Shmulik’s story – stuttering “no longer an issue”
May 31, 2010 By View Comments
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
May 31, 2010 By View Comments
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
March 17, 2010 By View Comments
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
January 11, 2010 By View Comments
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
December 10, 2009 By View Comments
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
October 27, 2009 By View Comments
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.
The Evolution of Dynamic Stuttering Therapy
September 8, 2009 By View Comments
Over 20 years ago, I decided to devote all my time and effort as a Speech Clinician to one specific communication disorder – stuttering. It was then that I resigned as a public school speech therapist and opened Communication Therapy Institute. In the early years, I administered a fluency-shaping program in an intensive 3-week group format. At the time this was considered to be the most successful stuttering program available and I intended to do this kind of therapy for years to come. However, after about 4 years of trying to stick to the procedures and goals of fluency shaping as I had learned them, I began to realize that this approach did not take into account many of the aspects of stuttering that I was discovering. So, with care, I gradually made small changes that grew into big changes and evolved into an entirely different way of looking at and treating stuttering.
In 1993, the idea that stuttering was the result of a malfunctioning speech generating system was clear enough to me to write about it and to present it to my colleagues at The 3rd International Dysfluency Conference in Oxford, England. I also decided to write my program in the form of a Workbook and Clinician’s Guide. It was published in 1997 under the name Generating Fluent Speech: A Comprehensive Speech Processing Approach.
During the ensuing years my staff and I continued to treat clients while carefully observing what they did when speaking, how they felt, what they thought and how they were able to speak in the short and long term. Just when I thought I really understood how stuttering and fluent speech was created, the whole process of speaking became even clearer. As this happened, I made changes in therapy procedures. Instructions, activities and even the delivery model were changed. Sticking to my goal of making therapy as simple and effective as possible, I rewrote the workbook that was published in 2007 as Dynamic Stuttering Therapy.
Today we treat people who stutter of all ages. We still believe that the best delivery model when possible is intensive treatment, at least until the person is able to use and reinforce the process between therapy sessions. From then on some clients are able to continue independently, while others require more direct support from the clinician. We no longer do group therapy as we have decided that we prefer to give each client our undivided attention during the learning process. We do, however, recommend group practice and participation in support groups for clients who would benefit from a group atmosphere.
Our mortar and brick clinic continues to receive clients in New Jersey, USA and in Israel. In addition, we are making the same outstanding and effective treatment approach available to people all over the world via video conferencing.
All clients are treated according to the principles of the speech processing approach, the process of change, and the principles of developing new networks for neurological functions on which Dynamic Stuttering Therapy is based. We do not administer this therapy approach because we are loyal to the program. We administer this therapy approach because we are dedicated to our clients and we have seen that beyond doubt Dynamic Stuttering Therapy is the most up to date, most logical, practical and effective treatment for stuttering.
Welcome to The Dynamic Stuttering Therapy blog
August 21, 2009 By View Comments
Welcome to The Dynamic Stuttering Therapy blog. Here I will tell you my views of what stuttering is and the best way to treat it. My journey toward understanding stuttering has been a long one. Like many of you, I’ve hit blind alleys and dead ends as I looked for ways for overcoming stuttering. The first time that I ever had a person who stutters come to me for therapy was over 40 years ago when I first began working as a Speech Clinician. As an undergraduate, I had been taught that stuttering was a problem of personality dynamics. It sounded good, but I had no idea of how to change someone’s personality, so I looked to the textbooks for advice and in the meantime received a Master Degree from Boston University. I tried everything: stuttering modification, desensitization, airflow, Gestalt therapy, fluency shaping and more. Unfortunately, I did not find that any of these approaches were the solution my clients’ desire to speak normally. During these years I met some people who were devastated because they stuttered. Although, at the time, I did not know how to successfully treat stuttering, I could not accept the common belief that my role as a clinician was to help my clients learn to live with stuttering. I became determined to find a way to help people who stutter speak freely. For the past 20 plus years that has been one of the main priorities in my life.
Today, I am a Board Recognized Specialist in Fluency Disorders. I have treated well over 2000 people who stutter of all ages. I realized many years ago that stuttering had many facets that had to be related. This lead me to look at it as a problem of how the speech production system functions. Through the years, with the help of my clients, researchers, other professionals in many fields, a bit of optimistic stubbornness, and faith, I am happy to say that I have unraveled many of the mysteries related to stuttering. Now when people come to me because they stutter, I do not have to guess what goals they need to achieve. Therapy is not a question of trial and error. I know for a fact that stuttering is treatable, and I can clearly see the cause and effect relationship between how the speech system functions and the ability to make both stuttered and fluent speech.
Today I am able to help people who stutter discover that they are capable of speaking fluently with ease and comfort. I have the joy of watching so many of my clients gain confidence and enjoy speaking. I know I am looking at stuttering from a different perspective than most people. It is the perspective you will read about on my blog. I think you will find it enlightening. I look forward to your comments and hope you will enjoy mine.