Ludo Max's talk in Paris

I am going to write short summaries of the conference talks so everyone gets an idea what was talked about. It would be shame if the non-attendants missed out on a good conference. Of course, I have to simplify and my notes are definitely not perfect. And I did not understand each statement, question or answer! But I am sure that this applies to all attendants! I will give my opinion at the end.

Ludo Max gave the first talk. He is a professor at the University of Connecticut, south of Boston. I visited him in October of last year. He is originally from Belgium. Check out his webpage with all relevant references to his work: here.

He didn't really say anything revolutionary new. His approach to stuttering is still the following:

1) Use the most plausible flow diagram of the processes that generate (speech) motor control.
2) Test the various components for people who stutter.

He argues that this is what real science should be about: namely testing theories. A key component of the model is the efference copy concept. In order to correct for imprecise muscle movement, the brain needs sensory feedback. For example, if I reach for the glass and I miss it by 1 cm, my finger and my visual cortex generate a "not touching by a bit" information. Then the brain can correct for this. However, this is quite slow as the brain needs to wait for the sensory feedback from my finger and my eyes, then combine and process the information, and then send the "not touching by a bit" information to my motor regions. This mechanism will fail if the brain has to do too many movements in a short period of time like in speech, and therefore it has invented the efference copy, which is effectively parallel processing. So once the motor command is sent to the muscles, a copy of the comman is sent to a region that predicts what the sensory feedback should be at the same time as the muscles are executing the command. So the expected sensory feedback is ready and waiting for the actual sensory feedback. Time is saved, because the actual feedback does not need to be analysed any more but only compared to the predicited sensory feedback.

Ludo showed results from his experiments. Actually, I participated in one of them. It is a nonspeech experiment that involved making reaching movements in the presence of a visuomotor rotation. You have to move your finger towards a target, which is easy enough. However after a while they manipulated the visual field by a rotation and you are actually missing the target by a bit. After a few minutes of irritation your motor control system gets used to this shift and automatically corrects for the rotation. The experiment tests how fast you can adapt, which depends on your inverse internal model (I think) which is part of the motor control framework. Ludo found a noticeable but not dramatic group difference between controls and people who stutter. He also talked about an experiment involving a formant shift, but I do not have anything written down on it. He also said that the visuomotor rotation experiment is currently being repeated with children, but the boring targets being replaced by basketball baskets. Ludo also talked about a new set of experiments he is conducting to find out whether differences in the control of orofacial movements lie in the sensory and/or the motor domain. The experimental setup involves being stuck into an apparatus that monitors your orofacial movements, which looks a bit like a chastity belts for your mouth!

Christy Ludlow asked a methological question. I did not really follow on what, but the gist of it is that the interpretation of the experiment is not completely clear-cut and other effects could distort results allowing for alternative interpretation. I asked Ludo whether he had tried to correlate the group difference in the visuomotor experiment with stuttering severity. I suggested he could divide the sample into three: controls, mild stutterers, and severe stutterers, and see whether the controls-to-mild difference was in between the controls-to-severe group. He replied that he hadn't done this but might do.

In my opinion, Ludo is a good scientist and in principle doing the absolutely scientifically correct thing, namely to start out with an established or candidate model and then test the different components. However, in the given circumstances his approach is probably not leading to significant results in the near term, because the setup, the result and the interpretation of the experiments is very sensitive to all kinds of experimental and theoretical issues. But he can prove me wrong! First, experiments like the visuo-rotation experiment seem to get only group difference results, i.e an average difference, because people who stutter do not have failures but only defficiencies. There is a high overlap between control's and pws's performance: some stutterers have in fact better skill than many fluent controls! Only their group average is lower. So deficiency is not a sufficient condition for stuttering. Second, there might well be sub-types distorting results. Third, the model is a functional model but processes of speech motor control might well be implemented differently in different people. So they might have the same functional ability but the brain actually uses different pathways. Fourth, in my opinion, most of the differences we see in stutterers across several areas are simply consequences or a side-effect in a stuttering brain, and not directly involved in causing stuttering. Fifth and probably most importantly, the experiments are quite hard work. You need to recruit the subjects, setup the experiments, be scared of all kinds of experimental artefacts. To me, his approach makes more sense from the perspective of a researcher interested in speech motor control with a focus on stuttering as opposed to a researcher only interested into stuttering.

Human language and brain plasticity at McGill

Maybe some of the researchers here are interested in this conference on language and brain plasticity:

International CRLMB symposium on human language and brain plasticity at McGill:
Mechanisms of Learning, Brain Plasticity and Critical Periods

The Centre for Research on Language, Mind & Brain (CRLMB) is pleased to invite you to join us for a two-day symposium on language, learning and brain plasticity, to be held on

20-21 June 2008 at McGill University (Moyse Hall) in Montreal

The symposium will examine recent advances in understanding mechanisms of language learning, and provide an overview of current developments in brain plasticity and critical periods. The goal of the symposium is to facilitate the interdisciplinary exchange of ideas among researchers whose complementary interests provide an important foundation for issues related to first and second
language learning and cognition development.

The meeting will feature presentations by eleven internationally renowned scientists whose work has contributed new and innovative perspectives on the neuro-cognitive basis of language learning and other cognitive processes. The topics to be addressed include: constraints on statistical language learning; the neurobiology of critical periods; and (psycho)linguistic perspectives on second language acquisition, among others.

Please help us to advertise this event by posting the enclosed Symposium poster
and give this email the widest possible distribution by forwarding it to your colleagues.

Karsten Steinhauer, PhD
(Organizing Committee & Chair in Neurocognition of Language at McGill)

No speech but singing with TMS

Check out this cool demonstration on how TMS (transcranial magnetic stimulation) knocks out the speech regions. Watch how his speech stops when TMS is turned on, and how TMS has no impact when he is singing the ryhme! Does this effect sound familar? We who stutter can sing fluently and not speak fluenty!

Here is the Daily Telegraph article, and here is the direct link to the video.

(Thx to Dave Rowley for this tip!)

Newsflash from Paris conference

I just made my way back to Luxembourg from the one-day conference in Paris. Have you ever been confused of the difference between "efficiency" and "efficacy"? Here is a good example: I took the TGV, the world's fastest train (the most efficient in terms of speed), but completely ineffective (i.e. in terms of actual output), because my return journey took 5 hours instead of the 3.5 hours with the old trains or the 2 hours in the morning!!! Some troubles on the rails which caused a late departure and reduced speed limits!

Here are my talking points:

1) We are currently seeing second generation brain imaging studies. I am very impressed with the latest very cool brain graphics, better scanners and the latest signal manipulation, interpretation (e.g. fiber tracking) and statistical software. The latest studies are now much more reliable than the first generation. I would even go as far as to say that we should forget about all studies older than 2-3 years, except maybe keep a summary in our minds with the meta-analysis by Brown et al.

2) All groups (Chang et al, Watkins et al, and Kell/Neumann et al.) have confirmed the presence of a white matter defficiency in the left frontal cortex, first found by Sommer et al. with more primitive and low resolution DTI scanning. What they disagree on is the exact location, however there are most likely differences in the sample and methods.

3) There was an interesting observation that stuttering and other disorders often show (similar) abnormalities, but that these abnormalities do not necessarily translate to dysfunction. A fascinating interpretation could be that a brain loaded with abnormalities actually shows a decreased (global) brain plasticity to compensate for a defficieny. And the people with disorders are just the biased sample of people who have failed to compensate adequately.

4) Riitta Salmelin talked about MEG and told us that she is going to take a second look at stuttering, after her first MEG study on stuttering where she showed some reversal in activation for people who stutter. MEG shows electrical activity down to a 1ms resolution, and she now has a working method to determine the time sequence of events. I am very keen to see what she will find as this tool has never been applied to stuttering!

