October 22nd, International Stuttering Awareness Day, is fast approaching and the countdown is being celebrated in the form of the ISAD Conference, A VOICE AND SOMETHING TO SAY, that began on October 1st. I have found the papers extremely interesting, so if you haven’t already joined in, I highly recommend that you do. Judy Kuster, the conference chair, once again deserves deep gratitude for putting together a conference that is very interesting and informative to professionals, people who stutter and anyone who wants to know more about stuttering. Kudos to Judy!
I have to admit that I still haven’t read all the papers yet, but before I do, I want to bring to your attention two that I found to be especially meaningful, because they put us in the direction of greater light and clarity in understanding how to treat stuttering. First, A preliminary survey of vocal tract characteristics during stuttering: implications for therapy by Anelise Junqueira Bohnen from Brazil points out some of the laryngeal characteristics that can be seen better internally with a flexible fiber optic laryngoscope than externally by the observer. She even links to YouTube videos of the vocal folds. If you have never watched vocal folds in action, you will find these videos very fascinating. I think it would have been nice to watch a side-by-side video of a fluent speaker saying the same sentence, because it would have made the differences in functioning clearer. Nonetheless, her study shows that there are indeed differences in laryngeal function.
Of course, we have to be careful not to infer that laryngeal differences are the only important feature of stuttering. I am hopeful that more research will be done that will investigate the interaction of the laryngeal function with the functioning of the articulators, and the interaction of the articulators and larynx with language planning and the thoughts and feelings of the speaker.
This brings me to the second paper that I want to bring to your attention, What is stuttering: Revisited by Eric Jackson, Robert Quesal, and J. Scott Yaruss from New York, Illinois, and Pennsylvania. This paper gives me hope that the perspective that I have been purporting since 1993 when I gave my first talk at the Oxford Dysfluency Conference will finally enter the mainstream. In 1993 I said that the definition of stuttering should not be based on a description of the speech produced …i.e. repetitions or prolongations of speech sounds, physical blocks or hesitations in the flow of speech. At the time, I suggested that stuttering is a condition in which the speaker distorts one or more of the processes involved in the planning and production of speech. At the time, one of the leaders in the field Hugo Gregory congratulated me on my presentation, but warned me that my ideas would not be accepted in our lifetime. Hugo who passed away in 2004 was partially right, but I am pleased to be here in 2012 and read that leaders in the field are suggesting the following definition:
“Stuttering is a neurobiological lack of integration of the underlying processes of planning and producing language and speech that, upon verbal execution, can lead to interruptions in the acoustic speech signal (e.g., blocks, part-word repetitions, disfluencies) and physical struggle (e.g., tension). These surface behaviors may not be present, however, when the speaker exhibits communicative avoidance (e.g., circumlocutions, fillers). The underlying features may lead to surface behaviors, as well as emotional and cognitive reactions. Depending on the individual, these may result in significant difficulties in communication and an adverse impact on the speaker’s quality of life. The physical symptoms, emotional and cognitive reactions, and impact on the speaker’s life all comprise the disorder of stuttering.”
This definition may still need to be tweaked and refined, but it is a definite shift from the usual definition that focuses on the speech that has been produced. Some people may still disagree with this shift in perspective, but I believe that now that professors are suggesting it, acceptance will come at a much quicker pace. This will influence the direction of research in the future. It will also impact the way people will approach the treatment of stuttering. It is very possible that more people will want to explore a therapy model that has already been successful in treating the integration of the underlying processes of planning and production of language and speech. This model is called Dynamic Stuttering Therapy.