May Conference at Hotel Croatia

Check out the website of the upcoming May conference in Cavtat at Hotel Croatia: see here.

All the speakers are relatively well-known and some of the most dynamic researchers in the field. I just find it a bit strange that Katrin Neumann talks about the state of genetics, and not about brain imaging, because she is not a geneticist or worked in the area. And as always I am concerned when experienced therapists think they can do proper outcome research. Please share your experience with us not your faulty scientific expertise.

Disastrous NSA key note speaker?

The choice and message of the key speaker, Sander Flaum, at the NSA conference seems extremely popular with informed people who stutter. He is the typical key note speaker, the type that the informed person who stutters hates. They never studied stuttering in depth nor do they have the intellectual and scientific ability to realize their limitations in understanding, they never worked with many different people who stutter or followed them over several years, they never attended other conferences but are parachuted in (mostly because the organizers hope to get them to give them money!), they all stutter relatively mildly or not at all, and finally talk about their glorious interpretation on stuttering even though they have no clue whatsoever.

Why don't they let people talk who know what they are talking? Or if you really want to roll in those "successful" people, tell them to talk about their experience and not their glorious interpretation!

Why don't we start a campaign that allows NSA members to VOTE WHO THEY WANT TO HAVE AS A KEY NOTE SPEAKER!

Check out StutterTalk's conference chat, and this reader's comment:

The Keynote Speaker for the NSA Convention basically said that every person who stutters can become completely ---100%--- fluent if they will commit to all the practice that is required. It is the fault of the PWS that they "FAIL" in therapy. Fluency Training is the CURE...JUST PRACTICE. EVERYONE WHO STUTTERS CAN BE FLUENT; YOU MUST PRACTICE THE TECHNIQUES.

FANTASTIC message for all the speech pathologists out there and the parents of CWS demanding that their CWS practice more in order to stop stuttering!!!

CRUSHING message for all of us who stutter who know that this is not true...

ABSOLTELY EVIL message for 1st time parents to hear...For kids who stutter to hear. Totally F***** UP!

What is the NSA Organization thinking as they choose Keynote Speakers???

I feel like making like Lebron and leaving this thing...

No pill makes you a good public speaker

A reader asks me about medication, because he needs to give an important speech. Here is what I replied:

You do not need medication. You need to challenge yourself. You need  to start working on yourself and not try to find quick-fix solutions that don't exist! You cannot become a good sportsman by taking pills, you need to train.

You need to get at ease when speaking in front of groups so that it feels like talking normally. That's a conditioning and learning process that everyone can do, but it takes time and you have to face
your fears.

There is only one way to do this: to continuously speak in front of people.

I recommend you join a Toastmaster club. Many stutterers have found this useful. Spend the money on the membership fee!

Here is what I did: http://www.youtube.com/watch?v=YrQCIEKYxMY

You can do that, too!

The more speeches you give the more relaxed you feel and the less likely stuttering will be triggered.

 

Dave - Conclusions from the Congress

Paul Brocklehurst













Now that the Congress is over, it's interesting to look back on it and provide some sort of summary, or perhaps conclusion. First, was there anything really new? I'd have to conclude, not really. It seems to me that at most conferences there is not a lot which is really new presented. On the other hand there were some interesting papers. Jerry Maguire and Nan Ratner's talk was excellent and highly entertaining - they make a great double act and I like where stuttering is heading in DSM-V if they get their way. I particularly liked the paper by Paul Brocklehurst on the potential link between stuttering and perfectionism. It wasn’t clear from his data that PWS were more “perfectionist” than non-PWS, but it seems like an idea worth pursuing.

