Shocking or not?

Donald Trump called Seth Meyers a stutterer: "I thought Seth Meyers -- his delivery frankly was not good. He's a stutterer." And Stuttering Foundation of America slammed Trump: "We at the Stuttering Foundation find it discouraging that in 2011, Donald Trump has chosen to use the word 'stutterer' in a derogatory fashion, something to be made fun of, to describe Seth Meyers' speech at the annual White House Correspondents' dinner."

I am not so shocked. He probably used it more in the sense of mental hesitation. What do you think?

Unlearn fear

A reader asks:

Is it possible to reduce your autonomic response to moments of stuttering? I mean the pounding heart, tightness in the stomach, etc. If it is possible, how does one go about doing this? By just entering into more situations that evoke the "fight or flight" response?

The pounding heart, and tightness in the stomach is due to a reaction to the situation you are in. Your brain has learned to associate certain situations with fear and anxiety. So the next time your brain encounters a similar situation, it automatically triggers fear and anxiety TO HELP YOU TO BE PREPARED FOR THE DANGEROUS SITUATION. The reason your brain has learned to associate certain situation with fear is because your belief system has said that the situation is dangerous.

Two things you must do:

1) Re-visit your beliefs (Is stuttering in front of people dangerous?), and change your beliefs. At the end of the day, you need to have a belief like "It is not my fault that I am stuttering and there is no reason to be scared, embarrassed, or uncomfortable."

2) Unfortunately, changing your beliefs is not enough, because your brain has learned the association and you can only undo it by learning a new association. This means that you need to enter the situation over and over again, so that your brain realizes that it's not a dangerous situation. There are several techniques to achieve this effectively: here is a rough summary.

Part of the problem

Here is an analogy that captures an important aspect of stuttering: the swallowing-a-pill analogy.

When you drink water, you swallow the water without a problem. When you have to swallow a pill, you might choke on the pill. Being aware of swallowing makes us choke.

Being aware of stuttering makes the stuttering worse.

Guitar calls Lidcombe critics ridiculous

Barry Guitar launched a frontal attack on those who are doubting Lidcombe in this radio interview on NPR. The journalist Jane Lindholm asks Guitar why some doubt the evidence base of Lidcombe due to small sample siz. He says that "This is the most ridiculous critique you can imagine". Check at 7:30 minutes. He refers to 100 studies showing efficacy with gold standards. He says that critics don't want to see 100 studies but 1000s studies. He also says that other treatments have no evidence at all that they work.

He falls into the common traps:

(a) equating perceived success in an outcome trial with success of the method itself. (it could well be that other treatments are as effective, and success is not due to Lidcombe specific issues.)

Fraud and weak research

Maybe you heard of the scandal where a study "established" a link between vaccination and autism, and parents (mostly mothers) in the UK went nuts and stopped vaccination. This study has now been severely discredited.

Ora made me aware of an interesting article about the quality of scientific research in the psychological and social research area. See Lehner's article.

An interesting article in the New Yorker magazine about a phenomenon in scientific studies. 

Before the effectiveness of a drug can be confirmed, it must be tested and tested again. Different scientists in different labs need to repeat the protocols and publish their results. The test of replicability, as it’s known, is the foundation of modern research. Replicability is how the community enforces itself. It’s a safeguard for the creep of subjectivity. Most of the time, scientists know what results they want, and that can influence the results they get. The premise of replicability is that the scientific community can correct for these flaws.
But now all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain. It’s as if our facts were losing their truth: claims that have been enshrined in textbooks are suddenly unprovable. This phenomenon doesn’t yet have an official name, but it’s occurring across a wide range of fields, from psychology to ecology.

I suggest you read the first page (screen) and then stop and think hard what might account for this effect, before you read the rest of the article.

More of the Australian gold standard

Here is an article for all those that claim that Lidcombe never claims to work magic.Even if you argue that the journalist got it wrong and they don't claim cures, you must wonder how the journalist came to the idea of "cure". This fits well into the last post where the therapist suspected the child's family to be the cause of the "non-cure", because she too was indoctrinated with the "cure". Here is the article.

Online remedy for stuttering
Nick Galvin
May 2, 2010

Relief may be at hand for millions of people around the world who stutter, thanks to the pioneering work of Australian experts.

The Australian Stuttering Research Centre in Sydney has won a federal grant of nearly $5 million to develop a system that sufferers can access via the internet. The simple program has cured pre-schoolers in 12 weeks.

''Parents ask kids every now and then to say what they just said without the stutter,'' centre director Professor Mark Onslow said. ''It works amazingly well but the problem is that there aren't enough speech pathologists to deal with all the kids who are stuttering.''

Tom: You have been out-handicapped

As you might know, I am an active member in Toastmasters, and regularly participate in contests. Last Saturday, I participated in the Area contest (after the club contest) but I didn't make it to the first three of eight. All eight were very good speeches. I spoke about The King's Speech. An Indian guy won with a speech on Mr Impossible who tells us not to try, and he had polio as a child leaving him with difficulties in walking. He had a very good theme, and comes across as a very nice guy and relaxed speaker. After the contest, someone came to me and said that he liked my speech, but said that I should move and speak of other topics than stuttering, which I agree with, and he finished off by saying: "Tom, great speech but you have been out-handicapped". ;-)

In any case, everyone liked my speech, so here it is:

You helped me find my voice

In this grave hour, perhaps the most fateful in our history, I send to every household of my peoples, both at home and overseas, this message, spoken as I were able to cross your

Lidcombe never fails, only parents do

Here is a comment from a mother in which she says the therapist blames them for the relapse, because Lidcombe works so it must be the parents:

Hi, my son has been on the Lidcombe therapy for 3 months seeing a SLP almost every week in that time. We saw a big improvement for the first few weeks but after that his stutter pattern has returned to how it was before, some days really bad and then a gradual decrease to hardly any problems and then over the next week it becomes worse again. It seems now the therapist is at a loss at to what to do and seems convinced something is happening at home to make it keep getting worse and then better which is insulting. She has blamed my husband because hes in the army and works away alot, then it was my eldest son because he left for uni, nursery, and now she seems to be pointing the finger at me, saying he has to much of an attachment to me (surely if this was the case I wouldnt be able to leave him at nursery). Im so frustrated with the whole experience and feel were no further towards helping him that we were before we started the course. I hope other people have a better and more productive experince from this course. I feel it is more suited for children with less severe stutters xx

I am not going to the Oxford Dysfluency Conference

Some good news for some! I decided not to go to the Oxford Dysfluency Conference. It's just too expensive. First, I was not given the reduced fee unlike at all other conferences in the past including Oxford. Apparently, Elsevier is not allowing this. And then they charge 20% VAT, because Elsevier organises it and not Dave Rowley as part of his university. Claiming back VAT is about as easy as understanding stuttering. So I would end up with a bill of over 1200 Euros for 3 days. Too bad. It was a nice place, and an OK conference.

The only person non-sensitive to the price are those who are paid for by government and on blind travelling grants. I also heard that others from less well-off countries or therapist not funded by their department are unable to attend.

In general, conference organisers like Elsevier are destroying real science and draining the system out of money with expensive conferences and journals.

Death to Elsevier and long live Plos and privately-organised conferences! There is a BSA conference one week later. Maybe I am attending it, and try to get a few people together to talk science.

