Hi Barbara,

Since we the last session, I must say that there has been a definite change in the way Josh speaks.  I can’t tell you the change that has occurred.  It seems like he really has just GOT IT.  He has control of his speech and it has lasted well over a week.  This is the longest that a notable change has been observed. Last night, he had 30 minute telephone conversation with his friend – absoultely beautiful speech.

I suppose I was waiting for the fall before emailing you again for another session.  Maybe we won’t need any more – a very unusual concept in this household as Josh has needed speech therapy since he was 6 and he has just turned 14 years old.

We have really not needed to remind him to use any technique, he self corrects – this approach to his speech works.  At times, I can see Josh working at using the strategies he has learnt from you – it works  …. IT WORKS.  He practices the strategies all the time – using it at all times – he has control – he feels in control.

Last December, I searched for an approach to Josh’s speech that would work for him – he had all the ingredients for success – interest, focus and dedication – but he needed a brilliant therapist and approach.  You are unique – the long search for an approach to fluent speech that worked was worth it.

Barbara, apart from the approach to speech, it was the discussions you had with Josh about the way he feels, linking this with his speech and ability to take a different perspective on board that was also integral to the improvement.

And can I also say that Josh not only enjoyed the skype sessions, but felt respected and liked by you – so thank you for the whole package.

Forever grateful,

Ellen

Dear Barbara,

This letter is past due.  I’m sorry it took so long but my husband and I, wanted to personally thank-you for the unbelievable work you put into our son, Avromie.  Before we started treatments with you, we thought it would be just another try, and another large sum of money, going to waste.  At our first visit, we were able to see how your idea and way of treatment just made so much sense!!  Your patience and KNOWLEDGE was just a miracle for our son!!  When our son does practice your techniques, it’s like, (as my husband put it), as if he swallowed some sort of pill!!  Thanks again of everything.

Hi Barbara,

Here’s as promised, a review of the therapy:

I have been trough the online stutter therapy,

I had my first sessions for some months ago.

I chose the online therapy because, first of all it was avialable for me - it is available for everyone who has internet.

And the online stutter therapy is very diiferent from other therapies.

What I learned was that my “stutter” (we are thought in the therapy to not use the word stutter) was affected from the major areas: 1) positive thinking and feelings towards my language

2) Fosucing on my vocal chords

3) Speeking in syllables

And also, I learned that my stutter is an old habit, from producing controlled language, in the wrong way.

The goal with the online stutter therapy is a fluent, enjoyable way of speaking.

And after 5 months of therapy I feel that being very much more the case than before, and I recommend this therapy to everyone. Just make sure you have the time for it first. If it is your goal to become fluent, and you have time for it, then I suggest this approach.

Friendly regards,

Oliver

Dear Barbara,

I need to tell you how valuable the Dynamic Stuttering Therapy program is to my students. Your approach gives students a “new” way of speaking which they can embrace and share with their families. Being in the public schools it’s often difficult scheduling students but I find my students seek out additional time to work on their speech, because of the program’s “user friendly” units/ goals. Thank you for clearly stating the goals and objectives and providing so many appropriate techniques.  Your program has been extremely helpful to not only the stutterer but to families. Thank you.

Susan Abrahamson CCC/SLP

(translated from the original Hebrew testimonial)

Hi Barbara,

First of all, thank you for the online session we had. I really enjoyed talking to you and of course reviewing the natural and normal way of speaking that disappeared from me for some time. The session was very successful and I got a lot out of it. I learned a lot about myself and about the way to speak.

I understand the (treatment) approach at CTI. I know that this approach is the right one and most important the natural method of speaking.

I’m happy to share with you and help you understand the person who stutters. Even though I have always stuttered mildly, I suffered from a lack of confidence in some situations when I had to talk or express my opinions. That was certainly very frustrating and caused me discomfort and not a few times bitter disappointment.

It is absurd to say that the normal way of speaking is the natural and easy way that little children speak, without any control or “filter”. It is just speaking without thinking about how to speak; speaking the way nature meant for us to speak. As a person who stutters mildly, I absolutely know that most people who stutter monitor their speech and plan what they are going to say. This is what disrupts the speech and makes it sound unnatural, causes prolongations, ends in blocks and causes certain words and sounds to get stuck. And it’s terribly, terribly frustrating for some one who has stuttered that unfortunately people who stutter still carry have a negative stigma. The secret is to speak without any monitoring, without filters, without preparing. Simply… talk automatically so that there is a natural coordination between the brain and the whole speech system!