Shelly Jo Kraft gave an excellent paper on “Temperament, life events, and home environment in developmental stuttering severity”, which formed the basis for her PhD research. She argued that children with high effortful control (EC) can cope with changes in their environment. According to her, Effortful Control is the ability to ignore something distracting, like the TV and concentrate on what you want to do, e.g. reading. She argued that stuttering children with high EC may be able to attain more fluent speech. There was also a very useful presentation on the use of the speech analysis program PRAAT for timing and tallying dysfluencies by Paul Corthals. Having used PRAAT I can verify that it is a very powerful program.

I also attended the presentation by Peter Lajos entitled “Case Study of a 13-year-old Boy with Depression and Stutter”. This took essentially a psychoanalytic approach and as a single case study was very different from most of the other presentations. Whilst I don't generally favour a psychoanalytic approach I thought it was excellent, reminding us of the need for SLTs to understand individuals and their thoughts and of the need for SLTs to have a strong sense of humanity.

There were also several workshops, e.g. "A Brief Introduction to Solution Focused Brief Therapy" by Willie Botterill and "The Camperdown Program for Adults who Stutter" by Sue O'Brian. These provided a good opportunity for therapists to learn some practical skills.

Of course, I missed a lot too. Usually there were three or four parallel sessions and of course you have to make a choice of what to listen to. It was made more difficult because we only had the authors and titles to go on - the abstracts were not available. A pity. I imagine many people sat through stuff and wished they’d been in another session.

There was also a lot of very preliminary work included. Here’s one example, my comments in brackets:

"Although no definite conclusions can be drawn from this small (so why not have more?) sample of subjects, the results indicate that 50% (5) of the ten SpeechEasy users had less problems after one year of using the device.. "

(So I guess this means 50% had the same or more problems? Hardly worth reporting is it? And another ten refused to use the device!)

All these preliminary publications are partly because of the trend of Universities to demand more and more publications from their staff. The same thing is happening in journals. It is driving down quality, because there is not really enough good quality research being done - it take a long time, it can’t be knocked out in a couple of weeks. And of course conference organisers are reluctant to reject papers because it means the presenters will not attend, with a loss of income.

Overall though, a very enjoyable Congress. Thank you, John and Monica.

Finally, I’d like to thank Tom for giving me this opportunity to be a guest blogger and never interfering. All the thoughts and words are mine alone.

Dave - International Stuttering Association - Time for Change?

Interview with Suzana Jelčić Jakšić, board member of the International Stuttering Association

Thanks for agreeing to this interview. Let’s start by asking why you wanted to do this interview and have your views made public.

I don’t think that at the moment ISA is being run as a democratic organisation. It seems that anyone who disagrees with the Chair ends up either being forced to leave or being sidelined, like me. This is my last attempt to get my democratic rights back and be treated equally.

The ISA symposium was a bit of an embarrassment. It looked like there hadn’t been any planning about who was doing what. Is that right?

Yes, that’s very much right. Benny asked me about seven months ago if I'd be a part of it - the title was “ISA and its Role in the Community”. I was to speak on the last World Congress in Cavtat and I obviously agreed. Claudia from Argentina was asked to speak about the next World Congress. I asked for an abstract from Benny in February so I had better insight into what was required but never got it. Never heard from him about it again, despite asking for this information. Until it was published on the IFA web site I did not even know how long the session was. Because there was no communication for several months I was not sure Benny really wanted me to be a part of it.

You seemed to know nothing about the specific plans for an ISA/IFA joint congress?

I knew of previous talks between Chairs of ISA and IFA, but no other discussions. Benny said nothing about such ideas. As far as I know it’s not been discussed anywhere, but Benny presented it there at the workshop as if it was something that was agreed. It was disappointing to me that Benny said nothing about my keynote speech at any time during the Congress despite the fact I was talking about the importance of strong national associations and the ISA and the role of self-help groups. He did not even acknowledge that I had given a keynote speech.

What was that comment Benny made about “I’m at the top and you’re at the bottom” when he put up the list of Board members. It sounded quite insulting. Do you think that was intended?