Breaking News: Chinese dopamine genes not-confirmed

Finally some evidence that stuttering research is actually following the scientific method. In a highly unusual move, Drayna's team has actually tried to replicate a study rather than churn out new stuff. They looked at the Chinese gene study, and could not replicate the study.

Kanstantsin made me aware of this new study (that was probably finished years ago but only now published! So the wider community was deprived out this valuable information despite Drayna being funded by the publicly-funded NIH). He writes:

Drayna is one of the authors. of "Evaluation of the association between polymorphisms at the DRD2 locus and stuttering."

They basically tried to replicate the 2009 study from chinese group (I think you blogged about it). [Yes, I did in More Genes from China!] "Association between dopaminergic genes (SLC6A3 and DRD2) and stuttering among Han Chinese."

On the origin of our feared letter

I had an interesting thought. I am currently revising a late draft of my upcoming book, and I have a section on stuttering. I was writing about associations with different letters that stutterers might acquire. So for some the letter /d/ might be a problem for others the letter /m/.

Then I realized that /d/ is the first letter of /daddy/, and /m/ of /mommy/. So I was thinking that maybe we develop an association between a stuttering event and the letter that we most or first used as a child in speaking our first words.

So a child might first say /mommy/, and obviously she will first experience delays of speech initiation on the letter /m/. And the brain will look for correlations, and realize that when I have to say /m/, I am likely to have issues. So the brain stores an association between the letter /m/ and a stuttering event. My guess is that if you fear /d/, you might have been a daddy child! Or in other languages, /p/ for /papa/.

Students: here is a final year project: test my theory!

1. find stutterers 
2. ask them about their feared letter.
3. ask them whether they were mummy or daddy children.
4. find stutterers from different countries where daddy does not start with /d/ or mother not with /m/.
5. analyse data: especially compare countries.

Stuttering WWII general

Nathan found a stuttering WWII US general:

This was never mentioned on any famous PWS list. Apparently there was an American WWI and II general who stuttered significantly. Here is the Time Magazine article. The stuttering isn't mentioned until page 3.

A stutterer reads the news: Please support Alex's campaign!!

I got a request from Alex von Gudenberg, who created and leads the only healthcare-approved clinic for stuttering in Germany. They have launched a campaign for more public awareness. Please support his campaign. They have asked for the news to be read by a person who stutters! Luckily only one day! ;-)

Dear fellow stutterers,

I am the director of the Institute of the Kasseler Stuttering Therapy (KST) and was a severe stutterer.

By chance we created a campaign against discrimination of stutterers in Germany, which is becoming quite successful. The film maker Henning Burk, a stutterer himself, did a report for a TV station (3SAT) about stuttering in our institute when The King's Speech started. He had the idea to ask for stutterers to read the prime time news in the two major German channels to achieve more tolerance and attention for stutterers.

It started more as a campaign without real chances of realisation. But now a website with information and on-line signing of the petition exists: HERE.

Stutterers in major German cities supported this campaign by collecting signatures at the movie theatres, in addition to press releases and TV appearances in support of the idea. The German media (radio, TV, print media) jumped it.

About 1000 people have signed so far.

Therefore I wonder, if this might have potential for a worldwide campaign. It does not seem too ambitious to get Colin Firth and David Seidler and other as supporters.

What do you think of this idea?

Best wishes from Germany

Alexander von Gudenberg

(You can also email him: AWvGudenberg at Kasseler-Stottertherapie.de)

Slate Columnist Nathan Heller stutters

Nathan Heller has made me aware of his article on The King's Speech in Slate. Nathan works there as a columnist, stutters himself, and is a fan of my blog!

If you want to hear an intelligent and insightful review on The King's Speech: check out his article.

Amnesia cures stuttering?

Stuttering Stanley asks:

Tom, do you think that if a stutterer had sudden total amnesia, he or she would cease to stutter? I ask because I surmise that if I have times where I am fluent, then why can't I find a way to ALWAYS be fluent? Doesn't that indicate that I have the capacity to be 100% fluent? Maybe if I forgot about stuttering...it would disappear?

My answer is the following. If you have a total amnesia (where I include semantic memory but also associative memory), you will be like a young child at onset. You have a brain that is prone to abnormally long and frequent jamming or delays of speech initiation. These delays will feel long but just like a mechanical failure in the sense of accidentally hitting a chair because you had a glitch in your motor code for walking. You will not feel any fear or nervousness. And your jamming will probably only be noticeable in very stressful or demanding situations. And you will not have any secondary behaviour. However, over time you will feel the functional handicap and the social reaction. Coupled with your knowledge of what is normal speech and what role you want to play in society as a person, you will start to react to your jam-prone system and develop secondaries. You will add tension to get out what you want to say more quickly. You will also learn to fear certain words and situations. This associative learning will then trigger more stuttering and nervousness.

To sum up, your neurobiology is still there, and the information content that you have lost in amnesia will be filled again with learned behaviour, fears, and beliefs. BUT THEY WILL LIKELY TO BE DIFFERENT TO YOUR ORIGINAL LEARNED BEHAVIOURS, FEARS, AND BELIEFS.

You can be 100% fluent but only if you manager to control your jamming in two respects: (a) you take measures to reduce the neurobiological jamming, such as staying calm in demanding speaking situations, sticking to pauses, shortening your sentences, and so on (b) you take measures to prevent yourself/your brain from launching a reaction to jamming that is counter-productive to speaking fluently.

Wireless neurostimulation for stuttering?

Manik sent me a link to a venture capital enterprise, Microtransponders, which developped the SAINT™ System, a wireless neurostimulation technology platform to treat neurological disease. He is excited about a possible application to stuttering. Nature has already published an article on treating tinnitus in an animal model.

The website, technology, and research looks solid, and should not be rejected off hand. I will write to them and ask whether they have ever considered stuttering. I am not exactly sure how a treatment for stuttering should work. As far as I am aware, stimulation has only increased and never decreased stuttering. However, every new approach should be checked for.

Let us assume the technology works, would you accept having implants, even if very small, implanted in your brain? I can only see severe stutterers considering this option.

Another article on the King's Speech

A reader asks me to post this link to an interesting article (apart from the science part which is not wrong but very fuzzy.)

You are an inspiration and a hero to the stuttering community, and a
role model for children who stutter. PWS trust you to be independent,
fair, and not influenced by anyone.

You showed that PWS are not hopeless victims, but smart and driven.
You have hundreds if not thousands of loyal readers who support you
and thank you. But you also have a few enemies.

There is a article written by a female PWS (I am not sure she knows
much about the causes of stuttering, the way she explained it sounded
fishy to me). Can you post this on your blog.

http://www.timesunion.com/opinion/article/The-king-and-us-myth-and-all-1017358.php

No stuttering mice!

Currently, I am reading articles by science journalists in well-respected newspapers and magazines, telling us about the prospect of stuttering mice. And other highly inaccurate stuff.

I am nearly convinced that there will NOT be a stuttering mouse. The Drayna group claims that single mutations in one of three genes, forming part of a metabolic pathway, causes stuttering in nearly all cases. This finding needs to be replicated for me to believe it.

Consistent with their finding, they (or collaborators) plan to create mutations in mice, and see what is happening. They will most likely find subtle damage in some cell types in some brain regions, but they will not hear stuttering mice. People need to get away from the myth that a gene is coding for a special property. Genes deliver the instruction to create a protein, and in combination these genes can create complex molecules needed by the body. My theory is that the mutation only affects specific brain regions that happen to be responsible a stable communication between language and motor areas. Subtle damage to these regions leads to an unstable, low capacity speech system.

