Thursday, October 22, 2009

PRESS RELEASE

This press release went out to all the Luxembourg media outlets, parent associations, and a few ministries to set the record straight on causes and treatment of stuttering after the misinformed interview of Hild and Hermes. It took me nearly two days to get everyone on board and to have a common press release text. Big thanks to Prof Ratner (for feedback and encouragement), the British Stammering Association (especially to Norbert Lieckfeldt for encouragement, the first draft and feedback), Prof Neuman, Prof Euler, the German Stuttering Association (Beate Schwittay), the Swedish Association (Anita Blom), and last but not least ELSA (Edwin Farr).


PRESS RELEASE (original version) October 22nd, 2009

Response by international stuttering associations and world-leading university professors to statements made on the causes and treatment of stuttering attributed to Georges Hermes, Director of the Centre de Logopédie, and Jean Marc Hild, the Head of the Service Audiophonologique in Luxembourg.

Today is International Stuttering Awareness Day. Like most communication disabilities, stuttering is generally not well understood by the general public, and there are many myths and prejudices. 
We are surprised to read, in the Luxembourg Tageblatt on October 21st, reports of the views of the Director of the Centre de Logopédie, Georges Hermes, and the Head of the Service Audiophonologique, Jean Marc Hild, on the causes of stuttering, and what treatments are available. We feel compelled to reply, because these views, if reported correctly, are rather eccentric, and at odds with research findings of the last decade and more.
Mr Hermes appears to assert in the article that a cause of stuttering is "fast immer in der Psyche zu suchen" which is demonstrably incorrect. Stuttering starts in very young children - and these children are, at least initially, utterly unaware that they stammer and have no emotions or feelings about it. It is undeniably true that persistent stuttering can have a long-term detrimental psychological impact but the root cause of stuttering is physical - it is a childhood developmental disorder, a symptom that the brain's neural circuits for speech are not being wired normally.
Equally, the distinction between three different causes of stuttering is problematic. Mr Hermes suggests that the most prominent cause of stuttering is "Ausdruck eines traumatischen Erlebnisses über Schock oder negative Erlebnisse über einen längeren Zeitraum" and yet, earlier, he relates the story of the parent telling him the child stutters because he got frightened in the cellar. Mr Hermes correctly identifies the event as a possible trigger for stuttering that would have emerged anyway, not as a cause.
As a second possible cause, Mr Hermes identifies "Stotterer nachahmen und nicht mehr hinausfinden". There is no scientific evidence for this statement. In almost all cases where stuttering begins in childhood, there is no other person who stutters in the child's environment. Stuttering simply cannot be acquired by imitation.
He correctly identifies that stuttering starts as the child develops language skills "beim Entwickeln der Sprachkompetenz" but dismisses this as unimportant, because according to him it is a type of stuttering that always resolves itself. While it is true that the majority of pre-school children who experience a dysfluent phase in the course of language development will recover naturally, a minority will not and are at risk of developing a lifelong, chronic stammering problem without prompt and early intervention. Critically, while we know some risk factors for persistent stuttering, we cannot predict individual children’s outcomes.
Mr Hild seems to suggest a focus on avoidance behaviour and tricks ("Das kann ein Klopfen auf das Knie sein oder Schnippen“) in treating adults, an approach that has not been practiced by experienced and skilled therapists outside Luxembourg for decades, as such methods are notoriously ineffective. We worry what kinds of therapies are offered to children and adults based on the assumption that the root cause of their stuttering is psychological and based on long-term response to trauma.
We know that the cause of stuttering is not psychological but physical: see, for example, Büchel and Sommer (2004) What Causes Stuttering? (free access on www.plosbiology.org). We know that early intervention, as soon as possible after onset, has the best chance to result in full recovery. There are therapy approaches that will help the child to recover normal fluency and avoid the psychological impact of stuttering in later life. And there also exists more effective adult treatment than what is described in the article.

Note: The authors either represent international stuttering associations or are world-leading university professors researching stuttering. Please feel free to contact any of them. (Or the coordinator of the press release: Dr Tom Weidig, tom.weidig@gmail.com, 621 432263, 2684 5033.)

Prof. Nan Ratner, Chairman of Department of Hearing and Speech Sciences, University of Maryland, author of the most cited reference The Handbook of Stuttering. Cengage/Thomson Learning, 2008.
+1 301-405-4213 nratner@hesp.umd.edu

Prof. med. Katrin Neumann, Goethe Universität Frankfurt, Leiterin Schwerpunkt Phoniatrie und Pädaudiologie, and author of brain imaging studies of the stuttering brain.
+49 (69) 6301-5775 katrin.neumann@kgu.de

Prof. Harald A. Euler, Professor für Psychologie, Uni Kassel, author of outcome studies on stuttering treatment
49 561-804-3577 euler@uni-kassel.de

Beate Schwitta, Geschäftsleiterin der Bundesvereinigung Stotterselbsthilfe e.V.
+49 221-139 11 06 schwittay@bvss.de

Norbert Lieckfeldt, Chief Executive Officer at the British Stammering Association
+44 20 8983 1003 nl@stammering.org www.stammering.org

Anita S. Blom, Chair of the Swedish Stuttering Association
+46-70-5223916 anitablom@telia.com

Edwin J Farr MBE, Chair of European League of Stuttering Associations
+ 44 7860609279 elsa.europe@totalise.co.uk www.elsa.info