I noticed that I was at the bottom of the list on the ISA web site, but it did not seem important. But I couldn’t believe my ears and eyes when he commented on the slide like that, particularly since he did it turning to me with a smirk and pointing out personally to me that I should notice that he was at the top and I was at the bottom. And this was translated into Portuguese too. Fortunately there were hardly any people there to hear it, but obviously it wouldn’t have mattered to Benny how many people there were present.

Since the last World Congress it doesn’t look like ISA is a very happy family. Am I right in thinking that Keith Boss resigned and John Steggles was expelled?

Yes. There was the problem with two members, Keith and John. Keith had a lot of ideas that Benny could not follow and both Keith and John had some strong views on what the board should be doing. If they were representing their national associations I don’t understand why they couldn’t be replaced by someone else nominated by their associations. But this didn’t happen. If they were not representing their national associations then the national associations shouldn’t interfere to try to get people removed from the board as was the case presented to the board about John.

According to the ISA web site you have a Chair and Secretary on the ISA board. You also have a Co-ordinator. What does the Co-ordinator do?

Apparently the co-ordinator takes over the discussions when Benny is not ready to answer some questions. But Thomas does not do this in a very concrete way, so often we get no answers to our questions which is very frustrating.

What has ISA done in the last two years? From the point of view of an outsider it looks quite inactive. Apart from publishing three issues of ‘One Voice’, what has it done.?

It’s certainly not good if it’s not obvious to people what ISA has been doing. There’s been the 2nd African Conference, but these conferences were started by the previous Board and people from Africa were responsible for the second conference. There’s the ISP-S project which was started by Mark Irwin and the previous board but to my knowledge the current board did not seem to want to act on any of Mark’s further suggestions for this. ISA supported this with a limited amount of funds. We also spent a lot of time changing the venue of the next World Congress. This is ok, but the work is done very slowly and it is not enough. In my view ISA should be making links with WHO, UNICEF, and other global organisations to further the cause of PWS.

You might not want to answer this, but how does the ISA make any money to run itself? I can’t see any mention of fund-raising activity on its web site.

I’m not aware of any fund-raising activities so I can’t say much more, but I do know there is a fund-raising committee.

It really looks like you and Benny don’t get on. It also looks like he has a sexist approach to women, judging by the way he relates to you. Do you think that’s true?

It’s hard for me to believe because I was not raised in such a society and I never felt any discrimination being a woman, but now I have to admit that might be the case. I can’t imagine Benny treating a man as he’s treated me. I am a board member and I should be treated equally and that’s what we ask for the rest of the world when it comes to stuttering. At the moment I’m not granted access to the ISA forum, where some important discussions about board matters took place, and despite asking for an explanation and access several times Benny refuses to do either. I don’t know what you can do if you ask questions numerous times by email, even go on strike, but the Chair won’t answer the questions. It was suggested by some other board members that we have a drink in Rio to find the way to communicate better, but then you have Benny who pretends he can’t hear me, doesn’t understand me, says it’s not important and treats me in a sexist manner. He says when the time comes I’ll be allowed access to the forum, which seems an odd word to use since as a board member I have the right to have access. So what I should do now? The easiest thing would be to resign, but I don’t want to stand aside because of someone like Benny.

Finally, do you think Benny has done a good job as Chair?

I think I was really generous to Benny, I had a really good opinion and he was really dear to me and when he asked me to stand for election to the Board, I said yes only because of him. I had many urgent jobs to finish and I was exhausted from organising the World Congress and had no interest in being a part of the board. So he asked me to be there. Some time after that, several board members said they were unhappy with the way Benny ran things and wanted me to join them in showing their lack of support for the Chair. But I said no and defended Benny, saying he needed time to grow into the job and they should give him a chance. But the first time I disagreed with him, didn’t say what he expected, I was sidelined. I think with Benny he thinks you are either with him or against him, nothing in-between. Now, especially after meeting him in Rio, I am sure he sees me as his enemy. I don’t think those are the qualities of a good chair. If we are not all in agreement with him, he sees us all as people he is fighting a war against who should be removed. I want to say here that now I don’t think he’s capable of running the ISA. If the Chair can’t communicate well with board members then I don’t see how this board lead by this chair can create a world that understands stuttering. So, Benny does not have my support and I don’t think someone who behaves in public as he behaves whilst representing the ISA is a fit person to be chair. I think he should resign, but I don’t believe he will, he’s taken the role of a general who must prevail against all who disobey.