5) No theoretical breakthroughs at all. The consensus seems to be to wait and get more empirical observations from the second generation brain imaging, especially in terms of correlating activities between different regions first.

OK. That's my first twist to a very interesting conference. I'll talk about each presenter over the next weeks. And pictures!!

Off to the Paris conference

Sorry for not posting. I am very busy studying for an exam and playing an international chess tournament. Tomorrow, I am taking the train to Paris for a day to attend the workshop of neurology of stuttering. It should be very interesting. I will try to make notes and write posts.

Food allergy and stuttering

A reader wrote to me:

I’m 38 and started stuttering very late at about 8. I went to speech therapists etc and generally lost respect as the “techniques” never worked or helped me. After a conversation with a friend, I tried a different approach about 3 years ago. I got anti-anxiety meds that helped me greatly. I realized I had some “wires” crossed and started to dig deeper.

I saw various doctors and tried various homeopathic pathways. Which were hitting around the problem, but never got super close to answers. I was tested last fall for food allergies and the results were astounding; I was allergic to food and a diet change transformed my life. My speech improved very quickly and I also felt better. I was still having ups and downs but they were less severe. I went to see a couple gastroenterologists to explore the food allergy further. I would, at times, wake up with a headaches for seemingly no reason. My fluency would have ups and downs (however less severe) even when I would eat “safe” foods. My gastro said I might have an enzyme deficiency and prescribed some Creon (enzyme) for me. The Creon also changed my life.

I probably have never digested food well. When I eat, my body could not cope and it would ultimately engage my sympathetic nervous system instead of my parasympathetic nervous system. Thus, I would immediately go into fight or flight anytime I ate. This would increase my overall body tension and create an ever moving target with regard to my fluency. Good days, bad days, always unexplainable. My body became more and more averse to certain foods and I became more and more allergic to foods b/c of my difficulty in digesting them. This tension/anxiety would focus in my neck area and I would stutter. I cannot explain how much changing my diet and the digestive enzyme has helped me.

I would be really interested if anyone else out there has pursued this avenue

Are you close to or travel to Montreal/Toronto?

If you are close to or travel to Toronto or Montreal, you can help Sarah Smits-Bandstra in her research! Click on the picture to see the details...

Different types of researchers

In my experience, there are four types of researchers:

a) the full-time scientists that look at stuttering by opportunity and chance
b) the scientists that focus their academic career on stuttering but do not treat but teach.
c) the generalists that focus on all aspects of stuttering from research, teaching, and treatment.
d) the practitioners who focus on treatment and teaching but do research part-time.

Type a are mostly geneticists and neuroscientists. They are in my view the best scientists for experiments. They now relatively little about stuttering as a disorder, and live in their experimental paradigm. They just happen to fall on stuttering. Without bias, they just look at stuttering. They are mostly funded by general research councils, and publish mostly in non-stuttering focused journals. I trust them most in terms of experimental results.

Type b knows a lot about stuttering and are professional scientists, and direct their research according to what they perceive as an important experimental question. They say: I have a theory and I want to test it, whereas Type a says I have an experimental method and I want to use it. They publish in both stuttering and non-stuttering journals. They also get their funding from research councils but they might rely more on money pools with a focus on speech and language or communication sciences. Such research resources are often dominated by some professors. Especially junior type b are relatively sensitive as not to offend such an important person who might be editor of a stuttering-related journal or a powerful member of a research council. This is especially true in the UK, and also to some degree in the US and Australia. At least four have told me that they try not to provoke or openly criticise work by a big name, because they are scared of having a paper rejected or getting no funding. Actually, they like me because I say what they do not want to say out of political reasons! So view my blog also as the voices of some in the research community!

Type c is a bit of a generalist. They do teaching, treatment, and research. They are quite focused on stuttering journals, and are at all the conferences. They mostly publish in stuttering journals. In general, they are not full-time and not very good scientists, but are good all-rounders.

Type d are practitioners first. They treat patients, but are too energetic and intelligent to just do their job and go home at 5 o'clock. They are closely connected to the stuttering associations. They are very much focused on treatment, and do research in the area. It is often non-funded research, small pools of money or funded by private money.

In any research team there might a bit mixture of researchers.

I forgot Type e)

e) They stutter, generally have a good science background, and follow research in stuttering. They do not do any experimental work nor treatment nor teaching. They do meta-analysis of research and try to understand what stuttering is about. They do it all for free. Some even write blogs! :-)

Fall in different ways

Oren asked me:

I'm interested to know whether you have the same sensation for all types of stutters (repetitions, prolongations, pauses, etc.)? If not, how is the sensation different for each stutter type?

I think it feels the same before the event. There is some mental blockage, i.e. I know what to say, my brain gives the signal you can say it, but then I sense that I cannot. Whether this translates into repetition, prolongation or pause is secondary. Like if I fall, I can struggle not to hit the ground, I can fall on my knees, or use my hand to soften the fall. The share of different behaviour is either learned or based on where I am in the sentence I guess... So I would say that I do not know which symptom is going to happen. I often notice that if I try to suppress on symptoms like a block then I have a pause. Or if I stop hesitations and fillers, I have blocks.

First donation!

Yesterday I received the first donation for TheStutteringBrain! It is good to know that someone thinks I am doing a good job and actually supports it with an action!

Natural dysfluency vs stuttering?

Another reader asks the following the question:

Do you -- as a person who stutters -- differentiate between disfluency and stuttering? Are they the same?

As a person who stutters, I can clearly sense a difference between natural disfluencies and stuttering. Natural disfluencies feel like a mental hesitation that is translated into disfluent speech. I do not know what to say or changed my mind, and I just say "ehhh" or "mmm" or do no continue or extend the syllable I have started. Or sometimes it feels like a glitch in my motor control in the same way as I sometimes make wrong hand or arm movements. It's more like "Funny.. why did I do this? I am clumsy today", and then I just do the correct one with ease.

Stuttered speech feels to me very differently. To start with, I know exactly what I want to say or at least I have the sense that my brain knows what it wants to say without me necessarily consciously knowing what it will be. :-) So I have this "your message is ready and we are ready to go live" feeling, but I can't get it out or I know it is going to be a struggle. It is also associated with other symptoms like tension, loss of control, and also some kind of blockage in the brain. It kind of feels like it involves more than just this local glitch. My whole mental space seems to become restricted to the moment of stuttering. And I know that it is not just a glitch, but will continue with the next sentences. I also feel that I have lost the control of my body posture.

Overtly when only listening to speech samples, it might well not be possible to distinguish clearly between natural disfluencies and stuttered speech, but internally it is most definitely very different. So I think a person who stutters has also natural disfluent speech like a fluent speaker and in addition he or she stutters.

What is your experience? I would like to hear from people who stutter, but also from others who listen a lot to stutterers. Can they detect the difference between natural disfluencies and stuttering?

The last provacative question

And here is the last question I was asked by the reader:

Do you think non-stuttering researchers do better research in stuttering, they seem to get more funding and on "the cutting edge" of modern stuttering research.

Let's start with therapists. For the typical adult cases, I am convinced that people who stutter or stuttered can well compensate most if not all of their lack in an appropriate qualification or training, as long as they are qualified or trained in something that requires some kind of self-control, moderate intelligence, and learning ability. For difficult cases with psychological issues, a professional is needed.I have also seen so many "therapists" who are just not very good: BEING A NICE SMILING CARING PERSON DOES NOT MAKE YOU A GOOD THERAPIST! :-). For children you need a professional to diagnose children and deal with the parents. So you need to know all the kinds of developmental disorders that can happen and exclude them. But some part of the therapy itself again could well be done by any people who stutter or parents who are not completely out of their mind. So I could well see myself organising a therapy for adults, but if I had a stuttering child, I would take him or her to a generalist speech and language therapist first to exclude other disorders and then discuss with a specialist one on what to do. But I would probably most of the training with the child myself, because as a parent I have more "access" unless the child wants someone else.