Quality of human discipline research

Ora writes

Beyond the familiar problems we've discussed - such as publication bias, the tendency to publish results which show something, anything, rather than nothing - we have the confounding effect of bad data.

Take a look at this NY Times article.  20 percent of the data is just wrong?!

From Freud to fMRI: Untangling the Mystery of Stuttering

There was a symposium on stuttering with Smith, Drayna, and de Nil organized by Nan Rantner.

This symposium will track current developments in the study of stuttering, the fruit of recent collaborations among researchers in the fields of genetics, speech motor control, and language processing. Until the past decade, much of the research into this common yet poorly understood communication disorder tended to be narrowly focused on accounts within a single discipline, from psychoanalysis to learning theory to articulatory control to hemispheric asymmetry. In this symposium, we will provide examples of the cross-disciplinary research that is changing consensus on the probable basis for stuttering. Recent advances in genetics, brain imaging, and speech motor control will be discussed in terms of their ramifications for better understanding this elusive disorder as well as treating it more effectively.

All are excellent scientists. However, they are foremost experimentalists and clinicians that work within their respective paradigm. Their challenge is to work on a cross-disciplinary theoretical framework on stuttering and I fear they will get slowed down due to a lack of 100% conceptual and theoretical rigour. I discussed with all of them. They are all bright, but no-one of them is an excellent theorist.They are very much in their experimental paradigm, and their talks suffer from 100% conceptual clarity. Ann Smith is the one with the clearest conceptual mind. But even she is in my view stuck in a single functional cause picture, as far as I remember from our short discussion at Oxford.

I find the mention of the name "Freud" in the title complete and utter kitsch. Why do we need to mention his name or work? Can we not focus on the here and now?

Different voice, no stuttering?

 An interesting self-report of a reader. I am wondering whether the change in voice in puberty affects stuttering. In a sense, the brain does not identify its own voice, and you might have the choral effect!! ;-) That's the first time, I hear this:

I've had MASSIVE fluctuations in stuttering around the time my voice changed. These were much more than a period of good or bad days. I was reduced to a complete absence of stuttering. I could not make myself stutter during these periods.

When I was going through puberty, I stopped stuttering for 2-3 months. I was reading fluently in class and I introduced myself in front of roughly 300 people. I was as surprised as my classmates and teacher were. I attribute this to my voice changing and I gradually relapsed. Around this same time I was becoming really popular so my confidence might have increased, but that might have been a side-effect of the fluency. As I was relapsing, the biggest change back to stuttering was when I got an ear infection, that caused fluid build up in my ears reducing my

Why apparent short-term success in Lidcombe treatment

Perti asks me a question about Lidcombe:

I am an SLP student who has been wondering about the Lidcombe program for a while [...] I've just been wondering about the Lidcombe success rates. How come the Jones et al (2005, British Medical Journal) had such a huge difference between the control group and the actual subjects. The field of stuttering is a complex one, as our professor said. One could fill a library with books that are all about stuttering and still none of them is absolutely right about it. The problem is that somehow they managed to pull off such a huge difference between the groups. The same incidents seems to occur with other studies as well like Miller et al (2009, American

Yet again they make fun of us

A reader asked me to post this

Hi Tom,

http://www.itv.com/itvplayer/video/?Filter=213151

This is a clip from last night's Celebrity Juice (show from the UK). The presenter made a disgusting reference to the King's Speech at the very beginning imitating a bad stammer for the audience to laugh....

The show starts with "Keith's Speech" in front of a microphone... "For the ffffffffffifth time in the lives of most of us there is a fffffffff celebrity juice, I call on you to stand calm as I sssssssssssssolemnly promise there will be no more rude fffffffffffffffffffffffffffff jjjjjjjjjjjjjjjokes". Then he stands up and is completely naked from the waist down with his penis on show although pixelated which isn't really the impotant part. The fact that he made fun of a bad stammer for the audience to laugh at the stammer was the unacceptable part.

I don't understand why there are people out there who think this is "entertaining" or "funny". If someone made the same fun of blacks or disabled people it would be considered of bad taste right? I looked at Youtube but they don't have the clip there unfortunately.

Making fun of stammerers in such a way is by no means acceptable or appropriate so could you post this on your blog and encourage people to send a complaint to ITV either by phone or email (viewerservices@itv.com), I have already sent mine.

The second cure of Martin Schwartz

At age 20, when I was an exchange student at Indiana University, I decided to do something against my stuttering. I went to the university book shop, and found a book by Martin Schwartz: The Airflow technique. (I think) I still remember that I was highly embarrassed to buy the book, I guess buying books on stuttering is a bit like buying condoms! The book cover promised the solution to all my questions: What is stuttering? How do I cure my stuttering? I read a very dramatic expose of Dr Schwartz's quest for knowledge. But the more I read, the less convinced I became about what he offered, especially because he came up with a theory, where I clearly saw that different interpretations of the data is possible, too. And he proclaims a cure.

Now nearly 20 years later, Dr Schwartz has a second cure! ;-) I am just wondering why he bothered to come up with a cure. Is one cure, the airflow technique, no enough?

HIS "National" Center for Stuttering has a recent press release: Breaking News: A Possible Cure For Stuttering. He claimed that Thiamine "cures" stuttering in 30% of people who stutter. I feel pretty miserable, because I have a ready post for a Crackpot Award, but I never posted it because he is not quite a crackpot. He is just a very bad scientist with excellent marketing and sales skills. If I include those, 50% of researchers would be crackpots!

So I am going to post the text here, and I leave it to my readers to rip apart the methodology. To all students,

NSA Research Symposium

Here is the program of the research symposium of the National Stuttering Association on July 5th and 6th 2011.

I am a bit taken back by Jerry Maguire's talk title: Advancements in the pharmacologic treatment of stuttering! Advances? Pagoclone was hailed as the advance, and the first serious trial has not been successful as far as I can see. Of course, the outcome data has not published. I seriously hope that this will be done soon. I must say that the title is a smoke screen. Jerry would do better to tune down his rhetoric. The same is true for his book which is more of a propaganda book! We all admire his commitment and focus on finding a pharmaceutical treatment, but science only cares about facts and benefits from a neutral discussion. A sales pitch is misplaced at the NSA symposium.

I like the high numbers of group discussion. I hope that the discussions will be beyond the typical "Thank you very much for all your efforts. I was wondering whether", and be a though honest no-niceties no-consensus-seeking intellectual debate. The success of such discussions depend on the moderators.

Volunteers needed for a Boston-based study!

If you are able to get to Boston, please consider volunteering for a study:

The Speech Communication Group of Research Laboratory of Electronics, Massachusetts Institute of Technology (MIT) is looking for a volunteers who stutter to particpate in an NIH-funded research on persistent developmental stuttering. 

Inclusion criteria (apply to all):

1) You have persistent developmental stuttering (also known as stammering).
2) Age between 18 and 50.
3) No history of speech or language disorders, apart from stuttering.
4) No history of hearing disorders.
5) No history of neurological or movement disorders.
6) Speaks North American English as the first (native) language. First langauge refers to the language in which your parents spoke to you when you first started speaking as a child.

!!!!!!!!!!!1000 posts!!!!!!!