Thank you for your time and frank thoughts.

Dave - Problems in ISA

There was a brief presentation during the ISA workshop on the possibility of a joint IFA-ISA congress in the future from the current Chair of ISA, Benny Ravid. I noticed Suzana Jelčić Jakšić (one of the board members of ISA) looking surprised at this. Although she obviously knew that this general idea had been floating around for several years, she knew nothing of the current discussions and plans. In fact the ISA workshop did not run particularly smoothly - it looked like there were some communication difficulties in ISA, with some of the other presenters not having been briefed by Benny Ravid, who was running the workshop, about their role. I also noticed a rather snide remark from Benny to Suzana when he put up a slide of ISA members, with his name at the top of the list and Suzana’s at the bottom and said “there’s me at the top and you at the bottom.” It definitely seemed like he was intending to insult her. So I’ve got an interview with Suzana coming up where you can find out more about what’s going on in ISA, or maybe what’s not going on!

Dave - Symposium on Cluttering

The symposium on Cluttering on the final afternoon was excellent. Presenters took various aspects of cluttering and so the audience got a good overall view of cluttering and its history. However, it was obvious that really very little is know about cluttering, if you think we don’t know much about stuttering, then for cluttering it’s about 100 times worse! One of the most interesting papers was by Yvonne van Zaalen from the Netherlands, which applied Levelt’s model of language production to cluttering, specifically the language monitoring aspect of the model. No-one mentioned anything about brain imaging and cluttering. The prevalence of cluttering was discussed by Ken St. Louis. This was more preliminary work than a full-blown prevalence study. However, it did highlight the relationship between cluttering and stuttering. Cluttering and stuttering do seem often to occur within the same individual, which poses an interesting problem concerning what aspect of speech is being monitored by individuals who both stutter and clutter, given that one of the points often mentioned is that people who clutter are often not aware of the problem.

Dave - Reception

Suzana Jelčić Jakšić (keynote speaker here and organiser of the last World Congress for PWS in Croatia), Sarah James and Hilary Liddle, both from Leeds University and speakers at the Congress.



Delegates enjoying the music.

A group of delegates chatting. That looks to me like Pete Howell (UCL, London) with his back to the camera. Pete's giving several papers.



Paul Brocklehurst From the University of Edinburgh


And here's me at the opening reception. It looks like it's already been too much for one delegate!

Dave - Opening ceremony

This could remind you of the "Last Supper", but it was only the beginning!




Monica Medeiros de Britto Pereira looking surprising relaxed!

Dave - IFA Reception

The show’s on the road! The opening ceremony was good - brief and to the point. Willie Botterill, IFA president, gave an amusing talk and we were of course introduced to all those who made the conference possible. After that we had drinks in the court yard in the open air and got to see who else is here - no list of delegates, which seems unfortunately to be increasingly the case at conferences. Total number of delegates is about 140. Nothing like as many as Dublin or Montreal, where there were nearly three times as many. Had a chat with several people, including John van Borsel, one of the organisers, who said he’d never heard of this blog! Also saw Margaret Leahy, from Dublin, Hilary Liddle and Sarah James from Leeds, Yvonne van Zaalen from the Netherlands, Ken St. Louis from the US, Pete Howell from London, Suzana Jelčić Jakšić (one of the keynote speakers, always good to know the keynotes are here!) and lots of other people.

