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‘Your patience and knowledge was just a miracle for our son!’

We’ve added some recent testimonials to the site – we hope you’ll enjoy reading the successes patients and participants in Dynamic Stuttering Therapy have achieved. We’re very proud of each of them and what they have accomplished.

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

Whose Fault, part II

In part 1 of Whose Fault, I said that a major cause for the failure of stuttering treatment is a lack of knowledge of how to treat it. That is pretty amazing in the 21st century when so many advances have been made in the treatment of very complicated diseases, and innovative behavioral programs are abundant and often very successful. Our knowledge of biology, physiology, neurology, genetics, physics, and even human behavior has taken giant steps. However, mainstream stuttering therapy has remained pretty much the same, albeit with some refinements, for the past 80 years. We have learned a lot about the nature of stuttering from clinical observations and research, but this knowledge has not been incorporated in how stuttering is treated.

This leads me to what I believe is another major cause for the failure of treatment. There is a tendency on the part of professionals to become so rooted in a treatment approach or a theoretical belief about stuttering that they do not apply research findings and knowledge to treatment. Their prejudices and emotional investment in their work block them from being open to new ideas.

I recently searched for a title for a seminar that I will be presenting to clinicians. I chose Treating Stuttering With Confidence: A New and Logical Approach. “New” that word should no longer be appropriate. It has been almost 20 years since I gave my 1st presentation in Oxford, England in which I said that stuttering can be explained and treated through an understanding of the process of speaking. The presentation was well accepted, even though we still had so much to learn about the differences in brain function and motor processing of people who speak fluently and those who stutter. In spite of the initial enthusiasm of my colleagues, as the research backed my theories and as the clear-cut cause and effect relationship between internal processes used to produce speech and the fluency of the speech became apparent, I saw a growing resistance from my colleagues.

Interestingly, I found a correlation between clients, including young children, telling me this approach to therapy “rocks” and that Dynamic Stuttering Therapy is the most logical therapy they have ever had, and professionals telling me they don’t understand what I’m getting at or just being too busy to review my materials. I do not take this resistance personally, because I don’t think that it is related specifically to the approach or to me. I do think that the inability to change perspective stems from a very human condition – resistance to change.

While understandable, professionals are at fault for not overcoming this resistance. We ask our clients to put their feelings and beliefs into perspective and overcome their fear of the unknown. It is also our responsibility to do this. The time has come to let go of the arguments of whether clients should work on fluency or accept stuttering. Calling fluency the “f-word” as I have heard fluency experts do is not helpful. It is demagogic. The affiliation by professionals with a theoretical camp should to be abandoned. All voices should be heard and minds should be open. Professionals need to work together. We need to brainstorm. We need to put our heads together to make sense of stuttering and to insure that clients do not suffer disappointment from our efforts to treat them.

Some people who stutter that have had disappointing and frustrating therapy experiences are angry with clinicians in general. They think that clinicians are taking advantage of them and don’t care about them. In all my contacts with my colleagues, I have not seen that this is the case. I see that clinicians are concerned with their clients’ wellbeing and believe they are helping people by sticking to their belief. Nevertheless, the lack of progress and being closed to new ideas is hurting these clients who we care about. We, as professionals, owe it to our clients to make therapy the most rewarding experience possible. If not, it is our fault.

Ariel’s story – a client before and after stuttering therapy

Shmulik’s story – stuttering “no longer an issue”

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

Gil’s story – before and after stuttering therapy with a client

At Stuttering Online Therapy, we see firsthand the progress our clients make, but we love it when our clients are happy to speak for themselves.

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.

Stuttering and brain plasticity – how learning changes your brain

As we learn more about stuttering, we are seeing increasing evidence that stuttering is related to the workings of the brain. If stuttering proves to be a genetic disorder or a neurological problem related to how the brain processes speech production, many people question what the point is of having therapy?

Once it was believed that the brain was hard wired. People thought that once the brain developed, there was no possibility of making changes. Today neuroscientists believe that this is not true. There have been many studies on brain plasticity, the capacity of the brain to change by developing new connections between neurons resulting in changes of the internal structure of the existing synapses.

We are all born with a specific genetic makeup that determines our tendencies. Musical tendencies, language abilities, handedness, and mathematical ability, among countless others are influenced by our genetic make up. However, when we engage in a specific activity to the point of becoming expert, the areas in your brain that deal with this type of skill have been shown to change.

Other evidence that the processes that produce stuttered speech are not so hard wired that they cannot be changed comes from a lot anecdotal evidence in which people who have once stuttered appear to be naturally fluent speakers and from our clients who report that stuttering is no longer an issue in their life. This is proof that the same person can produce speech differently at different times in his life.

