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November 3, 2011 By Leave a Comment

fluent speech, stuttering treatment, stuttering therapyHave you ever wondered why you speak much more fluently when you are talking to yourself or to babies and animals? Aside from making you curious, the inconsistency in your ability to speak in different situations has probably caused a lot of frustration. There you are talking to yourself and having no problem. Then someone walks into the room and oops, the words don’t flow anymore. Talking alone or to pets is just one of the many fluency enhancing conditions that needs to be explained in any adequate theory of stuttering.

To try to understand what the difference is between speaking in the fluency enhancing situation and when talking to others, let’s look at the situations more closely.

Scene #1

Rover has just started to chew on your favorite pair of old slippers. “Rover, stop that. I love those slippers. Naughty dog. What am I going to do with you?” flows through your mind and without realizing it, your thoughts become audible speech.

Scene #2

Mother walks in the room, expressing her frustration that Rover is causing more damage. You want to defend him. You try hard to find the right words to tell her what a good dog Rover is. You have to say that “m” sound that is so hard for you to say. “M-M-Mother, HHHes only being (pause) playful.”

What is the difference? Between scene #1 and #2? In the first scene you forgot that you were talking. Actually, you were thinking aloud. The aloud part was secondary. You were not really conscious that you were talking. You were involved in the situation, not the speech. In scene #2, you were “trying” to talk, “trying” to find the right words to convince Mother, “trying” to get that awful “m” sound out. You were conscious of the act of talking.

In my theory that stuttering is a condition in which there is too much control and consciousness about speaking, these scenes make perfect sense. People who stutter are capable of developing flowing language as they think. It is only when they are thinking about the words they are saying and “trying” to consciously to make speech that they have a problem. “Trying” to talk and allowing your thoughts to flow aloud are two different neurological processes. The first is stuttering, regardless of whether it is perceived by the listener, or covert in nature. The other process is the way most people produce speech, most of the time.

Knowing this, it is possible for each person who stutters to explore what is easier, the conscious act of “trying” to talk, or talking with as little consciousness as possible about how to talk. This exploration will lead to a greater understanding of how fluent speech is naturally created.

Filed Under: dynamic stuttering therapy, therapy approach

Getting to the heart of the problem – why stuttered speech happens

September 5, 2011 By Leave a Comment

Now that summer (at least over here in the the northern hemisphere) is over, life is getting back to normal and I want to get back to my efforts to explore the validity of my theory about stuttering. Central to this theory is my belief that there is interaction between speech planning, beliefs, emotions, and the pre-motor and motor programs involved in speech execution. Speaking is meant to happen automatically, but when there is over control of planning words and how to say them, the result might be feelings of anxiety, as well as the wrong signals being sent to the mouth and vocal folds that need to keep vibrating if the speech is going to flow.

Now the question is can this hypothesis be validated through research? Not being a researcher myself, I was very excited to attend a lecture at the NSA Applied Research Symposium by Dr. Jennifer Kleinow of LaSalle University. Kleinow’ et al.’s research related to Smith and Kelly’s Multi-factorial Model of Stuttering, a model that I have referenced many times. The study she presented was designed to see if something in the internal monitoring system of people who stutter is different than in people who speak fluently. What Dr. Kleinow and her colleagues found is that stutterers showed heightened peaks in looking for errors, regardless of whether an error was actually committed. This supports the vicious cycle hypothesis that says stuttering results from over-monitoring the speech plan.

In addition, Kleinow explained that the part of the brain that tells you to stop and start all over might be the anterior cingulate caudate (ACC). This area is a kind of switchboard between the premotor, linguistic, cognitive, limbic system. It is active during speech production, apparently overactive in some people who stutter.

So here we have some support that stuttering is not just a linear problem of blocks, rate of speech, breathing or voice production. It is most likely a problem of system function and is effected, at least in part, by over control of speech planning. There may be other areas of control as well, but this study related to the monitoring of phonological errors before they happen. It is my hope that learning about this connection might encourage those of you who stutter to be aware that planning what you are going to say gets in the way of what you want – the ability to speak without effort.

Filed Under: dynamic stuttering therapy, fluent speech, nature of stuttering

Mapping a Plan for the Future

July 31, 2011 By Leave a Comment

levelt stuttering modelEarlier this month I attended the Applied Research Symposium: Mapping a Plan for the Future, sponsored by the National Stuttering Association. The purpose of this seminar was not only to advance our understanding of stuttering but also to see how we can apply the findings to treatment for people who stutter. I was happy to have the chance to participate in a dialogue with researchers in the field. It was also very important for me to see if their findings fit into the Dahm Theory. The presentations touched on many aspects of stuttering, including the psychological processes of non-linguistic and language processing, and error-monitoring and motor control. I found it very encouraging that these topics touched upon the factors that I discuss in my model.