Dave - Social Anxiety and DSM-V

Arrived in Rio safely after a terribly long flight. I managed to do a bit of work on the plane, but the space is so small it’s really cramped typing. And of course there’s no power to recharge the battery in economy! I can see the advantage of business class, apart from the extra cost, of course.

After the queue at passport control I got a taxi to the hotel. Pleasant room and if I stand on the balcony and look down the street I can see the Atlantic.

Spent most of yesterday putting the finishing touches to my presentation. Tonight is Registration and Welcome, so I’ll get some idea of how many people are attending. Be interesting to see who’s here from Europe.

In my paper I’m touching on social anxiety disorder and stuttering. One of the problems, which Mark Irwin refers to (Stuttered Speech Syndrome), is that DSM IV (Diagnostic and Statistical Manual of Mental Disorders) excludes a diagnosis of social anxiety disorder if the anxiety is mainly focused on symptoms associated with the stuttering ( and also other conditions such as Parkinson’s Disease). I’ve known for some time that DSM V is currently being produced, but primarily in secret. You can see some of the debate here: MIWatch and here: Wall Street Journal. The official web site is here: APA.

Which all goes to show that: a) psychologists and psychiatrists just don’t get on, b) the more secret things are, the more suspicious everyone is, c) don’t hold your breath that there will be much new about stuttering here if everyone is bickering amongst themselves!

If anyone knows anyone on any of the panels involved in this revision some lobbying may be in order.

Dave - Guest Blogger

Tom has asked me to be a guest blogger while I'm attending the 6th World Congress on Fluency Disorders in Rio De Janeiro in Brazil. This runs from the 5th to the 8th of August. I'll be giving a paper myself, co-authored with Suzana Jelčić Jakšić and Behlul Brestovci, on the relationship between Social Anxiety and Stuttering Severity. Of course, I want to find out what else is happening and I've already made a note of several presentations I want to attend. But first I have to get there - a flight from Heathrow at 6:20 am on Monday, change in Madrid and then straight to Rio, arriving at 17.35 local time. Glad I have a day to recover! More later! Dave

Guest Blogger: Dave Rowley

Dave Rowley has agreed to be guest blogger for the International Fluency Association Congress in Brazil which is held from August 5th to 8th. Dave is the organizer of the Oxford Dysfluency Conference, and a lecturer in psychology at de Montfort University in Leicester.

If you want to be guest blogger for an event or a topic, please send me an email.

We need your opinion

I got a request by Suzana Jelčić Jakšić. She prepares for her presentation at the International Fluency Association Congress in Brazil please let her know what you think are the three most important needs for people who stutter in your country. Email your answers to suzana.jelcic-jaksic at zg.htnet.hr.

Bresil or Not?

I just looked at the costs of attending the IFA (International Stuttering Assoc.) 2009 conference in Rio de Janeiro: see my post on speakers . I get to about 2000€, which includes 275$ on conference fee, more than 1000€ on flight, 500€ on accommodation, and extras. Of course, I could look at it as a 2 week holiday in Brazil with 3 days break at the conference. Still not cheap... The deadline for submission is End of February... so I still have some time...

ASHA2008

The American Speech and Hearing Association (ASHA) holds its annual meeting End of November: see here . It is a very big conference, and a small part of it is on stuttering. I never went. Too expensive for a non-member. I was unable to get the program from the web. If you can find it, let me know!

ISAD 2008

 

Check out Judith Kuster's online conference. With many good quality and no quality discussions on stuttering, research and treatment.

