Hit a hornet nest

I seem to have hit on a hornet nest, as they swarm out for a few attacks in defence of Bodehamer:

To denigrate the work of someone who has such success because you don't agree with it, is both unkind and unprofessional, and only contributes to the tension in the stuttering community at large.

(a) I denigrate his statements on the causes of stuttering, because he does not change them in the face of obvious and clear evidence to the contrary.
(b) I do not denigrate his desire to help and do not say that he has not helped some people.
(c) not "I" don't agree, but a lot of scientific articles and researchers don't agree with him.
(d) What is professional? To stay silent on the scientific non-sense he is propagating?
(e) What you can call "tension" is what I call an open intellectual debate with the demand for consistency with established science.

His views are religious. He and his followers want to believe, and arrange their world view around. Why does Bodenhamer not change his views despite clear empirical and theoretical arguments? Because he has the mind set of a believer of an unenlightened type. Maybe we should also ask Bob Bodenhamer whether he believes the earth was created a few thousand years ago? Does he deny evolution? Does he believe in a personal God that actively intervenes in our life and is not just a creator?

Given his state of mind on stuttering, I would not be surprised if he ignores empirical evidence here, too.

Bodenhamer: Second reply

I have come to the conclusion that he communicates and thinks in a style that is optimized for creating growth and positive change for stutterers, rather than in a style that is optimized for academic discourse or even "truth", whatever that is. As someone with an engineering degree from an Ivy League school I know what academics consider "truth", but I reject the idea that it is the be all and end all for advancing the lives of stutterers.

You are constructing a straw man here, because I never said that it is the be all and end all for advancing the lives of stutterers. I have explicitly criticised his causal theories on stuttering. I have nothing against him creating growth and positive change for stutterers. You can do this without knowing anything about stuttering.

Bodenhamer: First reply

 Several readers have left comments to which I would like to reply:

Explain to me why some people stutter on the same set of words in some situations and are fluent in others.

 It is not relevant whether I can give an explanation or not. I say that his statements are wrong, and I give evidence from brain imaging and genetics. You have not disproved my arguments.

Even though my explanation is not relevant to the debate, I will give it nevertheless. There is a neurobiological instability in the brain of people who stutter, unlike in fluent brains. This makes the speech system very sensitive to breakdowns at high demands. My theory is that

(a) some situations are more demanding that others. Maybe the person had a bad day, more stress, is ill, or just feels anxiety in the current situations. Moreover, in some situations our brain is much busier formulating our message and filtering out stuff.

All these things modulate the capacity of the sensitive speech system, and leads to block.

Pagoclone rumours

Here are good old rumours:

The Pagoclone study ended and they did not continue the study. They will be making a decision in December, I think, whether there was enough benefit to a sub-group of the trial study (meaning there was not a benefit to everyone in the study but definite benefit to some)  to justify continuing on with the drug.  My trial administrator in Atlanta said he saw definite benefit to a sub-group and he is still positive on the drug.

Please support Beth's research project!

Beth Harris asks for your support:

I’m a 4th year speech and language therapy student from De Montfort University, Leicester, UK. I’m doing research for my final year project on how often stuttering occurs alongside abnormal involuntary movements. Due to your position within the stuttering community, I was wondering if you could post a link?

The questionnaire has been granted ethical approval by the ethics committee at my University. Everything is anonymous and takes only five minutes to fill out.

This is the questionnaire.

Deconstructing Bodenhamer

The NLP stuttering guru Bob Bodenhamer writes on his website:

The cause: There could be several causes for blocking including genetic predispositions and/or developmental problems. However, our concern is not primarily about the first cause of blocking. Our concern is with what has continued the behavior. We believe that it is the meanings placed around those early experiences of struggling to speak that have become well learned which continues the behavior. This explains how most children grow out of stuttering while some don't - it is about the meanings that the child placed around the behavior. The question then becomes: was it "OK" for the child to stutter some or was it pointed out as unacceptable behavior? Click on the link "How It Works" for many articles depicting our beliefs about blocking as well as those of others.

