May Conference at Hotel Croatia

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

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

Screening test for stuttering?

The BBC has an article entitled Screening test for stuttering 'closer': see here.

Here some important quotes:

The Wellcome Trust team says a specific speech test accurately predicts whose stutter will persist into their teens. The researchers, based at University College London, used a test developed in the US called SSI-3 (stuttering severity instrument). They found that the SSI-3 test was a reliable indicator of who would still have a stutter and who would recover - while other indicators such as family history, which have been used, were less so.

I am not sure exactly what the hype is about, but it seems to be saying that the more severe you stutter as a child the less likely you recover? That sounds to me obviously true on average. That's also the factor I found in my outcome study that correlates with positive outcome: the less you stutter before treatment, the more likely you are fluent afterwards! I have to read the paper, but I am skeptical.

The most interesting comment is that "researchers also found so-called "whole word repetition" was not a reliable indicator of persistent stutter". I vaguely remember that being a prediction by the EXPLAN theory pushed by Pete Howell. But I could be wrong.

I am also not impressed by Mr Lieckfeldt's BBC comment:

 "At five, there is still a window of opportunity to help those with a stammer."

 And afterwards, no opportunity to help those with a stammer? ;-)


"If we intervene early enough, there is a really high success rate of normal, fluent speaking, whereas for six- to eight-year-olds, the recovery rate drops like a stone."

OBVIOUSLY, due to the natural recovery rate! Those that would recover, recovered already!

Delayed Auditory Feedback wins Nobel Price!

This year's Ig Nobel Price winners:

ACOUSTICS PRIZE: Kazutaka Kurihara and Koji Tsukada [JAPAN] for creating the SpeechJammer — a machine that disrupts a person's speech, by making them hear their own spoken words at a very slight delay.

REFERENCE: "SpeechJammer: A System Utilizing Artificial Speech Disturbance with Delayed Auditory Feedback", Kazutaka Kurihara, Koji Tsukada, arxiv.org/abs/1202.6106. February 28, 2012.

Their "discovery" is that you can use DAF to stop people from speaking. When people hear their own voices with a slight delay, they stop speaking. One proposed application is a portable speech jamming gun, for use in places like libraries, as a quiet way to stop people from speaking, since loud interruptions are more disruptive than the speech itself.

I glanced through the paper, and it does refer to DAF for stuttering:

DAF has a close relationship with stuttering. DAF leads physically unimpaired people to stutter i.e., speech jamming. On the other hand, it is known that DAF can improve stuttering [1], and medical DAF devices are available [6]. We utilized DAF to develop a device that can jam remote physically unimpaired people's speech whether they want it or not. This device possesses one characteristic that is different from the usual medical DAF device; namely, the microphone and speaker are located distant from the target. [Thanks to Ora for his contribution]

How much do stutterers know about stuttering?

I have been stalking the ISAD conference again on Lidcombe as someone asked why Lidcombe is successful without asking first whether it is.

But let me inject some encouraging comments. I really liked to two posts.

From Jon Reilly:

Hello, I'm currently a graduate student at Kean University conducting a thesis regarding "education on stuttering." I was curious if you could recommend any studies that tested the knowledge of PWS on basic facts about stuttering. I researched and found John Van Borsel, but he presented surveys to the general public. I'm looking for PWS. Thank you in advance for any assistance you can offer.

I have never heard anyone do this research, and I really like the topic. Obviously, knowing about stuttering as a person who stutters is important. I was thinking for a while to suggest that a stuttering therapy should have a test for pws about stuttering. And only if you pass the test, can you enter the therapy. I would really be interested in seeing how much they actually know about stuttering. But then I also would like to see the same study done on generalist SLTs! ;-)

From Lynne Shields on common factors for lasting change:

Hello Reuben, There are quite a few factors that contribute to successful management of stuttering for adults. A few that I have seen as important among the people I've worked with are: 1) being ready for change (as opposed to just wanting change to happen), 2) having fairly specific goals (as opposed to wanting the stuttering to go away), 3) developing tolerance of stuttering, allowing them to experiment with their speech, 4) readiness to manage negative feelings and attitudes about their stuttering, if appropriate, and 5) the willingness to experiment, facilitating problem solving and independent management of their stuttering. There are certainly others, and I am sure others will share their viewpoints, as well. Best regards, Lynne

Molly rocks!

Molly shows great courage and determination to speak out. She definitely has taken the right decision, and she will feel more and more liberated from stuttering. She might still keep on stuttering but not be a slave of her stuttering.

How do all those who keep the obvious a secret feel about those public outings?

International Stuttering Awareness Day

Check out the on-line conference for the International Stuttering Awareness Day starting tomorrow! An interesting mix of articles from people who stutter sharing their experiences, therapists talking about treatments, and researchers sharing their research and theories. The good thing is that you the reader can leave questions for the author, that cannot really be ignored and a no-answer is obvious to all! And it's a great retro experience of what the web used to feel like 10 years ago... ;-)

The worse thing about the conference are all those (female) students who start their questions with "Thank you very much for the efforts you have put into your article. I am really fascinated by the topics XYZ...." If  we are lucky, they actually ask a real question after those few sentences! So here is my advice: Just ask your damn question, no-one is interested in whether you find something fascinated, don't think about the consequences of your questions, don't be blinded by authority, and make up your own mind!

P.S. I have hacked the website in 10 seconds and you can already access the conference here. ;-)

Stuttering: Inspiring Stories and Professional Wisdom

Check out Peter Reitzes' book which collects stories and wisdom from people who stutter and professionals. I asked him to send me a summary of what his book is about. Attentive readers will note the ambitious "Publication No. 1." on the title page. I didn't have time to read through the book, but it seems to be cast in the mindset of its editor: providing others the opportunity to talking about their experiences and throwing out ideas while avoiding more definite scientific or generalizing statements that I could take apart! ;-)

 Here is the summary:

The book is titled Stuttering: Inspiring Stories and Professional Wisdom.  

It contains 25 chapters written by people who stutter, leading professionals and the spouse of a person who stutters. All chapters were donated to StutterTalk to help raise money for the free podcast. The book is available in paperback at Amazon for $12.99 and as an ebook and download at Kindle, iTunes and Smashwords for $5.99. Barnes & Noble online will carry the book within a few weeks. I

In Berlin

I will be in Berlin from Wednesday to Saturday with Jelena, and have to attend a business meeting, too. So if someone is from Berlin, let me know and you can join us for drinks or dinner! I am already in contact with Blanka, who had the first (and only) German-speaking blog on stuttering: Stottern usw. I am actually very much surprised that no-one else has a German-speaking blog...