Our first speaker was Dr. Nan Bernstein Ratner. She set the tone for the need to look at all these areas as she explained, “We tend to ‘swing’ between trying to find a physical ‘locus’ for stuttering (in the larynx, tongue or brain), or origins in the ‘mind’ (whether by learning, repressed needs, or anticipatory struggle) … without making much effort to build theories that can accommodate aspects of both approaches AND fit within well-attested understanding of normal speech production.”

My theory of stuttering is, of course, an exception; as it does take into account all of these aspects. It also provides some preliminary understanding of how they interconnect as well as showing how to apply research to a practical therapy approach that actually gives people who stutter a way to speak with normal and comfortable fluency.  As research progresses and we learn more about the brain, neuroplasticity, the speech motor system, linguistic processing, monitoring processes and more, I’m certain my theory will be more refined and that the basic premise I am proposing today will become mainstream.

All in all, the symposium left me feeling optimistic that the field of speech pathology is reaching the consensus that stuttering is multifactorial in its nature and needs to be treated as such.

Filed Under: dynamic stuttering therapy

Understanding the Dahm Theory of Stuttering

July 6, 2011 By Leave a Comment

If my theory of stuttering is valid, it must be able to explain the variable nature of stuttering. There are some people who stutter in almost all conversations, but this rare, and even these people do not stutter on every word. Most people have times, or situations during which they report that they don’t stutter. Sometimes people can predict when they will stutter, but sometimes it just seems to happen without any warning.

According to my theory both stuttered and fluent speech is the outcome of the way the brain functions when speaking. Brains are dynamic. Therefore, while there is a preferred neural network for carrying out a specific task, different neural networks can kick in at different times according to the circumstance, health, thoughts and feelings of the person, or environmental cues. Let’s take the task of writing. The letters we see on the paper are the outcome of a neural network that we develop as we learn to form letters to express language, and do this repeatedly. After a while our handwriting becomes automatic and individualized. However, over time it changes. It also changes if we are relaxed/excited, happy/sad, distracted/concentrated, and, according to graphologists, as our personality develops. The same is true of speech. Fluent or stuttered speech is the outcome of a neural network that we develop as we learn to verbally express language, and do this repeatedly.

One of the factors that I believe affects the way the brain functions is the degree of conscious control that the speaker exerts over how to move the mouth to form words. More control equals more stuttering and less control results in better fluency. If you are speaking to myself, to an animal or small child, you are probably not at all concerned about speaking. In fact you might even be oblivious of the fact that you are speaking. What you are doing is simply giving expression to your inner thoughts. You are not thinking at all about talking, let alone trying to be fluent. Here is a situation that will not trigger the control mode of speaking, the mode that helps to create stuttering. Different situations can be linked to different modes of speech production. In later blog, I will explain the neurophysiological speech control network and why it creates stuttering.

Of course, there are people who also stutter in the situations that I’ve mentioned. Maybe they stutter less than when speaking before an audience or telling a joke, but they do report that their speech is not completely fluent. According to my theory, the network may have become so hardwired that even when not trying to control fluency, it is the default program. You might say it is basically the way the brain functions.

I invite all of you who stutter to see if there is a connection between your trying to speak fluently, articulately, or just trying to talk and the degree to which you stutter. When you totally forget that you are speaking, as in swearing or making asides, such as “I-I-I b-b-built a mmmm-mmmm-mmmm (aside: ‘This word is not coming out’) mmmmodel airplane,” do you have some spontaneous fluency? After you look into  this, I invite you to share your experiences. You might just find out why “chasing fluency” is so very unhelpful.

Filed Under: controversy, dynamic stuttering therapy, fluent speech, therapy approach Tagged With:

Throwing Away Speech Tools That Don’t Work Anyway

May 26, 2011 By Leave a Comment

stuttering therapy, online stutter therapy, web stutter therapy, fluent speech techniques

I have received several emails from people looking for quick tips on how to eliminate stuttering. I try to answer each and every email with as much helpful advice as I can give, but I know that I have disappointed the writer when I reply that changing speech from stuttered to fluent involves more than taking a deep breath, speaking slowly or trying to relax in one way or another. People have been trying to do these things for many hundreds of years. They don’t work. Occasionally, at best, techniques such as these can act as a catalyst that starts the person on a process of change. The problem is that in the vast majority of cases, these techniques become the focus of attention and as such, they are not helpful. In fact, they may even cause more frustration, added physical tension, and increase the person’s difficulty in speaking.

We know that speaking is meant to be an automatic and subconscious activity. Nevertheless, people tend to look for some way to control their speech. You can’t learn how to do an automatic activity by trying to find ways to control it. You can’t dance flowingly to the music while you are thinking about how to move your feet; you can’t speak with flowing thoughts while you are thinking how to say the words, take breath, or formulate your language.

