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Archive for April, 2009

An alternate view of pagaclone & pharmaceutical stuttering management

April 17th, 2009 1 comment

I read an alternate view of pagaclone & pharmaceutical stuttering management.  And to be honest, I greatly disagree with the perspective.  However, its’ also my view that all perspectives ought have a seat at the table.  (And once at the table, each scientific perspective needs to provide evidence to retain said seat.)  In short, I’m hesitant to try and account for the neuromechanics of pagaclone from an untestable theory; instead, we ought let the data speak for itself.  Data drives theory; theory should not drive data.  The latter is the very definition of dogma, at least in my eyes.  Secondly, while past drug treatments have been awful, I can’t see that as a good rationale to not try and find better alternatives.  Drugs don’t (or rarely) ‘cure’ pathologies; their purpose is to improve the (net) quality of life in those who live with the pathologies.

I’m fully prepared to admit that maybe I’ve missed the point entirely…  But for the record, I’m excited to see some legitimate innovation in the treatment and management of stuttering, and I’m excited that the pendalum has begun to swing into the direction that stuttering is a legimate medical condition.

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Pagoclone users post about their experiences…

April 17th, 2009 5 comments

Pagoclone users are posting about their personal experience with the drug.  It’s like data from the trenches…  (i.e., the real users themselves)

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Steven posts a great account regarding dignity

Steven on Stuttering posts a great account of a scenario that went down at an eatery.  I love how he handled it; powerfully advocating for self and stuttering with compassion and dignity.

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It sure is refreshing to see a mom that gets it…

It sure is refreshing to see a mom that gets it.  (Or, seems to be on the right road to ‘getting it’.  Parental modeling of patience, self-acceptance and self-advocacy continues to bring me joy…)

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Recent stuttering reserach is like “that rug really tied the room together”

Make no doubt about it, I am a fan of The Big Lebowski.  But what’s more germane to this discussion is how the emerging neurophysiological perspective is slowly beginning to converge into a single unified perspective.  In the past, you had people citing (just the): cerebellum, premotor cortices, temporal cortices, etc…  Everybody was documenting neural functional errors without putting it into a proper (big picture) context.  (Fortunately, the field didn’t get sucked into past mistakes and lock-in to one perspective and subsequently confuse the symptoms as the cause of stuttering.)

So this recent article attempts to look at the big-picture neurophysiological activation patterns between stutterers and nonstutterers.  Usually, I’m wary of such an idea–because it’s impossible to differentiate between a cause of stuttering and the characteristics (or result) of the stuttering phenomenon.  But if we keep that in mind, this sounds like a powerful study…

In essence, it’s comparing the whole-brain activation patterns between stutterers and nonstutterers in a non-speaking-task.  And this non-speaking-task is a stroke of genius.  Because as soon as you include the act of speech, you’ll include all the bodily compensations that stutterers will automatically do to try and compensate for the neural stuttered state.  This point bears repeating: The fact that this is a speech-less task better approximates the stuttered neural state; we’re bypassing so much of the garbage that has invalidated research of the past.

And the results seem to support past (good) neurophysiological research–but it does it in a holistic fashion.  We’re beginning to put the pieces together as a puzzle, rather than inspect them one at a time (without referencing them as a big-picture).  So in that sense, studies such as these are like that rug really tied the room together.

There are a whole lotta implications to the most recent article–too many to discuss in any one post.  But it’s good to see progress.  Hopefully, this progress will change the way we fundamentally view the stuttering phenomenon, which will lead to new ideas and new venues of research.

Take hope point: Stuttering is NOT a speech pathology.  It is a neural state.  The stuttered neural state is manifested in the behavior of expressive communication.

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Introducing Stuttering.TV — A (stuttering) video podcast

April 12th, 2009 4 comments

Danny (from StutteringIsCool) and I thought might be cool to start a (stuttering) video podcast.  Not exactly sure where we’re going with it, but I know that it’s a lot of fun.  (So that’s reason enough, isn’t it?)  Feel free to check it out at Stuttering.TV.  It’s basic, minimalist, short, and I’m sure we’ll experience a learning-curve along the way… (And since I’m here, let me give StutteringIsCool another shameless plug; it’s a great site w/ a lot of great content.)