He has completely misunderstood the nature of stuttering, and he keeps on spreading his pseudo-scientific babble. Had he actually read through several text books, he would realize his arrogant confidence and naivety on causes. So let me explain to him what is actually going on.

There could be several causes for blocking including genetic predispositions and/or developmental problems. However, our concern is not primarily about the first cause of blocking. Our concern is with what has continued the behavior.

He seems to be of the opinion that genetics or developmental problems are causing the first blocking and then magically disappear. That is clearly not the case as brain imaging studies show. Moreover, mutations in genes are present in the body until death. There is a neurobiological basis that is present in all adults who stutter. What has continued the behaviour is the neurobiological basis due to genetics or unresolved developmental issues.

We believe that it is the meanings placed around those early experiences of struggling to speak that have become well learned which continues the behavior. This explains how most children grow out of stuttering while some don't - it is about the meanings that the child placed around the behavior.

That is complete non-sense. For example, more girls than boys recover. Is he therefore saying that more girls recover because they place LESS meaning on blocks? That is just ridiculous. If anything, I would expect girls to be more susceptible to social pressure.

He falls into the fallacy that a theory that makes sense is actually true.

Here is what he should write. Stuttering has a neurobiological basis due to genetics and/or neurological developmental issues. On top of this, every person who stutters has a psychosocial adaptation to this neurobiological propensity to block. I am offering advice on how to change psychosocial maladaptation, which can reduce psychosocial stress and by consequence also reduce the severity and frequency of stuttering.

Yet more evidence for strong heritability from twin studies

Fagnani, Fibiger, and al. have just published a twin study using a database of over thirty thousand twins. Their findings are consistent with past twin study results (see on old post of mine on the Dworzynski study). They find a high heritability of 80%, and only moderate unique environmental effects. Note that they do not mention shared environmental effects.

This finding fits my view on stuttering. Genetics drives the onset of stuttering in many people. The other factors (alone or in combination with genetics) are internal developmental issues caused by unique environmental events like neurological incident, virus and head trauma. Only some of these events were reported in the twin study, so the effort is measured as moderate. Needless to say that, as in many other conditions, the social environment plays a negligible role in the actual onset.

Here is the abstract:

Heritability and environmental effects for self-reported periods with stuttering: A twin study from Denmark.

Fagnani C, Fibiger S, Skytthe A, Hjelmborg JV.

National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.

Abstract

Abstract Genetic influence for stuttering was studied based on adult self-reporting. Using nation-wide questionnaire answers from 33,317 Danish twins, a univariate biometric analysis based on the liability threshold model was performed in order to estimate the heritability of stuttering. The self-reported incidences for stuttering were from less than 4% for females to near 9% for males. Both probandwise concordance rate and tetrachoric correlation were substantially higher for monozygotic compared to dizygotic pairs, indicating substantial genetic influence on individual liability. Univariate biometric analyses showed that additive genetic and unique environmental factors best explained the observed concordance patterns. Heritability estimates for males/females were 0.84/0.81. Moderate unique environmental effects were also found.

Had I participated in the Pagaclone trial

Over the last months, I felt that my fluency has improved. I recently realized that had I participated in the Pagoclone trials, I would be written:

Hey guys, I took part in the trial months ago, and I noticed that my fluency has improved. Pagoclone is definitely working for me. I think you should try it out. But of course I am not saying that it works for all.

Workshop on Brain Speech Processes

The Society for Neurosciences organized a workshop on COMMUNICATION ENGAGES COMPLEX BRAIN CIRCUITRY AND PROCESSES: see pdf file.

Research released today shows that:

• The network of brain connections vital to understanding language is more extensive than previously thought. Researchers identified new speech-related pathways by mapping language areas in the brains of people with and without language difficulties (Nina Dronkers, PhD, abstract 837.13, see attached summary).

• People who stutter show abnormal brain activity even when reading or listening, which suggests stuttering is due to problems in speech processing, not just production (Kate Watkins, PhD, abstract 563.19, see attached summary).