The concept that speaking will improve by way of speech controls that are sometime called “speech tools” is deeply ingrained in the human psyche. Even as my clients are experiencing the natural and automatic way of speaking, I see that some of them still want to find a trick to control what they did so automatically.

In answer to all of you who are looking for that elusive fluency trick, I’m going to give you a tip. Take the first step toward speaking fluently. Do as the National Stuttering Association suggests in the title of their newsletter, “Letting Go”. Let go….of your speech controls. Stop looking for a magic trick. Accept that stuttering is not a speech problem. Stuttering is symptom of a malfunctioning system for speaking. Then take step 2: on your own or with the help of a knowledgeable clinician, explore what you can do to get it your system to work in the natural automatic way that it’s meant to work.

 

 

Filed Under: dynamic stuttering therapy, therapy approach

One small step for stuttering therapy

May 23, 2011 By Leave a Comment

Last week I experienced a first for me in the realm of technology. I had been invited to give my first 3-hour online seminar to the Speech Clinicians attending the Mississippi Speech-Language-Hearing Association Convention. The seminar “Treating Stuttering With Confidence” was held last week.

During the seminar, I was able to show slides along with movies and recordings. However, the audience and I could not see one another. While I was not able to converse with the audience during my presentation or afterward, I have received feedback from some of the participants telling me that they enjoyed the presentation. I did miss the interaction that I have when training clinicians via video conferencing and hope that the next time video technology will allow for face time contact. However, it was wonderful to be able to reach so many people from a great distance.

I am always happy to share my experience and the knowledge that I have gained over the years in the field of stuttering. I do not intend to stop treating the people who stutter in the near future. However, I would like more people than I can treat myself to have the opportunity to receive Dynamic Stuttering Therapy from clinicians who understand the importance of helping their clients develop the normal processes for speaking.

 

Filed Under: dynamic stuttering therapy, history, therapy approach

Join Barbara Dahm for an interview on Rusty Mike Radio

May 4, 2011 By Leave a Comment

Barbara Dahm will be joining the Afternoon Schmooze, hosted by Nettie Feldman, this Thursday from 2-4 p.m. Israel time (7-9 a.m. Eastern time) to discuss stuttering and therapy methods.

To listen live, visit the Rusty Mike Radio website at rustymikeradio.com and click Listen Live.

A podcast of the broadcast will also be available afterward – we will share the link as soon as it becomes available.

Filed Under: dynamic stuttering therapy, therapy approach

The Key To A Successful Treatment Experience

April 7, 2011 By Leave a Comment

Do you want to speak with ease and confidence? If you do, read on. You are about to find out how every one of my successful clients has accomplished this. If you learn from this, you will better understand what you need to do to create the automatic and natural way of speaking that you desire.

Successful clients understand that once they learn the new process, they have to repeatedly use it with awareness. They know they are not going to become normally fluent speakers overnight. Speaking in a different way is not something that will instantaneously happen, they make it happen.

In addition, they know that thoughts and actions together determine the habits that they develop. Clients succeed because of the thoughts and the actions that they take. During Stuttering Online Therapy clients are encouraged to think beyond their habitual thoughts. Successful clients are able to give up their fears as they realize that the feeling of fear is related to thoughts connected to the past. They replace old thoughts with new thoughts of joy, ease and comfort that are part of their new way of speaking.

These are three of the basic ingredients to a rewarding therapy experience.

1. The first is to have a clear intent. Focus on your intent i.e. have a clear goal of what you want. You will learn that the energy for speaking comes from the signal that your brain sends to the vocal folds as you focus on the general message that you want your listeners to hear. You will learn that your voice, not words, is the essence of talking. Make your intent the discovery of how to make your own natural voice be heard in a way that is new to you. Dynamic Stuttering Therapy is a goal-oriented therapy that shows you how to produce speech naturally. If your intent is to achieve the goals, you will find that they will become a part of you. If you intend to change, you will make the change.

2. The second ingredient to success is to be proactive. Thinking about what you should do, or knowing what thoughts would be nice to think will not help at all. You have to be the one to take action and make things happen. If you are not doing anything, you will produce nothing. The brain makes new connections through repeated experience doing the same thing. That is why repetitive practice is more important once the goals of therapy have been achieved than it is during the learning stage. Repetition of the process and making sure you do something each day to strengthen the process and create new thoughts is absolutely necessary for long-term success. Action produces results.

3. The final ingredient is to never give up. This is common sense, but unfortunately, too often people give up at the first barrier they encounter when working to achieve their goals. There are even people who go to therapy expecting failure. From the very beginning every mistake, every problem is reinforcement to their existing belief. Successful clients do not focus on and reinforce problems. Instead, they take note of every small change, and attend to how different and pleasant it feels every time they experience giving up the control of how to get words out words. They decide that they can change what they think and what they do and they do not quit until they reach their goals. They know that quitting is a waste of all the effort that was previously exerted. Successful clients see errors and setbacks as opportunities to learn that lead to improved knowledge and ability.