I still think that it is not so easy to get rid of the habit of focusing on words and doing all sorts of preparations to speak, such as changing words, prolonging words. It is really difficult for someone who has used the wrong process for speaking for many years to give up old habits and get used to speaking naturally. Making this change is not easy or simple for everyone, but it is possible and it is the only way to speak naturally without stuttering!! Practicing internal speech (speaking silently in the head) is really worthwhile. (That was what was missing for me all these years!!)

So thank you very much for helping me get back my confidence in speaking. Already, during the past few days since our session, I have felt an improvement. This is the right approach!! A great approach!!! It is the approach that gets to the source of the problem instead of the syndrome and shaping the speech.

If you would like, I would be happy to send you heartfelt recommendations so that everyone will see and will learn the importance of realizing that this is the approach that can save everyone from the problem of stuttering.

Hi Mrs. Dahm,

That hope that you have been well. I’m afraid that I have the bad habit that when I don’t respond to an e-mail right away I get busy with other things and manage to forget about it completely… Anyways, here’s my update. I have overall been relatively pleased with the progress that I have made toward consistently speaking correctly. I would say that one particularly positive point has been my attitude toward speaking situations in general.

I have gotten to the point where I really don’t worry about any speaking situations any more. I gave an approximately 10 minute speech at my brother’s wedding, in front of a few hundred people, and I was not nervous about stuttering beforehand. No doubt related to that fact, I spoke correctly pretty much the whole time and therefore was able to speak fluently. There was a long time when I would have probably declined that opportunity to speak for fear of stuttering, and if I had done it I would have worried so much and tried so hard to speak fluently that I would have spoken incorrectly and therefore stuttered a lot.

In general, I have been making progress toward speaking correctly more of the time. I still sometimes slip back into my old way of speaking, trying to use my mouth too much to shape and force out my words. I think that I’m usually pretty good about noticing when I’m doing that and then going back to speaking correctly. I’m still working on making the correct way of speaking more habitual. I hope that you have been well. I’ll keep you posted about how things go in the future.

All the best,

Daniel

11 years after treatment with Stuttering Online Therapy, Shmulik, who once stuttered severely, explains that stuttering is no longer an issue in his life.

During Gil’s first therapy session:

Gil: Let’s say, there are times when I realize that my stuttering slightly bothers me. It happens when I’m a bit tired or if I go out to a pub and drink. Then my thoughts are not organized; they are free and not in my control. I noticed at these times that I have a tendency to stutter more. Or I have problems with the flow of speech, so in these situations I have more stuttering…

After 15 hours of treatment:

Gil: First, I got a new way of expressing myself. (Before) the words were always in my head, but the way to get them out was a bit of a problem.  (Now) the ideas simply flow in a very free way.  Suddenly, after a long time of not doing this and not being used to doing it, you feel a real relief. Suddenly everything goes smoothly like it’s supposed to. Speech is something so basic. It’s your way of communicating with the outside world. Suddenly, something that was so difficult and not right goes smoothly and, in short, that gives you an excellent feeling.

(In this therapy), you have goals that are A,B,C,D and you know you have to focus on them. These are the basics and you go according to them. This makes the therapy very focused.  It doesn’t say to you, “Well, you have to loose 50 kilo in a half a year.” It’s not like that. It’s not something abstract like that. There are specific goals that go with you all the way. The therapy is very focused.

Barbara: Have you changed your perspective about what speech is?

Gil: Yes, of course. Before (treatment) I didn’t know at all what it was – how you develop ideas, how it gets out of your mouth, how everything happens in your brain. Suddenly you actually realize that it (speaking) is really about not doing anything.

Barbara: What is your feeling today as you complete the formal stage of therapy?

Gil: Humm. First there is still more to do. I am not yet 100% there, so that I can’t say, “Great, after 15 hours of this treatment course, I can do everything that I want.”  But first of all, it really contributed a lot to my self-confidence. If once, you were afraid or hesitant to open your mouth because of how people might react or because you couldn’t speak fluently, then it’s already normal not to be that way. That helps a lot. I don’t know, it’s just that everything is so much freer. The thoughts that you always had that were such a bother are reduced. They suddenly just aren’t there. So you have the time, freedom and energy to think about a million and one other things. Once the energy was directed to another place. Now you have the energy to use freely for whatever you want. You have peace of mind.