• People process words spoken in their native accent differently compared with other accents, which may explain perceived communication difficulties and social inferences attributed to foreign accents (Patricia Bestelmeyer, PhD, abstract 169.13, see attached summary).

• Men who stutter show different brain connections than women who stutter. These findings may help explain why five times more adult men stutter than women (Soo-Eun Chang, PhD, abstract 790.9, see attached summary).

(Thanks to Oliver for the link.)

Note: the Society is a great organisation and publishes a primer on neuroscience key concepts and a booklet on neuroscience.

Participate in research project

A student needs participants for his project on Adults Impressions of Private Therapy for Stammering

I am a final year undergraduate student studying speech and language therapy at DeMontfort university, Leicester UK. I have put together a small website www.researchstammering.com, so that I may collect information from adults who stammer, on the types of private therapy that they have undertaken from the age of 18 years. ....

The research is conducted through a questionnaire that should take no longer than 15mins to complete. It can be accessed at: -

Questionnaire: www.researchstammering.com/questionnaire.html

Emily Blunt: Fluency is a goal for everyone?

StutterTalk, and especially Eric, were really excited by their latest guest, movie actress Emily Blunt.

First, she really did stutter when she was a young teenager. All her comments and descriptions are very realistic, and shared by many people who stutter. So she does understand us who are still stuttering.

Second, she tells the story on her being saved from stuttering due to acting, but what she really means is that stuttering waned at the same time that acting happened.

Don't understand the critique

A new blog Stutter-Mind writes on stuttering focussing on medication

The most vociferous critics of fluency drug testing (e.g., The Stuttering Brain blog; Roger Ingham, Journal of Clinical Psychopharmacology, October, 2010) rely heavily on the placebo argument to bolster their beliefs and prejudices--namely that individuals respond favorably to a particular drug not because of its therapeutic efficacy but rather through a placebo effect. And, according to them, this effect might be short lived. Since stuttering is basically a mind-body problem, and the mind

Pagoclone is dead, long live Asenapine?

Ora and Holger sent me this very recent interview with Jerry Maguire.

Maguire seems to have given up on Pagoclone:

A few years back Maguire and his team tested a drug that showed great promise: Pagoclone, the only drug ever designed specifically to help stuttering [ERROR OF AUTHOR], eased anxiety among subjects and helped them speak more fluently, without any major side effects. But it hasn't been approved by the Food and Drug Administration, and it won't be any time soon, Maguire said.

And now he seems to believe in Asenapine:

... and he may have finally found the solution: a drug that's going through a trial at UC Irvine

Science must not care about its impact

Dave sent me a link to an article by Goldrake who is an interesting guy highlighting the same type of bad science. Check out his website.

However his article is on how a genetic origin adds more stigma to those with such a disorder.

And lastly, more compelling than any individual study, a review of the literature to date in 2006 found that overall, biogenetic causal theories, and labelling something as an “illness”, are both positively related to perceptions of dangerousness and unpredictability, and to fear and desire for social distance. They identified 19 studies addressing the question. 18 found that belief in a genetic or biological cause was associated with more negative attitudes to people with mental health problems. Just one found the opposite, that belief in a genetic or biological cause was associated with more positive attitudes.

I say very clearly that science should and must not care about how their findings impact on society and individuals with a biogenetic disorder. Science is about describing aspects of reality, and this cannot change depending on whether its impact is good or not.

However, no disorder ever is purely biogenetic. Humans are biopsychosocial beings with biological, psychological, and social processes being intricately linked. Whatever the origin of a disorder, be it biological (like a disease or gene), psychological (like traumatic stress), or social (like bullying), the impact is always felt on all three systems. For me, stuttering definitely starts and stays a biogenetic disorder, but its impact change psychological and social processes as well which in turn add to the disorder.

SIGN THE PETITION

Please please please please please sign the petition against an Indian movie that ridicules stuttering.

Go here for the on-line petition of the Indian Stuttering Association.

And please spread the link all over the stuttering sphere!