Web-based Cognitive-Behavioural Treatment: an innovative approach

I am not any more on the mailing list of that gold-standard Australia stuttering group except for threatening letters from lawyers. But I have my agents everywhere. So thank you, Agent I!

Here is an initiative that is probably reasonable: a web-based Cognitive-Behavioural Treatment. The idea is that a lot of the suffering and handicap comes not from stuttering but from our psychosocial adaptation to stuttering. CBT is a well-known psychotherapy approach that helps patients to achieve a better psychosocial adaptation by changing unhelpful thoughts or reducing conditioned fears, for example.

You can register from anywhere in the world. So might be an interesting experience with little downside and probably little relapse.

Reading about how they analyse their outcome and then sell it is probably not, but that is my problem not yours! ;-)

Here is their invitation.

Paul's stuttering course

I highly recommend to you Paul Brocklehurst's course: see link here. In a sense it's a revolutionary approach, because he does not focus on treatment, but he only wants to inform people who stutter about their condition. I strongly believe that you can only manage your stuttering well by looking at yourself from a different perspective where you understand where stuttering comes from, what it did to you, how it affects you, and what treatments people have tried.

What I like about it is that no pressure for more fluency is applied. You are not expected to be more fluent, but you just go there to learn more and ask as many questions as you want. Impossible to feel like a loser afterwards as there is no relapse of understanding and knowledge!

And as Paul says, this will prepare you well for a real treatment.Well done, Paul!

Here is a quick summary of what he intends to do:

These classes are designed to provide people who stammer with a clear and detailed insight into their condition, including what factors influence its severity and what practical steps they can take to better control and manage it. The course will be interactive, with plenty of opportunity for questions and answers and to try things out. It will provide an ideal foundation for individuals wishing to enrol on one of the intensive therapy courses. Each meeting is divided into two halves. In the first half we give a presentation, introducing the topic to be discussed. Then, after a short coffee break, the second half will be practical and interactive, giving participants an opportunity to share their experiences and to contribute to the class.

Fill in student's questionnaire

Please help a "poor" student, Beth Harris from De Montfort University at Leicester (England), to collect data for her thesis work. Your participation won't change the way we look at stuttering, but will provide her with good data to learn how to do statistical analysis in the real world.

Go to this link.

A blog on taking meds for stuttering

A PhD student, M.,  has created a new blog:

I've created a blog where I will post information on the experiences people have with various medications they're trying for stuttering. This way we can get as many people as possible to post their experiences so that we have a nice little anecdotal data source for stutterers interested in meds. 

It is a good initiative, but based on experience I know that quite a few have written to me about their successes but then when I re-contacted them months later, they stopped taking them! In fact, I do not know a single person that contacted me that still takes them! NO-ONE!

He wants to stay anonymous. So here is my message to him:

Of course, I will do that. But if you ask me to remove your name from this post, then I think that psychotherapy (and self-help group) might actually be a better choice of treatment for you. You are running away from your handicap. All that effort spent on hiding and taking pills with uncertain outcome...

BREAKING NEWS: Lidcombe no better than Demands & Capacities

Last week, the International Fluency Association's conference was held in Tours, France. Check out the IFA 2012 website: here. I as many others boycotted, voluntarily or due to a lack of money, the conference organised by Elsevier, the publishing company that has the academic community against themselves for over-charging. Even the local organisers have expressed their concern to me.

Anyway, I have breaking news for you. As you might remember, I have been and am a strong critic of what I see as sloppy outcome trials done by the Lidcombe consortium testing their own therapy approach, and force-feeding that approach to the therapy community as the gold standard.

In previous posts, I talked about an interesting trial with far better methodology (especially on sample size and observation period.) They decided to split the kids into two groups: one doing Lidcombe, and the other group doing Demand & Capacity. The published pilot study of 30 kids showed no difference between the two approaches. After much difficulties (including some unacceptable actions by some people), they managed to get a full long-term 18 month trial started with at least 120 kids, much more than the Lidcombe studies ever did but with zero public exposure, except on this blog.

At her IFA talk last week, Marie-Christen Franken said that their preliminary analyses show no difference between treatment when they compare pre with 18 months follow-up randomisation in percentage of stuttered syllables. They found an effect of time and of severity. Final results are not expected for a few months, as the PhD student is on maternity leave...

Anyway, to conclude, the combined evidence (from the pilot study and the preliminary results) point to the fact that both approaches show no difference in outcome. The message to all therapists in the world  should be crystal clear: don't believe what the Lidcombe people preached that they are the gold standard and no other approach should be not used as not tested. Other approaches are not worse. This fits well to evidence from psychotherapy showing that no method is better (except for a few special cases) and what counts is the PATIENT-CLIENT RELATIONSHIP.

But if no-one is better, maybe nothing is ultimately effective. The trial cannot answer absolute outcome as they did not have a control group.

For my beloved speech therapists!

Tim Poe: Not stutterer but mental issues??

And the story continues... He is apologizing for his lies, but insists that he did not lie. Does he have a mental disorder making it difficult for him to distinguish between reality and lies? Or is he just putting on a show?? He didn't seem to stutter in the interview either.

Does Tim Poe fake his stutter?

EVERYONE is asking the question..

Tim Poe has told lies about his life as a soldier, and provided a fake picture. He never got the Purple Medal for war injuries. But he seems to have been involved with the Army in some respects. No doubt the full story will emerge very soon.

So let's study his stuttering. As I wrote, I have never heard of a similar story, i.e. a non-stroke brain injury with such clear symptoms and no other apparent deficits at first sight. However, as his injury story is wrong, this fits with my observation that this case would have been unique. But he could have gotten an injury from somewhere else, too.

The real question to me is a) whether he stutters or not, and b) did he exaggerate his stuttering. I have to say that at first sight he sounds rather authentic. He stutters at the right places. However, as I replayed his speech over and over again, I noticed that his non-stuttered speech is very very smooth and controlled. And his stuttering is rather short and does not propagate into tensed non-stuttered speech. So he does not seem to feel a lot of emotional stress during the stuttered syllables. But he did have secondary symptoms during the stuttered syllables. So I am wondering about whether a middle-of-the-road theory is possible. He is a stutterer, knows how it feels to stutters, but has exaggerated his stuttering. Maybe he stuttered as a child. Or he is just a very good actor. Or he really did stutter as severely, and just invented the rest of the story to feel better about himself. And by telling that lie in a small social circle, for example with his fiancée, he might have had to keep it up as he entered the contest and then it just got bigger.

I have no idea. Except that he can sing. And his confident and calm singing must be the result of many many years of practise. His story that his therapist told him to sing in the shower and then he discovered his voice is not adding up, in my view.

And did he also learn to play the guitar while singing in the shower?? ;-)

But who cares... he is famous... and we are not!