The therapy on skype is something that I had heard of for the first time and had never thought of doing it. I had never heard of such an option. At the beginning I was a bit skeptical.  I said, “What? Via skype?” I am used to using skype just to talk to my friends abroad. It seemed strange to get therapy via skype. But, honestly, it is a great development. It’s not the conventional way of coming (to a clinic). It cuts out a lot of the bureaucracy of traveling, parking and sitting face to face. The therapy was much more comfortable and pleasant.  It’s so much nicer. You go home to your own home and open up your computer for a 1-2 hour session, and that’s it. You’re finished. You also have all your home practice on your computer. It’s not the regular therapy and I really liked it a lot.

In addition, Barbara will be available to work with clinicians looking to expand their expertise in stuttering treatment.

For an appointment, please contact us at barbdahm@gmail.com or by phone, please call us at 201-378-0089.

Barbara will also be giving a workshop at the National Stuttering Association Convention in Cleveland between July 7-11, 2010.  She will be talking about the disparity between research and treatment for stuttering and explaining how this can be overcome. It looks like it will be a great convention. It’s an opportunity for people who stutter and their families to meet and discuss all aspects of stuttering and to have lots of fun with a great group of people.

Nevertheless, people who stutter can go through a process of helping themselves to become fluent speakers. This process starts with discovering how fluent speech is produced and comparing this to what you do to produce speech. So for those of you who want to take an active role in this process, I thought that it would be a good idea to give you an activity to do.

The activity I am describing here is meant to show you that speaking does not involve thinking about what you want to say and then trying to get it out. So let’s explore….

Activity: Discovering how language develops in the brain i.e. developing internal (sub vocal) speech

Step 1: Write an email to some one. While you are doing this, become aware of how language automatically develops in your head. This is your internal or sub vocal speech.

Internal speech automatically develops in your head when you are writing, figuring out a math problem or simply talking silently to yourself. Language is meant to develop in the exact same way when you are talking to all people in all situations. Developing internal speech is speaking and there is really nothing else that you need to do. Doing anything less, or anything more, will very likely lead to speech blocks. I suggest you look at these fascinating link related to sub vocal speech. It will help you understand the power of this inner speech.

Step 2: Speak silently as you become aware of how language develops automatically when you are not thinking about the words that you are saying or planning to say.

For most of you, this will be natural under the condition of silent speech, but for others, you might find that even in silent speech you have a tendency to preplan your thoughts or choose your words. If this is the case, you can try giving up all control by experiencing automatic internal speech while counting or saying the ABCs. Later you can move on move on to spontaneous speech.

Step 3: Once you are speaking naturally in your head, continue to do this as your mouth simultaneously moves as you develop internal speech.

Some of you might have been doing this already in steps 1 & 2. If not, do it now. If you are using automatic articulation, you will hardly feel that your mouth is moving, even though it is. Also you will be able to speak without any effort.

Step 4: Talk silently and then talk aloud. See if there is any difference at all in the way your internal speech develops and the way your mouth moves.

Being aware of whether the process of speaking silently and aloud is the same, or even slightly different, is the prerequisite for changing how the system works.

There are a few examples of famous people who for the most part have become fluent speakers. Carly Simon, who once struggled with stuttering, set her speech to a rhythm. In an interview she gave with Tavis Smiley, she showed an example of how she made herself speak with what she describes as syncopation. To me it looked like her speech progressed in syllables, as she was no longer trying to get words out. In the same interview, Smiley, who also once stuttered, says he began speaking fluently by imitating the cadence of Dr. Martin Luther King’s speech. This is an example of achieving a normal pattern of intonation.

Vice President Joe Biden tells of his efforts to overcome stuttering by practicing reading aloud in front of a mirror and trying to eliminate the contortions of his face.

My clients changed their neurophysiologic processes by learning to develop speech internally without any effort to get it out and by letting their voice reflect normal patterns of intonation while giving up all control over forming words or speech sounds.

Whether the change was made by self-help or within a treatment program, we can learn a few things from people who as older children and adults do change how they speak I am listing a few of them here:

1. They investigate how people who do not stutter speak.
2. They learn from watching and listening to themselves when they speak.
3. They become aware of the act of speaking, instead of trying not to stutter.
4. They are persistent in looking for solutions, instead of focusing on problems.
5. Whether or not it is their conscious goal, they change the intonation pattern of their speech.
6. They take responsibility for the recovery process.
7. They are willing to do repetitive practice on a daily basis.
8. They believe they are capable of making changes.
9. They focus more on what they do rather than blaming external situations for their stuttering.
10. They realize making change requires patience and time.