For researchers, my answer is a clear yes, but out of statistical reasons. A good researcher has to have an above-average intelligence. So from a pool of 100 researchers, there is on average one that stutters. So if I impose an equal ratio, I would decrease the quality of researchers because I have to hire some less qualified stuttering researchers than qualified non-stuttering researchers. But I guess I am not answering the question, because he most likely means: Does the fact that you stutter makes you an even better researcher, assuming you are a good researcher? Is there an added-value? There are three reasons in favour. First, the researcher is probably truly interested in the research, and does not mind to work on the topic above his calls of duty. Second, he or she understands some issues much better. I have often seen researchers misinterpreting certain behaviours of people who stutter or being unaware of certain issues. Third, the stuttering researcher might have a better connection to the consumer associations, and finds it easier to recruit for experiments or get invited to conferences. He or she is also not open to suspicion that they are only nice to stutterers because they need subjects. On the other hand, a stutterer might hold biased views, and might be reluctant to accept "hurting" experimental results. Let's say he finds strong evidence for Freud's anal displacement theory, he might ignore it, not publish it, or minimize the results. A neutral researcher just reports what he or she finds.

So it is a mixed bag in my view. Both kinds of researchers are needed really. And I have also not seen any evidence that research councils favor researchers who do not stutter. I would guess that the opposite might be more likely.

A provocative question Part II

And here is the second interesting question:

I am impressed that you are able to go to all these International stuttering conferences and to present posters. Do the leading authorities in the field of stuttering take you seriously or are you just a consumer with a PhD who ask good questions? Why don't you study stuttering for real, in a lab?

All the conferences are open to everyone, so no magic there. The same is true for presenting posters. Stuttering conferences virtually never refuse any poster or talk proposal, and at best correct the bad English! Of course, I need to find the time and money to attend. I have managed to reduce the fees, which is a sign that my blog is gaining traction.

The question on whether the leading authorities take me seriously is a very interesting one! Who are the leading authorities? The one that do the key note speeched at conferences or the real leading authorities? My experience is the following: The very good ones (mostly with a natural sciences background) take me seriously, and I am in close contact with some of them. Maybe at the beginning they see me as a consumer and might be a bit patronising, but as soon as I hit them with good or surprising arguments, they are a bit shell-shocked but recover and are happy to discuss research. The other leading authorities simply completely ignore me. I like to think that they are mostly not very good scientists (or have personality disorder!) and became authorities more based on their social, networking, management, lobbying & bullying and marketing work. They do not want to loose their face, or they simply do not understand what I mean. One professor once told me as I tried to convince him that brain imaging is the future: What do you know with a PhD in physics? This person is now co-author on precisely such a brain imaging article! Finally, my work so far is more brainstorming and spreading the news rather than proposing a theory that can be discussed or writing papers. So I am not actually doing real science and not very open for criticism. But, I am currently working on these stuff and hope to send in some articles for review. Also, the stuttering field is not known to be very outspoken in public. Rarely, are there intellectually fierce exchanges on conferences. Many also like to talk to me because I tell them what is going on in their field or we discuss fields where they are not experts either!

So why do I not work in a lab? That is a good question. Maybe I should go into research. I actually had some opportunity, but I only want to go if I really believe that it is worthwhile for me. Also, I still have a few plans for my consultancy work in finance. And, I am a better theorist than experimentalist.

BERCOW REVIEW

Ley Geddes asked me to post this link to his video here. He is lobbying for better services for children who stutter:

The BERCOW REVIEW of services for children and young people with speech, language and communication needs has published its Interim Report; the Final Report is due in July. See: http://www.dfes.gov.uk/bercowreview

The Interim Report states that 'communication is at the core of all social interaction. Communication is a key life skill. Communication is a fundamental human right'.

The good news is that Our Prime Minister, our Secretaries of State for Children, Schools and Families and Health, and the leader of the review, have already accepted the principle of Early Intervention.

But, on the other hand, governments are often tempted to spend their money - our money - on higher profile or more politically expedient projects.

A great deal of research and well documented clinical work supports the claim that 9 out of 10 children can be saved from a lifetime of stammering. Please ask if you would like to see a summary of some of the relevant cases and the results of current work.

If you understand what life with a stammer can be like, or simply feel that it is time to write this wrong, please support this call for the introduction of an Early Intervention policy for stammering.

If you are in Great Britain, and want help with your or a child's speech, or want to support the work of our leading stammering charity, please contact info@stammering.org

A provocative question

At last after years of blogging, a reader finally asks the right question :-)

I do wonder: Do you have more credibility (than the average consumer who stutters) because you have a PhD in theoretical physics and high IQ, despite your lack of background on formal SLP coursework and training. With a Science PhD: you understand the research methodology process and are able to ask good questions on stuttering research?

The short is: Yes and no! The long is as follows

1) The truthfulness of a statement depends on the strength of the supporting and opposing arguments, and not on the proposer of an argument. So, if Einstein gives an argument to support the statement that 1+1=3, he is wrong, even if it is Einstein, and if Adolf Hitler, a little child or myself say that 1+1=2, then we are right. Science has, well let's say should have, an in-built disrespect for any authority, and 100% respect for reality in form of scientific experiments and logical/mathematical reasoning. So it does not matter who gives the argument, whether they are trained practitioners or work as researchers in stuttering, have a PhD in science, or have no education whatsoever. This includes serial killers.

2) Of course, experts in a field have a much higher probability of making correct statements or of giving correct supporting or opposing arguments than non-experts. However, you cannot argue that an argument is correct because X or Y has made it. Many are confused, because they think "X is true because Prof Y has said so", when in fact they really mean "X has a high probability of being true, because Prof Y is an expert in the field". And many more are just blinded by authority or experts.

3) Have you ever asked yourself: Who determines who an expert is? In my experience, three modes are possible. First, a non-expert realises that you have more expertise than herself, and calls you an expert. For example, a journalist that had half a day to dive into a subject. This myth is then propagated and the person labeled expert obviously is not protesting. Second, experts are self-declared. You just need one self-declared expert, who then nominates others as experts, and so on. Third, an institution is self-declared, and by its authority confers expertise to people and other institutions! You see that the process is rather fluid.

4) Are you an expert in stuttering by being qualified to practise as a speech and language therapist? No. In my experience, 99% of those just out of training have no clue about stuttering, and 95% of those with long-term experience had relatively little exposure to stuttering and hold naive or old-fashioned views. Moreover, having a degree does not necessarily make you a good therapist at all! The same is true for a medical doctor. Some of the best I have seen are people who stutter that managed to control their stuttering. I would only call those experts who specialise in stuttering, e.g. for children or intensive speech therapy. But even for those experts, you can ask the question: "So if you are an expert, how come my child is still stuttering or Tom is still stuttering despite many therapies?" The fact is and many therapists would agree that they the experts don't know who is more likely to recover or which therapy is most effective. So the gap between a non-expert and an expert on therapy is really fuzzy, much more than between you and a math professor. And, of course, they can never really understand what it is like to stutter. It is a bit like the pope talking about sex; how can he talk about it when he never (probably) had sex? :-)

5) Lets look at the researchers. If you do research in stuttering, are you an expert in stuttering? Many are experts in stuttering first, and then conduct research. Maybe I am a bit biased here, but they often lack a thorough research training. You need to go through the PhD experience of focusing on a subject in detail for three years, and you need to have been exposed to constant reality checks and peer reviews. Rarely do practitioners have such expertise nor harsh reality checks, and when they conduct research it is often not very good, especially in statistics and methodology. There are exceptions. On the other hand, you have the hard-core scientists like geneticists or neuroscientists who research stuttering, but sometimes have glaring gaps in their overall understanding of the disorder. Some even prefer it this way, they work on the basis: Give me a disorder and I scan it or look at the genes. They do not want to be biased by expertise. That's fine. Some try to do it all, which is great. But no-one is an expert in all research fields. Many are expert in one field and semi-experts in the others. And I feel that I am a semi-expert in all fields.