P.S. I just listened to an interview with his fiancée. She sounds genuine, but just knows him from after the "injury". Either he had another brain injury and mixes up stuff. Or he completely made up the story...

Even neurogenic stutterers can sing

Check out the performance of this ex-soldier who got brain damaged. He stutters but he can sing like all people who started stuttering at a young age. I do not actually know of a similar case in the literature. And it shows that speaking and singing is not the same neurological pathway. Would be interesting to see his brain scans? I am convinced his damage is in one of the loci that Catherine Theys showed us at the Antwerp.

Treating stuttering with pharmaceuticals might harm you

A reader's comment on Holger's suicide:

I think it was the medicine that made him commit suicide not the stuttering itself. i really feel sad about him. I also used some medicines to cope with my stuttering. It really helps i was almost %100 fluent but it had serious side affects, i started to have memory loss, sexual disorder, i was always tired and sleeping too much so i quit, when i quit i get into depression and at some point i did not care if iam dead or not. before this drug i was always baffled when i heard someone committed suicide it seemed impossible for me to do it but after what i go through with the medicine i understood how those people feel. So if you ever think about taking drugs consider it twice. it really messes up your brain chemistry and i assure you that thats much worse than stuttering.

And another who tried it:

My conclusion is, right now, it's not the solution, but may have some positive effect on some people. My stuttering has been greatly improved by getting over the fear of it and accepting it. I believe you have written about this before, and perhaps part of why you joined toastmasters and participated in other activities. When I took the job that I have now, I knew that I would be faced with speaking often and in front of large groups. I had a lot of fear about that. However, now...the fear does not have as much sting as it used to have. 

The European Fluency Specialization

For speech and language therapists who want to specialize in stuttering:

CALL FOR APPLICATIONS COURSE 2012-2013 (download here) 

The ECSF consortium would like to announce that the registration for the 2012-2013 course cycle is open. The ‘ECSF’ is a one-year program, providing both the knowledge and the clinical skills, to assist speech-language therapists in becoming European Fluency Specialists. The program is a well-designed combination of lectures, clinical practice and home assignments. If you are already working as an SLT, this specialization course is compatible with your current workload. Lectures are provided during two intensive weeks, scheduled during the academic year. These modules are combined with follow up sessions in the home country of the participant. The local sessions take place outside the intensive weeks. Preparatory reading and home assignments form an integral part of the course. The specialized clinical training, under supervision of a fluency specialist, can begin after the first intensive week.

Visual Outing...

An interview with me appeared in the biggest weekly t'Revue: here in German language.

A bit of a visual outing as I allowed them to publish pictures while I am stuttering. Pictures that will be seen by ten thousand people. And the pictures were filling the upper half of two pages! A bit like a Playboy spread! ;-)

Holger Stenzel is dead

I received the sad news that Holger Stenzel is dead. He was well-known in Germany and with international experts for his keen interest in stuttering medication and his self-reports on using medication. Holger was also a great source for my blog, and constantly kept me informed on stuttering medication.  Check out these few posts where I talked about Holger.

He once came to visit me in Luxembourg. I was certainly impressed by his level of understanding on the functioning of neurotransmitters in the brain. His day job was as an independent electrician. He tried a few medication and wrote about his experiences, but none was ultimately very effective. He had high hopes for Pagoclone. Too high hopes, which ultimately left him deeply disappointed and probably without a fall-back option, I think. Which should also be a lesson for those that create those high hopes...

I am really sad to see him gone. Especially, as his sudden death was of course not an accident, but his own decision. Which makes me wonder whether stuttering played a crucial role or not. We will never know.

Holger, Vielen Dank für Deine Arbeit und Deine Unterstützung. Durch Dich war ich und alle meine Leser immer gut informiert! Wir werden Dich nicht vergessen und an besseren Therapien und Verständnis des Stotterns arbeiten: Medikament oder nicht!

Stuttering-language connection?

I have always questioned the connection between language and stuttering. Clearly, adults who stutter do not seem to show any language deficits. I have not observed a deficit in myself, nor in others. Studies showing a connection therefore must suffer from statistical error (correlation by chance), sample error (clinicians only see the extreme cases, i.e. children suffering from multiple deficits), and measurement errors (language ability measured wrongly), if I am right.

Here is an article by Nippold from the University of Oregon questioning the connection.

PURPOSE:

This article explains why it is reasonable to question the view that stuttering and language ability in children are linked, the so-called "stuttering-language connection."

METHOD:

Studies that focused on syntactic, morphologic, and lexical development in children who stutter (CWS) are examined for evidence to support the following claims: 1) that CWS, as a

Presentations are now on-line

The presentations from the Antwerp conference are on-line: here.

You can also find my workshop: here.

And the title, abstract and summary:

3. Title:

From genes to social context: Understanding and treating stuttering in a biopsychosocial framework

4. Abstract:

Genetic, neurobiological, behavioural, cognitive, and social factors contribute towards the dysfunction and handicap experienced by people who stutter, and are also key to an improvement of the condition. In an upcoming book, we propose an overarching

Meet up with TSB readers in Zuerich.

Yesterday, I met up with Lukas and other people in Zurich who stutter. They invited me for dinner. Thanks! We had a lot of discussions on stuttering, on my upcoming book, on disadvantages of covert and overt stuttering, and on finance.

I will soon put up a picture of three of us... unfortunately the others had already left.

Joseph Agius: Using humour

Joseph Agius does what I want therapists to do, namely to talk about aspects of therapy. He chooses the topic of humour. His talk is quite funny. For example, he asked therapists whether they use humour in therapy (result: 95), and he asked patients (result: 20% use humour)

He then switched to gelotophobia, the fear of being laughed at, and how pws differ to fluent speakers. They only seem to be relevant to situations where stuttering is relevant.

He went too fast through the slides, so I cannot catch up, but he mostly shows how humour is affecting stuttering/psychosocial functioning and therapy. Some techniques are shifting perspective, exaggerating, word plays, and self deprecation.

Emergent topics, Neurogenic stuttering: Theys find that neurogenic stuttering is due to lessions across a network

She focuses on patients with neurogenic stuttering after strokes.

Many case studies are known.

She talked about prevalance, functioning, MRI scans, and aim to find the lession locations

She had N=37, 17 neurogenic stutterers and 20 controls.

9 areas of the left hemisphere showed differences between control strokes: all important for speech production. She suggest that the location lessions are part of a network that disintegrate and leads to stuttering.

Due to limited coverage, other area might not appear in this study. But her results are consistent with most current understanding of the neurobiological basis.

