Tuesday, February 16, 2010

Engaging Norbert in Semantics

In a previous thread you criticised Jane Fraser for saying that Early Intervention (EI) can prevent stuttering. You then quoted the Packman research about how *some* children relapse after Lidcombe therapy as proof that what she said was incorrect. This is either a strawman or you seem not to have grasped that all we are saying is that EI *can* prevent stuttering. It's not a guarantee, and no-one has ever said it was a guarantee.
For me, "can" is equivalent to "is able to" and applies a strong causality and certainty. The sentence "EI can prevent stuttering" reads to me as "EI has the ability to prevent childhood stuttering to become adult stuttering." What you really want to say is "EI may prevent adult stuttering in kids who stutter", which I also disagree but I am less certain. Even if you insist on your interpretation of the sentence, I do not share this interpretation and I would not be surprised that my parents and other concerned parties read the sentence as "If you have (well-administered) EI, my child will stop stuttering forever." It is your responsibility to come up with a sentence that is crystal clear as to the meaning you want to convey, because you communicate to
everyone and you do not want to mislead. The word "may" is crystal clear as to no guarantee but the word "can" is much softer. Compare the sentence "EI can prevent stuttering. Therefore there is no guarantee." to "EI may prevent stuttering. Therefore there is no guarantee." In the first example, the second sentence does not seem to follow logically from the first one. I am not a native speaker, so I might be wrong.

The second issue is the expression "prevent stuttering". Preventing means to avoid something from happening that would have happened other wise. Therefore, in those kids who would have naturally recovered anyway, EI cannot prevent stuttering because they would not have become adult stutterers anyway. And for the minority, 20% or less, you can make the statement "EI can prevent stuttering" but only if it does, of course. And here we need to know what is meant by stuttering. Overt symptoms, no jams in the brain, no neurological deficit? Even the statement "EI can prevent overt symptoms" is problematic as it applies that in some cases EI has prevents all overt symptoms. Now, that might be possible for some cases. But it is hard to know for sure. The statement "EI can prevent the neurological deficit" is wrong, definitely for the genetics subgroup.
EI is not something medical or magical that's 'done' to the child. EI is something through which therapists can aid the child in their natural recovery. Natural recovery can mean either a normal recovery which may or may not have happened in any case; or it can mean helping the child to develop ways in which they can circumvent the restrictions imposed by nature.
Fine. I agree in the sense that what you say makes theoretical sense, except that an intervention is not a natural recovery for me. Now, how effective such an intervention in the real world is, i.e. whether it is possible to help many kids in a significant way. That's a different question, which is difficult to answer due to the natural recovery fog. Many factors play a role: do the parents practise with the kids, does the kid want to practise, is it ill and cannot practise, and so on...
I believe there has recently been some research indicating that children who have recovered from dysfluency can still show dysfluent brain activation patterns. Somehow, with these abnormal brain activation patters, they can produce fluent speech.
Yes, recovered kids seem to show structural abnormalities, but it might not be the same ones than in adult stutterer. Might just explain that they have different speech area organisation that takes longer to learn speech.

But guess what – I don't *know* these things; I *know* this is speculation, in the same way that you apparently *know* what Jane Fraser or the BSA mean when we say that EI can prevent stammering.
Again I say that it's her and your responsibility to be very clear on statements and not even give morons like myself the opportunity for misinterpretation!


Ora said...

Tom - In response to your point on English semantics...

As a native speaker of English, I agree with you that there is potential ambiguity in the phrase The standard interpretation is "EI is always able to prevent stuttering". But you're right that it might also be understood to mean "EI can sometimes prevent stuttering" or "EI offers the possibility (not the certainty) of preventing stuttering in some cases".

Norbert will have to tell you which he intended. But I agree with you that the sentence itself is subject to multiple interpretations.

Norbert @ BSA said...

Well, now I've seen it all, two Germans arguing English semantics.

Seeing how you take apart my statement I wonder how we would ever manage to say anything at all.

You're right that we should make statements that are meaningful and generally understood in the right way. But in my own, admittedly limited experience of 18 years at the BSA, I've yet to come across *anyone* who took the statement that EI *can* prevent a lifetime of stammering to mean it is guaranteed that it *will* prevent a lifetime of stammering. Would be lovely if we were able to say that with confidence,and then the statement would read "EI prevents a lifetime of stammering".

Seeing that in 18 years you are the very first person ever to raise this as an issue, I'd say we're doing a fairly good job about communicating our view of EI.

Norbert @ BSA said...


you say "
Norbert will have to tell you which he intended." - I have made it clear many times over which version is intended. I'd be most surprised if you found *any* BSA publication that has ever said that EI is a guaranteed treatment for stammering.

Ora said...


My intention was to address the narrow question of English usage that Tom raised, since he seemed to have some uncertainty as a non-native English speaker. I didn't intend to express an opinion or imply anything about the larger issue. (Maybe I was naive to imagine I could make a narrow comment, outside of the overall context of the discussion.)

Who are the two Germans you're referring to?

Norbert @ BSA said...

"Who are the two Germans you're referring to?"

Let's just say neither Tom nor me are native speakers.... :-)

Anonymous said...

Pretty nice blog you've got here. Thanx for it. I like such themes and everything connected to this matter. I definitely want to read a bit more on that blog soon.

Best wishes

Tom Weidig said...

Hi anonym,

you can also read the older posts. Some are timeless! ;-)

Best wishes,

How do you know no-one else received it in this way?

Why don't you write "may" which would make it much clearer?

Again, the research findings does not justify such a statement in my opinion.


Norbert @ BSA said...

"How do you know no-one else received it in this way?"

Because in 18 years not one parent has ever come back to me to say "You told me if I took my child to therapy he would be cured and now he isn't". And in 18 years, not a single therapist has come to us and said "you told this parent that EI is a guaranteed success and now they're blaming me because it is not working." That's why.

I don't use 'may' because I don't believe it makes it any clearer. Because I believe your view of the meaning of the word 'can' as "to be able to" is, IMHO, influenced by the usage of "können" in German. 'May' has connotations of 'being allowed' that does not fit here and does not add clarity. Anyhow, you weren't too happy with the phrase that EI may prevent stammering, so I'm not sure changing this word would really assuage your concerns.

We disagree on the outcomes and success of EI. One of the reasons is that I believe your attitude to bias re natural recovery in the samples is unreasonable. Another is the fact that I value clinical evidence. But that's something for another discussion.

Ora said...

"Let's just say neither Tom nor me are native speakers.... :-)"

Right, I forgot. ... although not sure what our luxemburger Freund will think of being called German. :)

Anonymous said...

Jane Fraser gave her 3 year old grandson early intervention and it worked.

Anonymous said...

According to the Philadelphia Inquirer, she read her 3 year old a book with a lot of rhymes in and his stuttering stopped.

Anonymous said...

Malcom Fraser gave Jane Fraser early intervention and it worked.