 

This post is the 1001th post on TheStutteringBrain blog! We need to celebrate. When I was starting to write in 2005, I was not sure whether I would keep up with publishing but I did! I also have nearly 100 followers, and 20'000 page views per month.

Below is the graph of the evolution over time. You can see that the increase is relatively linear, but will probably level off in the next years. The numbers also depend on how many posts I write. But overall I am getting close to half a million visits to the blog.

A great majority of my readers are from the US, followed by the UK and Germany, but readers are from all around the world. I receive a few emails every week from readers from asking for advice to sending my interesting information what certain people or association privately do.

I am very likely the most popular and most read blog on stuttering. Number of awards received from stuttering community: ZERO. Number of awards received by Emily Blunt for saying: I stuttered. ONE. Number of people invited for key note speeches for being famous or rich, for talking about their miraculous recovery from mild stuttering, for scientific sloppiness or propagating crackpot ideas: TOO MANY. Number of emails received from readers thanking me and saying that they like my blog: HUNDREDS. Speaks volumes.

Crackpot Award for Dr Miriam Stoppard

TheStutteringBrain awards a Crackpot Award for Dr Miriam Stoppard for the outrageously uninformed article Stop stammering ruining your big speech in the Daily Mail.

Here is the laudatio:

According to Dr Stoppard's website, she "has been at the forefront of the revolution in health information since she began her writing and broadcasting career in the early 1970s." Her article on stuttering shows that she has not even made the effort to consult wikipedia on the causes and treatments of stuttering. Nor has she consulted with any expert on the field. But why should she? She is known by millions, and she is a real medical doctor.

She has acted in a highly irresponsible manner, which in our opinion has violated her own standards of ethics as a medical doctor, and misinformed the general public, parents, and patients on stuttering. As we do not want to waste our time on explaining line by line why she is terribly wrong, we refer to a response by the British Stammering Association.

We speculate that the only reason she wrote this article, despite her very glaring lack of insight or expertise on the matter, is an effort to keep in the limelight to sell her books and services.

Ask yourself: How can I trust Dr Stoppard for any advice on any health issue, if she got her advice so clearly wrong on stuttering. If she is sloppy on stuttering, is she sloppy on other issues as well? She has lost her credibility.

Crackpot Awards are given to people who make claims about stuttering that clearly violate scientific facts and express these views with crackpot-like confidence.

We are very grateful to The King's Speech for giving us the wonderful opportunity to out those unprofessional professionals.

NOTE on BSA's response:
 
Stammering is acquired - but we do know from recent genetics research that people who stammer are born with the predisposition and that it is highly unlikely that without this predisposition a child would begin to stammer.

I don't agree that "Stammering is acquired". Stammering occurs (or shows itself) at a certain point in development like you only notice that your engine has a flaw when driving at high speed. The neurobiological basis for stuttering was either already there from the start (i.e. genes), or in the course of development due to an incident, but well before the actual onset. It's like saying traffic jam is acquired in a city that has been growing too fast with appropriate planning.

Abnormal auditory system in people who stutter?

Here is the latest research finding on the stuttering brain. The Japanese scientists claim that people who stutter have abnormal auditory regions. I am a bit confused by this piece of research.

I also want to point out that this signal, if true, might not be the cause of stuttering directly. It could be that this abnormalities is responsible for non-recovery, but not for the cause of stuttering.

Neuroimage. 2011 Jan 11. [Epub ahead of print]

Spatiotemporal signatures of an abnormal auditory system in stuttering.

Kikuchi Y, Ogata K, Umesaki T, Yoshiura T, Kenjo M, Hirano Y, Okamoto T, Komune S, Tobimatsu S.

Department of Otolaryngology, Faculty of Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Clinical Neurophysiology, Faculty of Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

People who stutter (PWS) can reduce their stuttering rates under masking noise and altered auditory feedback; such a response can be attributed to altered auditory input, which suggests that abnormal speech processing in PWS results from abnormal processing of auditory input. However, the details of this abnormal processing of basic auditory information remain unclear. In order to characterize such abnormalities, we examined the functional and structural changes in the auditory cortices of PWS by using a 306-channel magnetoencephalography system to assess auditory sensory gating (P50m suppression) and tonotopic organization. Additionally, we employed voxel-based morphometry to compare cortical gray matter (GM) volumes on structural MR images. PWS exhibited impaired left auditory sensory gating. The tonotopic organization in the right hemisphere of PWS is expanded compared with that of the controls. Furthermore, PWS showed a significant increase in the GM volume of the right superior temporal gyrus, consistent with the right tonotopic expansion. Accordingly, we suggest that PWS have impaired left auditory sensory gating during basic auditory input processing and that some error signals in the auditory cortex could result in abnormal speech processing. Functional and structural reorganization of the right auditory cortex appears to be a compensatory mechanism for impaired left auditory cortex function in PWS.

The real king's speech.

THE KING'S SPEECH

My dear friend Einar has sent me this link on the king's speech. Georg VI clearly has a stuttering problem, but I must say that he is handling it extremely well. He has long pauses to give him time, and he only starts struggling a few minutes into the speech. Watch from 5:55 onwards, you see the time if you go Full Screen. Despite his hesitations and visible struggle at times, his performance is clear and strong. Not like my performance on StutterTalk or yesterday when I gave a radio interview to be aired on Monday.

I am nearly convinced Firth was also working from this video as the secondaries ressemble those in the movie.
But I must say that the stuttering is more severe in the movie than at this public talk. However, I can very well imagine that his stuttering was more severe at times, and at times he was fluent.

Do we stutter alone in the universe?

Today, I want to talk about life on other planets.

The Kepler telescope has made a huge step in understanding the likelihood of extra-terrestrial lifeforms. The telescope is fine-tuned to look at the light-emission of stars, and detect fluctuations due to the passing of a planet in the foreground. They found 5 passings of Earth-size planets with acceptable temperature while observing 156'000 stars. So roughly at least 1/3 * 10^(-4) of all stars have one habitable planet.

The universe contains about 3*10^32 stars, so roughly 300'000'000'000'000'000'000'000'000'000'000 stars.

So we have about 10^28, i.e. 1'000'000'000'000'000'000'000, habitable stars in the universe.

The King's Speech review

I have finally watched The King's Speech, but not in the cinema. ;-) Here is my review:

The most interesting aspect for me was the relationship between the two men. Showing how even the king is very human and mortal. The movie was also interesting in playing with the class system that reigned in those days. But in a sense the movie also degraded the king. They applauded him for reading a speech that was written by other people. If I were king and people applauded me, I would be thinking: God Tom you are such a looser when people already get excited when you read a prepared speech!

I am not convinced that all the words put into the mouth of historical figures are very accurate, and could easily give a wrong view on history. I am also not convinced that Churchill told him about his speech impediment. I think the script would have benefited from leaving out a portrayal of Miss Simpson and Churchill.

In terms of the handicap arising from stuttering, the movie did an excellent job. Only a person who stutters/ed like David Seidler could have written such a script.