Interesting avenue, but i am not sure whether you can 100% relate to developmental stuttering. I asked whether there are differences in people who stutter since childhood and those due to a stroke. She said that some patients especially with Parkinson behave differently, but many are similar to "normal" stutterers.

After the talk, I had the opportunity to have an in-depth discussion on her research. An interesting aspect is that most patients are HAPPY to stutter as it is a sign that they improve because the stroke led to a temporal inability to speak.

Emergent topics, Vanhoutte: no results yet

She talked about speech motor, research done with her supervisor van Borsel.

She talks about preparatory loop and executive loop, and that timing is not right.

She studied temporal aspects of speech perception and production using EEG. They did silent reading of action words to get a clean experimental signal. These action words trigger a response in relevant motor/sensory regions, and that's how she can study motor perception...

She did not present any results... so it's a bit of a no talk... :-(

Emergent topics, Emotional reactivity & regulation: Ntourour finds difference

Katerina Ntourou talks about a similar topic than Haley. She wants to study emotional reactivity and regulation.

She tortured kids for science. She showed them toys, asked for the favourite one, and locked it away in a box! And she then gave them 10 keys to open the box, and they ALL didn't work!!! How did she pass through the ethics committee? :-)

Anyway, she then studied differences between fluent and non-fluent group. She found differences, but she went too fast at the end. I was a bit surprised that she said she found differences between the two groups look similar. I couldn't fully absorb it because it was all too fast..... :-(

I am somewhat concerned about the experimental set-up to measure emotional reactivity and regulation. It does not seem to be a very well controlled variable nor is the environment. As a past child who stuttered, I most likely suffered from social anxiety, and hated having to communicate with new people. Had I been tested in such a situation, the social anxiety would have made me more aroused quickly.So I am not sure about what exactly is measured. But as I said, it went too quickly, I would need to see it in detail.

Emerging topics from Antwerp, Autonomic arousal: Arnold finds nothing.

Hayley Arnold showed us research she conducted with MacPherson on the autonomic arousal in pws as compared to fluent subjects. We know that autonomic arousal may negatively impact speech motor control. So maybe pws have a higher arousal and so this might increase stuttering or might prevent them from recovering.

She did not find any significant differences between children who stutter and those who don't for different tasks elicitating autonomic arousal. Also, arousal seems to start BEFORE stuttering events. I don't find this surprising at all. Kids are getting anxious because they have to speak and then this makes their stuttering worse...

So CONGRATULATIONS for the courage of presenting NULL results! Signs of great science! Watch out those who always find something... :-)

Blogging from Antwerp

I am sitting in the lobby of Lessius College right now. Let me blog up the conference day of yesterday.

The conference started rather abruptly with Ludo Max's first slide showing us a typical box-arrow diagram of a brain function model: the standard model for motor control. Some people were probably a bit shelled shocked. In the past I spent some time understanding the different parts of the model, and I understood then after 20-30 minutes. But in the lecture, I didn't have enough time to regain complete understanding. But Ludo's strategy is pretty straight-forward. Test the different arrows of the model. And that's what he has done. Over the last years, he has rigorously tested the different parts of the system in people who stutter. I took part in one of them when I visited lab in Connecticut a few years ago. He explained the different experiments quite nicely. And he kept returning to the theme that pws learn slowly but they eventually get it. I liked his talk. But I am still not sure exactly what the results are telling us. Maybe the slow learning is a symptom for an on average inferior processing capacity in certain brain regions, but I am not sure slower learning caused stuttering to manifest itself. I asked about subtypes, and he agreed that this is an issue but it is not clear how to resolve this currently, on which I agree. He made an analogy with Eskimos' having tens of words for snow to discuss more subtle aspects of snow. But here, our great scientist is the victim of an urban myth: they don't! :-)

Marilyn Langevin's talk was a good example of what is wrong with clinician-turned-researcher research. She is a good, and foremost confident, speaker, and probably also a good therapist. But the informational content of her speech was low. She presented an outcome study of low standards and many potential flaws. I don't have time to list all the flaws, but here are a few: (a) low sample size, (b) highly biased overt measurements, (c) great fluctuation in sample (one person was highly dysfluent in year 1 sample and fluent in year 2 sample, so the fluency in year 2 is a result of treatment?? right... ) (d) potential sample bias (many did not reply to questionnaire) (e) focus on counting stuttering syllables. I challenged her on this, and she said that we should be happy with this due to the lack of funding and difficulty of getting data. Well, I never understand this pseudo-argument. Surely you cannot justify lowering standards, right? Either you can ensure good standards, or YOU JUST DON'T DO IT. I am especially sensitive to this area as I analysed the outcome data of a fluency shaping therapy with 300 or so patients: that is 300 not 10-15. And everything else was done more rigorously, and still I don't even fully trust these results. Unfortunately, this outcome got little exposure, and I am not even sure where Prof Euler published it. He did present it at an Oxford Dysfluency Conference.

The worst of it all was that she repeated words like "as a scientist", "the p-value", and "in science". Let me be clear, she is not a real scientist for me. She should have talked for 60 minutes about WHAT SHE DOES IN THERAPY, and not how badly she does research because a lack of funding and mishandling of statistics and set-up. I want to know about her experience as therapist.... drop "science" and focus on what you are good at!

Norbert Lieckfeldt spoke about clients' expectation of therapy. I was unable to attend, as I was preparing my own speech/workshop in the afternoon. He kept on saying after the speech that pws and parents want foremost better social functioning rather than fluency. He also supported this by some research from a communication research project. But I pointed out to him that in many other communication disorders parents KNOW that their kids' dysfunction is permanent and that's why they focus on better psychosocial adaptation. But in stuttering, parents and pws experience great fluctuations in fluency, and that's why their goal is also based on more fluency. Only later when many attempts of permanently more fluency failed do they switch to improving psychosocial adaptation.

Then we had the poster sessions. Unfortunately, I was busy with my talk.

The afternoon session was for young researchers. That was also one of the criticisms I gave for the last conference. I am happy they follow this path. All three speeches presented interesting topics. I am not going to discuss them here...

Then I had to go to my workshop. I had about 20 people in the audience. That's probably a good number because my room was on the third floor, and the others on the ground floor, first floor, and second floor. So I had to fight with gravity. I was not very happy with my delivery. I had too much to say in one hour, and left many concepts under-explained. I had two good questions at the end. I was happy they got my idea, namely to unify all frameworks into a single one. A Dutch researcher mentioned a similar model than mine, but when we talked afterwards, we realized that it was quite different.