6) Regarding myself. I stutter so I know what it feels like. I have talked to many others so I understand the variety, though I understand that I am not a good listener! :-) Then, I have been at many different therapies (probably more that therapists who work for one school) with many different therapists. A few therapists even suggested that I would be a good therapist, but I have doubt because I still stutter. How credible is it if I say "I ccccann reddduce youuur stttutering?" Regarding research, I am a trained scientist with PhD experience in an intellectually hard discipline. I feel like all the scientists in stuttering research who study the other fields where they are not experts.

To summarise, everyone can discuss research and treatment, and focus should be on their arguments and not on who they are! Given my science background, I am as able as the researchers in stuttering to discuss research at the same levels as they for fields where they are not working in. This means that I have a higher chance to get it right than the non-scientists, a lower chance than the expert in the field, and an equal chance as the experts in fields where they are not an expert.

And if you don't find me credible, STOP READING MY BLOG! :-)

Paris Conference open to everyone

I have just spoken to one of the organiser of the conference. He is a PhD student there and helped Chris Kell to organise the conference. He said that everyone is welcome, and that they appreciate as much advertisement as possible.

Here is the poster of the conference: click to get a bigger picture. Looks like they have done a fantastic job at bringing good people together. I have just booked my TGV train ticket. TGV is the fastest train in the world and I have never traveled on it. I will definitely blog from the conference to keep you updated!!

IFA Congress in Rio in August 2009

The 6th World Congress of the International Fluency Association (IFA) will be held in Rio de Janeiro (Brasil) from August 5th to August 8th 2009. Deadline for submission is October 10th, 2008. Early Fee deadline before May 28th 2009. Download this pdf for more information here.

Or contact: Claudia Regina Furquim de Andrade (I hope she is not a stutterer with such a long name! :-) clauan at usp DOT br, and John van Borsel for scientific committee, john dot vanborsel at ugent dot be.

Humans nearly wiped out 70'000 years ago

I have decided to add exceptional scientific research to my blog from time to time, that is not directly related to stuttering. I want to share my fascination with the scientific research out there, that allows us to understand our world better every day, often with surprising answers. I am always impressed how it all fits together harmoniously. And, the confidence gained should comfort us that science will find out what stuttering is all about. I have no doubt about this!

My first post links to this article: Humans nearly wiped out 70'000 years ago. Apparently, humans went through a dramatic phase 70'000 years ago when we were reduced due to severe droughts to a few thousand people, as compared to the insane 6.6 billion that we are today! It is fascinating how geneticists can make sure statements from long long time ago just by looking at the (mitochondrial) DNA. Often, such periods of extreme stress are periods of extreme selection, and we might well have gained part of our cognitive and communication abilities from our ancestors' suffering! What doesn't kill you makes you strong! :-)

My posts ordered by topic

I discovered a cool new feature. I am now able to give labels to my posts, and then group the posts by labels. You can see my first try on the sidebar under "View my posts on". I have always been looking for such a tool, because I do not view my blog as a diary where the posts become irrelevant after a few days. At least that's my personal construct! Now, you can browse my blog at will focusing on a single topic. In this way, there is much more depth to my blog. Of course, I need to review each post and give it one or more labels. This will keep me busy for a few days, but should be a useful exercise, much like reading your diary from 20 years ago!

Please have a look at the new feature, and you can also suggest other topics that I should label! Thanks!

More pictures from Antwerp

(Source: Daca)

We only look under the lamppost

I have become more and more aware of a fallacy committed by researcher in stuttering; a fallacy that is hard to avoid unfortunately but not very strongly stated anywhere. Many are not really aware just how prevalent and strong it is.
It is the looking-under-the-lamppost fallacy. Here is the story: A policeman sees a person searching the ground in the light cone under the lamppost at night. The policeman approaches, and notices that the man is a bit drunk and is looking for his key. Trying to be helpful, he asks: So where exactly have you lost them? The drunk points with a finger to a location a bit further away from the lamppost. Surprised, the policeman says: So why are you not looking there? Well, it is too dark to see anything. I have to look for my keys somewhere, don't I? I don't want to give in, and there is a small chance that I actually lost in around the lamppost!
In the last years, the view that we should study children rather than adults to understand the causes of stuttering has become increasingly popular and rightly so. I wrote a post about it. I also heard it repeated again at the Antwerp conference by Nan Rantner and Ed Conture. And indeed brain imaging work has moved in this direction, with work by Chang and by Watkins. Children's brains are still fresh, and unspoilt from decades of stuttering.
However, current stuttering research is not exactly doing what it preaches. In fact, the absolutely most important time window in children is completely, and I mean completely, ignored. It's the time before onset of stuttering and at onset. The dormant phase where the deficiency is present but unnoticed. I just know of one study that looked at infants. 99.999% of the research starts a few weeks and months after onset. Many researchers do work on children precisely, because they want to avoid the complexity of adult stuttering. However, they are not consequent enough, and stop at onset. Onset of stuttering is an arbitrary moment for the search of causes of stuttering. Think of a rock emerging from a receding tide. Is the moment of emergence relevant for the existence of the rock? No!
I am sure some of you are not happy with my comments. After all, how can researchers study kids before onset because the kids don't stutter yet? And who am I to criticise the researcher when I have no solution ready. First of all, my criticism is valid irrespective of whether I have a solution: if you are over-weight, and I point it out without offering a solution. Is my observation incorrect? Second, I have never seen the fallacy stated clearly and explicitly. In fact, every study on kids on onset should have a health warning: "We did this study knowing full well that the time before onset is as or even more important that the weeks and months after onset to discover the causes".
And, there are possible avenues. Of course, 20 children at onset means that you need at least 20 times 20, 400, children before onset to get the stuttering children. So any reasonable study would include 1000 children. That's difficult to do. What might be possible is to only monitor all children from stuttering families!

A picture from the Antwerp conference

(Source: Jelena)

In the picture you can see Dave Rowley (organiser of the Oxford Disfluency Conference) and myself surrounded by speech therapists Jelena (on my right) and Daca (spelling?) from Serbia and Suzana (on my left) and Mirjana from Croatia who organised the last ISA congress in Cavtat. Please note, I drank the orange juice! If you have other pictures from the conference, please send them over.

Trying out Medication: Week 30

Here is an update on the self report from a reader: last posts. I want to clearly point out that I have never tried medication. I got several emails from you asking me about my experience. I am only reporting on the experience by the reader. I also emphasise that it is a case study and should not be over-generalised. As you can see from his report, medication is not a wonder drug presently. His report fits with what many others have told me. Initial success (not sure how much placebo, but it could be a lot) but gradual (but not complete in their experience) relapse with side effects still present and a search for a better solution, a clear indicator for an insufficiently high benefit/cost relation.
Here is what he reports:

I have been taking olanzapine (Zyprexa Zydis) since September 2007 and my experiences so far are as follows:

The first 6 weeks after taking the drug I felt completely fluent....I had no hesitations in my speech and all facial contortions and secondaries were gone. Since then some of the blocks have started to creep back into my speech and I have some hesitations with the usual things i.e. name / introductions etc. I have good and bad days, some days I feel good and am basically fluent and feel at ease with speaking and on other days I feel almost as bad as I did before I started taking the drug. However, on the whole my speech is better for taking the drug and all facial ticks have stopped since day 1 of taking the drug which is a good thing. I have tried to increase the dose but all this did was leave me feeling tired, so I reverted back to the 5mg daily dose. In fact I am finding that taking the drug on alternate days seems to give me a better flow of speech on the whole. The drug has affected my weight - I have put on around 10-15 lbs, however I am working to get this weight off as we speak.