PRESS RELEASE: Stuttering in Luxembourg

Together with friends from our informal support group in Luxembourg, I have just sent a press release about The King's Speech and the bad care for people who stutter in Luxembourg. The release went to all media, ministries, and political parties. Here are the documents. (In German, one of the official languages in Luxembourg, apart from Luxembourgish and French)

PRESS-RELEASE

The King’s Speech, der Oscar-nominierte Film über den stotternden König Georg VI

Schlechte Versorgung für stotternde Kinder und Erwachsene in Luxemburg

Am 4. Februar kommt The King’s Speech in die luxemburgischen Kinos. Der Film handelt von der Freundschaft zwischen dem stotternden britischen König Georg VI und seinem Therapeuten Logue. Durch intensives Training gelingt es Georg VI, sein Stottern unter Kontrolle zu bringen, und mit beeindruckenden Reden gegen Nazi-Deutschland das britische Volk zusammenzuschweißen. The King’s Speech wurde 12 mal für einen Oscar nominiert.

Ca 5% aller Kleinkinder durchlaufen eine stotternde Phase, wenn sie Sprechen lernen, und ein Prozent aller Erwachsenen stottern. Stottern ist eine neurologische Störung, die auch vererbt werden kann. Durch temporäre Unfähigkeit, Gedanken in Sprechen zu verwandeln, kann eine starke Sekundärsymptomatik entstehen. Viele leiden zudem unter Sprechangst, Vermeidung von Sprechsituationen, Spott und Diskriminierung auf dem Arbeitsmarkt.

Excellent CBS News report on stuttering.

Check out this excellent CBS NEWS report on stuttering. (Thanks to Nathan for this link!)

Beautiful report where I agree with 100% of what is said, even the science bit. Anne Smith and Weber-Fox are interviewed and they did an excellent job. They are good scientists, and clear science communicators. And note they did not drum up the early-intervention myth of eradicating stuttering with conditioning.

Congratulation! We should give CBS News an award!

Stuttering constant across cultures?

 An interesting comment by a reader on the prevalence of stuttering across cultures.

This subject is very interesting, as big part of speech pathologists believe that stuttering rate is the same everywhere, and only a minor part believe that there are substantial differences in the rate of stuttering in different populations. Those who believe the rate is same everywhere, unfortunately, are not interested in cross-cultural studies. After asking people from different cultural background for many years about stuttering, I found that the differences in the incidence are absolutely huge. For example, you will find that a huge number of people from sub-Saharan populations had a stuttering problems (many have it as adults as well). On the other hand, you can hardly find a stuttering individual among the Chinese, or among Native Americans. Unfortunately, most of the "serious" speech pathologists are not interested to examine these cultural differences, instead they try to explain the published data on the existing differences by different methodologies used by different speech pathologists in different populations. But how come that experts, almost educated in Western Universities, always make the same "mistakes": they exaggerate the number of stutterers in sub-Saharan Africa (and African Americans), and grossly underestimate the number of stutterers among American Indians and Chinese populations. Fearing to face facts has never helped anyone in finding the real causes of any phenomena. I very much hope that many professional speech pathologists will read this blog and comment from their own experience on this topic.

In the past, I wrote that stuttering is relatively constant across cultures. I am not so sure any more. For following reasons:

Crackpot Award for Dr Martin Stephen

TheStutteringBrain awards Dr Martin Stephen a Crackpot Award for his article in the Independent:

The truth is that a stammer is psychological, not physiological. We're afraid to admit that, because it smacks of mental illness, a worry shown clearly by both partners in the marriage in The King's Speech. It's in the mind, a stammer, and comes from a massive feeling of inadequacy.

Dr Martin Stephen is High Master of St Paul's Boys' School, but he would do good to get outside his intellectual comfort zone: Dr Stephen is an expert on intellectually low demanding subjects like English literature, modern naval history and war poetry. Unfortunately, the world has become more complex and complicated. Science is difficult, but we understand much better the neurobiological and genetic basis of human speech.

He is a terrible example for his students. He should actually do what he probably preaches to his students: THINK BEFORE YOU WRITE, and DO YOUR HOMEWORK!

He clearly has not done his homework. To claim that stuttering is due to a massive feeling of inadequacy is completely wrong. And shows his lack of literature review on the subject.

Check scientific research or even just wikipedia! Or does he feel too sophisticated or intellectually confident in his abilities to look at it?

I know 100s of people who stutter who feel perfectly adequate in all respects except being able to say exactly what they want to say.You only have to talk or know me!

He gets extra points for

Yet I would argue that losing the ability to speak clearly is no less important to the development of a child than the loss of an arm or a leg, or the capacity to see or to hear.

 Please leave a comment and counter his non-scientific arguments: here.

Trudy Stewart on treatment/science

I am disappointed by Trudy Stewart's science part of the Today interview, but I agree with her point that The King's Speech is the first movie to reveal the psychosocial difficulties people who stutter face. But not on the science:

1) There is still no compelling evidence that early intervention is "really really effective.", and that it "prevents stammering going into adulthood". At best, treatment optimizes the psychosocial adaptation to a stuttering brain which might also reduce stuttering. Recovery is very likely a neurobiological process unaffected by treatment.

It's just a wrong hope for parents. They hope for a full recovery, but therapy can at best reduce stuttering and psychosocial maladaptation. And if they fail, they blame it on themselves.

2) I also don't agree with risk factors like family history and part-word repetition helping in treatment. They don't guide us in the method of treatment. They only inform us that some are more likely to keep on stuttering. Every child needs to be treated for what could happen, and not how likely they will stay stuttering? OK. I guess you can make the case that children with no risk factors should be less often monitored.

I would also add that family history could also point to an anti-risk factor. A friend of mine stuttered as a child severely (more than I did apparently), but he recovered fully. And his daughter went through the same process. I strongly suspect that genetics can also point to recovery.

3) The brain imaging has ALSO been on structure which is a more significant finding than just different brain functioning.

King's Speech cast and audience joke and laugh about stuttering

I just watched a Q&A session on the King's Speech. The main actors and director were talking about the movie in front of an audience of actors, I think. [18:00]

The moderator said that the British Stammering Association liked the realistic portrayal of block. Everyone in the audience laughed at the thought of there being an association about stammering. Then the actress playing the wife of the king, also made some really stupid jokes about stuttering. Like the movie would have taken too long, and so on. Only Colin Firth comes out relatively unscathed, except for a few jokes at the end.

Basically, for most in that audience and panel stuttering is just a funny thing a strange king does. Most have no idea what it feels like to stutter. Stuttering is a matter of laughter. They would have never made the same comments about wheelchairs or blacks. Watch it, and you will feel ridiculed. Transported back in the times when your friends made fun of you.

We are totally drunk about the movie. Finally a movie on stuttering. And we think the actors are so concerned about stutterers. They are not. They did the movie for a good story, and not for us. They do not care about us. We are the poodle of the King's Speech.

Do dopamine levels play a role in stuttering?

Holger made me aware that a study on Dopamine Function in Developmental Stuttering has recently been closed. The study

will use positron emission tomography (PET) to examine the role of the chemical messenger dopamine in stuttering. It will measure and compare the number of dopamine receptors and the amount of dopamine released in the brains of stutterers with that of normal volunteers. The results may provide information about how drugs that block dopamine's effect might work to enable fluent speech.

Jerry Maguire is quite interested in this area of research since his involvement in a similar experiment in 1997.

I am just concerned because the starting date is 2001. Did it take ten years? And I never heard about it? Maybe the study never materialized. Would be great if someone could check or replicate Jerry's work.

Selecting out embryos with stuttering genes?

Yesterday, I saw a talk show on German TV on IVF (in vitro fertilisation). The guests discussed whether parents should have the right to select out embryos with genetics disorders. One guest suffers from a genetic disorder causing painful chronic inflammation. He said that he wished his parents had selected him out. And he would scan embryos for the gene defect, and select them out.