After the day, I went to have drinks with Jelena, Paul, Max, and others who I am not sure want to be publicly associated to me! ;-) With one of them, I discussed the standards of research in the field. And we discussed the leaking of emails regarding the quality of PhDs from Australia. We also discussed my blogging style, and ways of changing it were gently suggested. ;-)

Then, two of them left for the official dinner for the conference VIPs. As Kurt Eggers noted this morning to the whole auditence: "I hope you all enjoyed yourself yesterday evening. We did, too!"

In the evening,

Battle of conferences?

Check out this new conference in Rome: website. I am not very impressed by the scientific committee and some of the key speakers. Looks like the Italian have gotten some funding and choose to invite the wrong people! ;-) We now have four conferences in the next four months. WOW. That never happened before. The one in Antwerp (I am attending), in Rome, in France, and in the US. I heard that this new conference is attracting some speakers that have cancelled for the other conferences. Are we starting to see a battle of the conferences? Might be a good thing..

German book on stuttering therapy

Einar recommded a book to me from his German therapists. So if you speak German, check it out: here. Please note that Einar still stutters, but seems to be a happy communicator. Actually, he sometimes talks far too much! ,-)

Clearer thinking within the Lidcombe community

Finally, reason seems to have come to the Lidcombe community in the words of Ann Packmann's article Why does the Lidcombe Program “work”? Mary Kingston, the editor of the newsletter Lidcombe News, quite neatly summarizes the Lidcombe community's mental bias by asking Ann to answer how Lidcombe works and not whether Lidcombe works. She does not even contemplate the thought that Lidcombe could not work!

Ann answers the how question with "I don't know" and the whether question is very much watered down to a level that I can more or less agree with. She says many things that  I have been preaching all those years...

It's time that the Lidcombe community tones down its claims, and listen to Ann's words. And maybe it's also time that Ann and Mark Onslow should switch posts. She should be professor and he senior research fellow. ;-)

Here are her words together with my comments. Take the time to read carefully!

.... It is a topic that has intrigued me for years, as I am sure it has most

Final Program of 3rd European Symposium Fluency Disorders

3^rd European Symposium Fluency Disorders

March 9 & 10 2012

Lessius University College Antwerp

The finalized program is available on the website.

Alcohol and stuttering

A readers asked me how drinking affects my stuttering. I had a very clear answer. I am a teetotal and I just don't know! ,-)

Generally two things happen. You can get more relaxed, you think much less about what other people think about you, and your motor control goes down. So I expect moderate drinking to ease stuttering, and severe drinking to let you loose motor control.

To be honest, I am not sure about research findings. People taking any drugs (psychoactive substances) report changes in fluency, but it seems to be different for different people.

So share your experience with us! Any drug is allowed! ;-)

Between acceptance and improvement

A friend posted on facebook: "if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid" I invented a reply: "if you let a fish be a fish, he will never become a lion!"

Both statements are relevant for stuttering. I receive many emails from readers asking for advice, and I am drawn between both statements.

People who stutter have clearly a neuroanatomical weakness in the brain that makes us stutter. Nature did not gave us the ability of effortless speaking. Yet, we want to climb that tree, and feel frustrated, inferior, unfairly treated, and angry. Why should we react in such a way when we are not at fault! We should not judge ourselves with those who have "normal" brains.

However, acceptance is very close to resignation, and might prevent you from achieving your potential. I very strongly believe that the majority of the negative psychosocial reaction to stuttering is due to our interpretation of life, and not due to the stuttered speech. Our abnormal brain region does make us fear, doesn't make us be embarrassed, and doesn't prevent us from speaking up. We learned that as children as a natural reaction. We must strive to be a lion even if it's unachievable. Only then can we improve.

So a clear advice is that you should work on reducing your psychosocial reaction and accept that you are a fish. I can clearly say that my handicap now at 38 is far less than at 18 even though I still stutter (and probably not less).

TED Talk on Stuttering

TED is famous for interesting thought provoking speeches. Many side TEDs have developped over the years, for young talents and for regions for example. This TEDxNewy talk is on Lidcombe treatment by Sarita Koushik. I know her, because we meet at the Oxford Conference some years again, and were part of the happy party gang. She is a nice person, but I must say that she has unfortunately been indoctrinated by the Lidcombe way of doing research. Her talk is very much in-line with the highly doubtful statistical approach to evidence based practise. Her research involves finding the optimal treatment schedule, and very likely a fata morgana due to huge statistical fluctuations. You already need 100 kids to just test efficacy of treatment. So how do you compare between groups of different treatment length??? I am nearly convinced she is chasing a phantom...

And I am not sure I like her stuttering at the beginning, because she does not actually stutter. What is your opinion?

Mother blames herself for therapy failure

Here is another story of a mother where the Lidcombe magic did not work, and again she blames herself because the scientific outcome studies are so convincing.So it must be her fault:

I am a mother of a boy who just turned four and has been in Lidcombe for over a year.  We have barely missed an appointment in that time and I unless my son has been sick I have always implemented the home treatement.  We live in Australia and attend a private clinic in Sydney... I guess the family history is pretty strong. 

...  Am even a bit nervous writing to you and reading your site, as of course I want to believe my son will speak fluently forever aqnd never know he stuttered.  After another relapse, and my son still being in stage one of the programme after approximately 13 months of non stop weekly treatment I have started to wonder what is going on and if there is other treatment available.  Also

Is Elsevier suffocating yet another stuttering conference?

Earlybird* member of IFA	€574.08
Earlybird* non-member	€693.68
Earlybird* consumer*	€418.60
Student**	€358.80
Conference dinner	€83.72

Have a look at the IFA Congress 2012 page, and see yet again what happens when the organisers are not doing the work themselves but outsource to Elsevier. Let me make a quick calculation: cheapest possible with early bird. The student fee is the cheapest with 360 € plus 80 € conference dinner. So 440 € plus 4 days accommodation (lets say cheapest 50€). So we are at 640 € plus travelling. Let's say from Britain: 150 €. So we end up with roughly 800 €. And that is the very cheapest! Which student can pay that, except if it comes from a research grant.

If you are a consumer (i.e. stutterer) or a therapist, you must pay at least 1000€. If you come from overseas, probably 1500 or more. That pretty much excludes all except the richest countries.

The key is that Elsevier is taking a profit and you have to pay VAT. And they would claim that they have to pay staff and website. But that is a semi-lie as their staff probably handle 10+ conferences each, and most admin is done by the website.

1.5 years to write four pages!

The luxembourgish audiophonological institute has finally managed to produce a leaflet for stuttering kids. It took them about 1.5 years for four pages, even though I have given them a corrected version of their old leaflet.
It's in German and French, and I have to say that at least I cannot disagree with what they wrote, only the infantile font they used. They used to write that stuttering can be due to psychological stress from their social environment but not anymore. Progress has arrived in Luxembourg. See here.