I have already posted a comment to Susan Block's article What clinicians should know to avoid the spreading of that myth Lidcombe should be used:

You are writing that "Current research indicates that the Lidcombe Program should be the treatment of choice for young children who stutter (Jones et al, 2005; Lincoln & Onslow, 1997)." This is misleading 1) It implies that Lidcombe is better than other early interventions. However, Lidcombe has never been tested against other forms of early intervention in a random control trial. It could well be that ANY intervention has a similar (or no) effect. There was only one pilot trial by Francken in the Netherlands and there was no difference with demands and capacity. She is currently conducting a large scale study between Lidcombe and DC. 2) You only cite the Jones 2005 article, but there is a follow-up paper from this year with long-term outcome. Three children have relapsed and many kids were not contactable any more. The sample is close to the natural recovery rate, not to speak 3. The study of Jones 2005 is questionable and has statistical and methodological flaws: wrong statistics, no long-term control group, and more. I think clinicians should know these facts. Evidence based practise is important but should be based on WELL ESTABLISHED evidence.

Christian Kell at the Paris workshop

Here is the last talk of the Paris workshop: a few weeks late. Christian Kell was the last speaker. He is a post-doc at Ecole Normale, and did his PhD in Frankfurt where he collaborated with Katrin Neumann on brain imaging studies on stuttering. I have already dedicated one post to him, to recapitulate: he is famous for finding the sensory location of the male penis in the brain!

Thank God then for Christian Kell of the University of Frankfurt who stuffed eight blokes into an MRI scanner and then tickled bits of their bods with a feather while (no doubt) keeping his eyes firmly fixed on the brain activity monitor. The NS notes: "Each man's penis was represented in the same place - flanked by the areas for the toes and abdomen - Kell told the Organisation of Human Brain Mapping annual meeting in Toronto." Kell went on to lament: "The only depressing thing is that the representation is very small."

Katrin scolded me for writing about this, saying that he was shocked to read about this on my blog. I asked him at the conference, and of course it was not true but her over-reaction as always. Chris said that he was surprised by the deluge of interest, that he got used to it, because after all it will stay with him for the rest of his life. To be honest, I think he enjoys his claim for fame. Chris seems multi-talented. He asked good questions. His French for being a German is quite good. He was a driving force behind the conference. And at the end of the workhop, he played the piano supporting a singer he recruited. So if he fails to get another job in neuroscience, I am sure he can make his money in a piano bar in Pigalle!
Chris spoke about research he has done in collaboration with Katrin in Frankfurt. I haven't found the article on PubMed, so it might not be out yet. They looked at people who recovered unassisted, who improved due to a fluency shaping therapy (before, just after, and one year after), and controls. What are the brain differences? It is an interesting question. Is there a difference between unassisted recovered stutterers and controls? Is there a difference between unassisted and assisted recovered?
(It is important to say a few words on unassisted recovered. I am not sure he said something about it his talk. But, I remember someone saying that many are not really like fluent speakers, but still have hesitations at times. When you ask them about this, they say that they are fluent for all practical purposes. They do stress that fluent speech is not always automatic and that they have to work to get it. This is even more true for people who undergo therapy and become fluent. The major difference is probably that unassisted recovered have managed to have lasting improvement, whereas people who become (more) fluent through therapy are likely to relapse fully or partially.)
As with all the other talks, I do not have access to the slides, so I can only rely on the abstract and my notes. They use functional and structural MRI. Not surprisingly, they find grey matter reduction and white matter anomaly on the left side in all stutterers. I think also in unassisted recovered stutterers. So constancy across groups. However, there were clear difference in activation. Stutterers activated several regions on the right side including the activation of the right analogue of the anomalous left brain region. After therapy, the right hand side activation was normal except again activation of the right analogue. And unassisted recovered stutterers show similar activation but additionally showed activation in the anomalous right region. He refers to the Brodman area 47/12. And they conclude that: "recruitment of the left posterior orbitofrontal cortical region (BA 41/12) appeared in this study as a unique and necessary feature of long-lasting repair of stuttering.
He further states that this region is probably involved in executive control of rhythmic tension. He actually talked a lot about rhythm, but I did not follow it all. I just have written down that the right side keeps rhythm and the rhythm competence (not sure exactly what it stands for, but this is probably understanding rhythm as opposed to executing rhythmic tasks) is on the left side.
I asked him a question on methodology. They used people from a fluency shaping therapy: the Kassel Stuttering Therapy. I have also attended the intensive course plus a one-year daily practise. One striking feature is the strong rhythm and gently onset of the newly learned speech pattern. It is quite funny. If you go to Kassel, everyone speaks the same way. Though I have to say that this is on purpose and the idea is to reduce the strong rhythm gradually: over-learning. I was concerned that the stutterers were just using this way of speaking and so you should see activation in rhythm areas, after all you speak in a rhythm! He replied that they told them to try to speak as natural as possible. However, I do not completely buy this argument, because when I was in this mode of speaking and tried to speak normally, I found it hard to do. In fact, some region in my brain kept me in the other mode, and I would only gradually shift and loose the restraining power of the new speech mode. Anyway, it is an interesting study! ;-)