If you want to help yourself to speak with greater fluency, the first step is to develop as many of these qualities and behaviors as you can. It will make the process of change easier and so much more rewarding.

I want to make this point, because I have heard many people who stutter say that if they could make themselves care less about stuttering, they would not stutter. The fact that they are still stuttering seems to them to be a failure in their ability to cope emotionally. This is not the case. A person can be the most centered, emotionally intelligent and socially well-adjusted person and still stutter. This is true, because stuttering is a condition that involves so much more than the person’s feelings.

Today researchers are coming up with more and more evidence that the place where speech is created, the brain, is the source of stuttering. Recently new genetic research lead by Dennis Drayna at the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, has shown that at least some people (thought to be 9% of the people who stutter) have a gene mutation, not found in fluent speakers. It turns out that these particular genes are responsible for the production of two enzymes necessary for a metabolic process required by all cells, but that especially affect a group of cells in the brain responsible for speech. Other researchers studying other families have also found indications of mutations in genes of those members of the family who stutter. The relationship of these genes to speaking is not yet clear. However, what we are seeing is that stuttering isn’t simply a question of how the person feels.

For those people who have tried to stop stuttering by changing only their attitude and feelings, it is important to know that stuttering is not only about what you feel inside. Advertising stuttering is good and helpful. Learning to be self-accepting of yourself whether or not you stutter is essential for your personal wellbeing. Being disappointment in yourself and thinking you have failed because you still stutter is self-defeating and misplaced.

In an effort to speak fluently, people who stutter, their family and friends are busy trying to find out what outside factors make them stutter. Their hope is to eliminate, change, or learn how to deal with these factors. The emphasis is on external factors. This search is ineffectual because the external factor is not the problem.

The role of external factors is that they may lead the speaker to use a more, or less, controlled process for speaking. It is the individual’s reaction to outside factors and the way their brain functions when these factors are present that actually causes the fluctuations of stuttered speech. Therefore, it is the individual’s reactions, not the catalyst leading to the reactions, that need to change.

Brain functions are not carved in stone. They fluctuate for the better and worse as a result of experience, learning, practice, self-talk and imagination. When an activity has been done in a certain way over and over again, it becomes automatic and consequently more efficient and less subject to influence by outside circumstances.

Taking control over normally automatic processes will always have a negative effect. We see this when we give too much thought to our body movements when we walk or dance. Controlled action makes us clumsier and less flowing in our movement. The same thing happens with our speech.

Stuttering comes and goes according to the degree that controlled processes function to produce speech. By learning how to produce speech automatically, and by accepting the need to speak without control, people who stutter can develop a stable system that generates fluent speech.

Part of the frustration of covert stuttering is the result of the lack of understanding by the people around them. Parents, friends and teachers may not be aware of the feelings or the difficulty that the speaker is experiencing. Unfortunately, even when they try to explain, people who stutter covertly are too often told that they really don’t have a problem or that it is a psychological problem.

Some people believe that covert stuttering is different than overt stuttering. Speech pathologists have been known to turn covert stutterers away from speech therapy. After all, it’s difficult to use speech modification or fluency shaping techniques to change the speech when no stuttering is heard.

Even people who stutter overtly sometimes fail to understand covert stuttering. They may minimize the problems that the covert stutterer feels, and claim that if stuttering is not heard, it isn’t really stuttering. This only adds to the torment that people who stutter covertly experience.

I want to say unequivocally that covert stuttering is as real a condition as overt stuttering. In both conditions the speaker is not generating speech easily and automatically. Even when stuttering is not audible, there is very real pressure that can be felt in the head, chest, vocal tract, or abdomen. The person who stutters covertly may be very good at changing words quickly so that planned words are not actually forced out, or they may use more pausing so that blocks are not actually heard. However, what is going internally is not very different in overt and covert stuttering. In fact, some speech techniques for controlling overt stuttering, actually lead to covert stuttering, i.e. they result in less stuttered speech produced by a still mal-functioning speech production system.

Effective treatment for covet stuttering usually involves reducing the effort to hide stuttering, but people who stutter covertly do not have to try to stutter overtly on purpose, because this puts the focus on the stuttered speech instead of on the process of speaking. Learning how to process speech is as important for people who stutter covertly as it is for people who stutter overtly. They can learn to produce speech automatically and without effort. Since this is the goal of Dynamic Stuttering Therapy, treatment is just as effective for people who stutter covertly as for people who stutter overtly.