(Thanks to Lukas for telling me about stuff happening in my own country!)

Happy New Year!

I wish you all a Happy New Year. I know I have not been keeping up with my regular posts. The next months will be a bit stressful because I have to read 3000 pages for an exam (CFA Level 3) and I need to get my book published.

But I do have plenty of material for posts and try to make more time for the blog.You can find my prediction for 2012 on StutterTalk. As usual, I am not very happy with my StutterTalk performance. I keep on making grammatical mistakes, phrase my ideas in strange ways, or just have strange ideas. I am just not good at on the spot performance. I also see that at Toastmasters. I really need to work on that part more... The only type of short-term performance I am good at is making jokes on the spot. Or at least, I think I am. But trying to say something intelligent usually fails to be so...

Oh, and if you want to be a guest blogger, just email me!

BREAKING NEWS: ENDO STOPS PAGOCLONE.

I have breaking news for you. Endo, the phamaceutical company owning Pagoclone, will stop the trials on Pagoclone completely and focus on their core business model.

As I have already announced, the Phase II trials did not go well (or well enough).

A few thoughts:

1) Endo spent millions on this. Now you know why pharmaceutical companies need to earn a lot of money on successful drugs because they spent so much on those that don't make it!

2) People need to ask themselves why they were part of the hype. And why they interpreted the Phase I and IIa so positively.

3) Thanks to all those who have worked hard to run the random control trials, especially Jerry Maguire. I never shared their enthusiasm, but in science you need to take risks and try it out.

4) This trial has given us information about stuttering, just not the one we want. Endo now has a large sample of control data. We now know much more about the placebo phenomena in stuttering. That is very valuable information, if it is published in a paper...

TED Talk on the brain

For a visually beautiful introduction to the brain and how scientists are measuring the structure and gene activity. Check out the TED TALK by Allan Jones. You can even access the data on-line. Download the software and zoom into the brain. These maps are important to study brain disorders, including stuttering. As far as I know, no-one is using these maps in stuttering, or working on building up a database of dead stuttering brains.

Would you donate your brain? I am not sure I would. Slicing up my brain would inevitable lead to my final destruction... even though it won't really matter because I am already dead at that point!

I also wonder whether you need healthy, fully developed, and not yet declining brains, ideally 25 years of age. Foundas did some research on the anatomical structure of stuttering brains. But I am not sure if they were dead or not.

(Thanks to Will for pointing this video out to me!)

Paris: ce lundi ou mardi soir?

Je suis à Paris pour un business trip du lundi au mecredi. Mon hotel est près de George V. Si quelqu'un est intéressé d'aller boire un coup le soir, email me under tom dot weidig at gmail dot com!

Text me under 00352 621 432263.

Sanne Hans: A true role model...

Another video from Sanne Hans (Miss Montreal) with a good song Addicted to Crying. She is a real role model for people who stutter and for the public. And not one of those Joe Bidens or Emily Blunts that I and no-one else has ever heard stuttering publicly but I have to endure their story on how they overcome their stuttering by doing XYZ...

It could be so easy

In a sense this is a perfect scenario for those advocating open stuttering, and a slap in the face for those who do not and preach we should not. This young singer very clearly stutters and struggles at time. But she is so relaxed, funny, and just gets on with speaking. And she is a good singer (check at 3:10)

Notice that the audience is not at all embarrassed. Why? Because she is not embarrassed! Isn't that what people sometimes tell us: What's so bad about stuttering, you are just not so fluent. So what? Is stuttering really purely neurological?

Good mix of keynote speakers

Check out the keynote speakers at the Antwerp Conference: here. It's a definite improvement over last conference. Check also the emergent topics in fluency research: here. This session is for young researchers to present their findings. The conference organizers have definitely taken feedback on board (for example mine), and improved the setup. I will most likely be at the conference, and might propose a contribution.

First Stuttering Conference in India!!

My good friend and TSB supporter Sachin asked me to put up a link to the first Stuttering Conference in India: check here. He told me that I have many "religious" fans in India!

The meeting is held from December 28th to January 1st in Bhubaneswar (Orissa) on the East Coast. If you live in India, consider taking part! Such conference are a great opportunity to know more about stuttering, possible treatments, and about how other people who stutter deal with their handicap and life.

Mmmmm now that I think about it. I have never been to India... :-)

Stuttering research goes biochemical

Stuttering research is entering a new phase, the biochemical phase. As far as I know, it's the first research that deals with fundamental biochemical aspects of our brain that are linked to stuttering via genetics research.

Kornfeld on what the three mutations found by Dryana's group do to possibly 10% of us:

...two mutations appear to trap the proteins in the cell’s protein manufacturing center, though some get out before being destroyed. “It’s not an all-or-nothing thing,” Kornfeld says. “Of the material that does get out, its activity is normal.”
But the third mutation causes a larger folding problem and the protein is destroyed just minutes after being made.

I will write more on this in the next post. Fits well into my picture of stuttering...

Kornfeld on therapy: (so you can keep your dream of a cure alive! ,-)

Such findings offer a glimpse at possible future therapies for stuttering. For two of the mutations at least, the problem is not that the protein can’t function, but rather that it

Questionnaire on Stuttering

Lloyd asks for our support:

I am conducting research about employment and people who stutter for my Master of Public Administration degree at Baruch College in New York City. I have created an anonymous on-line survey.

I am writing to ask if you know people who stutter and fluent speakers who might like to fill out this survey. I am looking for as many unique responses (from both groups) as possible. I encourage you to take the survey as well.  The survey queries attitudes about the Americans with Disabilities Act, among other things.  While this may not be germane to a European audience, I would really like as many respondents as I can get.

Gene therapy for the blind

William pointed me to a BBC report on gene therapy for the blind. I am sure it's still decades away, and might not even be possible theoretically. The intervention is probably very local, but the damage to the speech system and possibly adaptation is distributed.

Think of bad genes as mistakes in a construction plan for a house. Once the house is built, correcting the mistakes are not helping. Of course, the brain is a bit different, because genes instruct the cells to build proteins for a life time. However, the main fibre structure are set at early age and never change again.

The Therapist-Patient dictionary

Here is the therapist-patient dictionary. It is actually designed to understand British people, but works equally well for understanding therapists when they talk to you, the patient!!!

Seriously, that's what you have to face up to when you try to discuss science with them! In a clinical environment, I can kind of understand the logic but not in a scientific debate!

Brenda Carey changed her website!

A reader made me aware of irresponsible marketing by Dr Brenda Carey. She has now changed her marketing strategy from a misleading "Stop Stuttering with ..." to a reasonable and factual "Stuttering Specialist Dr Brenda Carey": check out the website. She and her team are definitely stuttering specialists. I might not agree with everything they do, but, if you lived next door to their practise, I would not hesitate to suggest that you take your child to them.