Would you have wished that your parents had selected you out for another embryo? Would you scan embryos for stuttering genes and select them, assuming there are unambiguous genes for stuttering?

During my teenage years, my suffering was too much, and I would have wished my parents had selected me out! But now I would say No, also because my embryo not only had stuttering genes, but also genes for writing such an interesting and challenging blog! And I could not possibly spare that experience from the stuttering community! ;-)

In terms of scanning embryos and selecting out "stuttering" embryos, I would say: it depends. If the stuttering is expected to be severe, then yes. If it's mild, then no.

What is your opinion?

Revolutionary mood at BBC call-in

Check out this emotionally very powerful and liberating BBC radio call-in on stuttering: here. I have never heard so many people stutter on national radio. Especially the stories on how stuttering has affected their lives will change the attitude on stuttering of the listeners forever. There was a sense of revolution in the air: we will speak despite and we will speak out. Big thanks to the BBC and the host who has allowed people who stutter to stutter so publicly. Funnily, the host himself had hesitant speech. He even said that he got into speaking trouble giving a eulogy for a friend who died at his funeral! I mean who wouldn't stutter there!

Just one tiny little point. ;-) The audience kept on talking about handedness, to which Leys Geddes, BSA chair, said that there is no research confirmation. I don't think that gets people's mind changed. I always say: Really? So how come millions who changed hands did not start stuttering. And millions who did not change hands started stuttering. Leys also said that it might have triggered stuttering. I don't buy that either, in the sense that without a change they would not have stuttering. BUT, the audience might be right about their observation. There is one theory that left-handed is due to problems in the development of the embryo. Also, left-handedness has a different brain organisation. So I would speculate that left-handedness might be a moderate risk factor, which coincides with a hand change because only left-handed people had to change hands! So not hand change causes stuttering, but left-handedness causes stuttering and hand change! Subtlety kills the cat (and many others).

And Leys again said: "Early intervention will reduce the number of kids who stutter". I don't buy that either. Let's assume all stuttering is genetic. So how can early intervention EVER reduce the kids who stutter, they always will have their genes. Early intervention can only shape their psychosocial adjustment, but not push the recovery rate into higher territories.

Looking at failure contains information

I suggested that we should look at failed cases as a quick and cheap way to get a sense for the efficacy of Lidcombe.

You're going to have a biased sample. If you want to determine the effectiveness rate, you'd need to ask for parents of children who've been treated with Lidcombe Program - regardless of their outcome. THEN see how many are still stuttering.
At the moment your methodology is like saying you want to hear from people who've had a recurrence of cancer, after a course of chemotherapy, and concluding that chemotherapy is an ineffective treatment.

Bias is not an issue, because I don't look at the global population.

If the people die or relapse after chemotherapy, it says something after the chemotherapy. And the more stories I hear, the more concerning. I never hear that someone dies of a nose job or appendix removed. There IS information is that information.
 
If Lidcombe is 100% effective, no kid will be stuttering any more. So if I find someone or a few, Lidcombe cannot be 100% effective.

Someone once commented, I think it was Peter Reitzes, that the adult stutterers are going to die out in Australia! We shouldn't have any stuttering teenagers any more.

Moreover, we can look at those cases, and look whether they are normal cases, i.e. parents were following instructions, and therapist was well-trained. If we have such cases who fail, we seriously need to ask whether it is effective.

I am just saying it's a cheap way to do proper research. Find and look at the failure. Therapist researchers mostly do research on what is successful.

Moreover, if I find 10 failed cases, I should have at least 90 successful cases. We then have a success rate of 90%, which is a bit above natural recovery.

Predictions for 2011

I spoke with Peter from StutterTalk about our predictions for 2011. Here they are:

The King's Speech will alter public discourse:

The movie will put the spotlight on stuttering, and do more in terms of public discourse on stuttering than the last decades together. Stuttering will not be seen less as a matter of laugher, and more as a medical condition. This greater exposure might well lead to more funding for research or charities active in the field.

No difference between Lidcombe and Demands&Capacity treatment from Dutch study:

I had this on my list for last year, and according to my calculation the data is ready but not completely analysed and still private. In May 2009, the group had 106 kids enlisted for the trial. So by December 2010, these kids would have started treatment at least 18 months ago. So they already have DOUBLE the amount of kids with one-year after treatment data than as the Lidcombe study. Preliminary results should be there with a decent if impressive sample size.

But the whole publication is slowed done by the time it takes to analyse all the speech data (a complete nightmare if you ask a theorist like myself!), and by their obsession to have the complete sample (190 kids) done. Just think about it. Many groups publish with lousy 10, 20, or 50 kids, aka the Lidcombe group, and the Dutch group is too conscioutious and wait, effectively leaving us exposed to the weak but only research out there.

That reminds me of the saying: Good girls go to heaven, bad girls go everywhere! (or propagate the efficacy of their treatment with evidence-based practise with lousy sample size.)

So my prediction is like last year, that there is no difference. But they might not even publish in 2011. The data is there but maybe not for all 190 kids. But hey even 51 would be more than Lidcombe. I just hope that their group will keep up the efforts. I have seen many projects implode like the PEVOS project.

Pagoclone will be stopped for good and more information on the placebo group

It's not really a prediction, because the trial has been stopped. I guess the prediction or hope is that they publish the data of the study. I hope it won't take ages. And if a editor refuses because it's a null result, he/she should go to hell! As I said before, I want to see the placebo group, how much did they improve? If there is no measurement bias, the improvement should be low or zero. One open question is whether a subgroup have benefited, but even there I am not so sure.


Not much on genetics and neuro-imaging unless new technology

I am not sure much will happen in 2011, unless a new technology like MEEG will emerge. Genetics might find more genes. That's difficult to predict. But fundamentally, I don't think the neuro-imagers are going to have a breakthrough, because more theoretical work is needed.

So what are your predictions?

Is your kid still stuttering after Lidcombe?

I want to hear from parents and clinicians who treated their child with Lidcombe and the child is still stuttering. Only a few cases are enough to show that Lidcombe is not highly effective, because they will immediately drag a perfect 100% recovery down kid by kid and it's not far to go until 80% natural recovery. Researchers should search for those kids, because this trial does not need as many participants to get to statistical significance.

Here is one kid I found on STUTT-L:

We did not have a strongly positive experience with the Lidcombe, but did try it for several months with my little boy, Steven, who had just turned 4 (he's now 4 1/2). Our little boy seemed to do well with it for about the first 6 weeks, but then after that began prolongations, blocking, and ingressive breathing. I knew those were not good signs, but did not get any assistance from Steven's clinician when I requested 'tools' to help him with these struggles. I have come away thinking Lidcombe is possibly helpful for children with mild stuttering.
Anyway, our clinician calculated the %'s and we did one rating for a full 24 hours. We just averaged his score---meaning we considered the best and then also the worst scores for the 24 hours.
We have many mixed feelings about Lidcombe (as I think many other parents and clinicians do, too). We are now pursuing a more traditional approach--would be happy to talk with you more about it if you would like.

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The outing of the stuttering king

In the King's Speech, the king has been outed against his will, and certainly against that of his wife, the Queen Mother. Much like in the gay community in the Eighties and Nineties, the outing and coming out of prominent figures will lead to a seismic shift not only in the public perception but also in the self-perception of the affected individuals. Ironically, stuttering is blatantly obvious when most stutterers speak, but it's hidden in that it's not talked about.