During Dynamic Stuttering Therapy people who stutter learn to use the normal processes of producing speech. They begin therapy thinking that what they do is the only thing they can do, but soon see that it is indeed possible to produce speech in a way that is so very different. If it weren’t possible to change their way of producing speech, we would not see this happen. No matter what the cause of stuttering proves to be, change is possible and treatment can help people who stutter to make the necessary changes.

Schedule your consultation for our New Jersey clinic today

Barbara Dahm will be available for therapy sessions and initial consultations beginning in February at The Ridgewood Speech and Language Center in Midland Park and Tender Touch Therapy in Lakewood, New Jersey. Clients beginning therapy will be able to continue treatment via the web.

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 until Jan. 28 and 201-873-2093 after Jan. 28.

Barbara will also be part of a roundtable discussion at the American Speech-Language Hearing Association Conference on Unique Challenges and Common Themes in Stuttering Assessment, Treatment, and Research, which begins on Jan. 29 in Tampa, Fla.

The Issue of Control

In my next few blog posts, I want to talk about the issue of control. People who stutter sometimes feel a loss of control when they are speaking. Their tongue or lips may go to places where they are not meant to be; their larynx may tighten uncontrollably; they feel like they cannot breathe and experience involuntary blocks. This certainly seems like a lack of control, because all these symptoms of stuttering occur without the speaker’s control. However, this does not mean that the speaker does not have control. I will argue that these unwanted symptoms occur because the speaker is exerting too much control in the central processing of speech.

Those of you, who have followed my writings, have heard me say that, according to psycholinguistic experts, speaking must be an automatic process. Automaticity is the requirement for fluent speech. The development of language happens automatically without thinking about the words. Controlling the choice of words, preplanning and scanning ahead is not part of normal speech production.

If you are a person who stutters, when do you stutter most? Is it when you forget that you are speaking or when you try to control your speech so that you will not stutter? We know that many people stutter less when they are alone, caring less about stuttering and taking less control over speaking.

Thinking about words is one form of control. Another is trying to control how you say the words. This involves using a controlled motor program. Sometimes the control of muscle movements is conscious, but at other times the control is subconscious. Many motor programs can be carried out on either a controlled mode or in an automatic mode. Automatic programming is always more efficient, more stable and faster than controlled programming.

Let’s take a minute to experience the difference between controlled and automatic programming. For an example, we can use the movement of the eyelids. Purposefully open and close your eyelids. When you do this you are using a controlled movement program. Do the movements feel heavier, more labored and slower than those automatic movements of your lids that occur throughout the day?

The same difference can occur regarding the speech muscles. We know that in order to speak theses muscles must also move with light, extremely rapid and miniscule movements. This requires the automatic mode. When control is used, muscle movement becomes more labored and, often, muscle groups not normally used to speak are activated. The fluid movement of speaking is compromised and the stuttering symptoms so often associated with lack of control happen because the program used to process speech is one that involves too much control.

These Are Our Clients

The people who come to CTI for treatment reflect the character of the stuttering community. They are of all ages, cultures, economic status, professions, levels of intelligence or any other criteria you could think of. We do have more male than female clients. This would be expected, because there are about 4-5 times more males than females who stutter. There is, however, a common denominator among all our clients. They all are processing speech with too much control and effort, and they all have the potential to change the way they speak.

When CTI began over 20 years ago, we treated only older children and adults, but as we gained a greater understanding of the speech production system, we were able to adjust the therapy procedures so that the therapy was also suitable to very young children. Now in our mortar and brick clinic, we have treated people from ages 3 to over 70.

At stuttering online, we treat people from the age of 14 – adult. Although the therapy goals would benefit anyone who stutters, we do not yet have the computer software that would be appropriate for younger children. During online therapy we use the Dynamic Stuttering Therapy Workbook. This book was written for teens and adults.

Although we do not actually treat children online, we do consult with parents so that they can help their child develop the normal processes for speaking. We also offer consultations to SLPs who would like to use the speech processing approach with their clients.

Stuttering severity is not a consideration for determining suitability for Dynamic Stuttering Therapy. We treat people who are in the 99th percentile for stuttering severity, people who stutter very mildly and at all levels of severity in between. Dynamic Stuttering Therapy is also highly recommended for people who have been described as “covert stutterers”. By this, we mean that their struggle to speak is internal and not usually perceived by listeners. The person who stutters covertly is not using the normal processes for producing speech and often has a great fear of being “found out”. Since Dynamic Stuttering Therapy does not focus on the stuttered speech, treating people who stutter covertly is in essence the same as treating those who stutter overtly and every bit as beneficial.

Past Client 11 Years Later