In summary - The initial amazing results were not maintained, however my speech has improved through taking the drug. The facial ticks have all gone and also the blocks are easier to plow through. The drug is not a cure, but it can offer some benefits, but these have to weighed against the negatives of potential weight gain + the effects on your metabolism/blood work/lipids etc. I am continuing to take the drug as my bloodwork remains stable and the weight gain will be dealt with via diet and exercise. I am awaiting to hear about the phase III pagoclone trials as I would switch drugs as pagoclone offers the benefits without the side effects that zyprexa carries.

Neural Basis of Stuttering Paris Workshop

There is an interesting up-coming conference on the neural basis of stuttering in Paris on May 16th. Such a workshop / conference is long over-due! Many good people are attending. I met up with Ludo Max, Christy Ludlow, and Soo-Eun Chang last October.

I'll try to get more information. Here is what I found on Alexandre's blog:

Thème : The Neural Bases of Stuttering

Programme :
9h30 : Ludo Max (U. Connecticut) Critical sensorimotor mechanisms
10h15 : Soo-Eun Chang (NIH, Bethesda) Childhood stuttering
11h30 : Anne Foundas (U. New Orleans) Anatomy of stuttering
12h15 : Christy Ludlow (NIH, Bethesda) Pathogenesis and pathophysiology
14h00 : Riitta Salmelin (U. Helsinki) Cortical dynamics
14h45 : Kate Watkins (U. Oxford) Sensory-motor integration
16h00 : Henny Bijleveld (U. L. Brussels) Neuroscience and therapy
16h45 : Chris Kell (ENS) From pathology to recovery

Organisé par : Anne-Lise Giraud, Chris Kell, Christophe Pallier, Richard Frackowiak
Sponsorisé par : IFR49 et Association Parole Bégaiement

Lieu : Ecole Normale Supérieure, Salle Dussane 45 rue d'Ulm, 75005 Paris

Solutions to Logical Fallacy IV-VI

Here are the last three fallacies.

IV: Statistical Fallacy

A researcher says: "We have tested 100 kids who stutter on 20 variables and found 2 that were significant (p<5%). Therefore, I conclude that onset of stuttering is correlated to these two variables."

Explanation:
The researcher has committed the mistake of over-fitting the statistical model, because the more variables you look at the more likely one correlates by chance! And if he uses p<5% as a threshold, one in 20 variables will [Correction: is likely to] show a correlation by chance. Moreover, he has only looked at p-value, but effect size is absolutely crucial. The p-value only says whether two distributions are from the same underlying distribution, and any outlier or systematic error can easily lead to low p-values. Therefore, he needs to look at the size of the difference as well.

V: Treatment-Sucess-Factor-is-Cause Fallacy

A person who stutter says: "After I have come to terms with my childhood trauma and undertook psychological treatment, my stuttering vastly reduced. Therefore, stuttering must be caused by a traumatic experience in childhood."

It is true that his psychological treatment has helped him greatly. However, the cause might still be of non-psychological nature that triggered psychological issues that affected his stuttering severity. If you have a car accident and are in shock, psychological therapy might help you to overcome it, but that does not mean it has causes the accident.

VI: Timing fallacy

A researcher says: "We have recently launched a large-scale study to study kids around the onset of stuttering, because we want to find out what causes stuttering."

The researcher assumes that the causes of stuttering lies close to the onset of stuttering, but that could well not be the case. For example, genetics clearly played a role in many cases of stuttering, and the genes were there from the beginning onwards. Or a neurological incident in the womb or later like a virus infection or a head injury could be the cause, but is not close to the onset of stuttering.

Solutions to Logical Fallacy I-III

Here are the solutions to the first three sentences that contained a logical fallacy. I showed the six sentences on a poster at the Antwerp conference, and during the poster session people had to guess what the fallacies were. And they won Belgium chocolate! (actually I gave everyone a piece, either for brilliance or effort! :-) The three who gave the clearest correct answers were Dave Rowley, Robin Lickley, and Luc de Nil. The majority knew that they were wrong, but they were unable to clearly formulate why the reasoning was not correct.


I: Correlation-Causality Fallacy

A parent said: "My kid started stuttering after our car accident. Therefore, his stuttering was caused by the accident."

Explanation:
It is true that both events, onset of stuttering and car accident, happened close to each other, but a correlation (relationship between them) must not imply that the accident caused stuttering. There are alternative interpretations. For example, both events happened by chance around the same time, and only a study of 1000 car accidents can exclude the chance factor. If all kids that are in a car accident start stuttering, the chance interpretation needs to be rejected. But, of course, there are millions of kids who had a car accident and did not develop stuttering, and the vast majority of kids who do stutter did not have had a car accident. It helps to look at all cases, and not just focus on one single one.

Concept:
If A and B are correlated, the interpretation "A causes B" is only one of four possible interpretations. The alternative interpretations are:
1) the correlation between A and B happen by chance. (The car accident happened randomly, and by pure coincidence the kid started stuttering around the same time.)
2) B causes A. (The onset causes the car accident, e.g. the kid was acting strangely before the onset of stuttering and the concerned mother crashed the car out of nervousness!)
3) C causes A and B. (The parents' house was burgled, the kid started stuttering and the parent crashed the car!)

II: Correlation-Causality Fallacy

A therapist said: "We have compiled reliable statistics on 1000 kids over the last 20 years, and we notice that many kids start stuttering around the time of the birth of a younger sibling. Therefore, the emotional effects must cause stuttering at least in some kids."

Explanation:
It is true that many kids start stuttering around the time of the birth of a younger sibling. This is a subtle fallacy related to the third alternative interpretation. Imagine the onset of stuttering is at the age of 20, how many would have younger siblings born at that time? None! What is the most likely age that anyone has a younger sibling born? Around the age of 3, because parents have their children in one go and spaced by two or three years. I use empirical data from a large-scale fertility study and found that 25% of kids between the age of 2.5 and 3.5 witness the birth of a younger sibling. Therefore, both onset of stuttering and the birth of younger sibling are individually linked at age 3, and therefore age 3 links both event.

III: Trigger-Cause Fallacy

A therapist said: "We have compiled reliable statistics on 1000 kids over the last 20 years, and we notice that a traumatic event is often close to onset of stuttering. Therefore, traumatic events can cause stuttering."

Explanation:
It might well be true that the occurence of a traumatic link is statistically closer to onset of stuttering than it should be. However, this does not imply a causal link. We need to be more careful with the word cause. In fact, an alternative and most likely interpretation is that a traumatic event is a trigger (the last drop) that makes stuttering appear. The kid might well have started stuttering anyway even without a traumatic event, but the traumatic event led to a shock and accelerated the appearance. In fact, it might even delay appearance but we would never be able to witness such a delay because trauma and onset is more spaced in time. Think of your old car, it will break down earlier if you do a long journey now and in 2 weeks later if you postpone the journey by two weeks. Surely, you would not assign a cause to the journey!

Antwerp Conference Day II

Over all, a very well organised conference with good speakers... Congratulations to the organizers, especially Kurt Eggers.

We are in Day II of the Antwerp conference. This morning we had a talk by Ed Conture on his Diathesis-Stressor Model of Childhood Stuttering, and by the conference organiser Kurt Eggers who talked about his PhD research on temperament and attention. Kurt showed his results on the 16 temperament dimensions, and shows two variable below p<5%. However, I do not find this a very strong result, especially because he did not indicate the value itself and he did not show the effect size. These are essential parameters to interpret results and should be in any scientific talk. So it might well be a marginal result and not very clear signal. Also, a measurement error analysis lacked, but I can hardly fault him on this issue as NO-ONE does it in stuttering research. I am convinced that if everyone includes such an analysis, it will reduce the number of significant results considerably. The article is going to be published soon, so maybe I know more then. Concerning Conture's model, I am not convinced. I asked a question about whether emotional aspects are important before even before onset, and he said yes. I find this hard to understand. I can see that the model or a similar framework is useful to explain why some kids recover and some don't but not for onset itself.