The movie will have a dramatic impact on stuttering world-wide. Not because of the realistic portrayal of stuttering, but mostly because The King Stuttered.

1) Stuttering is now acceptable. Many influential people did not come out publicly about stuttering. But now even the king stutters, so it's OK for them to say: I am like the king. I have the same issue as the king. Like the king, I overcame obstacles and this made me a stronger person. Check out Sandra Howard's coming out. She is the wife of the ex-leader of the British Conservatives.

2) "Ordinary" people will also come out, or be asked to admit to stuttering. If the king stutters, you are a bit like the king! Many will be proud to be like the king. Don't know why, but they will!

Pagoclone trial ends beginning of January

A reader gives us some more insight into the end of the Pagoclone trials. His report confirms what we know. The trial has ended for most, and the few showing some success continued taking the compound. The company probably wants to see whether their effect is waning, or stays stable. I have always said that some of the success could be due to statistical fluctuations (the trial coincided with an up-swing of fluency) plus measurement bias and possibly a long-term placebo. Those extra months for the successful groups should clarify my hypothesis. My prognosis: some will loose those effect. But to be strict, one would really need to create two groups: the successful one with no continuation and the successful one with open-label to discount for further placebo.

Here is the report:

Hi Tom,

I participated in Pagoclone study in NJ which concluded for me in October,10. When I enrolled in the study, I was told that I'd be compensated for my time and travel by getting paid $50/visit. I made around 10-12 visits and was told that I was sent a check at the conclusion of the study. When I Inquired about my compensation at the end of the study, I was told that study is still on-going for some of the participants and it'd conclude in December. I again asked about it the last week and now the center where I went for trial, gave me a date of January,11 citing the reason that the study is still going on. This is frustrating to say the least.I believe the study/trial has concluded for everybody. They have to compensate me as they promised. I'm not sure if this delaying tactic is at the part of Pagoclone or the center where I was enrolled in the trial.

Can you post this letter anonymously on your forum and put the question in front of your readers if any body else is also encountering this situation of is there a way I could contact Pagoclone myself.

Oxford Dysfluency Conference on September 1-4th 2011

The Oxford Dysfluency Conference is from September 1-4th 2011. I have been to the last three conference, I think. The setting is very nice, the historic university town of Oxford. The conference is also OK, with the usual ups and downs. Don't expect a true scientific conference. For many years, it was the only conference on stuttering apart from the ISA and IFA conferences. They have been organized by Dave Rowley, a loyal TheStutteringBrain reader from de Mountfort University.

Unfortunately, he has given the responsibility of the many conference admin shores to Elsevier, the leading academic publisher. As a result, the prices have gone up dramatically, and I am sure many are going to ask themselves whether it's worth the money: £595 + 20% VAT. British institutions can probably claim VAT back, but the lonely therapist cannot not can overseas attendants, I would guess. As Elsevier is not able to provide the full price on their website. I have done the *very* difficult calculation: 714£. Plus travelling expenses, and you have to count 800£ for British, 900£ for continental European, and over 1000£ for

Onslow on The King's Speech

Mark Onslow spoke reasonably about The King's Speech. He even managed not to mention Lidcombe, but claims that nowadays we know exactly what to do with adults and children who stutter. I am not so sure, but such claims obviously bolster the political capital of the speech and language therapist establishment. And he says that not minimizing stuttering at a young age creates terrible problems. I guess I would agree, but this statement also backfires in that by judging stuttering as a terrible problem he thereby creates part of the handicap experienced by people who stutter. No problem, no work?

But one mistake. He claims that Newton stuttered. This myth is just not dying out. I should create an award price. Five hundred for the person who proves to me that Newton stuttered!

On The King's Speech from a journalism student who stutters

Check out ‘The King’s Speech’: A Stutterer’s Reflection by Adam Polaski, a junior journalism major at Ithaca College.

We must get a text scroll into The King's Speech

That's what we are all afraid of, from Pam's facebook post:

A co-worker just came to me. She: "I saw The King's Speech last night". Me: "how did you like it?" She: "people may come away with wrong ideas, like my husband. He thought it was an emotional problem. I corrected him. Maybe there needs to be a dialogue about the myths".

Actually, I have a brilliant brilliant idea. We should lobby the producers to include a text scroll down on stuttering after the movie.

Three very simple messages STRAIGHT INTO THE MINDS OF MILLIONS!

Stuttering affects 5% of all children and 1% of all adults across all cultures.

Most stuttering has a genetic or neurological origin, and gets accentuated by strong emotions, stress, and mood.

There is no cure but good treatment reduces frequency and severity of stuttering, avoidance of speaking, emotional suffering, and improves self-esteem.

Of course, I am an idiot. I should have come up with this idea months ago! It might not be possible any more. Maybe for the DVD or foreign language release.

In any case, write to your association with the request!

Peter and Nan on Lidcombe at StutterTalk

The Larry Kings of stuttering discussed Lidcombe's academic claim of treatment success, i.e. the Emperor's New Clothes. When I say to the king: "Wake up! You are naked", they would say: "My Lord you might want to consider the possibility that other people have more clothes on than your Highness."

They made many important points that are frightfully close to the ones I made on my blog. ;-) Therapists should definitely listen to the podcast. Nan made the interesting point that the Lidcombe group needs to publish a lot to get funding. I'll get back to this points in relation to the wwwikileaks documents in a future post.

Here are a few extra comments on their debate:

• Taking a theoretical perspective bypasses all this esoteric debate on statistics and empirical data: Stuttering starts due to a neurobiological cause due to either genetics and/or developmental issues. So the questions become: Can operand conditioning undo the neurobiological cause? How does natural recovery undo the neurobiological cause? My answer to the second question is: the neurobiological cause is just temporary, e.g. different development schedule. I would answer the first question with a moderate NO. Brain plasticity is a myth. Sure, targeted practise can increase or decrease the brain resources used, and optimizing occurs. But operand conditioning is about learning, which means changing memory to have new behaviour. Kids can speak more fluently, and the conditioning tells the brain to use this behaviour. It does not work on the general structure of the brain.
  
  It can change your behaviours but not the neurobiological cause. So I would expect kids who undergo Lidcombe to change their behaviours and decrease stuttering behaviours with a better control over stuttering moments. But the neurobiology is not affected. Either the brain naturally recovers or the brain stays. If it stays, the critical question is whether the kids who have shaped their behaviours via operand conditioning relapse or not. But it is clear to me that the neurobiological cause is not going away.
• Nan Ratner needs to decide whether she wants "1000 kids to get decent statistics" or claims that there is some evidence for success. How do the two square up?
• They did not talk about the children's version of relapse after stuttering therapy. Rightfully, the dogma states that the majority of adult patients relapse after therapy. It is the norm and not the exception. But I rarely hear people talk about it for Lidcombe. We should expect that a treatment with operand conditioning to be very vulnerable to relapse. Why? Because the cause that led to maladaptive behaviours is still present, because the neurobiological cause is still there. This cause leads to temporary speech initiation delays, which lead to reactions which leads to learning.
• Peter made the interesting point that decades ago parents were blamed for the stuttering of their kids and now some within Lidcombe blame parents for not properly implementing the treatment. In a sense Mark Onslow is right, with perfect parents you can probably keep shaping the behaviour in such a way that stuttering is minimal. But we do not live in a perfect world. Parents loose influence once kids go to school.