Neurological or neurophysiological?

At the Oxford conference, I asked a question to Mark Onslow during the panel session. I asked how a behavioural treatment like Lidcombe could possibly be highly effective if as he agrees stuttering is driven by an underlying neurological problem.

Instead of answering the question well, he replied by saying that I did not understand terminology and that I probably mean "neurophysiological", and that there is a big difference.

Well, is there really a difference? I asked three people after the session, and no-one understood quite why one would be better than the other.

I looked up the words "neurological" and "neurophysiological".  In typical dictionary manner, I got the following very enlightening definitions: "of or relating to or used in or practicing neurology", and "of or concerned with neurophysiology"!! :-) OK, so I had to look up "neurology" and "neurophysiology".

Let's start with neurology: The medical science that deals with the nervous system and disorders affecting it.

And for neurophysiology, I got The branch of physiology that deals with the functions of the nervous system.


I cannot see any big difference. Both terms seems fine.

Highlights from Oxford

I am currently in London on my way back to Luxembourg. Let me post the highlights from the conferences as I see them. I will talk details in future posts. If you have pictures of the conference, please send them to me!

1) Per Alm gave a scathing review talk on the emerging field of study that claim that certain temperamental traits are important causal components of stuttering. Specifically, he raises serious concerns about a study by the Conture group, and, on top, he said that the results of their likely-to-be flawed study have been misinterpreted and exaggerated by the Washington Post which have also found its way to the BSA (British Stammering Association) website. To summarise, the supposed evidence is evidence of bad methodology.

2) Dave Franklin from the Pagoclone group (and colleague of Stuttering Drug Tsar Jerry Maguire at Irvine) presented a poster with the results of the open label period of the Phase II Pagoclone. They claim that Pagoclone shows positive results in a subgroup and has less side effects. He handed out copies of the posters to everyone, and I am trying to get the permission to post the scanned handout here.

3) There is a widespread agreement that stuttering is a neurologically based disorder. Ann Smith pointedly asked in the final panel session whether it is not time to change from "the causes of stuttering are unknown" to "stuttering is a neurologically based disorder whose details are unknown". We all agreed.

4) Many speakers talked about very high rates of success of stutteringin early intervention, but barely mentioned the natural recovery rate. Many strongly believe that early intervention is effective above natural recovery. I can see improvements being possible but I am just not convinced that the vast majority recover fully.

5) Mark Onslow talked about a large scale longitudinal study of 1000 children starting before onset of stuttering. This should be a very interesting study, unless they mess it up statistically as they did with the BMJ study.

6) No new imaging, genetics, or theoretical developments.

7) Two talks were enlightening as they explained well concepts that I find lacking in stuttering research and therapy but are important to see the big pictures. Paul Dolan gave a good conceptually introduction to health economics, but I did not talk about specifics. Kuhn and Packman talked about complexity theory, and the complex brain with its self-regulating loops. But are these concepts applicable to help real understanding? I doubt it, and if not not by the speakers.