Some people look at how fluently successful clients are speaking and ask me what technique was used. The answer I give is that they became aware of what they needed to change, had the clear intent to change their mind and process and took the initiative to do so.

 

 

 

Filed Under: dynamic stuttering therapy, therapy approach, treatment results Tagged With:

Taking Stuttering Therapy Beyond the Clinic Setting – All About Transfer

February 16, 2011 By Leave a Comment

People who stutter often say that they are able to speak fluently in the clinic, but find that their fluency disappears when they leave. This is a serious problem and I believe the solution lies in rethinking the issue of “transfer.”

One problem in “transfer” is, of course, that people want to transfer fluency. Anyone who has been following my blog knows that I don’t believe that fluency comes and goes by itself.  It is how the person’s brain functions that results in either stuttering or fluent speech. So if you are trying to be fluent and disregarding process, the results will be very disappointing.

Another problem is that people jump too quickly from being able to process speech in a way that results in fluent speech to wanting to use this way of speaking all the time. When I was a young and inexperienced clinician, I used to be happy when clients would say, “This is a wonderful way of speaking, I’m going to speak this way from now on”. Today, I realize that this is unrealistic. It takes time for the brain to accept a new way of functioning. This acceptance happens only after a period repetitive focused intention that enables the network of neurons in the brain that is now firing together to become wired together. When this happens the way of speaking becomes part of the self.

My advice to clients who have learned to process speech normally during our sessions is not to expect that because you know what to do it will happen automatically. Also, I do not want them to go and try to use this process when they are feeling anxiety and trepidation. Instead of going off into life and “trying” to speak this way, I encourage them to use the process alone and in non-threatening situations again and again and again. I want them to use this process of speaking for their own fun and enjoyment. I want them to see the relationship between process and results and I want them to get the sense of how peasant and easy it is to speak this way. As a matter of fact, I tell them not to even think of using it in any situation until they can’t wait to start using it, until it feels like the preferred thing to do. When that happens they will not be trying to do something they fear they cannot do. They will be confidently doing something they love to do. Under this circumstance, transfer will not be a threat it will be a pleasure.

Filed Under: dynamic stuttering therapy, fluent speech, speech control, therapy approach, treatment results

Results Are the Problem with Stuttering Therapy

February 3, 2011 By Leave a Comment

People who stutter can become fluent speakers. However, this will never happen by trying to speak fluently.

This might seem like just one more of the many paradoxes related to stuttering, but it is actually common sense. That is, it is common sense if you are talking about playing tennis, dancing, skateboarding, writing, cooking, constructing a chair, or even a sand castle. In all these activities people understand that there is a way to carry out these activities effectively. They know that results depend upon the process that goes into doing them. When results are not as they want them to be, the natural tendency is to think, “Hmmm… What do I need to do differently?” i.e. feel the music, hold my body differently, add more flavors, cut the wood straighter, etc.

For some reason stuttering doesn’t cause people who stutter and those who would like to help them think with that same kind of logic. Perhaps this is part of human nature because it has been going on for centuries. People seem to want to change speech fluency without considering the process of speaking. They want the speech to be smooth by trying to make the speech smooth. They want to get words out fluently, even though words are not a thing to get out, even if you want to get them out gently. They wonder why a person who stutters can speak fluently when alone, but not in front of a crowd. However, they don’t come to grips with how thoughts directly affect speech production, and they don’t focus on how to change both.

The belief that stuttering is a thing, not the result of a process, is so firmly and indelibly planted in peoples’ minds, that it is hard to accept that stuttering doesn’t come and go. It is not a thing that happens to you. It is a challenge for people to accept that stuttering is the brain using an ineffective network for the activity of producing speech. We know from the latest research that people who stutter use a different brain process for producing speech, but in treating stuttering this fact is so often ignored. People still think that you can change stuttering by changing the speech, i.e. speaking rate, number of pauses, levels of tension, etc. The result is frustration, because these techniques only occasionally and only inadvertently cause changes where changes need to be made – in brain processing.

I know many people will not agree with me when I say that people who stutter can become fluent speakers. This is because these people are focused on results (fluency and stuttering). I have seen again and again that people who stutter can change the way their brain functions to produce speech. It takes time, repetition, changing thoughts and awareness. It is not a quick and easy change, but people who stutter can do it, and when they do, naturally fluent speech is the natural outcome.

The greatest breakthrough for people who stutter comes when they say, “Hmmm.. I blocked on my name today. What was I doing that I can change? What were my thoughts and how can I change them?”

Filed Under: controversy, dynamic stuttering therapy, fluent speech, therapy approach
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