Book on choral singing and stuttering.

I found a wikipedia entry for Who Asked the First Question? The Origins of Human Choral Singing, Intelligence, Language and Speech, a book authored by Joseph Jordania, a ethnomusicologist and evolutionary musicologis. Part of the book deals with stuttering:

Cross-cultural studies of stuttering and dyslexia

Cross-cultural studies of the stuttering prevalence is widely discussed in the book. It is claimed that there is a positive correlation between the presence of choral singing traditions and the higher prevalence of stuttering in a population. The book surveys the existing literature on the cross-cultural study of stuttering and it is suggested that on one hand European and particularly Sub-Saharan African populations have higher stuttering prevalence, and on another hand Native American, Australian Aboriginal and East Asian populations have much lower stuttering prevalence. Cross-cultural studies were very active in early and middle of the 20th century, particularly under the influence of the works of Wendell Johnson, who claimed that the onset of stuttering was connected to the cultural expectations and the pressure put on young children by anxious parents. Johnson claimed there were cultures where stuttering, and even the word "stutterer", were absent (for example, among some tribes of Native Americans). Later studies found that this claim was not supported by the facts, so the influence of cultural factors in stuttering research declined. It is generally accepted by contemporary scholars that stuttering is present in every culture and in every race, although the attitude towards the actual prevalence differs. Some believe stuttering occurs in all cultures and races at similar rates, about 1% of general population (and is about 5% among young children) all around the world. A US-based study indicated that there were no racial or ethnic differences in the incidence of stuttering in preschool children.^[3][4] At the same time, there are cross-cultural studies indicating that the difference between cultures may exist. For example, summarizing prevalence studies, E. Cooper and C. Cooper conclude: “On the basis of the data currently available, it appears the prevalence of fluency disorders varies among the cultures of the world, with some indications that the prevalence of fluency disorders labeled as stuttering is higher among black populations than white or Asian populations” ^[5]
Different regions of the world are researched very unevenly. Understandably, the largest number of studies had been conducted in European countries and in North America, where the experts agree on the mean estimate to be about 1% of the general population (Bloodtein, 1995. A Handbook on Stuttering). African populations, particularly from West Africa, might have the highest stuttering prevalence in the world—reaching in some populations 5%, 6% and even over 9%.^[6] Many regions of the world are not researched sufficiently, and for some major regions there are no prevalence studies at all (for example, in China). Some claim the reason for this might be a lower incidence in general population in China.^[7] Jordania suggested that the differences in stuttering prevalence may have a genetic basis

The Christmas miracle of Mr Tim

I wish you all Happy Xmas and a Happy New Year!

Check out the Xmas miracle! (tip from a reader)

WWWikileaks: Who has written the PhD thesis?

A few months ago, I received wikileaks-quality documents with the request that I should make the documents public. I have been hesitating ever since, but wikileaks has lowered my threshold. People who stutter and unaffected academics should know what issues exist in the stuttering research academia. So I am starting wwwikileaks.

The documents shed an interesting light on an unreported and rarely discussed aspect of the academic world of stuttering, namely the quality of the training of PhD students.

Remember the presented documents are only one aspect of an actual event that has happened (or it is a very convincing and mischievous forgery).

Why should we not know? If everything is to acceptable academic standards, the people mentioned in the documents should be comfortable with their actions and its release.

The leaker sent me scanned documents which, according to the leaker, led her to come to the following conclusion:

Research Symposium at NSA in July2011

A reader has pointed me to the up-coming research symposium at the NSA conference beginning of July.

Here is a list of the speakers:

Gayle Beck, Ph.D. – University of Memphis (keynote speaker)
Deryk S. Beal, Ph.D – Boston University
Courtney Byrd, Ph.D. – University of Texas
Dennis Drayna, Ph.D. – National Institutes of Health
Jennifer Kleinow, Ph.D. – LaSalle University
Gerald A. Maguire, M.D. – University of California, Irvine School of Medicine
Walt Manning, Ph.D. – University of Memphis
Laura Plexico, Ph.D. – Auburn University
Nan Bernstein Ratner, Ed.D. - University of Maryland
Jennifer Watson, Ph.D – Texas Christian University
Mandy Hampton Wray, M.S. (doctoral candidate) - Purdue University
Scott Yaruss, Ph.D. – University of Pittsburgh

I know a few of them. I have never heard of others. The key speaker seems to be a psychotherapist. Ask yourself why these have been invited but not others? How do we know that these are the brains? Or are they just the best adapters conforming to the US academic landscape? For example, I would bet that Mandy who is a doctoral candidate and who I don't know is on the list because she has some relationship with the organizers. Just a guess. Not saying she is bad, but there are so many doctoral candidates.

My first impression is that each is speaking about their own research. I hope they have a structure in place for cross-disciplinary debates.

The reader also asked whether I will be there. The answer is: NO. I don't know the organizers which is nearly a requirement if you want to be invited as an non-academic. They probably consider me a kind of crackpot or eager amateur until they debate with me. And they want to keep the quality level high. Second, from those academics who know me, some don't want to have me, because I ask lots of annoying questions and commit faux-pas. Some don't want to have me, because I have publicly criticized their work. Some don't want me, because I have not behaved as they wish I should have behaved and so don't want to support an invitation.

Whenever stuttering drags you down..

Apologies to John Harrison for deleting his comments

My apologies to John Harrison, and possibly others. Your comments went into my Spam Comments folder, and, instead of Not Spam, I hit the Delete button! I have moderation on for comments on posts older than 15 days, and comments with links sometimes go into the spam folder. And only check them from time to time.

I only briefly read through his defence of Bodenhamer, and would be happy to respond.

Can you please repost? Sorry, I know it was a rather long comment.

Bodenhamer is probaby a creationist!

I have been taken to task by several people, the followers of Bodenhamer and people who agree with my arguments, with me mixing in religion. Some even talk about an ad ad hominem attack.

First of all, I have not committed an ad ad hominem fallacy, because I did not say that Bodehamer's statements on stuttering are wrong because he is what he is. I actually presented counterarguments.

Second, I have started to move from looking at his arguments to the person himself. I mention religion, because I want to understand his and his follower's inability to engage in an intellectual debate, and actually change their views based on arguments and empirical facts. And, he reminded me of the mindset I have experienced in my personal talks with creationists some months ago. He and they exhibit religious beliefs.

And guess what! Bob Bodenhamer is mostly likely a creationist, and he certainly works for such a church. He writes in his biography:

Dr. Bodenhamer has served four Southern Baptist churches as pastor. He is presently serving as pastor of a mission church called Christ Fellowship Community Church. His time in the pastorate spans 44 years.

Southern Baptist is infamous for its inability to absorb scientific knowledge and rationality into religion, unlike the Catholic or European Protestant churches. So I found a FAQ on creation on the website of Christ Fellowship Community (note he is pastor in a small church in North Carolina). And here is what they write:

If one takes the Bible at face value, Genesis 1:1-31 seems to suggest that God created everything in six literal days. There is no reason to think that a being as great as God could not accomplish such a feat within this time frame.

People need to know where Bodenhamer comes from. He can believe what he wants to believe. But people, and the BSA who invite him for conference calls, need to understand that they cannot trust him to change his views based on science. In fact, he is an enemy to science.