Archive for June, 2009

Stuttering, circa 1950

About 12 years ago, I was at my wife’s grandparents house…where I ran into a relic of the past.  An encyclopedia set.  (!)  So I looked up “stuttering”, and here’s what I got:

Stuttering, sometimes called stammering, is a form of anxiety tension, manifested as a disturbance in the fluency of speech, motivated by an apprehensive anticipation of difficulty in initiating or maintaining an adequate flow of speech.

Pertinent surveys indicate that nearly 1 per cent of American school children stutter.  According to Prof. Charles VanRiper, Dr. C. S. Bluemel, Dr. Emil Froeschels, and other authorities, stuttering generally begins in early childhood and nearly always consists of easy, simple repetitions and hesitations in its early stages.  This general view has been confirmed and elaborated by studies reported from the State University of Iowa Speech Clinic, which indicate that the average age of onset of the difficulty is three years.  The studies also indicate that children who develop stuttering do not differ as a group from nonstuttering children so far as intelligence, health, physical development, speech development, and general behavior are concerned.  It is of particular importance that stuttering is usually originally diagnosed by laymen, usually the parents. What they diagnose as stuttering appears in the usual case to be indistinguishable from the ordinary repetitions and hesitations in the speech of normal young children, between the ages of two and five, who have been found to average 45 repetitions per 1,000 words.

As to treatment, there is general agreement that stuttering should be treated as a form of anxiety tension.  The main objective is to reduce the anxiety of fear regarding stuttering, and by this means, and in direct ways also, to reduced the hesitancy and tension characteristics of the stutterer’s speech.  Mental hygiene, or personality re-education, also is indicated in many cases to counteract the maladjustive effects of stuttering.  The treatment of young children is chiefly a matter of parent education designed to change the parental policies, so as to remove the sources of the child’s anxiety tension, which may be harmfully increased by parental demonstration of concern or by actually instructing the child to stop and start over, to speak more slowly, or to stop and think.

— (W.J.)
Collier’s Encyclopedia
Frank W. Price (editorial director)
Charles P Barry (editor in chief)
P.F. Collier and Sons Corporation, New York
First edition
Manufactured in the United States of America
Volume /S/  p. 258

And the sad thing is… this view (largely based on a predjudice second to the fundamental attribution error) is still pretty prevelant today…

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Speech-activated myoclonus masquerading as stuttering?

Ran across an interesting teaser article from pubmed entitled Speech-activated myoclonus masquerading as stuttering.  No, it has no abstract.  No, it’s not printed yet.  No, I can’t seem to download a digital pre-print.  No, I’ve not read the freakin’ article.  Yes, I’ll have to wait until it magically shows up at our library.  So what is myoclonus?  Well, I did a little reading on it–and it seems pretty interesting.  (Funny, pretty much all the online resources say the *same*exact*thing*; so there’s a whole lotta copy/pasting going on!)

So what is myoclonus?  Well, let’s break it apart.  Myo meaning “muscle”; clonus meaning “violent, confused motion”.  So we’re talking about confused muscle motion–such as involuntary jerks or spasms.  The most identifiable example is that body jerk that we all get from time to time *right* when we’re about to fall asleep.

Now–there are (behaviorally identified) subtypes of myoclonus out there…and the one that seems most stutter-esque is “action myoclonus”.  This is “characterized by muscular jerking triggered or intensified by voluntary movement or even the intention to move. It may be made worse by attempts at precise, coordinated movements.”  So I can see it… Maybe.  I’d like to read more about myoclonus and read the article as well.

The “cause” of myoclonus seems to be pretty wishy-washy.  The best description that I could gather is that there is “decreased inhibitory signaling from cranial neurons.”  And this could make a bit of sense relative to stuttering–as there have been a few long-standing theories suggesting that stuttered speech may stem from errors in physiological speech “feedforward” and “feedback”. (Postma & Kolk come to mind…)

Anyway–interesting to see what all comes from this…  And to get my grubby little paws on some data 🙂

Update 1:  A reader was kind of enough to pass along the article, and the format was more interesting than the paper itself.  It was a single page, 2 paragraph paper (with embedded video of the client).  Anyway–pretty interesting.  The client got sick around age 21 and “stuttered” ever since.  I’m suspecting that there was some viral infection that passed the blood/brain barrier and likely effected the basal ganglia-thalamocortical circuit–thereby resulting in the involuntary neural activations.  (But let’s get serious–I’ve got no clue..)  Further, the idea of linking speech myoclonus and stuttering isn’t new at all; Larry Molt wrote a good article on the concept for ISAD.

Update 2: Interesting.  I viewed the video of the client, and his speech does represent some aspects of “stuttering” in the textbok sense, but my stutter-senses weren’t tingling while watching the video.  Another nugget of trivia was revealed when the client said that stress and anxiety have an impact on his severity.  (This should give creedance to BGTC involvement.)

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Cluttering is not the same as stuttering

While most people at least recognize stuttered speech and pick it out from a line-up, most people (even SLPs) don’t have a clue about cluttering phenomenon.  This is a *great* resource that provides some of the basics. They ought have called it Cluttering 101.

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Marilyn Monroe struggled with stuttering

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Stuttering: Myths, Beliefs and Straight Talk

Some knuckleheads wrote this pamphlet; it may or may not be worth your time.

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How bad stuttering therapy teaches to the test

Over the years, I’ve come to realize that we only understand a concept after we teach it (effectively).  Until then, understanding may largely be an illusion.  Anyway, this past semester, I realized that much of traditional stuttering therapy is largely teaching to the test.  (In other words, the (a) therapist sets the goal as being some kind of fluency objective, (b) skills are taught that meet that objective, (c) treatment is measured in such a way such that the objective is met.)

So I just read a post over at the stuttering forum that describes this phenomenon very well:

I see a speech therapist on a regular basis. I am perfectly fluent during sessions and use my “skills” with no difficulty. The minute I step outside her office, all that goes out the window. I know exactly what to do but my stress level prevents me from doing what I need to. Should I continue therapy? I don’t know that I can benefit any further from it. It’s costly and I feel I’ve learned all I can about speaking fluently. The problem seems to be my negative thinking and poor stress management.

First off–despite my best efforts, I still can’t get an account over at Stuttering Forum.  So mods, feel like showing me some love?  Secondly, it’s time to change therapists–because we’ve got problems.  (1) What are the therapeutic principles?  (i.e., how is stuttering fundamentally viewed by both clinician and client?)  (2) What are the therapeutic values (i.e., what are the long term objectives?)  (3) What are the therapeutic goals? (i.e., what are the short term objectives?)  Just by reading this short post, I’m thinking that the clinician is confused at step 1, and thus has botched 2 and 3.  Sorry, I call them like I see them.

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What’s new in the online world of stuttering?

Read some pretty greaet posts this morning.  Pam writes “Sometimes I Just Stutter“; Danny posts a ‘cast on desensitization; and Steve writes about how choosing one’s life attitude impacts qualiy of life.

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