Blogging from the Antwerp conference

I am at the Antwerp conference, sitting in the meeting area. There were three good talks: by Nan Rantner on psycholinguistics, de Nil on neuroimaging, and Ambrose on genetics. Ambrose was reporting on genetics linkage studies, and pointed out that they found that males and females should different significant linkage to chromosomes: males on Chromosome 9, and females on Chromosome 21. That's quite interesting, and I will investigate further. Luc de Nil reported about work of one of his PhD students with MEG to study auditory (in)activation, and they found that pws differ in both. More soon.

Phase III Pagoclone is going ahead

I heard rumors that the Phase III trial for Pagoclone is going ahead, and there was a meeting to discuss the formalities of the trial. I am sure we will have more information soon.

Stuttering: a developmental disorder?

Sorry for the few posts over the last weeks. I am currently on a France round trip, and I will be at the Antwerp stuttering conference on Friday and Saturday. I will report on the conference.
Today, I want to talk about stuttering as a developmental disorder. The term is misleading. Let's assume stuttering is caused by genes (as it is in some families), how can you possibly label stuttering a developmental disorder??? After all, the body has developed smoothly according to what the genes instructed! The final results might well show deviations from the normal population that became apparent during the development of the child, but that is hardly a developmental disorder per se? On the other hand, if stuttering is caused by a neurological incident like a virus infection or head injury, the smooth development of the brain according to what the genes instructed has definitely been disrupted, and we can call it a developmental disorder.
People seem to define a developmental disorder, a disorder that becomes apparent when the child is in development. So it is based on symptoms. This way of thinking is highly misleading and confusing.

Can you spot the fallacy?

I am preparing my poster for the Antwerp conference next week. It is going to be about fallacies when assigning causes to onset of stuttering. Here are the examples. Can you spot the fallacy? Please post your answers. I will publish the solutions after the conference next week! The winner will be awarded the Mr/Mrs Fallacy title and can write a guest post! :-)

FALLACY I

A parent said: "My kid started stuttering a few days after our car accident. Therefore, his stuttering was caused by the accident."


FALLACY II

A therapist said: "We have compiled reliable statistics on 1000 kids over the last 20 years, and we notice that many kids start stuttering around the time of the birth of a younger sibling. Therefore, The emotional effects must cause stuttering at least in some kids."


FALLACY III

A therapist said: "We have compiled reliable statistics on 1000 kids over the last 20 years, and we notice that a traumatic event is often close to onset of stuttering. Therefore, traumatic events can cause stuttering."


FALLACY IV

A researcher says: "We have tested 100 kids who stutter on 20 variables and found 2 that were significant (p<5%). Therefore, I conclude that onset of stuttering is correlated to these two variables."


FALLACY V

A person who stutter says: "After I have come to terms with my childhood trauma and undertook psychological treatment, my stuttering vastly reduced. Therefore, stuttering must be caused by a traumatic experience in childhood."


FALLACY VI

A researcher says: "We have recently launched a large-scale study to study kids around the onset of stuttering, because we want to find out what causes stuttering."

Crackpot Award for Sigmund Freud

I am awarding a Crackpot Award to Sigmund Freud for his outrageous pseudo-science. His theories about stuttering are not only completely unsupported by any evidence, no he has also consistently misrepresented his case studies. And so have many followers of his. They are a good example of what happens when an ambitious, cocaine-taking, intelligent but pseudo-scientific mind starts day-dreaming without constraint from reality-checking experiments. His criminal negligence regarding the accuracy of his theories has done more than anyone else to confuse the weak minds of the 20th century. His influence still lingers heavily today in stuttering theories about the influence of the subconsciousness and traumatic experiences in childhood.

He has done more harm to people who stutter than any one else, certainly more than any previous crackpots. If anyone thinks of Freud as a great mind who has led to great breakthroughs, think again. Here is what wikipedia says:

Although Freud's theories were influential, they came under widespread criticism during his lifetime and afterward. A paper by Lydiard H. Horton, read in 1915 at a joint meeting of the American Psychological Association and the New York Academy of Sciences, called Freud's dream theory "dangerously inaccurate" and noted that "rank confabulations...appear to hold water, psychoanalytically" [21]. Peter D. Kramer, a psychiatrist and faculty member of Brown Medical School, said "I'm afraid [Freud] doesn't hold up very well at all. It almost feels like a personal betrayal to say that. But every particular is wrong: the universality of the Oedipus complex, penis envy, infantile sexuality." A 2006 article in Newsweek magazine called him "history's most debunked doctor."[22]

Freud's theories are often criticized for not being real science.[23] This objection was raised by Karl Popper, who claimed that all proper scientific theories must be potentially falsifiable. Popper argued that no experiment or observation could ever falsify Freud's theories of psychology (e.g. someone who denies having an Oedipal complex is interpreted as repressing it), and thus they could not be considered scientific.[24] Author Richard Webster characterized Freud's work as a "complex pseudo-science"[25].

H. J. Eysenck claims that Freud 'set psychiatry back one hundred years', consistently mis-diagnosed his patients, fraudulently misrepresented case histories and that "what is true in Freud is not new and what is new in Freud is not true".[26]

Mikkel Borch-Jacobsen claims that "The truth is that Freud knew from the very start that Fleischl, Anna O. and his 18 patients were not cured, and yet he did not hesitate to build grand theories on these non-existent foundations...he disguised fragments of his self-analysis as ‘objective’ cases, that he concealed his sources, that he conveniently antedated some of his analyses, that he sometimes attributed to his patients ‘free associations’ that he himself made up, that he inflated his therapeutic successes, that he slandered his opponents."[2]

Freud: unbelievable nonsense

I am shocked by what I read here:

At the beginning of the twentieth century, adult psychiatrists became interested in stutterers after Sigmund Freud wrote that the etiology of stuttering was "for the most part" psychological. Later, he stated that "stammering could be caused by displacement upward of conflicts over excremental functions"' Freud felt the adult stutterer's speech mechanism was enmeshed in a conflict between the wish to defecate symbolically on his parents and authority figures by using hostile words and a concurrent fear of retaliation that caused the stutterer to hold the fecal-oriented words inside.

The early psychiatric theories about stuttering (1900-1945) generally supported Freud's anal displacement theory, and led to the recommendation that stutterers undergo psychotherapy or psychoanalysis. However, child psychiatry and child psychoanalysis did not take shape as a medical specialty until the 1940s.

Modifications to Freud's theory were seen after 1945, as in the work of the psychiatrists Kolansky and Glauber and this author, who discussed the parents' role in the etiology of stuttering. In 1960, Kolansky wrote about his treatment and cure of a 3-year-old girl who began stuttering when her mother gave birth to twins and her grandmother concurrently vigorously bowel-trained her.' In 1965, he became one of the first child psychiatrists to emphasize that the treatment of a child's stuttering should include the parents' active participation .7 His treatment of the 3-year-old involved having the mother and child together in his office playroom. This author described the treatment of two stuttering early grade school girls and the concurrent' therapy with the girls' mothers.

I cannot believe why so many people glorified and still glorify Freud, when in fact the vast majority of his theories are just complete and utter non-sense. Especially his methods to "prove" his theories. Just imagine how much misery he and his blind followers have brought to the millions of sufferers from various disorders with their completely ridiculous theories and associated treatment approaches. And think about all those down-to-earth and honest doctors that told their patients that they just don't know what is going on, and were of course completely ignored. Who wants to go to a doctor or therapist who does not know what stuttering is about?

Inspirational Article

Here is an inspiration article on how to handle your stuttering, even if you are not fluent.