So please allow me to informally introduce Stuttering.TV

Valid stuttering research requires a proper review of the stuttering literature

April 11th, 2009 4 comments

Here’s an example of a poor research question that results in data that is both meaningless an uninterpretable.  And yet, it still gets published.  Since one of my sub-themes for this site is to empower the stuttering community by enhancing our research-consuming sophistication, let’s look at why…

The study is trying to measure one’s speech rate as a function of their overt stuttering frequency.  So they had people of different overt severities talk, and they try to measure speech rate.  Well–the concept of speech-rate is a tar-baby in and of itself; are you measuring X number of syllables in Y amount of time?  If so, that’s short-sided.  What if there are just longer spaces between words or syllables?  Or–what if each syllable is longer in duration?  The concept of speech rate needs to be better defined.  Articulatory rate may be a better gamble…

But here’s the real flaw.  Of course, the very act of stuttering adds time; so any added time (i.e., moments of stuttering) would show up as reduced speech rate.  (Duh!)  So the authors decided to throw out any speech tokens in which they heard stuttering.  Great.  Yippee.  What’s the fatal flaw?  They’re assuming that stuttering is only an audible phenomenon.  That if stuttering isn’t heard, then it’s not happening.  Wrong, Wrong, Wrong.

There was a nifty study (Armson & Kalinowski, 1994) that demonstrates sub-perceptual stuttering moments.  Moments of perceptual “fluency” were analyzed, and stuttering was still found to occur on the physiological level (as measured by any numer of physiological measures).  Subperceptual stuttering exists, people.

So this latest publication is yet-another example of how poor theoretical thinking results in silly research questions and wholly invalid data.  The authors apparently think that stuttering is (only) an audible phenomenon; and if it’s not overtly heard, then it must not exist.  So the use of perceptually fluent speech tokens is OK.  So they find, shockingly, that as overt severity increases, speech rate decreases.  They’re totally ignorant that their data is likely being contaminated by subperceptual stuttering–the stuttering that remains in existence even though their ears can’t detect it.

The authors of this paper are likely people who fluent; had they the sense to ask a stutterer (and actually listen to the response) they would have known better…

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Newsflash! Stuttering continues to affect people as they approach death!

Bring out some gold stars for this one…  People surveyed old people relative to the perceived impact that stuttering has on their lives.  Results?  Stuttering has an impact on their lives.

The shame of it is that this could have been far more interesting data.  They never reported the overt severity of the participants, nor did they do other surveys–such as on locus of control.  Do old people with a strong internal locus of control still feel that stuttering has a significant negative impact on their lives?  This seems like a valid question, since there was a teen-stuttering-therapy study from a few months back finding that the therapy didn’t have much predictive value relative to treatment success; what did have predictive value was the teen’s attitude toward life, themselves, and the treatment.

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Yet another example of the negative prejudicial stuttering stereotypes in pop-culture…

I ran across an interesting blog post today about Disney’s pop-culture-icon Miley Cyrus.  Apparently, she’s got a new song that more-or-less mocks stuttering.  Which is a really great idea when her target audience is the emotionally imbalanced hormonally challenged youth that can’t properly process emotions…  Good idea, Disney. Good job.  After you’re done exploiting the unfounded prejudicial stereotypes of the stuttering micro-population, why not go after the biggies?  Sing songs about _____ people, and then ______ people, and the pièces de ré·sis·tance , ______ people.  Yeah–no double standard there…

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Is there an increased (stuttering) risk for bilingual kids?

Ran across yet-another article citing that bilingual kids have an increased risk for stuttering.  If this is true, then we would notice significant differences in the incidence and prevlance of stuttering between continents.  Not-so-much-stuttering in the States, way-much-more stuttering in mutili-lingual countries.  But since such a common-sense observation has yet to be noted, I’m thinking that the the hypothesis is pretty much bogus.

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