated or they may not have as many muscle fiber-nerve connections. Or maybe it's because the male may rely more on the sound of the voice to guide his talk than on the muscular feel."

Webster also reports that proportional to their numbers, adult female stutterers are underrepresented in therapy. No one knows why. Perhaps the reasons are economic or perhaps, as Webster speculates, "Women more often tackle problems on their own."

Candace Lyle Hogan is a coauthor of "Diana Nyad's Basic Training for Women " (Harmony).
added April 19, 2004