(Thanks to Rehan Nasir for the link)

Some changes to my blog

I made some changes to the blog layout. I added a Donate button to support my blog work to cover my costs. Of course, please do not feel obliged to contribute! It is just for the wealthy and charitable ones! :-) I also added Sponsored links where I have added conferences that have given me a reduced conference fee in return to linking to their website. I also accept purely commercial links, but I need to decide whether I feel comfortable with their product and the marketing of it. The same is true for books. So if there is anyone who wants to have their book advertised, please let me know. I also changed the order of the archive so that the oldest are first, but what I really want to have is a list of 20 randomly selected posts from the last 3 years. I also changed my name to T--tom. I guess that my outing is. :-) If it gets on my or your nerves, I'll change it back.

I would like your feedback on the changes. Do you think that the changes are appropriate or destroy the integrity sphere of the blog? Or should I make some small changes to the changes? Just let me know.

Money, money, money

I am NOT stuttering on the title. It is just a recurring thought! I am spending much time and money on stuttering, but have exactly zero revenue: money-wise that it. I also have hidden costs of loss of opportunity, because I am spending my intellectual energy at age 35 (where you are apparently most productive?) on an area where I do not have a career. I am neither a speech therapist/pathologist nor a scientist working on stuttering. Instead I could be spending my time on more "productive" work and earn more money as a consultant. Of course, I get a lot emotional revenue (also from your posted comments and emails), because I am driven to understand what stuttering is about, and what helps most. And 1000 weekly readers is a great but unhelpful stimulation of my ego... ;-)
My goal is to make my efforts a zero-cost affair, but I am not quite sure how I can extract money from you, my readers, to cover costs. :-) Surely, no-one will pay to read me. My only chance might be to ask the few wealthy or charitable for donations but I am not sure how I should do this. My best bet is probably advertising. But, I have chosen not to advertise on my blog via goggle AdSense because most adverts are really fake promises of cures and I kind of find it difficult to rail against them and at the same time to get revenue from them! I might change my mind, and do it but only for a few selected one. I can certainly make the case that I have over 1000 unique readers per week and I am high on google search. So there is good exposure for the advert. This strategy is already working well for getting free books and reduced conference fees.

Going to Oxford Dysfluency Conference

After some long thoughts, I have decided to go to the Oxford Dysfluency Conference. There are several people coming that I want to talk to, for example: Per Alm (he works on neuroscience and theory), Jerry Maguire (I think, he led the Pagaclone Phase II trial), Kate Watkins ( I would guess as she is from Oxford, experimental brain imaging work) and other good people. By the way, Michael Palin is coming to the conference. So I feel like I cannot afford not to be there. I didn't enter any talk proposal, but I sure will ask questions to the poor presenters! And maybe I get invited to a panel discussion...
I am also stingy about the costs involved: 500 pounds. I am not saying it is not a good deal for the services offered, and I am sure Dave has done his best to keep the price down. But still combined with the travel, it is as expensive as a one-week holiday if not more. Though I have to mention that for the last ODC conferences, the British Stammering Association paid the full or half of the conference fees, for which I am very grateful. They usually have a few grants for the conference, and might have it this year, too. And I have also started trading with the organisers of recent conferences for a reduced fee in return for full coverage on "the by far most read stuttering blog on the Internet". As you can see I have started to use you as a bargaining tool! :-)

Chess: a sport for stutterers!

You probably don't know that I played a lot of chess when I was a teenager. I even managed to participate in the World Junior Chess Championships in Chile in 1990, in Romania in 1991, and in the Netherlands in 1992 for my country However, let me tell you straightaway that I am no Kasparov or Fisher and I always finished up in the bottom of the tournament. Being from Luxembourg, your chances of being one of the best is a bit larger than in the US or Germany, for we only have half a million inhabitants! :-) So I am a strong club player on the local level with an international rating of 2040, but the weakest on an international level. I only started to play in a club at the age of 16, far too late. All grandmasters and international masters start at 12 or earlier. The reason I didn't post for a few days is that I qualified for and played at the national championship, after a pause of more than 10 years of real competitive chess. I did OK against semi-professional chess players with relatively little preparation.
In a sense chess is an ideal sport for someone who stutters. You don't have talk, you just need to move your pieces around. It is a very good practise for mental control, strategic thinking, concentration, patience, willingness to accept risks, handling difficult situation and so on. Chess also allows you to build up self-confidence, and very importantly prevents you from blaming your defeats on your stuttering. My only issue is when I want to propose a draw ("a remis"). It even happened to me once, that I just couldn't say it and so I just told myself: f**k it, I am going to win this game and continued playing. :-)

H--appy Easter!

Primary and corrective-feedback phase of stuttering

From time to time, I have these flashes of enlightenments which either quickly vaporise or stay and I see clearer. Actually, it becomes so clear that I am wondering whether not everyone knows that anyway because it is so simple, and that I was just too stupid to have realised.

Stuttering goes through two completely different phases, the moment of onset being the phase transition. In the first phase (the primary phase), the subconscious brain, the person that lives with the brain, and its environment knows nothing about the abnormal nature of the brain. It is functioning happily. Still, the abnormality is there and detectable, and caused by either genes or a neurological incident. The phase transition happens at onset of stuttering. The moment of onset per se is nothing special at all, as its causes go back years, back to the genes or the neurological incident. It is like the emergence of a rock when the tide goes out again. The moment of the rock emerging looks special but it is not the rock that is not emerging, but the water that is receding and for the water it is nothing special at all! Still, something dramatically has changed that triggers a feedback loop leading to the corrective-feedback phase. Suddenly, the subconscious brain, the person of the brain, and the environment realise the abnormality, because it leads to atypical and functionally disruptive behaviour: dysfluent speech plus secondary effects. Immediately, corrective behaviour sets in by the brain, by the person who stutters, and by its environment. The future development of the disorder now depends on two things: the severity of the underlying abnormality, and the correcting ability of the brain (brain plasticity), the person who stutters, and its environment. And, the goal is clear, too: to change the atypical behaviour to within normal and functional behaviour. Note that the emphasis is on correcting behaviour, whether the brain is still abnormal is irrelevant as long as it produces normal behaviour. Of all the children who start stuttering, a majority of eighty percent manages this task well, the others like myself go on to become adult stutterers.

Idiotic introduction to stuttering article

If you are ever looking for an idiotic introduction to an article about stuttering, how about the introduction to this otherwise good article Verbal Bottleneck in Scientific American Mind from October/November 2006:

Greg K. was only three when the problem began. During a family vacation he saw two crashed cars burning. Soon after that, his parents recall, the boy began stuttering. Even today, at the age of 40, Greg is more likely to order lasagna in a restaurant and forgo his favorite pizza, capricciosa, because he cannot manage words that begin with explosive sounds like the letter "k."

Again and again, stuttering is linked to an accident story. And again and again, I am saying that MILLIONS of kids had traumatic experiences like a accident and only 1% is stuttering today, the same percentage as the general population! And MILLIONS did not have traumatic experiences and still stutter!

To the author's defense, I vaguely remember her saying that the editors sexed up the story without telling her, and this migrated from the German version to the US version. This might include the accident part.