Interestingly, she changed the text from "..what options are available to stop stuttering" to "what evidence based treatments are available to reduce your stuttering and improve your communication." I would have added "reduce your fears" or "improve your well-being".

Antwerp Stuttering Conference

Check out the announcement for the Antwerp stuttering conference in March 2012. I attended last time. My two memories are that I was utterly bored by two key speakers (one of them talking about how to set up a questionnaire!), and on getting nearly sick on eating mussels! I hope they will change the format a bit and have more panel discussions. Debates not monologues!

But overall, a cheap conference worthwhile attending, even if it's only for networking.

Will she change her website?

Check out Ora's question relating to my post on the unethical marketing of stuttering therapy. He got a reply from Brenda Carey:

Ora, I do thank you for your helpful comments. I certainly did not intend to mislead, and will be changing the wording of my site and its address promptly (as soon as I have the tech support). Regards, Brenda Carey

As in politics, watch their actions and not their words. Let's wait and monitor the site. But as she writes, she needs to find another web address.

Thanks to the reader who made me aware of the website, and all others who supported my post and put ethical standards above sensitivities of a paid professional!

Stop Dr Brenda Carey

[The situation has changed after writing this post, and Brenda Carey has changed her website. Please see here.]

A reader has pointed me to this rather outrageously marketed website Stop Stuttering by Dr Brenda Carey. A highly irresponsible marketing strategy if you ask me: to suggest that you stop (a marketing place holder for cure?) stuttering with her, even for kids. The sentence "Stop Stuttering with Dr Carey" reads in parents and pws's mind as "Dr Carey can make you stop stuttering".She falls below the ethical standards that I would expect of a therapist.

Judy Kuster's International Stuttering Awareness Day (ISAD) Conference is open until October 22nd, 2011. It's the 14th conference that she has organized and there are always some interesting articles: people who stutter and clinicians sharing their experience. Usually, I get an email asking to publicize the event, but not this year maybe my blog has ceased to be important...

Check out Drayna's summary of genetics results. I plan to ask a few questions.

You can leave questions for the panel of experts in Office Hours.

Have a look at the conference. She does a great job to get people to write and debate. And you get a feeling of how the Internet web pages looked fifteen years ago! ;-)

Do specialists get better outcome than generalist clinicians?

I had an idea for some useful piece of research, which would be a change to the research time wasted on useless research.

The treatment of non-specialist SLTs always struck me as scandalous from my own experience and that of others. These are people who have visited university for four years with one course at best on stuttering by an expert, but more typically a few lectures giving by a semi-crackpot prof on what causes stuttering. Then, due to the dictatorship of academic degrees and professional qualification, society gives them the monopoly to treat people who stutter even though they have no clue whatsoever. The clever ones openly admit to their cluelessness on the matter and refuse to treat. Thank you for your professionalism and putting ethics before money! Even though you are probably the non-specialist who would best treat people who stutter! The others are the "I am a qualified SLT and I know what to do." Run, run fast!

Well that is theory! But is correct? What I want to see is the following outcome study. Take 100 people who stutter, assign them to expert SLTs and generalist SLTs, and let's see what's happening. Will the experts get better results???

Parry's Valsalva theory and treatment

A reader has asked me about my opinion about the Valsalva theory and treatment created by William Parry. Check out Parry's website. As two year ago, I have not made up my mind.

At best, his theory is a partial theory of stuttering and only focuses on the stuttering and blocking events. For Parry, the mis-use of the natural Valsava mechanism greatly blows up the symptoms of our inefficient speech system. Relaxation of the muscles involved in a Valsava mechanism helps reducing the tension and severity of symptoms. It seems to me that his method is similar to muscle relaxation techniques.

I have added a diagram that I found on his page that illustrates his theory. Have a look at it! Let me know of your opinion.

Self-help in Sarajevo

On Tuesday evening, we met up with Alan who is leading the effort of setting up a stuttering organisation in Bosnia. He met us at our hotel and we drove into the surrounding hills to a restaurant with a superb view over Sarajevo. He showed us pictures of his sponsored trip to attend the ISA conference in Argentina.  Without any prompting on my part, he also had a picture of the ISA board meeting, and pointed to Thomas Krall, the German representative at ISA. According to Alan, Thomas was behaving out of place and

Stuttering in Serbia, Montenegro, and Bosnia

I am currently on a beach holiday with Jelena. On our way down from Belgrade, we met and stayed at Tiana's parents' place. She is a high school student, and lives in Prijepolje in South-West Serbia, close to the border with Montenegro. And her brother is a great fan of strawberry ice cream!

Yesterday, we met up with Gordana (see picture). She is a student in English and French and comes from Budva on the Montenegrian Coast, not far from famous Sveti Stefan. We spoke about her recent therapy experience and she also taught us some new Salsa moves! And today, we are heading to Sarajevo to meet up with Alan and the local self-help group. Should be fun! I'll post group pictures....

Two must-read up-to-date summaries

Here are two articles with an up-to-date summary of research findings in brain imaging and genetics.

Soo-Eun Chang wrote the first review Using Brain Imaging to Unravel the Mysteries of Stuttering. She has been spending a lot of years brain imaging at the NIH under Christy Ludlow, and has now moved for more independent research. I met her and Christy at NIH a few years ago. She is modest and diligent. Expect her review to be the same: measured and well-researched.

Drayna and Kang have a review on genetics research Genetic approaches to understanding the causes of stuttering (though expect that they talk a lot about their research) with the following abstract:

Stuttering is a common but poorly understood speech disorder. Evidence accumulated over

Wanne be a reviewer for my book?

If you are interested in reviewing my book, please send me an email. The book is about a new biopsychosocial model that allows modelling all drivers of human processes. You can find more information on this website. I also have a section on stuttering.

Auditory-motor integration in different part of brain?

Martin Sommer's team has published new results on their TMS experiments. Martin's student Nicole Neef presented results at the Oxford Dysfluency Conference three years ago on that same topic.The big issue with TMS is that you need to aim correctly to ensure that you "magnetically" knock out the targeted regions. I am somewhat puzzled what more they found. I would have to dig out the paper to see what has now changed to warrent an Elsevier press release. They claim that they have found further evidence that auditory-motor integration is located in a different part of the brain, because TMS has the reverse effect on people who stutter. Such a profound re-organisation is probably the effect of some neurobiological abnormality arising in early childhood.

As a footnote, you might notice that Alexander Wolff von Gudenberg is an author of the article. He is the boss of the Kassel Stuttering Therapy, and I introduced Martin to him with the aim to give Martin plenty of experimental subjects for his experiments. They regularly put clients into a bus and drive them up to Goettingen with their will [as opposed to "against their will"]. So delivering brains for research gives you co-authorship!