The collapse of Bear Stearns

You might have heard about the sudden and spectacular collapse of Bear Stearns, one of the largest investment banks in Wall Street. But, what you probably did not know is that I have worked for Bear in 2001! Namely in Risk Management, of all departments! :-) Risk management is a relatively small but important department of an investment bank that very carefully studies the risks taken by all trading desks and incorporates them into a firm-wide risk analysis. It is staffed only by quantitative PhDs and very experienced ex-traders, and uses a lot statistical and financial modeling tools.
After a post-doc in Manchester and a visiting researcher grant at Trinity College, I started working at Bear Stearns in London at the central tower of Canary Wharf with a fantastic view of London. I was responsible for monitoring the equity derivatives desk in Tokyo. I worked on/next to the busy trading floor, and every week we had a video-conference to discuss the risk exposure for Bear. I have to say that I didn't get off to a good start: I had serious back problems (a prolapsed disk) and couldn't sit for longer than 20 minutes, house mates from hell, my stuttering was quite bad due to my back and high pace, and didn't get on well with my supervisor.
Bear is quite different to the other investment banks. They are more of a creative chaos led by talented traders rather than a well-structured bank with a systematic risk management approach supported by strong IT. We completely lacked IT integration of firm-wide data into a risk management system. There was always a concern for the credit derivatives that are very difficult to price, and this concern grew over the years as what I heard from former colleagues. My guess is that the reason for the collapse lies within senior management and their failure to limit exposure to difficult-to-priced securities, and the (political) weakness of risk management to make this case.
It is quite dramatic for the people who work there, as many received bonuses via company shares that are locked for 3-5 years and it was considered bad taste to sell them even after the lock-up period finished. By consequence, the Bear employees own 33% of their company and lost most of it. The top people were millionaires or billionaired, and their fortune dropped by 90%! However, I have no pity for them. It is insane to hold stocks at the same company that you are working. It's the most obvious mistake of diversification. Still, there is a perfectly reasonable argument for why they did this. Bear Stearns is the most aggressive investment bank on Earth dominated by trader mentality. Their ethos was: Show us loyalty to the firm by keeping your stock, and we are proud of you. They want to bind you, and make you part of themselves. They might have lost, but I wouldn't be surprised if they say to you: "So what? We played though and lost. I am proud of what I have done. Life goes on. I took the risk. Others run." For that, they deserve respect: they have all taken common responsibility for their actions or lack thereof, unlike CEOs who get outrageous bonuses without taking any risks and even get golden parachutes for messing up companies.

My first speech at Toastmasters

Tonight, I have done my first speech at Toastmasters. Toastmasters is an association for people who want to become effective communicators and leaders. It is an excellent way to become a better speaker and overcome those butterflies. I heard about Toastmasters before, from people in the stuttering community and from Einar, a friend of mine who stutters, too. The group meets twice a month in an hour and a half long session. The first part consists of interpromptu speeches called the table topics, the second is a set of 4-5 speeches, and the third is an evaluation of the speeches.

Coming back to my speech, it was rather surreal. I had already attended two sessions and I introduced myself and mentioned my stuttering. The old story: I stutter, I have to work on it, Toastmasters might be a good way to practise, need to have patience with me and so. And then, I gave my speech and my evaluator said afterwards: Not sure Tom mentioned stuttering, because he didn't stutter! So I had to interrupt and say that I do stutter! My mentor who heard me stutter a lot from when I talked to her, was amazed that I was able to talk fluently. My trick was of course to: 1) write down the speech, 2) practise it 10 times 3) put on an acting mode. I was fluent... And they all seem to love it. The comments were: good sense of humour, good body language, CLEAR AND STRONG VOICE (give me a break ;-), interesting,...

Anyway, Toastmasters is a fantastic environment to work on your speech and to become more relaxed. I wholeheartedly recommend it to everyone!

Crackpot Award for EFT people

My next crackpot award goes to the EFT people. Check out this webpage. Unlike the standard crackpots, she is not claiming to understand what causes stuttering rather she seem to say that EFT (Emotional Freedom Technique) helps stutterers deal with the emotional side.

Nevertheless she deserves an Award, because her report of improvement is obviously completely naive (and shockingly unprofessional for someone who studied speech pathology) as stuttering can easily be reduced using ANY method (my favourite one is walking on all four) and she neglected the placebo. I am CONVINCED the improvement is placebo.

(Thanks to a reader for pointing this out to me.)

The bloguette of Mr BSA

The stuttering blogoshere has just undergone a phase transition: Norbert Liekfeldt, CEO of the British Stammering Association, has a blog where he talks about his activities: see here. (I have also put a link in my blog links.) The blog will be a good way for BSA members to see what's going on within the BSA on a day-to-day basis. But of course there will also be the delicate business that will not find its way onto the blog. Or can you imagine Norbert writing: "Today, I again had an annoying call from one of our BSA members. We need to do something about him." or "Today, we finally got rid of XY whom we recruited last year. He was a complete disaster and only cost us money. I need to find a way to exclude trustees from selecting staff in the future. And I still have to write a note for the website, and I am thinking of writing something like >XY has left the BSA to pursue his career at another charity. We thank X for his valuable contribution to the BSA.<" (No allusion intended to any real BSA event from the past year!)

In an email to TheStutteringBrain, Norbert Liekfeldt writes: "Just a bloguette.... Say something nice!" So here it is. Norbert is really Mr BSA, the glue of the BSA. He has been leading the day-to-day business for many years. Trustees (like myself) have come and gone, members have come and gone, financial crises have come and gone, staff members have come and gone, but Norbert is still there, a bit like the Cheops pyramid. So he certainly deserves credit for inducing stability to the BSA. Without Norbert, the BSA might not exist anymore. If there is one failure that I see, then it is the precarious financial situation of the BSA which has persisted for many years. The BSA is never far from the brick despite relatively conservative spending. Norbert but also the trustees (former and current) and especially the last and current BSA chairs have completely failed to recruit and keep wealthy and influential donors. If you could be one, call the BSA!

It's before the task, stupid!

Weber-Fox's team has looked at school-age children's brains while performing a visual rhyming task. They used ERP (event-related potential or evoked potential) which is a range of methods that record electrical activities in form of potentials in the brain due to a stimulus: see picture above. They want to understand why kids who stutter have lower accuracy on rhyming judgment (not sure exactly what they did; I guess the kids were given two words on a screen and had to judge quickly whether the words rhyme or not). They did not find any differences in electrical activity for the task, but they found atypical activities before the task itself. This observation makes sense to me. Many of the non-speech related deficiencies like in dual tasks or rhyming judgment are probably due to a sub-optimal coordination between the different brain regions, which is probably due to the brain having to compensate for some failing region(s). Think of a transport system of a big city. Imagine a bridge must close and be re-built. The impact on the transport system can be dramatic and impact not only the local area. For example, the heavy lorries now have to use another bridge which is less equipped to handle heavy traffic and therefore fast deteriorates, too. Or there are suddenly traffic jams in unexpected parts of the city, and for example disrupt the functioning of a big factory or hospital.

Atypical neural functions underlying phonological processing and silent rehearsal in children who stutter.

Weber-Fox C, Spruill JE 3rd, Spencer R, Smith A.

Speech, Language, & Hearing Sciences, Purdue University, USA. weberfox@purdue.edu

Phonological processing was examined in school-age children who stutter (CWS) by assessing their performance and recording event-related brain potentials (ERPs) in a visual rhyming task. CWS had lower accuracy on rhyming judgments, but the cognitive processes that mediate the comparisons of the phonological representations of words, as indexed by the rhyming effect (RE) ERP, were similar for the stuttering and normally fluent groups. Thus the lower behavioral accuracy of rhyming judgments by the CWS could not be attributed to that particular stage of processing. Instead, the neural functions for processes preceding the RE, indexed by the N400 and CNV elicited by the primes and the N400 elicited by the targets, suggest atypical processing that may have resulted in less efficient, less accurate rhyming judgment for the CWS. Based on the present results, it seems likely that the neural processes related to phonological rehearsal and target word anticipation, as indexed by the CNV, are distinctive for CWS at this age. Further, it is likely that the relative contributions of the left and right hemispheres differ in CWS in the stage of processing when linguistic integration occurs, as indexed by the N400. Taken together, these results suggest that CWS may be less able to form and retain a stable neural representation of the prime onset and rime as they anticipate the target presentation, which may lead to lower rhyming judgment accuracy.