Because of stuttering?

I know that TheStutteringBrain has been quite silent. I am currently working on my upcoming book intensively, and just didn't come around writing posts. Recently, I came across this statement:

Some stereotypes are self-reinforcing. If someone tells you over and over that you are oppressed, if you hit an obstacle and fail, like all of us do at some point in our lives, a convenient excuse is that you are discriminated against

I also noticed that we are often using stuttering as an excuse for failure: I didn't get the job, girl, recognition, the promotion, the attention, the qualification BECAUSE of stuttering. But everytime I probe us, I discover that stuttering was not the cause of our failure or at least not the only one and definitely not an insurmountable one. No, we either did not have the qualification, the charm and looks, the charisma, the ability for hard and dilligent work to succeed.

Here is a story from my life. I blamed the fact that I didn't have a girlfriend on my stuttering. Then I went to a youth camp for stuttering young people organized by ELSA (European League of Stuttering Associations), and thought that now I will get a girlfriend! When that didn't work, I started thinking that maybe it was not just due to my stuttering! ;-)

So the next time you fail. don't blame it on stuttering.

New trial for Pagaclone participants?

A reader informed me that

I’ve been advised that Endo is going to launch a new Pagoclone study involving people who have already participated in the trial.  Interested participants (again, it’s only for those people who have already participated in a Pagoclone trial) should contact Dr. Angelo Sambunaris ...

If the rumour turns out to be true, several questions will arise: Does Endo want to test whether a subgroup benefits from Pagoclone or whether it's just a fata morgana? Who is Dr Sambunaris? What ever happened with Jerry Maguire as chief investigator? Is that the reason he doesn't mention Pagoclone any more? What ever happened with the trial data? Will it be published or not? 

I am President of Greenhearts Toastmasters Club

I spoke about Toastmasters many times before, and what a great learning environment to face up to your speaking fears and develop public speaking skills. Ideal for the transfer and maintenance phase of an intensive therapy.

I am now President of Greenhearts Luxembourg Toastmasters Club. At first, I declined because I felt it was too much work. ;-) But then I realized that I should do what I fear, am uncomfortable with, or do not have experience of. Being the president of a club of 50 people is definitely a useful experience. On the organisational, behind-the-scenes, and running the committee side, I don't see much problems (so far). Also because my fellow committee members are all reasonable people. ;-) But I am not really a natural presenter when it comes to thanking everyone, being nice to everyone, only mentioning the good side, and so on. I need to talk at each meeting, and report on our activities. That's slightly different to preparing a speech and knowing it by heart.

So I challenge you to join Toastmasters or go into a new experience! What doesn't kill you makes you tough!

Great StutterTalk interview with a mother who did Lidcombe

Great interview by Peter from StutterTalk on a mother's experience with Lidcombe. And how she got promised the gold standard, and she was told how all experts agree. Again the same fallacy. Lidcombe works perfectly, so if it doesn't work, the parents are to be blamed or the treatment has not been done correctly.

Listen from 28:00 onwards for a very powerful report of the mother...

Even though it's a good interview. It's still frustrating to see how the mother struggles to understand the phenomena and commits fallacies, but also Peter's replies and statements on the evidence base on Lidcombe is not exactly correct. But mind you even what Nan Ratner said on StutterTalk was not exactly correct. This is just the trouble of the whole field, the debates are filled with not exactly correct statements.

Outcome trial on Phonation Intervals Program

I want to share with you this information on a big outcome trial founded by the NIH. Roger Ingham told me about the trial several years ago when I visited him in Santa Barbara. The program runs from 2006 to 2012. I don't know much about the Phonation Intervals treatment. He explained it to me, but I forgot. I think it's based on the idea that speech initiation is the core issues and phonation is trained, similar to fluency shaping?

The context for this study is an exhaustive empirical examination of a research-based and computer-managed treatment for adult developmental stuttering known as the Modifying Phonation Intervals (MPI) program. Within that context, the studies described in this proposal will test a number of hypotheses concerning the relationships among several critical factors: stuttering behavior, the neurology of stuttering, the cognitive and affective components of stuttering, stuttering treatment approaches, and the maintenance of stuttering treatment gains. Thus, this proposal simultaneously addresses two overwhelming needs: efficacious stuttering treatments for adults, and the integration of

Mindfulness in stuttering?

Boyle wrote an article on the potential use of mindfulness in the treatment of stuttering. The abstract is well written and the article looks worth reading. I myself have tried out mindfulness but not on a long term basis. The idea is simple: you just sit silently and direct all your attention to a single source of attention: be it breathing, eating a grape, your inner self, or focusing on a visual stimulus. Even five minutes give you a sense of peace. But of course no cure at all for stuttering, but rather gives you the ability to take a step back from daily life, reduce your stress levels, and reflect on your condition. I see mindfulness as a non-pharmaceutical treatment to decrease anxiety and stress in order to start working on stuttering or the psychosocial maladaptations.

Some readers always imply that I am against qualitative research or discussions. That is not the case. However, I do take the view that you either write qualitatively about techniques or experiences, OR you write a serious scientific articles. The mixture of both is usually a disaster.

Here is the abstract:

The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition to behavioral components. Yet, mindfulness based strategies and their possible usefulness in stuttering management have not been described in detail in the literature. This article seeks to engage professionals who treat stuttering in a conversation about the possible usefulness of incorporating mindfulness training into stuttering management. A review of the literature reveals that there is a substantial overlap between what is required for effective stuttering management and the benefits provided by mindfulness practices. Mindfulness practice results in decreased avoidance, increased emotional regulation, and acceptance in addition to improved sensory-perceptual processing and attentional regulation skills. These skills are important for successful long-term stuttering management on both psychosocial and sensory-motor levels.

Ready to help researchers?

Researchers are always looking for experimental subjects: a resource and time intensive part of being a researcher. In February, I posted a call for volunteers from Deryk Beal: see here. His call is still active, so please if you can get to Boston and you stutter, let him know! Sending me your calls for volunteers or other causes makes sense as TheStutteringBrain reaches out to many worldwide:

Hi Tom

Thank you for posting our call for research subjects on your blog. As a result of your post at least 3 different people who stutter contacted to participate. It may not sound like much, but that is a large number of people considering that your post is free and originates in Luxembourg! One of those people was able to go on to complete both an experiment at MIT and later one at BU. Unfortunately the other two were not able to participate.

We are still actively seeking participants. We have currently recruited 11 PWS who have completed the study, over a 8 month period, but we need approximately 10 more PWS

Deryk.